How risk communication could have reduced controversy about school closures in Australia during the COVID-19 pandemic June 2020, Volume 30, Issue 2

Background

There is a long history of school closures in infectious disease outbreak and pandemic control.¹ Research on influenza finds that for pro-active school closures to be effective in reducing the transmission of infection, they should be done early, at scale and for a prolonged period.² However, weighing heavily against these potential benefits are known and very significant social and economic impacts.³ These include economic losses⁴, job insecurity and income loss for caregivers forced to stay at home, a related loss of the healthcare workforce due to childcare demands, self-caring of children younger than 13 years, and differential impacts for disadvantaged children.¹ Disruption to the education of children has also been described following school closures.⁵

The questionable net benefit of school closures may be further reduced when considering the characteristics of coronavirus disease 2019 (COVID-19). Early evidence suggested much lower attack rates in children and young people aged under 19, compared with influenza.^6,7

Given this combination of factors, the Australian Government’s key decision-making committee for health emergencies, the Australian Health Protection Principal Committee (AHPPC), advised against proactive school closures on 17 March 2020, stating:

“The Committee’s advice is that pre-emptive closures are not proportionate or effective as a public health intervention to prevent community transmission of COVID-19 at this time.”⁸

The statement outlined experience from overseas, existing evidence on transmission in children and the serious impacts of closing schools. It presented suggestions for minimising transmission in schools and noted that advice would continue to be reviewed at daily meetings of the AHPPC. It did not contain references to the evidence sourced and only provided general descriptions of study findings.

Community response

The AHPPC statement, and statements of reassurance from government representatives at media conferences, were the only information the Australian Government provided at that time. Amid high public anxiety about impending outbreaks of COVID-19, healthcare workers and experts weighed in, including Dr Norman Swan, a well-known, medically qualified journalist at the Australian Broadcasting Corporation.

“I’m getting a lot of questions from parents saying, ‘Should I keep my kid home?’ The thing about keeping your child home, the risk to your child is low. But it’s a public health measure, because children spread the virus and they can spread it to teachers and so on and into the community. And my feeling is, to be blunt, we’re dicking around and we’ve just got to shut stuff down now.”⁹

A chorus of community, parent and stakeholder voices rose in support of closing schools with hashtags such as #closeschoolsnow appearing on Twitter.

These events occurred at the time when Australia began to ramp up its COVID-19 control strategies amid predictions that healthcare systems would be overwhelmed, and a sharp escalation in concerns among health professionals and the public about the threat of coronavirus in Australia.¹⁰

In Australia, state and territory governments have jurisdiction over primary and secondary schooling, and pressure was placed on these governments to diverge from Federal Government pandemic management decisions. The Australian Government’s recommendation to keep schools open was disseminated alongside announcements of increasing social distancing measures, such as banning gatherings of more than 100 people.¹¹ The inferred exemption of schools from these measures generated contradictions in messaging, creating confusion for parents, school staff and the community.

The impact of ‘fright factors’

This scenario represented a near perfect storm of ‘fright factors’ that have been identified in research on risk perception as driving up people’s fear while reducing their trust in those who manage the risk.^12,13 In this case, the fright factors included: that the issue affected the vulnerable (children, and also their grandparents); the hazard was coerced insofar as schooling is compulsory for children and teachers must remain at school; the outcome was dreaded; and the agent invisible, poorly understood by science and without expert agreement on management strategies. In the early phase of health emergencies, trust is a critical element, shown to influence whether people will accept new information and be compliant with infection prevention and control strategies.¹⁴ In a situation of high concern and high uncertainty, inconsistency in messaging erodes trust in officials’ competence to manage the risk. This inconsistency increased as the federal and state/territory governments and prominent health commentators took differing positions on school closures.

By late March 2020, State Premiers began to act. In Victoria, school holidays were brought forward to begin on 24 March. By 30 March, state-run schools in Victoria, New South Wales (NSW), Australian Capital Territory (ACT), Queensland and Western Australia were closed for face-to-face learning or open only to children of essential workers or, tacitly, for families in particular need. This situation, including school holiday periods, persisted for 8 weeks, and longer in some jurisdictions.

School closures cause harms although these are not uniformly distributed. A range of studies and reviews are now documenting negative impacts of COVID-19–related school closures on children’s educational outcomes and wellbeing. One report estimates that up to 46% of Australian children and young people are at risk from a range of adverse effects.¹⁵ One review estimated there would be a loss of 6 weeks of learning in numeracy and 4 weeks of learning in reading for Aboriginal and Torres Strait Islander students and those from lower socio-economic backgrounds after two terms of COVID-19–induced online schooling.¹⁶

Re-opening of schools

Despite these harms, there has been considerable resistance to re-opening schools following the successful suppression of COVID-19 in Australia throughout April 2020. The Australian Government has maintained a consistent stance that schools should be kept open. By May, the Prime Minister pushed further for a full return of all students to school, citing additional evidence from a NSW investigation of COVID-19 cases from 15 primary and secondary schools. The preliminary findings identified 9 initial cases occurring in students and 9 cases in teachers, from whom only two secondary cases were identified among 863 close contacts.¹⁷

This rhetoric and evidence were met with doubt and disagreement from parents and teachers. By early May 2020, the debate about when and how schools should re-open had become deeply politicised with a war of words between the Australian Minister for Education (in favour of schools being open) and the Victorian Premier (against reopening). The conditions and plans for a staged return to school varied greatly among states and territories, adding to inconsistency and confusion for the community. Ambiguity aversion – the tendency to favour the known over the unknown – drives people to be risk averse.¹⁸ It is therefore unsurprising that half of those surveyed in early May agreed that schools should teach remotely until the COVID-19 outbreak has passed.¹⁹ By the end of May, NSW, Queensland, Tasmania and the ACT had returned all students to full-time, face-to-face teaching in state-run schools, bringing a new communication challenge of ensuring that all parties are aware of measures to mitigate risk, are informed of changes in a timely manner, and have realistic expectations.

Over March and April 2020, fear increased and trust diminished as a result of three primary factors: a lack of transparent access to information driving state and federal government policy on schools; a lack engagement with community concerns; and serious confusion and inconsistency in messaging.

Principles of risk communication

The principles of risk communication have much to offer the management of health and other emergencies, particularly where uncertainty prevails.²⁰ Many of these principles are clearly set out in the Australian Health Sector Emergency Response Plan for Novel Coronavirus (COVID-19).²¹ Adoption of them may have reduced the anger and fear that, by late May, continued to make schools a point of contention in Australia.

We advocate for the following:

Prepare for two-way communication

• A pandemic requires many different actors to work together in a way not usually done. Kickbusch, and Sakellarides note these “loosely coupled systems must move closer together” and that “the smart city builds these long before a crisis occurs”.²² The clear inability to consult with the educational sector in way that was detailed and heard the impacts and concerns, harmed the capacity of federal and state/territory governments to address the issues with sufficient specificity. We recommend that systems for communicating between sectors are set up, simulated and refined prior to an emergency.
• Part of this preparation involves engaging trusted spokespeople from key stakeholder groups with whom governments have pre-established relationships and communication pathways, and with whom they can more rapidly consult as response strategies are developed.

Communicate early, be frank and transparent

• Communicate early and often, particularly when action may go against public demand. Public communication from AHPPC was released at the time when a public debate about schools remaining open had already begun, leaving governments in a reactive mode. Early communication, before or while decisions are being formed, builds trust rather than erodes it. It signals that the range of community concerns and questions are being considered by the governments. Here, experts can be given leeway by politicians to speak frankly with the public. Early communication continued to be in deficit by late May. For example, schools in NSW appeared to only become aware of a plan to return to full classroom teaching with 1 week’s notice, after it was reported by the media.²³
• Be clear and detailed in the evidence and rationale for a policy, and its underpinning values: models and studies used should be provided; if this is not possible, the source of information should be identified. Decision makers could communicate what questions are being considered by the government, expert advisers and stakeholders, and how they balance the potential harms against the potential benefits of closing schools. Leaders should acknowledge that trade-offs may be difficult to assess because some impacts are hard to measure and occur on different time scales. They should then communicate a plan for how they intend to mitigate harms arising from any strategy.
• Transparent criteria for the closure of schools and its reversal would create levels of predictability and enable planning and reduce the risk of politicisation. Studies show that people are more likely to trust a decision if they see the process of arriving at it as fair.²⁴
• Be explicit and open about uncertainty. In a pandemic, governments must make decisions before adequate information is available to guide them. The limitations as well as utilities of all types of evidence should be acknowledged. Acknowledging uncertainty helps demonstrate to the public how convergence on a policy occurs despite these variations and increases trust. For example, there remains uncertainty about the degree of risk from full school attendance, particularly for adults working at schools. It is possible that while the risk is low, there may still be outbreaks. Communicators should try to avoid overconfident proclamations that schools are “safe”, and rather communicate that they are considered safe enough in the face of overwhelming benefits of a full return to face-to-face teaching and strategies in place to reduce risk.

Respect and trust your audience

• Anticipate and tolerate early strong reactions. The schools issue was likely to arouse anxiety at a time when the public was receiving multiple emotive messages about the importance of social distancing measures. When risk appraisal is high and fear aroused, people can be given actions to follow.²⁵ A set of actions for minimising the already low risk in schools was released by AHPPC on 16 April 2020, 29 days after its initial advice to keep schools open.
• Empathy should characterise communication in a situation of fear and anger, avoiding a tone of admonishment or attempts to delegitimise public concern. Inauthentic empathy immediately reduces trust. To be genuine, leaders should comprehend and reflect the fears and concerns of those affected and demonstrate in its content a comprehension of the lifeworld of the affected person.
• Emphasising benefits can connect a policy with public values. However, communicating benefits can backfire if affected groups (such as parents or teachers with health concerns) feel they have not been consulted and that their concerns and needs have not been taken into account.

Conclusion

The principles of risk communication are a useful guide for managing fast-moving situations with high levels of public outrage, where public health strategies have implications for the health and wellbeing of large sections of society. Our recommendations on communication around COVID-19 and schooling have ongoing relevance over the coming months as the pandemic continues, and risks in schools, while likely to be minimal²⁶, need to be managed and communicated carefully.

Acknowledgements

The authors thank Dr Penelope Robinson for assistance in researching the article.

Peer review and provenance

Externally peer reviewed, invited.

Copyright:

© 2020 Leask and Hooker. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms.