Communicating Covid - with Jonathan Van-Tam | 91TV
Transcript
- Professor Frank, distinguished guests, ladies and gentlemen, good evening. I'm just so thrilled to
- see so many friends and colleagues here, and I thank you all for giving up your time this
- evening to be here. I know that some of you have really travelled quite some distance,
- and I'm truly grateful. So the lecture is called, unsurprisingly, Communicating COVID-19, and it's a
- mixture of science and some personal thoughts too. When I was first told of the David Attenborough
- Award, my first reaction was surprise, followed by a deep sense of unworthiness. Then it finally
- sunk in what a great honour it was to receive this evening's oration. The unworthiness really
- stems from being, until 2017, just a common or garden university professor who happened to have
- a 30-year experience in respiratory viruses prevention and control, but in other ways
- was still very ordinary, and essentially, unknown outside of my own academic field,
- with a very ordinary educational background, from a very ordinary market town in Lincolnshire.
- One of the potential titles of a book that I might write at some point is, Leading by Accident,
- because that's exactly what it feels like, and if accident isn't quite the right word,
- then unintentional definitely is. I expected my stint as DCMO, which began in 2017,
- to be kind of stimulating, challenging, important, something new on a career pathway, but I don't
- think anyone could have predicted how it became life-defining and life-changing, as it has done.
- Another title for the book, I suppose, is Communicating by Accident. Yes, there were
- arduous media tests involved in getting the DCMO role, but I think I just found myself in a certain
- place at a certain time in history, and when you find that, you've just got to get on with it.
- Sometimes in life you can't avoid difficult situations. The only way you can get out of
- them is to go through them. As someone who is not trained in communication or communication theory,
- I do feel like an impostor standing here, and people have said to me, 'Where did you develop
- your ability to communicate?' and the answer is, I really don't know. It just comes from somewhere.
- Now, in the lecture this evening, I'm going to start with some personal reflections on learning
- to communicate. I'm then going to talk about some general and specific observations about
- communication challenges in pandemics, and then the SARS-CoV-2 pandemic in particular.
- I'm not going to narrate the full story of our pandemic, but I'm going to touch on some of the
- specific phases and challenges, and then kind of leave you with some kind of personal approaches.
- So if I may begin with some personal reflections, I'm going to start with this slide. This is my
- dad. My dad passed on in 2015, but he had a really remarkable and very varied life. He
- grew up in rural poverty in the Mekong Delta, in what was then the Republic of Vietnam. He
- transitioned from there and adjusted to life as the son of a former prime minister of the
- Republic of Vietnam to life in Paris in the 1950s, with a very changed lifestyle, changed culture,
- and then he readapted again to coming to Lincolnshire for love, for marrying my mother,
- and then the ordinariness of just becoming a junior secondary school teacher of mathematics.
- He gave one of his probably only interviews to the local paper, and one of the things he said
- was that, as I teach the kids, they teach me, and there was something very kind of profound in that
- for me about, first of all, his ability to adapt his personal style to the environment he was in,
- but also the fact that education, so communication, is as much about listening
- to other people and getting that feedback from them as it is about speaking yourself. Let's
- fast forward then, to my first day in medical school. There I was, again, as a kind of imposter,
- surrounded by students with top A-level grades. At the time, the standard threshold for entry into
- medicine was three Bs at A-level in the United Kingdom, and so it did feel a bit strange with my
- D in chemistry and my E in mathematics, standing alongside these kids. Of course, it was before the
- days of widening participation, so welcoming now in our universities, and quite strange
- for a kid with bad grades from a state grammar school, with a broad-ish Lincolnshire accent,
- to be at this modern medical school in Nottingham. I'll never forget the dean's opening words,
- Rex Coupland, he said, 'If you've got a local accent, don't lose it. Keep it, because one day
- it's going to be really important for the patients that you treat,' and the next day he sent us down
- the coal mine, because at the time coal mining was still prominent in Nottinghamshire, and the
- purpose of that was to do a shift with coal miners and completely understand them, how they spoke,
- how they had to live and work, and what their lived experience of kind of work and health
- actually meant. That stuck with me. That really stuck with me forever, and it was the first time,
- I think, that the notion that a physician might be measured partly in terms of success by their
- ability to communicate to their patients, that really came to me, and it was the first time
- that authenticity crept into my conversations with myself about how to practice medicine.
- So it kind of dawned on me that if you want to talk to a miner and treat a miner,
- you need to know how a miner thinks and how a miner lives their lives. From that moment on,
- I realised it was okay to let some of yourself into conversations with patients, and that's why
- this quote on this slide is really important to me, that it isn't actually about what you know,
- it's about what you feel about what you know in terms of how you deliver it. That, again,
- has stuck with me all through my working life. Fast forward now to 1988. I'm qualified, and I'm
- kind of a bit a bit daunted to tell the story in front of a professor of orthopaedic trauma,
- but I'll give it a go. A miner hobbled into the emergency room in the Queen's Medical Centre,
- and on the on the casualty sheet it just said injury right leg. So I said, 'What happened to
- you?' and he said, 'Oh, I dropped a rock on my leg at work today,' and it was clear that it was
- an open wound, and it looked bad. So we got an X-ray, and then the X-rays came back and I said,
- 'Look, this is this is a compound fracture,' and the miner said, 'Oh, thanks. Thanks for that. I
- can go home then, can I now?' I said, 'No, no, no, it's a compound fracture. It's fractured.'
- Clearly, there was something that wasn't right between us, and I thought about it a bit more
- and I said, 'Look, mate, you've bust your leg,' and at that point he said, 'Oh, right, thanks,
- Doc. Now I understand,' and he got back on the couch and he didn't want to go home anymore.
- Then, as a kind of parting shot before he went up to theatres, I said, 'How big was this rock?'
- thinking it would be kind of like the big ones you buy at garden centres. He said,
- 'It was about three quarters of a tonne, mate.' I realised that actually the way I'd framed his
- injury was my framing, not his framing, and that was really an important and sobering lesson.
- So to communicate with ordinary people, I'm putting it to you that you need a
- connection. Now, my particular kind of loves and connections are to the UK Armed Forces and to
- the men and women who support lower-league football every Saturday. This is Boston
- United on the right, and some of my colleagues from 306 Hospital Support Regiment on the left.
- You don't have to have a love of the military or a love of lower-league football, but I put it to
- you that getting into an environment where you meet and interact with a broad spectrum of people
- with very different lived experiences to your own, very different backgrounds to your own, and
- possibly much, much less time to even think about health and medicine, is actually important. So
- good communicators tend to have a very wide range of people they interact with,
- and to those of you who are younger in the room, and aspire in the kind of communications side,
- go out there and just find your connections. They don't have to be my connections,
- but you do need to find some connections and practice working on communicating
- with different people in different places, in different walks of life.
- So now we're getting a bit more serious. Now we're going to talk about Communication theory.
- Now, I did say to you at the beginning, I'm not a communication expert, and that's absolutely true,
- but I do remember about two hours of teaching as a public health registrar on communication theory.
- This isn't quite the diagram that the lecturer put up, but it's pretty similar, and it basically has
- the notion that there's somebody who sends the message, there's somebody who receives it. The
- message is the bit in the middle. It might have some noise contained within it, and obviously,
- it's got to have a channel. There's got to be a kind of a vehicle by which the message moves from
- the sender to the receiver, and hopefully, there's a bit of feedback as well, but not always. If it's
- a very kind of linear model of communication, basically, you say it and you hope they heard it.
- If it's interactional, then you get more of a kind of two-way process, and if it's transactional,
- it's even possible that together you create the message and kind of refine and hone the message so
- that the end user says, 'I understand this now.' If you dissect it a little bit further, actually,
- it's a bit more complicated than that. There's a source, there's a sender,
- and they might not be the same. There's a channel, there's a receiver, there's a destination, which
- may not be the same as the receiver. There's a message, and the components of the message
- are the size and the purpose. Then there's some feedback. I'll come back to that later, but that's
- my little lesson on the theory of communicating for you. I'm going to now make some remarks
- about pandemics generally, and why I think they offer great challenges in terms of communication.
- So four things stand out for me. The first is that pandemics are rare,
- and they're not in the public consciousness most of the time until they actually happen.
- Sometimes they're severe, as in 1918 to '19, as in 2020 to 2023, but sometimes they are very mild, as
- in the swine flu pandemic of 2009. That again adds another difficulty that they're not always bad.
- People not only forget that they exist in between pandemics,
- but they're not always bad when they occur. The problem's actually deeper than that,
- in that many organisations - and I'm going to say it, and governments - don't always truly
- remember the last one. Corporate memory and instilled organisational memory and learning
- may be quite poor between pandemics, and there's a personnel issue too. Relatively few people who
- served in the present pandemic also served in the last. I've actually done my homework on this one,
- and I looked back to SAGE membership in 2009 during the swine flu pandemic. There were
- three of us who served on Sage in 2020, who also served on SAGE in 2009. That's not very
- many people. It's not a criticism, it's just a function of the passage of time and the changing
- in people's careers, but it is what it is. Not all pandemics are widely recognised by the public as
- pandemics. Certainly, respiratory pandemics are well recognised, but the HIV/AIDS pandemic - and
- it definitely was a pandemic - is not framed by everybody as a pandemic, though it absolutely was.
- As you have been following the news and understanding the nature of the inquiry
- and module one, what pandemics we've had in the past is relevant, and it is just a fact
- of contemporary global history that respiratory pandemics have very largely been due to influenza.
- There have been five respiratory pandemics in the last 105 years, and four of them
- have been due to a novel influenza virus. I'm going to leave that little bit there.
- Now, I'm going to turn now to things that are a bit more SARS-CoV-2 specific, in terms of
- the communication challenges. These are my own views, of course, but the first couple of things
- I want to talk about are the global resurgence of populism in terms of the political environment,
- which I think could reasonably be argued began again in 2018. I think that changed
- the environment, the kind of communication environment, in a very general sense,
- and certainly changed the kind of geopolitical backdrop to what happened during the pandemic.
- Students of business - and I'm a very, very bad one, but still a student at the University of the
- Highlands and Islands, desperately trying to get a qualification in leadership and management - I've
- been trying since 2016, but work keeps getting in the way. I think I might have cracked it this
- time, but I'm a very bad student there. We've talked and studied globalisation,
- and when it actually began and there are there are people in the room who say, 'Well, it began
- with the Silk Road and the spice routes,' and others say, 'No, it was the Industrial Revolution,
- that's really when the globalisation began.' We can argue about when it began,
- but I think we can all agree that in the last decade our economies have become hyper-globalised,
- and that has really changed the environment in which we've had to operate during this pandemic.
- Then a bit closer to home, this is the first pandemic that has been conducted in the spotlight
- of really intense social media, multiple channels, some good, some bad, some factual,
- some very non-factual. It is also the first pandemic in human history which has been severe,
- and where we've also had vaccines and antiviral drugs to offer against the threatening pathogen,
- but it's the first time those three things have occurred in combination in a relatively short
- period of time. It is the first time that most countries, but not all, have used population-level
- non-pharmaceutical interventions since 1918, and that, again, was a very new challenge.
- So I'm going to come back now to those key elements in communication theory and talk a little
- bit more about them. First of all, in terms of the source. One has to actually dissect communication
- out a bit and say, what is the source? Is it the government? Is it the public health agency?
- Is it a professional, or is it a non-expert? Secondly, then, who is the sender? Because the
- sender may not be quite the same as the source. The sender might be a politician, it might be an
- expert, it might be a healthcare worker, it could be a layperson, and it could be from a domestic
- or an international source, but the sender is a little bit different sometimes from the source.
- Then, the channel may be official or unofficial. It may be traditional or non-traditional,
- with all the different forms of social media that have now arisen and are established. The
- receiver is the person who listens for the message and takes the message in, but may not be quite the
- same as the destination, which is saying who are the ultimate recipients of the message. That may
- not be the person who receives it, in the same way that, in the military a message may well
- come through to a radio operator who then passes it on to a section commander, so it may well not
- be the same person who's a listener for whom the message is destined to be heard and understood by.
- Then, there's something about the message itself and the purpose of the message.
- What size is it? What size should it be? What information should it
- contain? Is it an instruction, or is it both, is it information and instruction?
- Then there's this element of feedback; who, how and whether the feedback was received and acted
- upon. I don't want to say to you anything more than, actually, it's a very complicated space,
- and the more you think about it, the more you realise that communication is quite a complicated
- space, but if you get it right, then success kind of ends with the destination. The people
- at the destination saying, 'This is a message that carries integrity, that I can identify with, and
- that I am prepared to respond to.' Those are the key things that you want, at the end of the day.
- So I'm changing gear now. I'm going to talk a little bit about some of the specific challenges
- of communicating during the Covid 19, the SARS-CoV-2, pandemic at different phases.
- This is not going to be a catalogue of what we've been through and who said what when. That's for
- the inquiry. I'm simply going to pick out just a few exemplars of things at times and moments
- where I felt the communication was challenging and it was important that we got it right.
- So some of you will have seen this slide before. It is a snapshot of about a month in October
- 2020 from Nottinghamshire. It is typical UK epidemiology of the ascending wave of
- infection during the pandemic. Each vertical slice is a day from late September until late October,
- and each horizontal slice is an age band from 0 to 15. So at the bottom through 16 to 29, 30 to 44,
- 45 to 59 and then 60-plus.what you can see is that this infection burns brightest earliest
- in the 16-to-29-year-olds, and the biomathematical models absolutely know that, because they know all
- the contact data, and they completely understand that at that age - you do too - you understand
- that at that age you have a lot of social contacts compared to as you as you get older.
- If you still own teenagers, you will know that they don't talk to their younger siblings very
- much, and you can see that in the data, that the youngest age band doesn't really heat up,
- but you can see that they do talk to big sister or big brother, who's just left home and comes
- back a bit, the 30 to 44s, and they then talk a bit more to their parents, and they then talk
- to their parents, to the grandparents. You can see, literally ,over the space of just a couple
- of weeks, this rapidly heating-up problem that gets more and more penetrative into the elderly
- population as time goes by. That, of course, is where and how we always get the problem.
- That was really the context of communication in the first half of 2020 of our pandemic, that we
- were faced with very rapid spread. We were faced with a very high mortality burden concentrated in
- the over-50s, a high hospitalisation burden, mainly in over-50s, but not exclusively so,
- and compared with something like seasonal flu, high clinical severity over about the age of 30,
- and crucially, no vaccines, no therapeutics, no drugs, and there could be no honesty at
- that point in promising that we could even get them. It wasn't just a case of when,
- it was also a case of if, and that was the reality of that kind of communication context.
- So I felt that what was needed was,
- first of all, just a straight admission that, at this point, we don't know everything. This is a
- new virus. The virus is changing. We are changing as we learn more, and we just don't know yet.
- A communication that all of this is difficult, there are no easy choices, and no choices without
- some kind of counter-cost behind them. There is also significant uncertainty,
- and probably a very long road ahead. Whatever an optimistic politician might have said in terms of
- a few weeks or a few months, actually, I think in the public health space, we understood this
- would be a long road that lasted several years and that there were no magic bullets at this
- point. There were no get-out-of-jail-free cards that were going to appear, and that we were going
- to take incoming fire. We were going to take some damage. Everyone's very sorry about the
- damage that has occurred, but every society in the world has taken damage because of this new virus.
- At the same time, you have to say, 'Look, this is not the end of civilisation.' You have to try and
- get people to retain some calm assurance, and the key is to hold the nerve. The key is to say
- to your population, 'Look, this is a team effort. This is a UK team effort. Right now, individual
- actions involving personal responsibility lead to combined epidemiological effects and
- we just have to follow this route. There isn't really anywhere else we can go at the moment.'
- The non-pharmaceutical interventions were difficult for everybody and they did have
- costs, and I'm not here to say they didn't. Absolutely not. What I am here to say is that
- the science behind the non-pharmaceutical interventions was actually quite complex,
- and there were probably three domains that stand out for me. First is top-left, the aerobiology
- of how COVID is actually transmitted from one person to another. Is it the big bits? Excuse
- the revolting thought, but is it the big bits that are like bullets that are ballistic and
- always drop to the ground, and what is their range? One to two metres. Or is it the fine
- particles that can stay suspended in the air for much longer and drift much further, but of course,
- they dilute in a cubic decay manner, because of the dimensions of how they're transmitted?
- So aerobiology is really complicated, and getting people to understand what
- was involved was very difficult indeed. The next bit was the period of communicability,
- and many members of the public I think thought that was the incubation period,
- and it's not. It's the time during which you are infected, where you are also able to pass the
- infectious organism to other people, and that is really tricky for people to understand. It's even
- more tricky when science eventually tells us that the time at which people are excreting most virus,
- is either just before or on the cusp of the start of symptoms. That's when I think people start to
- understand that this was really difficult to prevent, in terms of transmission. I love the
- simplicity of the Japanese three Cs. I thought this was really, really the best international
- example of helping people understand why non-pharmaceutical interventions existed and
- the conditions under which COVID would transmit. Very simple. Three C's, closed spaces (with poor
- ventilation), crowded places, and settings where the intention or the purpose was close contact,
- and if you got those three together, then it was largely a dead cert for transmission.
- Behind the scenes, the hope for us all was that we would get vaccines, and the UK vaccine task
- force was an absolutely astonishing endeavour that brought together the private sector,
- the industrial scientific sector, the commercial people, the project management and some real
- government expertise, with a ringfenced budget, and a very clear understanding
- that there was significant financial risk in everything that happened under that umbrella,
- and a portfolio approach to procurement for different vaccine platforms. Pursued
- messenger RNA, where the science had been going on for two decades, adenovirus vector vaccines,
- where the UK government had made a major contribution to funding in 2016,
- that gave it really an enormous headstart when the pandemic began, and some older technologies,
- the protein adjuvants and the inactivated whole viruses, but it was genuine partnership and
- it was a genuine attempt to increase the UK ability to manufacture vaccines really fast.
- You wanted to give people hope. It was very complex stuff, but you wanted them to understand
- it wasn't instant, and that's when I first started to use analogies during the pandemic.
- I wanted things that people would find familiar, that they would find relatable,
- that they would find believable. They were hopeful, but they were also phased and eventual,
- and they gave us this sense of a collective experience. There's something very collective
- about waiting for a train, and knowing that you can't get on it until it gets into the
- station and neither can anybody else. There's something very collective about desperately,
- desperately wanting your side to get three points at 4:45 on a Saturday afternoon. So that's really
- how and why I started to use analogies as I did. Now, there is actually, believe it or not,
- some theory behind analogies, and I had to look this up, because I didn't know it, of course.
- The Stanford Encyclopedia of Philosophy, and including contributions on the
- philosophy of science, has a chapter on analogy and analogical reasoning,
- and it tells me reassuringly that the explicit use of analogical arguments has been going on
- since antiquity, and is a distinctive feature of scientific, philosophical, and legal reasoning.
- If you delve further into that chapter, you can see that Aristotle actually put together some
- numerical theories of how analogies kind of work and interact. This was one example. It was about
- war between the Phocians, the Thebans, and the analogy I think was war between the Athenians
- and the Thebans. It was all very baffling when I read it, and I still don't understand it, and
- I'm not pretending I do, but I just thought you'd like to see that there is some kind of
- formulaic approach to analogical thinking. There's also other stuff in the book, in the
- chapter that says, look, you know, it's a bit more easy to understand. The more similarities,
- the stronger the analogy, and the more differences, the weaker. The greater the
- extent of our ignorance about the two domains, the weaker the analogy becomes. Hence the football and
- the railways. The weaker the conclusion, the more plausible the analogy. Don't lock it in too tight.
- Causal relations and structural analogies tend to be stronger, and multiple analogies supporting
- the same conclusion actually make the argument stronger. So there's just a little bit of a foray
- into analogical theory. Some of the other challenges we had were the fact that we, like
- every other country on earth, didn't have enough vaccines at the very beginning of the pandemic,
- and we had to think about what to do about this. The JCVI and the chief medical officers together
- said, 'We're going to extend the interval between the two doses. People are going to wait
- 12 weeks between one dose and the next one.' If you look at kind of immunological theory,
- and it's written down in the JCVI Green Book, it's likely to work. It's likely that if you
- space the vaccine doses apart, you're going to get a more potent immune response to the second one,
- but it was highly controversial, and there was a lot of vocal criticism from the BMA,
- from the World Health Organisation initially, but ultimately, that decision was supported
- by the data on infections. The red dots, really, are just hazard ratios from the SIREN healthcare
- worker study of the risk of infection. As you can see, the risk of infection gets lower as you move
- from left to right on the slide, and as you go on the x axis, the interval between the two vaccines
- goes from 0 to 3 days through to 81 days on the right-hand side. So it is actually true that your
- protection against infection gets better if you can space the doses out further apart, but that's
- not an easy thing to communicate to the public. It's just a fallacy to think that when that
- happens, the only thing in the room is science. Science doesn't exist in a vacuum. The surrounding
- issues around that decision and that that tension at the time, was the fact that we
- had a frightened elderly population, for whom vaccines meant the avoidance of death. We had
- people who had already been waiting in isolation for 12 months praying for a vaccine every day.
- We had the vaccine manufacturer's instructions saying, 'Give these vaccines 28 days apart.'
- That's all the instructions could say, because that's all the clinical trials they did. There
- were people that believed that vaccination was going to instantly restore individual freedoms,
- and there was international competition, and there was political rhetoric over vaccine supply and
- international tension. So is it really surprising that people got very kind of worked up about this?
- The next big challenge was when the thrombosis with thrombocytopenia safety signal appeared for
- the Oxford AstraZeneca vaccine. This was unforeseen. It was difficult. Thankfully,
- we did have supply alternatives and it did involve a very careful consideration of risk benefit,
- but it was a decision that was really badly handled in terms of communication outside of
- this country, particularly in Europe, where I think it undermined confidence in a vaccine
- that was actually so cheap and so affordable that it was really accessible to low-income
- countries. That was a shame. The Winton Centre, very helpfully, stepped in and gave us some lovely
- graphical breakdowns of the problem. The orange dots are the serious harms due to the vaccine
- at different ages, and the blue dots are the potential benefits in terms of not having a
- trip to the intensive care unit. You can see at the age of 60 to 69, it's an absolute no-brainer
- that the benefits totally outweigh the risks. This continues, really, and it only starts to
- become slightly equivocal in the 30-to-39-year-olds, and
- on the margin in the 20-to-29-year-olds, and that's why the UK decided that it would switch
- to messenger RNA vaccines in the under-40s, but this was a really difficult moment for us,
- and one that I found very testing indeed. I think the way to handle it was to just acknowledge it,
- that it was true. There was a safety signal. It was very rare. It couldn't have been discovered
- in the clinical trials - they weren't big enough - but it was there. Don't deny it, don't trivialise
- it. Just give a careful description of the issue. Dissect it away carefully into small,
- digestible chunks by age. Explain the logic. Use data to drive the arguments,
- and explain why there are rational choices and alternatives at different ages of the population.
- So that was another really quite difficult moment.
- So time marches on, and I'm now moving into just a few final remarks on personal approaches.
- The first one is this slide, which some people will read it as my CV on a page.
- Others will read it as a sign of this is a man who gets bored very quickly and has to move on
- between organisations, but the real message here is, look, if you can in your careers,
- if you can go to different organisations, you get new experiences, you get new lenses on essentially
- the same world, and you encounter different styles of communication for different audiences about the
- same subject. If you can do that and you can get these insights into other people's ecosystems,
- then you can get a better handle on how your message, or your messaging,
- might be perceived by others, and what the alternatives to the messaging are there too.
- Ultimately, I say, say what you actually mean and then lead by example.
- I say, answer the question as if it's your parents or your siblings who are asking you it.
- Give it back in honest and accessible language and don't dodge the question. Failing to answer
- the question makes everybody dislike you. You may think you've been very, very clever because you
- didn't have to answer the question, but actually you've just made everybody dislike you. So
- either answer it, or say you can't answer it, and give an answer that is consistent
- with the wider facts, otherwise you start to look disingenuous. I've heard various people
- talking about NHS waiting lists recently, and one of the things you can't do is talk about
- the wonderful news that no one's waiting more than two-and-a-half years any longer,
- if the whole shape of the waiting population is actually getting larger. You kind of missed a
- point. There's something in the room, and you have to acknowledge it, otherwise it starts
- to look difficult, and then be authentic. Let your true self into the room when you speak.
- Make a connection - back to my point about making connections - make a connection with
- your audience. If you make a connection with your audience, you've got them. They're there with you.
- They relate to you, and suddenly the rest is a bit easier. Now, size matters more than you
- think. Less may be more. I'm not referring to the fourth side of the Boston United Stadium,
- but I am referring to the fact that sometimes people in their lived experiences don't have
- time for all you want to say. They just want a quick bit. I did a call during the pandemic with
- the Premier League captains, and it was a Teams call. My two boys are in the background, 'Oh,
- there he is, there he is,' looking at all these Premier League captains. At the end of the call,
- one of the captains - and I'm not going to name them, so please don't ask me - said,
- 'Doc, could you do us a video, because it'd be really useful to play to the lads in the
- dressing room?' the whole squad. I said, 'Yes, I think I could probably do that for you.' He said,
- 'But 30 seconds. No more than 30 seconds, because they won't concentrate for any longer.'
- I'm not being demeaning about footballers, because I've got
- a child who's about to go into full-time football, but I'm saying that's the experience. That's
- the reality of what they want. They want 30 seconds; they don't want any more than that.
- So you've got to kind of tailor your message to the audience. I was at the University of
- Middlesex not very long ago, and over lunch, a lady who runs one of the big training centres,
- clinical training centres there, said, 'I'm always telling my students, talk English,
- not medicine or science.' Now, I know we could stray into the need for 21 different languages and
- translation of important key materials in the UK, and that's fair too, but the point I'm making is
- we as scientists and we as medics, we talk a certain language, but you can't talk that with
- the public. You've got to talk in native tongue, and it's okay not to be dour. It's okay to smile.
- These were very difficult times, but it was okay, in my view, just to let a little bit of yourself,
- just a chink of humour, into the room. Not inappropriately, not flippantly, but just
- to prove that, look, any fool can be miserable. I was told that a long while ago in the military,
- that when you're cold and wet any fool can be miserable. No one's going to change the
- fact that you're cold and wet, so you can either start to enjoy it, or you can just feel sorry for
- yourself and be miserable. So which is it going to be? And so, 'Any fool can be miserable,' has
- come back and help me so many times. Let yourself into the room, if you can, and I realise that
- not everyone can let themselves into the room as much as maybe I can. Then, finally and crucially,
- give people something they can make sense of in their own lives, because if you can do that,
- and they can walk away going, 'Yes, I get that. I'm going to do that tonight. I'm
- going to do that this week. I've got it. That's my job. That's my bit,' then you've won the day.
- Now, again, I'm going to say how grateful I am to you all for coming along, and how grateful I am
- to the Royal Society for somehow picking me out for this lecture and this award, but in my view,
- you're looking now, not at me, but at the supreme champion of communication.
- I think Jacinda Ardern was an absolute star during the pandemic, and she's now been studied
- by people who are qualified to study these things, which is not me, and they've picked
- out five high-level themes of Jacinda Ardern's style of communication. They are, first of all,
- that it's an evidence-based approach. Secondly, that she was decisive in how she communicated.
- She used education and information; she educated people and she gave them information.
- She was coordinated and aligned with everything else that was going on around her,
- and most importantly, and why I'm saying it last and why it's at the top of the slide, she
- showed real social solidarity with her people, and that is, for me, the absolute icing on the cake.
- So I am really now coming to the end of this lecture. I want to thank
- my family and friends for immense and really immeasurable support over the last few years.
- I want to pay tribute to the UK Armed Forces and thank them for many conversations over the last
- 40 years that have taught me the good and the bad about how to communicate with people from
- all walks of life, and have set the very best example for me in terms of demonstrating what it
- is to lead by example, and what it is to serve to lead. I want to thank my dear CMO family and DHSC
- extended family, who are mainly over there. It's a different kind of family, of course, but you are
- family, and we all knew what each of us were going through in that kind of technical and professional
- way that families at home, blood families, don't. That was that was really important too,
- so thank you for that, and thank you to the people of the UK, and for the representatives of the
- people of the UK, the public, who have come along tonight, for your feedback, your encouragement,
- your fortitude and your deep understanding of what we've been through. Thank you very much indeed.
- Thank you very much
- for that
- absolutely wonderful lecture. I'm glad I'm not a footballer. I could listen to you not for 30
- seconds, but for 30 hours. I could have kept going all evening, as I'm sure many of you
- could have done as well. However, things come to an end, and sadly, the lecture has come to an end,
- but we still have an opportunity to ask questions. I'm sure I'm not the only one who has questions
- for JVT. So we have people there with microphones, roving microphones. If you want to ask a question,
- please put your hand up, but we also have questions from the audience online. If
- you are listening online and you want to ask a question, there's a website called www.slido.com,
- and once you're in that website, there is a code you need to enter, and the code is #DA286.
- So let me repeat, so www.slido.com, and the code is dash - it should be up there. It is up there,
- but maybe you cannot see it. Anyway #DA286. So let me just first see if there are any questions
- online. Oh, gosh, I've got this advanced piece of technology here. 124578. 124578. Right, okay.
- So let me start with a question - there's some very good questions here - right,
- let me start with this one. It's from somebody called David Goldsmith, and the question is,
- with the benefit of the retrospectoscope and hindsight - it's an advanced medical instrument,
- the retrospectoscope - and hindsight, what should we have done better in the pandemic,
- and how should future teams managing pandemics have their communications
- better organised? Well, let's take that. Let's look into the future,
- not so much what we could have done better, because there's a whole inquiry on that, but
- what should future teams managing pandemics - how should they deal with their communication?
- Yes, so I completely agree with you, the retrospectoscope is a marvellous
- medical and public health instrument that does teach us things after the event.
- You're right also, Carlos, that the inquiry will deal with what we could have done better. In terms
- of what the future looks like, then I think we're in this difficult phase where people,
- including the public and politicians, are fed up of the pandemic and are very glad it's over.
- I think they're not yet at the stage where there can be a full consideration of the fact that,
- actually, future pandemics are extremely likely and are likely to occur in the professional
- lifetime of some of the younger scientists in this room, maybe once, maybe twice.
- Also, it's been a reminder that pandemics can be really severe, even with a modern range of
- technologies available to us. We were alone, without vaccines and without drugs for several
- months - almost a year without vaccines - and that is always going to be difficult.
- We are in a changed place. Some of the new vaccine technologies and platforms can offer
- the probability that next time we can respond even quicker, with vaccines for novel pathogens,
- and much depends upon the amount of corporate learning that is now done by governments and
- organisations, and how that learning is then kept warm-lit for the next pandemic.
- Thank you very much, Jonathan. The questions here from the audience, there were a couple of
- hands up that I could see. Yep. Maybe could we give a microphone to the lady over here?
- Hi. I have two questions. One is, in terms of communication, it seems that you worked
- very hard to try and stop the static noise in that diagram you showed to the audience.
- Please don't take my photo. Thank you. Sometimes that static noise can be deliberate,
- can't it? For example, given out terminal illness with a particular - as you said,
- the way you feel about it, maybe a little bit too interfering from one person to the patient.
- Do you think that's learned, or is that...?
- I'm not quite sure... Have another go.
- Okay, so how you feel about when you deliver information to a patient, to how you should
- deliver the evidence-based physical ailments or emotional ailments, whatever is going on.
- You mean when a doctor has bad news, how should they communicate?
- Absolutely, yes.
- Right, okay.
- Can I just finish? You've got a module that shows the basis of communication, and I'm sure that
- it's very basic that from one human being to the next, when you pass on bad news, it should be,
- I don't know, with some kind of mannerism, which maybe, if you want to pass on that bad news,
- maybe you can minimise that 80 per cent to like 1 per cent, so that doesn't come across.
- Okay. So I think I think the communication of difficult circumstances is always a challenge.
- I think empathy is the absolute watchword, and I don't think we've studied empathy in medicine
- as much as we should have done. I think maybe we've lost some of that. The Stoneygate Centre
- for Empathic Medicine has just opened at the University of Leicester. It's really
- going to - in my view, it's a groundbreaking new centre - and I think it's really going to
- challenge the way in which we re-examine how we communicate with our patients and our populations.
- Okay, is this your...
- Let me give you a chance to someone else who also wants to ask,
- because we only have time for one question.
- Can I just - I just have one more question. It's just in regards to the vaccinations that
- took a long time to come out. There was a lot of studying involved in putting that together
- and getting that out to people that were dying. Then, if we look at the Armed Forces,
- then, and if we look at scientific procedures that are put into place to develop certain chemicals
- which can create pain and discomfort to people on purpose, intentionally, why is that science
- then not kept separate from the National Health Service, and the National Health Service can get
- on with doing their jobs and saving people's lives instead of making them uncomfortable on purpose?
- I don't really understand the thrust of the second question, but on the first one, I think
- vaccines were enormously fast in being deployed to the UK population. I think the Department of
- Health and Social Care, the NHS, were completely ready to move as soon as results were available.
- Right, so we have one time for one last question, and I think there was a hand
- back there that came up towards the beginning of the questions session.
- Thank you. How was the communication different
- when you were either proactively prebunking or responding...?
- Sorry, can you speak up a bit? I can't hear.
- Okay.
- Is it on?
- Thanks. Can you hear me now?
- That's better.
- Okay. How was the comms strategy different when you were either proactively dealing
- with mis- and disinformation, or you were responding to it in real time?
- So on the disinformation subject, my view is that there was plenty of it out there.
- My view is, has always been, that if you give it air time, you make it more
- credible. It shouldn't have air time, because it's not credible. So my view has never been,
- oh please, please, please believe my version of events, not this nonsense. My version is,
- my response has always been, I'm not prepared to discuss this nonsense because that's what it is.
- Right. So I'm sure there will be many more questions. However,
- we have to stick to the timetable, but we're not completely done yet. There's
- one more thing we need to do, and I'll ask Jonathan to come up here.
- I should have a scroll here. So we're going to give you a...
- It's behind you.
- Ah, it's behind. This is this is like Christmas time. Right. Very good. So this to finish the
- evening, then, it's a tremendous honour for me, on behalf of the Royal Society,
- to give you the actual, physical David Attenborough 2022 Award. Much deserved,
- and we're so grateful for your lecture, and not just for that, for everything you
- have done. Although, this is only a reward for your ability to communicate. Jonathan, here...
- So I think we've already thanked Jonathan. So all that is left for me is to thank you, the audience,
- and I'm sure you have been as enthralled as I have with Jonathan's really amazing ability
- to communicate, not just during the pandemic, but even now, how he communicates about communicating
- is really amazing. Thank you, Jonathan, and thank you, all of you for coming here.
Join us for the David Attenborough Award Lecture given by 2022 winner, Professor Sir Jonathan Van-Tam.
Whilst pandemic vaccines and antiviral drugs have been used at scale in the past, the initial severity and spread of COVID-19 required additional extensive public health countermeasures.
A series of communication challenges was also inevitable in both political and public spaces. This was intensified by the lengthy duration of the crisis, the ever-changing epidemiology and a changing virus.
Scientists and clinician-scientists were under pressure as never before to communicate with clarity, integrity, and authenticity.
In this lecture, Professor Sir Jonathan Van-Tam discusses and reflects on his own journey through this challenging landscape.
Professor Van-Tam was awarded the 2022 prize for his critical role in public engagement during the COVID-19 pandemic as UK Deputy Chief Medical Officer, through national and international media.
91TV David Attenborough Award and Lecture is awarded annually to an individual for outstanding public engagement with science. The award, open to everyone, recognises high quality public engagement activities. The award is named after the United Kingdom’s best-loved naturalist and broadcaster, and honorary Fellow of the Royal Society, David Attenborough.
About the Royal Society
91TV is a Fellowship of many of the world's most eminent scientists and is the oldest scientific academy in continuous existence.
/
Subscribe to our YouTube channel for exciting science videos and live events.
Find us on:
Bluesky:
Facebook:
Instagram:
LinkedIn:
TikTok: