Public trust in health authorities is essential when it comes to the rapid, effective behaviour adaptations that may be required in the face of an epidemic or pandemic – and several factors can facilitate a high-trust environment Trust during pandemics: a critical determinant of successful response
By Sylvie Briand, director, Epidemic and Pandemic Preparedness and Prevention, and Sarah Hess, technical officer, Health Emergencies Programme, World Health Organization
E pidemics and pandemics are characterised by high due to the rapid demand for care and generate fear and uncertainty that can affect the entire social fabric of society. Epidemics and pandemics are dynamic crises and non-linear in nature. During the Covid-19 pandemic, changes in the virus produced different variants that were associated with ‘pandemic waves’. To control epidemics and pandemics, people must adopt temporary new behaviour such as wearing masks, getting vaccinated and self-isolating when symptomatic. It may also be necessary to change the levels of social and economic disruption. They can destabilise the health sector recommended behaviour during the event in response to emerging knowledge about the disease or the risk associated with it or as medical interventions become available. The constant need for individuals and institutions to adapt to changing risks contributes to higher levels of uncertainty during epidemics and pandemics and the risk of further destabilisation of existing systems.
To ensure rapid behaviour change, the population must trust that the recommendations from the health authorities are relevant, commensurate with the risk and are ultimately to protect their health. Trust in health authorities is therefore an essential component of an efficient and successful epidemic or pandemic response. But trust can be lost easily during a crisis. Many health authorities tasked with managing the Covid-19 pandemic response experienced a loss of trust. This reduced people’s tolerance of the recommended measures and their compliance with those measures, thereby reducing their effectiveness and further affecting levels of trust in the health authorities. Once this cyclical nature of mistrust starts, it is difficult to counter. Fostering trust in health authorities to enable a successful epidemic or pandemic response requires efforts and investments prior to the crisis. It is difficult to build trust during a crisis, so these efforts should be embedded within pandemic preparedness planning. It is standard practice for countries to strengthen their surveillance system, their vaccine manufacturing system, their
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