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The good, the bad and the ugly: a lesson in COVID crisis communications from Victoria’s CHO

Introduction by Croakey: He’s been referred to as the “dissenting view” in high-level expert discussions being held behind closed doors to guide Australia’s novel coronavirus pandemic response, but Victoria’s chief health officer Professor Brett Sutton makes no apology about being direct with the public.

Sutton, a public health and communicable diseases specialist with extensive experience in emergency and international field-based medicine, has been lauded for his forthright and responsive engagement with the public during the COVID-19 outbreak.

In contrast to the defensive, contradictory, and opaque course adopted by his federal counterparts, who only agreed on Monday after weeks of pressure from journalists and doctors to “unlock” the modelling and assumptions upon which their coronavirus response has been based, Sutton has been a study in openness and honesty.

While debate continues to rage about access to and criticism of the government’s response (more on this long-running controversy here, here, and here), Sutton has again been out on the front foot in recent days, broadcasting from Federation Square and not mincing words on Twitter, where he said he was “being blunt again… to save lives”.

In this piece for Croakey, he offers some insights into his determination to get the balance right on communicating risk, reassuring the public while reinforcing the urgent challenges of the months ahead.


Brett Sutton writes:

As the COVID-19 pandemic continues to escalate in Australia, it brings enormous challenges to both our health care system and to broader society.

I know that our healthcare staff will do a wonderful job in responding. There will no doubt be heroic efforts made in Emergency Departments, medical wards, in ICUs and in primary care. The critical interventions to save lives in these settings shouldn’t be underestimated.

For me, however, there’s a critical health intervention that is often unrecognised and potentially the most important of all – communication.

It’s important because it has the power to save many, many lives by preventing illness in the first place. As we contemplate health systems under huge pressure, communication becomes a health intervention that we can’t do without. We have to empower individuals to protect themselves, so that they’ll avoid the Emergency Department, or hospital ward, or ICU.

Risk communication is not an easy task, although it seems straightforward. My own journey is long. I guess that working in Emergency Medicine for 10 years helped refine the skill. And travel to 80 countries and work in humanitarian settings in Afghanistan, Ethiopia and Timor-Leste provided a rich opportunity to make health information clear, accessible and relatable.

That clear communication – in and of itself – is not enough, however. Risk communication demands something more of us.

Tell it like it is

I was lucky enough to see Peter Sandman present to the Department of Health and Human Services a few years back and he made an enormous impression on me.

Peter is a risk communication guru and he has been a source of guidance for me ever since that fortunate encounter. He makes a real point about honesty, authenticity and the courage to be blunt, open, apologetic when wrong, empathetic in a crisis, and honest about uncertainty. And when it comes to bad news (like a pandemic) to tell it like it is; to say it when you know it and not wait because you need to ‘reassure a panicking community’.

I think I was one of the first government officials in Australia, perhaps outside Asia, to say that a pandemic was likely, perhaps inevitable. That caused some ructions and I copped some criticism for it but the Minister for Health – to her credit – backed me; many others were quick to praise an approach of being upfront and straight talking.

I described it to colleagues at “the Twittersphere just let out a great sigh of relief”. People knew a pandemic was coming and they were perhaps frustrated with global messages that were overly reassuring. They didn’t know what the truth really was or who to go to for trusted advice.

My own journey on Twitter has been interesting.

In the tradition of Sandman, I wanted a means to communicate more directly with the community in Victoria and beyond, so I really pressed for my own Twitter account within the department. That took about a year (and another month for permission to use my own face) but we got there.

I was cautious and a bit concerned that it would be a platform to bash a public servant, but it’s been great. I think people recognise an authentic voice and I try my best to be me.

Some missteps, of course, but overall, it’s been great to disseminate information.

More importantly I can see what people are saying; what they’re concerned about; and what they’re asking. I try to engage individually and to sit with the criticisms. There are lessons in all of it.

The good, the bad and the ugly

I think the next phase for us is what Sandman calls ‘crisis communication’.

I’ll need to be forthright with the good, the bad and the ugly. I’ll also need to focus on what we can do to protect ourselves and how we can support each other.

I hope I can be a calm and reassuring voice, while still acknowledging all the challenges, the risks and the uncertainties that we will face.

I’m learning about this situation along with everyone else, but I’ve got a fantastic Health Protection Branch with wonderful expertise, working incredibly hard.

I don’t need to be the national expert in epidemiology and infectious diseases, with whole teams supporting me on all the global and local data.

I do, however, hope to be a skilled risk communicator and bring the best of my experience to a community I care deeply about.  

Brett Sutton is the Chief Health Officer of Victoria