How Quebec's bungled messaging is hampering the anti-virus effort

Quebec's health minister was irked and it showed.

Christian Dub had just been asked about a party at a restaurant in Laval where revellers were cavorting maskless, in joyful violation of essentially every public health recommendation.

"I'm going to uncross my arms because the moment you talked to me about that, I crossed them. That's not very good, eh?" he told Journal de Qubec reporter Genevive Lajoie during a news conference on Tuesday.

Yes, you might say the man who's managing the province's day-to-day pandemicresponse is sensitive to verbal and non-verbal communications.

The Quebec government, like many others, has been grappling with two big challengesas it tries to steer a COVID-weary populace through the latest phase of the pandemic: how to keep people on their toes without having them tune out andhow to keep an economy afloat while mitigating the danger to vulnerable populations.

It is like walking a tightrope.

"On the one hand, they want to protect the population ... and on the other hand, they've got to keep the economy going, they've got to keep the population feeling positive," said David Levine, a former junior Quebec health minister, hospital administrator and director-general of Montreal's regional health authority.

The fact that Quebec has already been through alockdown and is now in its sixth month of pandemic vigilance and privation makes it increasingly difficult to hold the public's attention. AsDub said this week, "People are tired."

But the perils of muddled communications are real.

Ifthe province decided to order another full lockdown, would people go along with it?

How much leeway does Quebec City have to make and enforce tough decisions?

The fact is, not everyone is listening to what the government is saying.

Earlier this month, researchers at Concordia Universityin Montreal published findings from an international survey of global attitudes thatestablished a correlation between messaging and behaviour.

They found that 12 to 25 per cent of people, most of them men and women in their 20s, aren't engaging with the public health discourse.

"The things that really resonate with them are things around the economic side of things," Dr. Simon Bacon, one of the study's principal investigators, told Radio Noon,"... and yet, there's not real talk about any of that. In fact, most of the messaging has been all around health, which we know doesn't really resonate with this group at all."

Or as Levine put it, there's a balance to be struck between safety and hope. Practically speaking, the provincial government has settled on a plan in whichit'smaking a general appeal to caution and individual responsibility, but without meaningful coercivemeasures to uphold either.

It's no wonder the messages seem, at best, mixed.

"People are very confused," said Kim Lavoie, a psychology professor at the Universit du Qubec Montral, who holds a Canada Research Chair in behavioural medicine. "Whenever there's an inconsistency, it gives space to people to say, 'Well, both these things can't be true, so I'm going to go with whatever suits me best.'"

WATCH | Six months into the pandemic, does Quebec have its messaging on track?:

Six months into the pandemic, does Quebec have its messaging on track?

4 years ago

Duration 4:45

An expert in behavioural medicine warns the Quebec government's new COVID-19 awareness campaign could backfire. CBC Montreal's Debra Arbec speaks with Kim Lavoie, the chair of behavioural medicine at UQAM.

Lavoie, who co-led the Concordia study, understands the challenges and is reluctant to openly criticize her public health colleagues, but, she said: "What I think is missing for most people ... is a transparent, common-sense plan."

The province's colour-coded alert system, for example, is an idea that could work. But its clarity has been undermined by confusion over what the various levels actually mean.

Going from yellow to orange is intuitively bad, but it's not always clear what exactly the progression involves.

"We have an algorithm now: If we move into orange, this is what happens. And even there, we're already starting to make compromises," Lavoie said. "We're in orange now, so [gatherings are]going from 10 people to six, but it could be eight if you're in the same family. But if you're nine, well no, that's no good. It's hard to know what to believe.

"Again, it leaves room for people to say, 'That doesn't work for me, so I'm going to ignore it.'"

Inconsistencies have also plagued other aspects of Quebec's messaging:

• Stay home, but don't forget to support bars, restaurants and local businesses.
• You'll have to wear a mask to go into a store or dentist's office, but if you're one of 25 to 30students in a classroom, you can take it off.
• Please avoid gatherings, but if you're having members of one other household over, it's probably OK.

"Is the message clear? I don't think so," Levine said.

Levine has experience, having spearheaded the response to the H1N1swine flu pandemic in 2009 (he also contracted the disease).

That episode is mostly remembered for what didn't happen "We were very lucky," Levine said but the messaging lessons from that period still hold.

"Make it short, make it clear, keep repeating it, find a level we can live with and stick there," the former Parti Qubcoiscabinet membersaid. "The idea of changing it, up and down, up and down, is what ends up being confusing for a population."

The current government, headed by the Coalition Avenir Qubec,appears to be trying to walk a very fine line hopingthat people act as if the province were in a lockdown, without actually havingto make that decision and enforceeverything that comes with it.

Dr. Horacio Arruda, the province'spublic health director, essentially said as much this week.

Arruda was being asked about why so many people seem so confused about the limits on gatherings.

"I'll tell you quite honestly, if we wanted to be simple in terms of communication, we'd bring up one number. The number to remember, right now, is six. And actually, in the current context, we've asked people not [to] gather ... try to avoid dinners with people who don't live in your house in order to try and stop this spread," he said.

Dub also acknowledgedthat the message has occasionally becomegarbled.

"You're right, our communications haven't been perfect," he said on Tuesday. "We're going to adjust in the coming days, and you're right to mention it, but I think we must explain to Quebecers that we want to find the right compromise to continue to live our liveswhile making the sacrifices we can stand."

By Thursday, Dub had refined his talking points, asking peopleto avoid large Thanksgiving gatherings so they can get together and celebrate Christmas.

Then on Friday, he said: "You asked us: Is the message getting out? I think that by better explaining what's happening we can make a difference in the short term.... It becomes a little unreal, we've been in this situation six months. And I think our role and I've said we can improve every dayis to say, 'We can see we're at the foot of that [second]wave.'"

And so, a new message: For the next 28 days, please don't socialize.