Uncertainty, scarcity and transparency: Public health ethics and risk communication in a pandemic

This article explores the challenges of communicating public health guidance during a pandemic, focusing on the example of mask recommendations in the early stages of the COVID-19 pandemic in the United States. It underscores the ethical dilemmas faced by public health officials in balancing transparency with evolving scientific knowledge and resource shortages. Initially, there was hesitation in recommending masks for the general public due to concerns about mask shortages, leading to mixed messaging. As evidence supporting mask effectiveness grew, guidance shifted to advocating universal mask use, contributing to public confusion and mistrust. The article underscores two key ethical principles: the precautionary principle, advocating for protective action in uncertain situations, and harm reduction, emphasizing minimizing harm when complete risk elimination is unfeasible. It also highlights the importance of transparent communication but acknowledges that excessive transparency can sometimes cause confusion and mistrust. To enhance public health communication during uncertainty and resource scarcity, the article recommends utilizing trusted messengers, structuring uncertainty, acknowledging the role of values in recommendations, and recognizing emotional responses to risk information.