You CAN handle the truth: How councils can build trust and recovery in an age of alternate facts

This essay is part of the Trust and Governance pillar of our Post-Covid councils workstream.

Trust underpins the relationship between citizen and state. During times of peaceful prosperity, trust and confidence in government leads to greater cooperation and co-production in a virtuous circle of better, more engaged governance. Trust is the grease of democratic machinery and the foundation of social cohesion. We trust that our fellow citizens want more or less the same as we do and that this collective will is reflected in our representation. Trust in politicians is conditional – and should be – we need to be able to hold leaders to account. But we also need to be able to trust that leaders have competency and conviction even where we may not agree with their policies. In times of uncertainty, conditions and understanding can change rapidly. At this juncture, we must be able to trust that best available evidence is being used, that good decisions are (mostly) being made, and that course corrections happen quickly when new evidence comes to light.

For local governments, trust really matters now. It is life and death. Exit-strategies for the Covid crisis will require local implementation, and that will require trust in local institutions. In this paper we present the results from a new LGIU survey on perceptions of misinformation, and explore:

• how trust is under threat,
• the link between trust and an effective pandemic response,
• how jurisdictional disputes and misinformation undermine trust and
• how we can shore up trust for local recovery.

If we are governed by consent, then trust is the measure by which we judge that our government has legitimacy to make decisions on our behalf. If government is of the people, then trust is a proxy for both engagement and compliance. OECD evidence shows that “government’s values, such as high levels of  integrity, fairness and openness of institutions are strong predictors of public trust. Similarly, government’s competence – its responsiveness and reliability in delivering public services and anticipating new needs – are crucial for boosting trust in institutions.”  In the before times, trust underlay compliance with everything from regulation to paying taxes, as well as public health programmes around healthier living and vaccine uptake.

In living through and beyond a pandemic and into recovery, we need trust between citizen and state to ensure that people are acting on the best available information and advice about how to reduce transmission. And as we have learned more about the virus and will continue to learn more about reducing transmission, we need people to be able to flex their behaviour as the advice and regulations change. It has been challenging to do this in an environment where, according to OECD data, only 45% of citizens trusted their governments and where different levels of government were sometimes sharing different and conflicting messages.

There has been much hand-wringing over declining levels of trust in government, with some argument over whether there really are declining levels of trust or what that might mean. Like so much else, Covid-19, has exposed the cracks in, and the necessity of, public trust. From encouraging the public to comply with behavioural changes that alter the entire fabric of our lives, to the information on which those decisions are made, governments rely on public trust. Trust in public institutions has a measurable impact on how willing people are to comply with restrictions on movement required for effective ‘lockdown’ or ‘shelter in place’ orders. Researchers from the University of Bordeaux compared compliance with restrictions with levels of pre-pandemic trust in regional governments and found a correlation (Bargain and Aminjonov, for Vox-EU,CEPR Oct 2020). To put a finer point on it, it’s a matter of life and death:

“Combined with the estimated relationship between trust and mobility, we find that a standard deviation increase in trust in Europe is associated with a 6.5% decrease in the growth rate of COVID-19 fatalities. To put things in perspective, recall that the death toll was around 2,000 by mid-March and 90,000 by mid-April in Europe overall.3 The compounded effect of trust indicates that a standard-deviation higher level of trust in Europe would have led to approximately 10,000 fewer casualties by mid-April.”

In the United States, parts of the Federal government have seemingly been at war with some state governors, and some state governors have been at war with their mayors, over business closures and mask mandates. US President Donald Trump, a Republican, openly called for citizens to defy restrictions set by Democratic Party governors, and ‘liberate’ their states. Subsequently armed ‘militia’ descended on state capitol buildings. In one case, conspirators who had attended these protests have been arrested over a plot to kidnap and murder Michigan Governor Gretchen Whitmer, beacuse of the public-health restrictions she implemented.

In the UK, amid milder lockdown protests, English mayors and devolved governments have clashed with Westminster over lockdown rules and regional economic compensation. As the attempt at tiered regional lockdowns continued, LGIU colleague Andrew Walker wrote:

“The scale of resistance from leaders in the North is striking. It raises serious questions about the Government’s strategy going into the winter and a second wave of the pandemic. It  highlights the chronic lack of understanding and dialogue between central and local government. This will have potentially disastrous effects for containing the virus.”

As we try to manage the crisis and emerge from the pandemic, councils in the UK fear that central government will move from a position of excluding councils to excoriating them. As LGIU  Chief Executive Jonathan Carr-West wrote in July when cases were at a low ebb:

“More worryingly, there are signs that government may wish to push councils into the firing line as the COVID blame game gets underway. We can see this in the idea that councils have been profligate in their borrowing and commercial investment and thus have only themselves to blame for their financial problems. Or indeed with the home secretary’s suggestion that local authorities were afraid to investigate Leicester sweatshops and so contributed to the upswing in COVID cases there.”

Is this a sign of things to come?  Doctoral researcher Joseph Ward, writing for LGIU, believes that “central-local government relations are becoming the principal site of conflict in the politics of the pandemic.”, and a senior local government figure has told us anonymously that “you don’t need to be paranoid to think government will start pointing the finger at councils, you just need to be aware of history.’” These power-struggles are visible to the public and add to levels of confusion and distrust of official messaging whether central or local.

Sturgis, South Dakota: A case study in poor leadership

The Sturgis motorcycle rally held in South Dakota in the US in mid-August attracted almost half a million people.hile much of the rally takes place outside, there were also multiple indoor venues welcoming revellers over a 10-day period. This is the largest known gathering of people since the beginning of the pandemic.

The Governor of South Dakota, Kristi Noem, a Republican, has long resisted any kind of restrictive public health measures or mask mandates. While there are some genuine critiques of the Sturgis study, she dismissed the findings as “”elite class of so-called experts” whose opinions impact individuals’ liberties. Local government officials in small town of Sturgis had consulted with the town’s roughly 7000 residents, and 60% of them had wanted the rally cancelled. But the city council voted to let it go ahead essentially unaltered, citing fears that people would show up anyway. While, the Mayor of Sturgis appeared to be in support of continuing, they certainly could not have expected much help from state or federal authorities who were dismissive of concerns about the virus.

The instincts of the local government were right. Consult the people. Explore the tradeoff between a tremendously lucrative festival and the public health consequences. But in an environment where the Governor is aligning herself clearly with a President who has called for states to ‘liberated’ against Democratic governors who were implementing public health restrictions in their states. The town council felt that the bikers would descend on their town anyway, and without being able to trust the support of their state government their safest bet was to encourage good behaviour during the rally.

That failed. Maskless attendees packed themselves into bars, restaurants and indoor venues over the 10-day rally.  Researchers connected to the Center for Health Economics & Policy Studies modelled that around a quarter of a million cases in the US can be linked to the rally, and that around one fifth of the US August covid case level resulted from a decision to go ahead.

When leaders across different levels of government are not in concert and decide to override the best available scientific advice, and indeed seek to undermine trust in science, the consequences can be disastrous in the short run – and insidious in the long run as trust is further eroded.

(Link to CDC data)

Leadership in the UK

The UK has not seen spectacularly visual failures in leadership on the scale of those seen in the US, and the nation is not led by one of the chief spreaders of Covid misinformation (NY Times: Study Finds ‘Single Largest Driver’ of Coronavirus Misinformation: Trump 30 Sept 2020). Nonetheless there has been persistent criticism of Boris Johnson’s leadership. Criticisms have included a lack of clarity in messaging, delay in bringing in more stringent public health measures such as mask mandates, and a lack of consistency around delivering economic relief to businesses, workers and children on free school lunches. Meanwhile, the government also faces criticism from the Right, where some believe that public health measures are hindering freedom and that fears of Covid-19 are overblown. Deaths per head of population in the UK are among the highest in the world.

The House of Lords of Public Services Committee, in reviewing the public service response to the pandemic, reported (13 Nov 2020) that:

“The overall public health response was at times hampered by over-centralised, poorly coordinated and poorly communicated policies that were designed and delivered by central Government, even though local-level providers were often better equipped.”

Trust and communication are at the heart of the implementation of policies to tackle the pandemic . Local government in the UK is consistently more trusted than central government, and pre-pandemic polling in October 2019 conducted on behalf of APSE found that nine times as many people trusted local government to provide services in their local area over central government and five times as trusted as the private sector. Yet councils have consistently battled with central government to have sufficient access to data and information about local cases and despite having responsibility for public health councils were initially shut out of test and trace initiatives.

In the first ever poll of locally elected councillors in England, Scotland and Wales on the subject of public health information and misinformation, (PDF: Covid-19 Information and Misinformation survey toplines), LGIU found that fewer than half (44%) were very or extremely confident that local decisions were evidence driven.

The survey also found that councillors are deeply dissatisfied with public health messaging from central government. Almost half (49%) were dissatisfied with central government messaging to them as councillors and local leaders, and even more strikingly, 61% were unhappy with central communication to their communities. They felt that their local public health authorities were doing a better job, around three-quarters being at least satisfied with communications to them as councillors, and 62% being satisfied or better with local communications to the public.

If competency and honesty and clear communication of values underpin trust, then the corollary may also be true. In focus groups carried out by University of Southampton researchers, they found an initial ‘rally round the flag’ effect as people had little choice but to trust government officials and there was a great deal of sympathy for politicians in dealing with a crisis of this magnitude. However, they also found that respondents cited  unclear messaging coming out of the first lockdown, and a sense that politicians were publicly lauding health workers while doing little to solve their problems. The fall out of the the Dominic Cummings affair was also raised. . The private infighting that spilled into public view, and the credulity-testing justification of ‘eye-testing’ family outings, gave the sense that there was not one rule for all and that what our most senior government officials were telling us or their judgment could be trusted. The study concluded that: “Dealing with an event seen as unprecedented gets you some breathing space. Not owning your mistakes, giving mixed messages, having double standards and lauding key workers for short-term political advantage costs public trust.”

The Reuters Institute and University of Oxford have been looking at pandemic as not only a public health crisis, but as one of communications. In new work published at the end of October 2020 they found that “After an initial surge in news use, news consumption in the UK has gradually returned to pre-crisis levels, news avoidance has grown, and trust in key sources of COVID-19 news and information has declined.” Further they said they have “seen a dramatic decline in public trust in the UK government as a source of information about COVID-19 and a significant increase in the number of people who see the UK government itself as a source of potentially false or misleading information about the coronavirus.”

The C19 National Foresight Group is a cross-government multi-agency group set up to support the UK response to Covid-19. The group works with Nottingham Trent University (NTU) to draw on academic insight and expertise “to save lives, relieve harm and support communities”. Their September 2020 report found signs of eroding trust in national government, and called for clearer dialogue with the public, including open admissions of difficulties in dealing with the pandemic. They also cited the lack of trust between levels of government and urged greater trust and empowerment of local public services who are already dealing with the situation on the ground. (See our LGIU briefing on this report.) The local government sector will be all too familiar with the sense that local government’s proven ability to deal with crisis after crisis has been overlooked and that “too much reliance on national leadership and a failure to perhaps see, or trust in local innovation opportunities to get ahead”.  As councils have worked heroically to deal with the pandemic, the public is recognising and applauding bin men and care workers, while central government fails to fund, inform or sufficiently engage local authorities.

There has been a proliferation of armchair epidemiologists and virologists. How many of us needlessly washed our groceries? (I did.) How many of us saw well meaning friends share information about the dangers of ibuprofen or the effectiveness of gargling salt-water as a prophylactic against the virus? All of this was alongside press briefings, digested findings of scientific studies and campaigns advising us to stay alert. Hucksters and presidents were touting worthless remedies and desperate people were buying the con.  Qualified scientists publicly disagreed over the effectiveness of masks. and the general public was familiarising itself with R-numbers and asymptomatic spreaders. It has become hard to tell exactly what is true and what is useful. This is before we add in bad actors who are deliberately sharing harmful information and those that pass it on wittingly or unwittingly. That is the infodemic, and it is affecting public health.

While humans have suffered from plagues and pandemics in the past, this is the first time we have done so with a 24-hour news cycle and the fire hose of information across social media. Some of these channels have been used to share vital information, but they have also been used to share information that is wrong – misinformation – and information shared deliberately to cause harm or confusion – disinformation. We are inundated with information, overwhelmed, and that can lead to poor decision making by individuals who are not sure which information they can trust.

The World Health Organisation (WHO) has defined the infodemic as:

An infodemic is an overabundance of information, both online and offline. It includes deliberate attempts to disseminate wrong information to undermine the public health response and advance alternative agendas of groups or individuals. Mis- and disinformation can be harmful to people’s physical and mental health; increase stigmatization; threaten precious health gains; and lead to poor observance of public health measures, thus reducing their effectiveness and endangering countries’ ability to stop the pandemic.

Getting guidance from bad sources matters. There is evidence that Britons who believe in conspiracy theories, or who get most of their information from YouTube or Facebook, are less likely to follow pandemic precautions such as avoiding household mixing or even going outside while experiencing symptoms of Covid-19. (Kings College London and Ipsos-Mori, June 2020). A study published by the Royal Society also found that susceptibility to Covid misinformation was correlated with poor compliance to public health measures.

Those who believe in Covid conspiracies are in a minority in the UK, but there is concern that exposure and belief is growing.  From the KCL and Ipsos-Mori research:

• Three in 10 (30%) think coronavirus was probably created in a lab, up from a quarter (25%) at the beginning of April.
• Three in 10 (28%) think most people in the UK have already had coronavirus without realising it.
• Three in 10 (30%) believe the Covid-19 death toll is being deliberately reduced or hidden by the authorities.
• One in seven (14%) believe the death toll is being deliberately exaggerated by the authorities.
• One in eight (13%) believe that the current pandemic is part of a global effort to force everyone to be vaccinated.
• More than one in 20 (8%) believe that the symptoms that most people blame on Covid-19 appear to be connected to 5G network radiation.
• More than one in 20 (7%) believe there is no hard evidence that Covid-19 really exists.

Councillors in the new LGIU survey are concerned about the levels of misinformation (link to PDF again) – 62% were concerned a lot or a great deal about the level and pervasiveness of public health misinformation. Two-thirds of councillors – 67% – say that they have seen or heard Covid-19 misinformation shared as true in informal channels and 59% say that they have seen official public health information denounced as false. And while about half of councillors (49%) feel reasonably confident that they’re able to spot misinformation online, three quarters were ‘not-so or not at all’ confident about the bad-information spotting abilities of the general public.

And councillors are spotting plenty of fake news. We selected 10 potentially contentious ‘facts’ about Covid-19. Two were true, one was arguably partly true – but mainly false, and the other seven were false. We asked them if they’d seen each claim and whether or not they believed it.

*Respondents were also allowed a ‘don’t know’ option so numbers may not reach 100%

**Respondents were allowed to choose both options for ‘have you seen’, so percentages can exceed 100%

Councillors in our survey were familiar with some of the common Covid conspiracy theories, but had lower belief levels to similar statements than the average British person. Interestingly, our survey was one of the few which asked respondents to identify where they’d heard information. We deliberately did not define “official source” – and some councillors rightly pointed out that they had seen or heard what they felt (correctly) was Covid misinformation from the US president and thus felt that it was an official source.

This mixture of misinformation from official sources and from unofficial but often highly trusted sources, such as one’s own social network,can seriously undermine the efficacy of science and evidence-based communication, and hence of public health interventions. It is also likely to have long lasting implications for broader engagements between citizens and state, and to undermine our democratic institutions when misinformation is targeted on wider public policy issues or the mechanics of democracy.

The organisation Hope Not Hate specifically looked at QAnon support among the British population. (October 2020). QAnon is a three-year old conspiracy targeted at US populations and focusing particularly on smearing Democratic opponents of Donald Trump. However, it builds on older – sometimes centuries old – conspiracies such as the anti-Semitic “blood libel”, and creates a broad tent for anti-vaccination and Covid-conspiracies. Its supporters have been linked to a number of violent events in the US.  And while specific support for QAnon is relatively low in the UK, interestingly the conspiracy most likely to be believed by the councillors in our survey – that mask wearing somehow puts children at greater risk from bad actors like paedophiles – appears to have arisen from QAnon.

The infodemic muddies the water. But there is still hope: information from reliable sources spreads in the same way and as rapidly as information from unreliable sources (Nature, Oct 2020). This suggests that we can combat misinformation by providing clear, shareable, correct information. Lots of it. Ideally localised and contextualised and from a source that is consistently more trusted than central government – local government.

Europe and North America are in the grips of what is at least the second wave of the pandemic. Yet even as we descend into a dark winter of rising Covid cases, restrictions, and fears of holiday intra-household transmission, there is hope on the horizon. At the time of writing, two vaccine studies have announced very promising results, with work on others still underway. There is also every sign that early lessons on Covid treatment protocols are paying dividends in lower death rates. But to save lives over the next few months, to succeed in vanquishing the virus,  and to recover to some form of normality, governments will need to have the public onside. To do this, we must shift activities locally and fully fund trusted local governments.

Given the lack of clarity in messaging, a failure of different levels of government to speak consistently, and the presence of persistent misinformation, there are serious concerns that the vaccine light at the end of the tunnel may be darkened by vaccine refusal or poor uptake. In 2019, the World Health Organisation named vaccine hesitancy as one of the top 10 threats to global health. As the pandemic opened, we interviewed Wandsworth cabinet member Melanie Hampton about measles vaccine refusal for the LGIU podcast. The combined measles, mumps and rubella (MMR) vaccine has an incredibly high effectiveness and safety rate and has been around for almost 50 years. She was leading a local campaign on vaccine uptake, countering misinformation and trying to inject some fun and visual and emotional resonance.  Of course, the campaign was overtaken by events. But if we have to work this hard to rebuild trust for an established and effective public health intervention, what do we need to do to make sure that the public will trust a new vaccine for a new virus in a feverish environment?  While we pin hopes on vaccines to help us emerge from the pandemic, vaccine confidence has dropped precipitously in the UK and in many countries around the world. New polling (November 2020) from IPSOS-MORI finds that “three quarters (75%) of Britons agree recommended vaccines are beneficial compared to 83% in 2019.  In Italy and the US there is an even bigger downturn, with Italy down 12 percentage points to 65% and the US down 17 percentage points to 63% agreement. France continues to have low levels of support for vaccines, now down to 54% from 63% last year.”

The British Academy and Royal Society have recently published a paper (Nov 2020) which raises concerns about vaccine hesitancy and our ability to move through the pandemic. But they also offer some concrete steps for encouraging vaccine uptake. This includes having an open dialogue, countering misinformation and filling knowledge gaps, but also building on trusted local infrastructure for vaccination programmes and supporting local authorities with vaccine communication toolkits.

David Nabarro, a WHO Covid special envoy and co-director of the Institute for Global Health Innovation at Imperial College London,  and John Atkinson, a specialist in systems change working with the UN and multilateral bodies, argue that “Better, smarter, local response systems are the only way to avoid further lockdowns”. They outline a number of steps we need to take to get through the crisis, including involving the public, behaving in a trustworthy manner, and resourcing and empowering local public health teams and outbreak management.

While it is important that we have clear national and international public health messages, people take action where they live. People choose to mask, or not to mask, when they go to the local shops. People choose to stay home or act safely in local public spaces and workplaces. Ultimately, we have to encourage social distancing through social reinforcement. It is local government that reminds people how to behave responsibly through signposting and engagement in local online groups. It is the council who explains why the playground is shut and works with local businesses to become Covid safe.

Councils need to:

1. Continue to build on the trust they’ve earned, by speaking clearly and consistently – clarifying if information has changed.
2. Tailor messages to local circumstances and crowd out the harmful and misleading information, while being supported with central guidance.
3. Deliver the response to local outbreak without becoming insolvent.

Government needs to:

1. Trust local authorities and institutions.
2. Share information with local decision makers.
3. Fund local programmes and provide fiscal certainty to local government.
4. Provide communications toolkits which can be tailored to local circumstances.

We are going to need to be able to trust each other to get through this and recover on the other side. The infighting and infodemic have eroded trust. We must work together and quickly to mend the relationship between citizen and state. Local institutions have a pivotal role as in general they have the infrastructure necessary to deliver solutions, and have higher levels of trust than that placed in central government. Ensuring that this local-level trust is maintained is more vital than ever. We can get through this and work to build a new normal. Trust is at the heart of it.