Communication for Coproduction: Increasing Information Credibility to Fight the Coronavirus

Coproduction Matters for Fighting the Coronavirus

Governments and citizens need to work together to fight and win the war against the coronavirus and coproduce better health outcomes. To fight the coronavirus, governments want citizens to wash their hands often, keep a social distance (6 ft), and stay at home as quarantine. Although all of these are useful methods to contain the spread of COVID-19 (World Health Organization [WHO], 2020), none of these outcomes can be achieved without the citizens’ coproduction.

Successful public policy implementation and public service delivery both rely on citizens’ coproduction. Here, “coproduction” refers to the critical mix of activities, in which public organizations, citizens, groups, and communities work together to provide public goods and services (Brudney & England, 1983; Li, 2020). Citizens are considered not only as the consumers but also as coproducers of public services (Parks et al., 1981).

In most public service areas, coproduction is indispensable, and public health is no exception. Governments’ efforts alone cannot achieve the desired policy outcomes of public health, education, and environment. They need their citizens’ coproduction (Brudney, 1985; Brudney & England, 1983; Li, 2020; Nabatchi et al., 2017; Ostrom, 1996; Voorberg et al., 2015; Whitaker, 1980). For example, if governments want to promote a healthier lifestyle that could save medical costs, public hospital doctors have to coproduce with patients to implement dietary changes, exercise, smoking cessation, and other activities to meet health needs (Nabatchi et al., 2017).

To motivate individuals to coproduce better health outcomes, governments need to communicate essential information with them (Jennings & Hall, 2012; Thaler & Sunstein, 2008). In an ideal situation, information between governments and citizens is symmetrical, which means there is no, or a limited amount of, information costs for either party. Governments can effectively communicate policy information to citizens, and citizens will then comply with the policy and voluntarily participate in the coproduction of the policy’s outcomes as desired by both parties.

However, governments are not always successful in communicating crucial messages to the public. Information asymmetries exist between public organizations and individual citizens and influence coproduction adversely (Li, 2020). Because of the information asymmetry between the two parties, individuals may be unaware of the coproduction needs and the methods to coproduce successfully. On the other hand, public organizations may be unable to communicate with the targeted audience and motivate them to coproduce the desired policy outcomes effectively. For example, information asymmetry discourages patients to seek health care professionals’ help and disables these professionals’ understanding of patients’ needs (Palumbo, 2016). The information asymmetry can also foster distrust and thereby reduce health care services’ efficiency (Frank & Salkever, 1994).

To reduce information asymmetries and promote successful coproduction of health outcomes, we need to take effective communications between public organizations and citizens into consideration. In this article, we discuss the influence of information asymmetry on coproduction performance and how public organizations can overcome information deficits and improve coproduction. In particular, we discuss how public organizations can increase information credibility when the public distrusts governments. We argue that governments can use intermediaries, such as experts and volunteers, to increase information credibility that could reduce the degree of information asymmetry and improve coproduction.

Information Preferences Matter for Effective Communication

Effective communication is necessary for maintaining a healthy relationship and building mutual trust that facilitates coproduction. As Graber (2003) stated, “A well-functioning modern democracy requires that bureaucrats listen sympathetically and respectfully to citizens and vice versa” (p. 193). From a public administration perspective, the remaining question is: How can public organizations communicate with individual citizens effectively to promote coproduction and win the war against COVID-19?

Types of information, contents, communication frequencies, and information channels all influence the communication’s effectiveness, which further affects the coproduction performance (Li, 2020). Therefore, public organizations need to consider whether they want to deliver more or less performance information or financial information through online or off-line channels when designing communication strategies. In addition, besides individuals’ social and demographic characteristics, their heterogeneous information preferences also influence communication’s effectiveness and coproduction outcomes (Li, 2017; Li & McDougle, 2017; McDougle & Handy, 2014). Public organizations then have to take various information preferences into consideration. In an ideal situation, public organizations only need one optimal strategy to communicate with individuals if their information preference is homogeneous. However, public organizations need to design mixed strategies to satisfy individuals’ heterogeneous information preferences and thus improve communication effectiveness and coproduce better outcomes in the real world (Li, 2020).

In general, some individuals need more information than others to make their coproduction-related decisions. For example, social distancing and quarantining are effective in combating COVID-19 (WHO, 2020). Individuals with higher information preferences might seek more information about why and how these methods could be effective than their counterparts with lower information preferences. Therefore, more relevant information should be made available and accessible to individuals who have a higher information preference. We can ask another question: How can public organizations communicate most effectively with different individuals with various information preferences to fight COVID-19 or other viruses, make the world a healthier place, and achieve better coproduction results in the long run?

Li (2020) suggested that public organizations should communicate strategically to satisfy these different information needs and increase organizational performance. System 1 and System 2, which Kahneman (2013) used to describe intuitive and deliberate thinking, respectively, might contribute to the heterogeneous information preferences (Tversky & Kahneman, 1974). System 1 can apply fast intuitive thinking to a limited amount of information, so even more information could be available. However, System 2 generally requires more information to make a slow and rational decision. Li (2020) categorized individuals with different information preferences into Type I and Type II citizens (Table 1). The former mainly relies on System 1 to make decisions and seeks less and cheap information that can be consumed intuitively without excessive cognitive efforts, while the latter primely uses System 2 when making decisions and seeking more information that then requires considerable cognitive efforts to process.

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Table 1.

The Type I and Type II Citizens.

Citizen types	Decision system	Information
Type I	System 1—Fast thinking	Less and cheap information
Type II	System 2—Slow thinking	More and costly information

Note. Created by the author based on Li (2020).

A mixed strategy of communicating less and cheap information to Type I and more and costly information to Type II will help achieve an ideal information exchange equilibrium if communicating with targeted individuals is costless or at a low cost that is negligible. In this big data era, information availability is not a major concern because the marginal costs of distributing information through online platforms and cellphones are almost negligible. We predict that governments do not need to design particular strategies to communicate to Type II individuals because they will bear their own costs to actively seek and consume additional information to make better decisions about fighting the coronavirus.

As for Type I individuals, information credibility plays a more important role than information availability in their coproduction decisions of fighting COVID-19. According to Fukuyama (2020), the main determinant in performance when fighting COVID-19 will not be whether it is a democratic or autocratic regime, but the state’s capacity and, above all, trust in the government. A democracy needs to delegate discretionary authority to a strong executive branch to provide essential public services. In particular, during times of crisis, citizens’ coproduction plays a more important role in working with governments to provide public services that can meet individuals’ basic needs (Brudney, 1985; Brudney & England, 1983; Ferris, 1984; Levine, 1984).

The effectiveness of coproduction and public service provision depends on “trust” (Fledderus et al., 2014; Fukuyama, 1996, 2020). If Type I individuals trust governments, governments may not need to worry too much about communicating effectively with Type I individuals as long as they get the basic information. That information is sufficient for the Type I individuals because they do not need additional information to make their own policy compliance decisions.

Information Credibility Matters for Trusting a Government

Governments will still have to design various communication strategies when individuals distrust them. In low-trust settings, increasing information credibility will be essential in persuading individuals to voluntarily coproduce. How can governments overcome their information credibility deficit to promote coproduction in low-trust settings? Type II individuals would seek and process additional information to meet their information needs.

However, how can governments regain Type I individuals’ trust? One way to increase credibility and trustworthiness is to rely on credible intermediaries (Tsai et al., 2020). These include, but not limited to, local community leaders, professional experts, and nonprofit organizations and voluntary groups. For example, the Liberian government implemented a door-to-door canvassing campaign during the 2014–2015 Ebola epidemic to motivate individuals to increase adherence to safety precautions and support contentious control policies that were proven to be useful for containing the Ebola virus. Tsai and colleagues (2020) studied the performance of the informational campaign and found that local intermediaries were effective in helping the Liberian government persuade their fellow residents to comply with policies. The effectiveness of these local intermediaries resulted from the fact that residents perceived them as accountable and credible (Tsai et al., 2020).

We can draw some lessons from China on how the Chinese government uses experts and volunteers to increase information credibility that helps enhance the public’s trust in the government. To fight COVID-19, governments also have to overcome information credibility deficits in motivating individuals to comply with policies. Using experts’ credibility to increase the overall policy’s credibility is utilized by the Chinese government to fight COVID-19.

Before January 19, 2020, rumors about COVID-19 were widespread in Wuhan, China. Residents distrusted the local government, particularly after the authorities punished Dr. Wenliang Li, a physician who blew the whistle about the virus and then died from it (H. Zhang, 2020). Fukuyama (2020) argued that the case of Wenliang Li could be viewed as emblematic of authoritarian dysfunction. However, the Chinese government quickly restored, at least partially, its trustworthiness by allowing Dr. Nanshan Zhong, a household name in China and a hero expert who earned an international reputation in fighting SARS (severe acute respiratory syndrome) in 2002–2003, to serve as the public face of the COVID-19 fight in China (Feng, 2020).

After the Wuhan government and public health officials denied the disease’s contagiousness for weeks, Dr. Zhong confirmed on January 19 that COVID-19 could spread from human to human. On January 23, the Chinese government imposed a lockdown in Wuhan, and most residents complied with the policy because of Dr. Zhong’s warnings about the contagious virus. The Chinese government successfully increased the lockdown policy compliance by using Dr. Zhong’s credibility.

The Chinese government also increased the quarantine compliance by using the credibility of Dr. Wenhong Zhang. Dr. Zhang is a well-known doctor, the leader of the Department of Infectious Diseases at Huashan Hospital, and a standing committee member of the Infectious Disease Branch of the Chinese Medical Association. Dr. Zhang is an expert in communicating sophisticated disease information in plain language to the public and persuading them to coproduce desirable health outcomes (W. Zhang, 2020). Dr. Zhang’s advice on fighting COVID-19 by washing hands often, wearing masks, and keeping social distances was spread through social media, national television programs, and other news outlets, and his credibility was believed to have contributed to the effectiveness of containing the virus (Yan, 2020; W. Zhang, 2020). Yan (2020) reported that people were confident in trusting the useful information and advice provided by Dr. Zhang because of his matter-of-fact style and firm tone, which differentiated him from other government officials and experts who usually use obscure language. For example, one of Dr. Zhang’s most popular comments is that everyone is a soldier fighting COVID-19, even those who stay at home and feel bored as they can bore the virus to death. In Yan’s (2020) report, one interviewee claimed, “The government needs Zhang and other first-level experts to talk to media to give the general public confidence.”

In addition, voluntary groups, which are another type of intermediaries, contributed to the credibility of the Chinese government’s policies for fighting COVID-19 (Woo, 2020). For example, volunteers established a group called Anti-2,019-nCoV (A2N) to curb the spread of disinformation and rumors in tandem with the outbreak of COVID-19 in late January 2020. The A2N (2020) helped the Chinese government to distribute credible information (Chen, 2020; Woo, 2020).

What Should the U.S. Government Do?

Can the U.S. government, like the Chinese government, increase citizens’ trust by using credible intermediaries? Currently, the U.S. government faces a crisis of trust. Individuals’ trust in the U.S. government is relatively low and declining (Rainie & Perrin, 2019). Fukuyama (2020) argued that trust in governments has two foundations: First, individuals believe in public professionals’ expertise, technical knowledge, and accountability; and second, individuals have confidence in their leaders in the United States, including the president.

Dr. Richard Besser, a former Centers for Disease Control and Prevention (CDC) director and an Epidemic Intelligence Service (EIS) alumnus, worried that the inconsistent messages from the president might confuse people and distance them from trusting in governments (Duhigg, 2020). For example, after suggesting on April 24 that injecting disinfectants into human bodies would kill COVID-19, President Trump claimed 3 days later that he was being sarcastic and is not taking responsibility for people ingesting disinfectants (O’Connor, 2020). Such irresponsibility from a leader is distracting in the best of times and dangerous in a pandemic.

Trust in governments becomes worse when the president distrusts the administrative experts who do not actively support him and denigrates public agencies that he feels are hostile (Fukuyama, 2020). Trump’s assault on public agencies and experts began long before the COVID-19 pandemic and weakened the federal bureaucracy and resulted in paper-thin policymaking competence. According to Acemoglu (2020), bureaucrats are getting accustomed to praising, agreeing with, and taking orders from the president rather than using their expertise to solve urgent problems such as fighting COVID-19. Even Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, has admitted, “You don’t want to go to war with a president” (Owermohle, 2020). The top leader’s discrediting and attacking expertise and bureaucracy causes administrative decay and thus further decreases public trust.

This low-trust setting brings additional challenges to governments in coproducing with citizens to fight COVID-19. For example, Michigan Governor Gretchen Whitmer (2020) issued the “stay-at-home” order to contain the virus. However, protesters gathered in Lansing, under the encouragement of President Trump, to discredit “the woman in Michigan” by opposing the order and clearly ignoring the information about social distancing and wearing masks (Gabriel & Martin, 2020). The political polarization and America’s deepening tribalism leaves slim opportunities in restoring the public’s trust (Fukuyama, 2020).

However, as Dr. Martin Luther King Jr. said, “We must accept finite disappointment, but never lose infinite hope.” And the hope of winning the war against COVID-19 is rooted in the American democracy. In particular, federalism and voluntary association could engage credible intermediaries to enhance information credibility, which would help fight the virus.

The “executive federalism theory” suggests that administrative discretion increasingly shapes the relationship between state and local governments and the federal government (Thompson, 2013). Such executive federalism allows state and local governments to treat scientists differently from the president.

For example, Seattle’s leaders let scientists take the lead in fighting COVID-19, and Seattle seems to have more successfully contain the virus than many other cities such as New York City (Duhigg, 2020). A group of epidemiologists, who are alumni of the CDC’s EIS Program, increase the credibility of Seattle’s combating COVID-19 policies. The EIS views a pandemic as a communications emergency as much as a medical crisis and epidemiology as a science of possibilities and persuasion, not of certainties or hard proof (CDC, 2018).

According to the CDC’s Field Epidemiology Manual (Rasmussen & Goodman, 2018), communication is crucial during a health emergency. The CDC’s Field Epidemiology Manual also suggests that there should be one lead spokesperson who communicates with the public and builds trust with them. The manual even suggests that the lead spokesperson should be a scientist who could avoid being caught by partisanship like a politician and demonstrate his or her advice ostentatiously. In addition, the message delivered by the spokesperson should be consistent. Epidemiologists have to use their credibility to persuade individuals to upend their lives, such as by forgoing travel and keep social distancing, even with scant evidence of risk.

Voluntary association, which is the foundation of the American democracy (de Tocqueville, 2000), can contribute to information credibility as well. For example, amid the pandemic, information overload is common among Chinese communities in the United States because of their bilingual advantage and information about what happened in China. Rumors, conspiracy theories, inaccurate advice, and unsupported suggestions about fighting the virus are overwhelming. The Chinese Association of West Michigan (2020) provides reliable information from credible sources to help clarify misinformation and help the Chinese communities comply with the policies in Michigan.

Another group of volunteer scholars in the Johns Hopkins Coronavirus Resource Center (2020) helps to advance understanding of the virus, inform the public, and brief policy makers to guide a response, improve care, and save lives. Its COVID-19 Dashboard provides timely updates of confirmed cases, total death, recovered cases, active and inactive cases, case-fatality ratio, and U.S. testing rate and is widely recognized and used (Dong et al., 2020). They created the COVID-19 Dashboard by using big data from various sources and visualized them in an interactive map. The Johns Hopkins group significantly improves the timeliness and quality of data, which contribute to the credibility of information, the effectiveness of communication, the public trust, and the performance of fighting COVID-19.

Kettl (2018) realized that information is asymmetric between policy makers and experts because scholars do not provide the necessary information, and decision makers are unable to understand the scholarly information and unwilling to use such information. He suggested that scholars can use big data analysis to tell the right stories and sell them to decision makers. Doing so can reduce the degree of information asymmetry and thus improve the coproduction of better policy outcomes (Kettl, 2018; Li, 2019). However, scholars usually are not very good at telling and selling their findings because they are unable and unwilling to communicate information with decision makers and the public. Dong and colleagues (2020) set a role model for what experts can do to help win the war against the COVID-19. For decision makers within governments, they need to think about how to nudge experts to contribute their shares in coproduction, just like what leaders in Seattle city did: Let the scientists take the lead in combating COVID-19.

In summary, the U.S. government can use experts and volunteers as intermediaries to increase information credibility and public trust and thus improve coproduction. This is a war against the coronavirus. Working together is the only way to save lives and secure a better future.