Virtual Roundtable: The Role of Trust in Pandemic Preparedness

Thursday, March 24, 2022
Kevin Frayer/Getty Images
Margaret Levi

Sara Miller McCune Director of the Center for Advanced Study in the Behavioral Sciences (CASBS) and Professor of Political Science, Stanford University

Michael Bang Petersen

Professor of Political Science, Aarhus University


Senior Fellow for Global Health, Economics, and Development, Council on Foreign Relations

Numerous research studies point to the outsized role that trust has played in the COVID-19 pandemic. Public compliance with expert recommendations for social distancing, mask wearing, school closures, and vaccinations have been linked to the perceived trustworthiness of government, its agencies, and other citizens. In this Council on Foreign Relations roundtable, Dr. Margaret Levi and Dr. Michael Bang Petersen discuss the role of trust in current and future COVID-19 crisis response and what governments can do to build trust before the next health emergency emerges—as it inevitably will.

THOMAS BOLLYKY: Good afternoon, everyone. Thanks so much for coming. I’m Tom Bollyky, the director of the Global Health program at the Council on Foreign Relations. Thank you for your patience in starting this session.


So, the COVID-19 pandemic has brought upon us an extraordinary situation—a crisis responsible for as many as eighteen million deaths and for throwing lives, societies, and economies all around the world into tumult. While this health crisis has largely been reported and understood from biological and epidemiological viewpoints, the social sciences have offered as much or, in some cases, greater insights. Research in political science, anthropology, and behavioral sciences has been on the forefront of helping us to understand public adoption of protective health behaviors, including vaccination, risk communication, and the drivers of political decision-making. Social sciences will continue to be relevant in understanding how to manage this pandemic moving forward, to rebuild after this crisis, and to better prepare us for the next pandemic threat. Ultimately, the most important lessons we will learn in this pandemic are less about the coronavirus itself, and more about what this microscopic organism has revealed about the political systems and societies that respond to it. History suggests those are the lessons we need to heed. It is time we accept that and better integrate social sciences and its researchers into pandemic prevention, detection, and response.


Today, we’re going to talk about a particular area of social and behavioral research: the role that trust plays in motivating and mobilizing citizens to act and comply with government and expert guidance. We are enormously fortunate with our speakers today. They are both well accomplished and have the lengthy biographies to match. In the interest of time, I’m going to ruthlessly truncate those biographies down to their titles and urge you to read the longer versions in your meeting packet.


Margaret Levi is to Sara Miller McCune Director of the Center for Advanced Study in the Behavioral Sciences and a professor of political science at Stanford University. When I began working on the role of trust several years ago, literally the first name on the list of everyone with whom I spoke was Margaret. For several decades, Margaret has been writing and researching the conditions under which people come to believe their government and its policies are legitimate, and the consequences of those beliefs for compliance, consent, and the rule of law.


Michael Bang Petersen is a professor of political science at Aarhus University in Denmark and a principal investigator on a large behavioral COVID-19 research project, the HOPE project, which has collected research in Denmark and many other European nations. He and his colleagues have been extraordinarily prolific in this pandemic, and if you’ve read about the role of trust in the COVID-19 crisis, there’s a good chance you learned about it from Michael.


My plan is to start asking Margaret a few questions on trust and its measurement and its role in promoting public compliance and cooperation with government policies generally. I will then turn to Michael and ask him a few questions about the role that trust has played in the COVID-19 pandemic, in particular. After that, I’m going to draw them both into a conversation about how we incorporate those insights into future pandemic preparedness. We’re going to try to leave twenty or thirty minutes for Q&A, of course, with the audience, and as was mentioned at the outset, this session is on the record. And with that, let me start with Margaret. Margaret, how do you define trust? And how do we measure it?


MARGARET LEVI: So, I think the place to start here—and thank you, Thomas, for including me in this discussion. I think the place to start here is not to think about trust, per se, but to think about trustworthiness. So, my focus is really on what makes a government trustworthy, and my focus is on several characteristics of that government: its fairness as measured by the standards of the day; its capacities and competence to actually deliver on what it promises; and its ability to ensure that those who free ride actually can’t free ride. So, it gives some confidence that it’s actually going to deliver on its promises. Now, perceptions of trustworthiness vary. They vary immensely and are partially captured by surveys. But I’m much more interested in behavior about when people comply and when they behaviorally consent. COVID, of course has given us, unfortunately, an immense opportunity as social scientists to study those things. So, when I look at these questions, I tend to not look so much at the surveys, but at the behavior. So, when we’re thinking about the COVID epidemic—and who masks, who doesn’t mask, who’s willing to get vaccinated, who’s not willing to get vaccinated, and why—we see immense variation, of course, that we can measure by actual behavior in terms of who is willing to go along with government mandates, or even requests, and who is not. And we have a lot of information about why that is: why people either don’t have confidence in government, or don’t have confidence in the messenger that government is providing, or in the science. And so that’s how I think about trust and trustworthiness in this particular domain.


BOLLYKY: Great. So, you mentioned compliance, and when it occurs with government guidance, and you alluded to COVID-19. I’m going to put those off to the side for a minute, and ask you what other behaviors are seen to be good proxies of trustworthiness in terms of compliance, and what you see in terms of consistency across those behaviors. Do we see compliance rates being similar for the other kinds of behaviors that you've researched, and with what we’re seeing in terms of public health?


LEVI: Well, as you know, most of my research has been across long swaths of history, looking at things like extractive demands of government, whether it be taxes or whether it be military service. I’m going to use the military service example, which I studied in five democracies over two hundred years, when people were willing to—young men, for the most part, were willing to volunteer for military service when their country declared a war and when they were willing to comply with conscription, a mandated government requirement, and when they weren’t. And there was huge consistency in that groups within the polity who felt that government had not kept its obligations to them were unwilling to go along with government’s request for either volunteering or conscription. They voted against it, they resisted it in various ways—if they felt the government was not meeting its own standards, even if they had been treated well. The Vietnam War is an example of that. Then they were unwilling to comply and engaged in all kinds of practices, whether it was direct resistance to conscription—in Australia, New Zealand, the United States, France—or whether it was engaging in some form of trying to get out of the military, either through conscientious objection or through using the medical system in some way. Now, there were clearly people who were trying to free ride using those things, and those were largely caught. But there were also people who were using those mechanisms as a way to show their objection to government extractions.


BOLLYKY: Great. One question I often get is: is it valid to think about notions of trust or trustworthiness in autocracies? You mentioned a fair bit around democracies. Do you think differently about the role of trustworthiness in autocracies and its measurement?


LEVI: Yes and no. So, I think all governments in order to be obeyed, need a certain level of what I’ve called quasi-voluntary compliance: some willingness to comply with government extractions, even to consent with them. And that’s autocracies. I mean, when I looked at tax extraction, for example, I looked at autocracies as well as democracies. People had to feel largely that they were getting something that they expected from the autocracy. And of course, there’s a huge variation in autocracies. But democracies are different in that one, there is a more explicit social contract between government and citizens, and one that constantly is being renegotiated; the standards of fairness change; the notions of due process change; and there’s also what we expect in a democracy is a healthy dose of skepticism that people will ask questions and challenge government about the obligations that it’s extracting from them.


So, I think we need to balance you know, where people feel government is trustworthy, and where they are healthily skeptical, which is going to be a feature of democracies and not a feature of autocracies. One other thing to keep in mind is that there are multiple domains in which government asks for compliance. And those vary immensely. They can vary across within the polity, across different groups. And they can vary over history and over time and over place. If you look at the World Justice Project, rule of law index, for example. Look at the United States. The U.S. citizens, as a whole may find government objectively trustworthy about one kind of domain, but not about another. We’re terrible, for example, on incarceration of people. There’s a good reason to feel that we don’t owe government a lot of confidence, or consider it trustworthy, in that domain where we may in others.


BOLLYKY: Great, let me draw in Michael, and then I want to link these two conversations. So Michael, you’ve been leading a large research project looking into trust as well as other areas of behavior. It is in Europe and, of course, in Denmark in particular. So to link it to our autocracy conversation, these are famously democratic countries with, in some cases, cradle-to-the-grave health-care systems. What are you learning about trust, and why do you think those results are generalizable beyond those countries?


MICHAEL BANG PETERSEN: So, I think the pandemic has been a real world example of the importance of trust. And just to take one step back then, if we look at how it was that that the experts out there were expecting countries to react if there came a pandemic, then there was a ranking of different countries that was published in November 2019. So, just before COVID hit. And the prediction from that was that the best prepared country in the world was the United States, and that the United States was the country that would engage most rapidly in the protection of its citizens during a pandemic.


But I think one of the things that these analysis missed was exactly the role of trust and how critical trust between citizens and the state—and vice versa—is to create collective action. So, what we can see in the research that we have doing—and we have been doing that in Denmark, but we have also been doing that in the United States—is that trust is critical for the motivation to engage in social distancing, for the motivation to get vaccinated. And that’s the case, both in Denmark and also in the United States—that in both countries, we can see that it’s those people who trust the authorities who are most likely to comply with the recommendations from them.


BOLLYKY: Great. Can you tell us a little bit about—Margaret talked a bit about survey data and its use versus other indicators of compliance and trustworthiness. How are you measuring trust, and what sources are you drawing on for that?


PETERSEN: Yeah, so we have been using essentially—in the project, we have been using all the toolkits in the social science toolbox. We have had ethnographic methods, people out doing field observations, we have been using a lot of behavioral data in terms of mobility data, we have been scraping social media data, but we have also been collecting huge amounts of survey data. And one of the reasons why we have done that is that the idea of the project was to get into the field and essentially track what was going on in the public. And that in order to understand what goes on in the pandemic or in the epidemic, you need to get good numbers on what people do. Do people support what is going on? Because it is really the behavior of the people now that is affecting the epidemic curve in fourteen days. And surveys are helpful there because you can repeat them over and over and over again. So, we have been repeating surveys daily in Denmark since May 2020, and we’’ll just stop that daily data collection this week. So, we have collected interviews with over four hundred, or almost four hundred thousand Danes. So, we’re using surveys because it does enable this sort of careful monitoring of what goes on. Of course, there are issues with reporting biases when it comes to behavior, especially in surveys, but they do allow us to measure psychological constructs such as trust, for example.


BOLLYKY: That’s helpful. So I’d love to hear, since you’ve been collecting these surveys so regularly over time in multiple countries, can you talk a little bit about how trust has changed over the course of this pandemic? And does that change manifests differently with different protective behaviors? For instance, are people less particularly less trusting of vaccination, or particularly less willing to comply with social distancing? Does it differ at all across public health behaviors?


PETERSEN: So, one of the things that we’re seeing in the data that we are collecting is—and that’s perhaps the most tragic part of it all—is that the pandemic has demonstrated the importance of trust, but what we can also see in the data, is that trust has been going down over the pandemic. So, that is the case also in in Denmark: that people put less trust in the political system today than they did at the start of the pandemic. And it seems to be that restrictions, severe restrictions, especially in situations where the pandemic is not very severe, is something that generates these feelings of fatigue, and that has an effect of decreasing trust. So, people are, in general, at least in high trust places, they are ready to engage in distancing, they’re ready to get vaccinated if they see that right now there is a crisis, now we need to do something. But they begin to feel the burden of the restrictions when the crisis, the sense of urgency, is less.


Social distancing is a way more adaptive behavior than many of the other types of behaviors. So, social distancing is going up and down with the level of the felt threat. We can see that it seems like masking is much less adaptive in most places. Denmark seems to be an outlier here because the Danish people, they put on the masks happily when the authorities are saying now we need to do it, but they also take it off just as happily in the very second that the mandates are being lifted. But outside of Denmark, it seems that that masking is something that lasts longer. And vaccinations, of course, that is something that when you are vaccinated, then you are vaccinated. But we are seeing declining tendencies to accept the booster vaccines, like for each time you get a new offer.


BOLLYKY: Great. Just one more question for you, and then I’m going to try to pull you both in. One aspect of your research that I found really interesting is that in addition to looking at the relationship between the citizenry, or the public, and its government, you look at different indicators of relationships among citizens. So, I have noted your papers on empathy, as well as solidarity as it may link to nationalism. And I’m wondering what you’re finding in terms of that research in terms of the connection among citizens, leaving aside their connection with government and what role that’s played in an effective response to this pandemic?


PETERSEN: Yeah, so I think trust in your fellow citizens in the sense that you feel solidarity with fellow citizens is really critical during the COVID pandemic. And I think the main reason why that’s the case is because COVID has such a skewed risk profile. So, if you’re a young healthy person, then you are mostly fine. But if you’re an elderly person, then that’s not the case. So, that means that in order to mobilize the general public, you really need the young, healthy people to have solidarity with the older, vulnerable members of society. And that’s why things like empathy become hugely important in this pandemic, but also why things like national identity—that you really feel that you are in the same boat—has been shown in the research that I’ve been participating in, to be to be pretty important to also explain why it is that some countries engage in more distancing than other countries.


BOLLYKY: Great. And I wanted to pull you in on this point, Margaret.  In terms of trust among citizens, or the role of solidarity and how it relates to trustworthiness of the government, if at all,  what is your sense of those linkages?


LEVI: Well, I think it’s very important. I’ve developed a concept with others on an expanded community of fate. And you would have thought that—“fate” not “fake”—you would have thought that COVID would, in fact, evoke that. In a country like the United States, it did not. In fact, it revealed the divisions among people. And I’m not sure it was so much about whether they trusted each other, but the variations in the differences in ways in which they have confidence in government, and in science, and in experts.


So one of the things that we can see in the data in the United States, both behavioral and the survey data—and I love what Michael’s been doing about combining all of those, because I think that’s absolutely essential, and his work is path-breaking in this regard—but there are people who’ve been studying, like the COVID-19 project in the United States, which have been looking at the variations in the vaccinated, the unvaccinated, the masked, the unmasked, and not surprisingly, we’re seeing differences that revealed the differences that exist in the United States. And what determines whether people are likely to change their behavior if they’ve chosen not to be masked or to be vaccinated is there’s a huge proportion of that population which is uncertain, as opposed to convinced. There’s about 18 percent or so—less than that—a very small percentage of the U.S. population is absolutely against masking, social distancing, or vaccination. But there’s a significant percentage which was persuadable. And that really depended on overcoming past histories of bad government behavior towards them.


So, we know the case of African Americans who because of the Tuskegee experiments, were very distrustful of unproven vaccines. There were lots of people who were uncertain; they weren’t, you know, they couldn’t afford to go get the vaccine. I don’t mean that the vaccine—the vaccine was free—but they had to take time off from work that was not necessarily provided. So, once you mandate the vaccine, people who weren’t sure, do it, as opposed to opposed. So, I think we really have to parse the population here, and it isn’t just about citizens feeling good about each other that actually helps. But it’s also how the messages are being provided, recognizing that there are different parts of the population with different access to communication, to information, with different kinds of messengers needed: local doctors, local physicians, local pastors, local government officials. And then there’s the partisan divide, which we see all over the world, but which has become particularly intense, among other places, in the United States. And so you can have Republicans giving messages to Democrats, and Democrats giving messages to Republicans. You really have to pay attention to what different parts of the population can hear, will be reassured about, and are hearing at all. There are communication deserts, still, in a place even as sophisticated in technology as the United States.


BOLLYKY: Great. Well, you’ve anticipated our move to “What does one do about this?” by talking about some of those strategies now. But before—


LEVI: Sorry.


BOLLYKY: No, no, it's good. I want to ask one question, just so people can think about what this means for the future, which is: how generalizable do you view society’s experiences with COVID-19? With a more virulent virus in the future—one that causes more devastating health impacts—is there any reason to think that in a future pandemic societies would behave differently than they’ve done around COVID-19? And after we talk about that, then I’ll start to ask you about some of the strategies we might employ. But how generalizable is COVID-19?


LEVI: Well, I think it’s generalizable, but I think we need to be careful. We know from the history not only of this vaccine in this disease, but of others. So, let me let me give another historical example, which is Prerna Singh’s work and others’, Larry Blake’s work on the smallpox vaccine. And when that was introduced in China and in India, for example, in the nineteenth century, early twentieth century, there were totally different responses. So, the British in India were the deliverers of the vaccine, and they were seen as the colonizers and to be totally distrusted. And there was not messaging that was really focused in a way that the Indian population could hear and feel trustworthy. Totally different way dealing with it in China, which connected the vaccine to various forms of Chinese health practices and acupuncture and things like that.


So, we’ve learned from various vaccines that the messenger matters and the way the message is given. But we also know that there are forms of distrust that are very deep in a polity, that need more than that, that we can’t just assume that because we’ve gotten more competent, that the disease is more virulent. I can’t think of a more virulent disease than smallpox. And yet the virulence wasn’t what mattered. What we really have to take away is convincing people. And one of the things that Michael said that I thought was really interesting and we should investigate, is why trust in government went down. And that’s because in a vaccine in a disease like COVID and where science isn’t certain and never will be, the competence of government seems to decrease rather than increase from the perception of the public. And that will continue to happen with diseases, I think, because science can’t keep up with the bacteria, with the viruses.


BOLLYKY: Great. Michael, let me draw you in here. I mean, Margaret raises a great point. We think of Denmark as doing reasonably well. Obviously, there are lots of inquiries about the latest transition that was made in Denmark and how well it was handled, and you’re welcome to talk a bit about that. But it’s somewhat disheartening to think that despite, comparatively to other nations, a fairly good performance in this pandemic, that trust has declined in government in Denmark, nevertheless. So I’d love to hear a bit what we should draw from that. But from your perspective, how generalizable is the COVID experience for potential future pandemics?


PETERSEN: I think it’s very generalizable because even if we’re facing a more virulent disease in the future, then I think what is important to remember is that in order to engage in an effective response, then first of all, you need to worry about the threat you are facing. But you also need to trust the solutions that you are offered to watch that threat. And so even if you increase the threat, even if you increase the virulence of the disease that we are facing, then if you don’t trust the solutions you are offered, then it doesn’t actually make a difference. You could say that things can go even more wrong with a more virulent threat because people have an even stronger impulse to react, and then they’ll just begin to look for the misinformation. They will begin to come up with their own ideas. So, the way that I think about it, and maybe this sounds terrible, but we got a, in some ways, a trial run of, of how things could be with COVID, and we should just be very, very happy that it wasn’t worse because the next pandemic may be even more lethal, and then we’ll be in real trouble.


BOLLYKY: Absolutely. So you mentioned before—and this will be a question for both of you—you compared the index that was put together in 2019, which is a benchmarking exercise to look at what capabilities governments had across a number have different areas that research had suggested or were believed to likely be significant in a pandemic. And you say that these pandemic preparedness metrics didn’t incorporate trust sufficiently. So, we have now this terrible social science experience of this pandemic and seeing how governments have done. If you have indications of having low trust in government or low trust, or solidarity, in one another, how should that be incorporated in thinking about future pandemic preparedness? And is it different for nations that have struggled in this pandemic versus other ones? Or are the lessons more universal about what people should do, or government should do with regard to trust?


PETERSEN: Should I start?


BOLLYKY: Sure, why don’t you start.


LEVI: Go ahead, Michael.


PETERSEN: Well, so I think what we’re being reminded of here is, first of all, trust can easily be lost. And we can see some of that in the data that we’ve been collecting. So we’ve been collecting data in Denmark and Sweden, which are both traditionally high trust countries. But we saw a low trust in the health authorities in Sweden, which I assume reflects initial failings of protecting the elderly, in the Swedish context. So even if you’re high trust place, then if you make mistakes, that will entail that you lose trust. But also that it’s very difficult to build trust during a crisis. So, it’s really something we need to invest in peacetime so that we have the resource for when things go bad. And if you are in a situation where you have a citizenry that doesn’t really trust the state, then I think that—well, Margaret’s point is extremely important—in order to have someone trust you, then you need to act in a trustworthy manner. So, when it comes to the relationship between citizens and the state, there’s only one actor that can make the first move, and that is the state by acting in a trustworthy manner, have solid institutions, have credible institutions, and thereby earn the trust of citizens. And of course, that’s way easier said than done, but I think this pandemic has reminded us of how important it is to focus on this long term building of trust.


BOLLYKY: Great, Margaret, your thoughts?


LEVI: Yeah, I agree with that. I just will add a few things to that. One is what we’ve learned—and Denmark is a good example of this, but even the United States is—that even if the government is objectively trustworthy by most of the measures we use for that, it’s not always perceived as trustworthy. So it is important to be constantly building confidence in the government, measured sometimes attitudinally as trust in government.


But it’s not just government, it’s also science. And that’s a different problem because science by its very nature is constantly contradicting itself. It has to in order to learn, and to progress, it has to try things, experiment, find a different solution. And that is a process that for many people undermines the trust in science, particularly when you add a skepticism about expertise used by government, through various wars, through various pandemics, through other things where the expertise has not always been trustworthy, as it turns out. So, we have that problem.


I do think that crises can build solidarity. We certainly see that during many wars—not all of them, sometimes they break it up, rather than create it. It should have been possible under the conditions of something like a pandemic. And we have seen in past pandemics, that it does create solidarity, at least among some groups. So, I think we really need to use this awful experience to think about new kinds of ways to be building confidence in government, confidence in science, and some notion that we’re in a shared community fate, which an awful lot of people in my country particularly, but others as well, did not experience. And I think that government bears some responsibility for that, not just social media and disinformation, not just particular partisan politicians. We have to find better ways of messaging, of making people aware that they are in a common crisis.


BOLLYKY: Great. I have a million questions. I find trust and this body of research fascinating. But I am being selfish by not turning it over to members of the audience to get a chance to ask some questions. So, I would ask that you do that, you identify yourself when you ask a question, and you keep that question short and make it sound like a question. So please, let’s start with Chris Collins.


CHRIS COLLINS: Hi, thank you very much. My name is Chris Collins. I’m with Friends of the Global Fight Against AIDS, TB, and Malaria. It’s fascinating research. Thank you for this. I wanted to ask: what then are implications for U.S. global health investment? What do we need to do through our global health programming that can get at this trust factor? Thank you.


LEVI: Well, part of it is, you know, making commitments and keeping them to others—since it’s global, and it is a global problem—to other parts of the world. I mean, I can see why there was a loss of trust and confidence in the United States and its commitments early on in the pandemic, when so much of the purchasing of the vaccines and other things were done by the United States in a way that really excluded even some of our closest friends like Australia, let alone some of the countries that were going to be most needy, because of poor health facilities, of vaccines and other kinds of material. So, I think we need to, governments need to make clear their commitments and honor them, and that was not the case, particularly early on in the pandemic.


BOLLYKY: Michael?


PETERSEN: Yeah, if I can add to that, or sort of take that a slightly different way, then I think one important thing is also to perch authority offices for certain ideas. And I think political scientists, especially the political scientists in like behavioral research, have been promoting the idea of citizens as not really being capable of much rational thinking. They don’t really know much about politics, they are really not reasonable, but are just influenced by emotions. I think behavioral economics have been pushing the same kind of portrayal of citizens. They are lazy. They constantly need to be nudged, they cannot really think for themselves. And I think those kind of images of the citizens are doing more harm than good in public offices because it motivates public officials to not really tell the complex truth and the unpleasant truth. And I think essentially a commitment to being transparent about the good, the good news and the bad news, to reveal the complexity of the decisions that you are facing as a public authority—I think those things are critical. So, I think we need—so one of the things, at least, that I’ve been mostly concerned about whenever I’ve seen that pop up is this idea of the panic prone public, and I see it pop up all the time in government offices.


BOLLYKY: Great. So, we have two questions in the queue. I should have said this from the outset. My colleague Julissa was nice enough to put the instruction in the chat. Please do press the raise hand function on the bottom of your screen there to ask a question. And with that, I will turn to our next questioner, Ambassador Rowe.


LESLIE ROWE: Thank you very much for the opportunity. I should start just by saying that I worked on HIV and AIDS in three countries during my career, and I have a great deal of respect for my colleagues and CDC. They were the best public servants I think I ever worked with. But I did want to raise the issue of masking in the United States, which was a real issue at the beginning of the pandemic.


And if I remember correctly, our health authorities on the national level did not recommend wearing masks. And it took until I think at least April before that was reversed. And I’ve read that, in fact, there were good reasons for this: there was a shortage of masks, they were trying to reserve them for public health officials. But in any case, I happened to do a telehealth call with my doctor during that period, and I mentioned how much I respected CDC. And she said, “Oh, well, I’ve completely lost trust in CDC because of the mask issue. People should be wearing masks.” And I was a bit surprised at that reaction. But if this was coming from one health-care professional, I have a feeling that there were a number of others in the United States that were also being rather skeptical of the advice. And if they were sharing it with other patients, then it would lead to a problem in terms of trust right at the beginning of the epidemic.


And I read recently, actually thinking about this particular session, that, you know, some of the countries—New Zealand, Taiwan—did things very differently. And that Taiwan very early on, developed digital communication, got the word out to, you know, be able to order masks. The public could order masks. They had a map in which they showed pharmacies that had masks—a completely different reaction than what we had in the United States. And as a result, I think that their trust level is much higher, and they were more successful with the public.


So, to me, it kind of comes right down to the issue of telling the truth. If we want the government to be perceived as trustworthy, then we’ve got to be truthful. And I guess my question is, you know, with a lack of transparency that we had at the beginning of the pandemic, I think it was very difficult to turn that around among a number of people. But how do we face this in the future when we’re caught off guard, even though our stellar health professionals like Tony Fauci have said. You know, every president, he says, “You're going to have a pandemic.” But how do we face this when we’re caught off guard, we don’t have enough masks, and we lose the faith of the public early on? How do we combat that?


LEVI: I think the example of Taiwan is excellent here. They did a remarkable job. And, you know, the supply of masks was one of the problems. I do think that Michael was right in emphasizing the importance—and you, Ambassador Rowe—in emphasizing the importance of transparency here, or at least honest presentation of the issues. What Taiwan did was an incredible amount of digital communication. So, it wasn’t just the provision of good information and math. Remember, not only do they have the digital czar in Audrey Tang, who was very excellent at this work, but they also have a deputy prime minister who’s an epidemiologist. So, they were able to present evidence and arguments well, which we did not do as well. Our messaging and communication was not so good. So, we can learn from that.


In terms of the provision of masks when there’s an undersupply, there’s a solution to that, which could have been utilized and was in some communities, where people thought they needed masks, they made them, and they had communities of people who were making cloth masks, which as far as we knew at that time would offer some protection. The issue was to ensure that the high-grade medical masks were preserved for medical personnel. That could have been managed while still encouraging other kinds of masks to be made available. It’s not that hard. And in fact, my cousins were doing it, were putting together masks made out of old fabric that were doubles, and created communities of people who were trying to help other people gain protection.


So there were multiple strategies there that I think we can learn from looking at what other countries have done, like Taiwan, and trying to emulate some of their practices. And look at believing, as Michael was suggesting, in our citizens to come up with solutions to problems if offered a problem that had to be solved.


BOLLYKY: Right. Michael, as you know, the U.S. CDC wasn’t the only one to be slow in recommending mass. WHO also delayed recommending masks. And I was wondering for your perspective, looking at the mask use internationally, whether you have anything to add on this issue?


PETERSEN: Well, I think Denmark was probably one of the slowest countries in the world, besides Sweden, to adopt masks. So, this is definitely something that’s familiar to me. And I think what the Danish authorities did, which was good in this communication context, was that they went out and said, “We made a mistake.” So, they were sort of transparent about saying, “Well, we made a mistake. We learned from the evidence. Now we think you should use masks.” And I think what we have learned from this pandemic is that this is such a long crisis, and given that you have such a long crisis, then whenever you do some kind of strategic communication for short term gain, then it will come out eventually—whether it’s about the masks, whether it’s about vaccines, or so on. So it’s really, really important to stick with the truth from the beginning, even if it’s something that you don’t really want to say or get out.


BOLLYKY: Great. Thank you, Michael. Prerna, you’re next.




PRERNA SINGH: Thank you so much. Thank you so much for this. These are people all of whose work I’ve admired. Michael, I’ve been reading your work. Of course, Margaret, I know yours, and thank you for the shout out.


So I had a question, which really, in a sense, builds on both of your research and in particular on your comments. And I think what troubles me when we think of, you know, what is to be done for the future--prefacing, I teach at Brown University in political science and also in public health—is the kind of fleetingness and the capriciousness of trust in the way that Michael’s surveys have captured. And that’s why I am inclined to use Margaret’s term trustworthiness. But then, as Margaret said, there’s also this gap between, you know, objective trustworthiness, if we can use that term, and the perception of trustworthiness.


And so when I think on the one hand of these kinds of dips and of, you know, again, what I say the fleetingness, the unreliability of trust is, you know, it changes so quickly. And also this gap between, you know, states are doing the things they should be doing, we think they’re trustworthy, and yet there is this gap in perception. And then it makes me think. So, okay. So, now when we think, given these two things, about how do we go forward from this, I think it’s clear, as Michael said and Margaret as well, that we have to build something that is independent of and prior to the next pandemic because the pandemic will happen. Viruses evolve.


As Margaret mentioned, my research has been on the world’s first vaccine, which was against a far more virulent disease, which was smallpox. But this gets me to this idea that Margaret has really pioneered—this kind of idea of the community of faith. But I think it links to Michael’s—I thought—quite provocative article about the importance of nationalism and solidarity, which is also where my work has been focused. And so I wonder, what is the relationship between trust and kind of this generation of a community of faith and nationalism and solidarity, particularly given polarization in the United States? Are the two the same? Are they distinct? And I guess, again, in the vein of being more provocative, given just how capricious trust is, should we be putting our energies in terms of thinking about how to build trust? Or rather, should we be trying to kind of build what I think is a deeper sense, which is one of obligation? And maybe the obligation comes from trying to construct a shared identity?


BOLLYKY: Prerna, I’m sorry I don’t mean to interrupt you, but we have two more questioners, and only six minutes left, so I want to make sure we can get to everyone. In fact, I’m going to table that question, write it down, because I’m going to take a second question in the hopes that we can reach everyone. Chip, do you want to ask your question next?


CHIP PITTS: Sure. Thank you, Tom, and thank you to our expert presenters in their wisdom. My question is about—it’s related to the prior question and what Michael said about, you know, behavioral science and behavioral economics. I’m actually less sanguine about the, you know, the role of facts, and given the backfire effect and the information deficit model—and I’m thinking here about climate change and the effect of polarization and perceptions of that—I’m not sure that just better government communication could solve the problem. Margaret, I invite you to opine on this as well. My own teaching about climate change, corporate responsibility and, and so forth, it’s clearly clear that we’re running up against obstacles. That’s also apparent in other context, dependent on evidence, including the misinformation and disinformation—like the Russian invasion of Ukraine. So, please respond to the backfire effect and the motivated reasoning, obstacles to understanding and action.


BOLLYKY: Great, these are very large questions, but hopefully that gives you both something to work with. Margaret, why don’t we start with you?


LEVI: Well, these are excellent questions. And I, you know, I don’t want to rely on building trust. I do think that it is important to create a sense of obligation amongst people. And when I talk about an expanded and inclusive community of faith, I don’t think it is just within one country. And I think a pandemic reveals to us how important it is to have that expanded and inclusive community of faith create, encompass multiple polities and multiple actors.


In terms of the motivated reasoning, and the question about facts—excuse me, a lot of noise going on outside of here. Sounds like a fire truck. I think that’s a really important question. And I, so I go back to: one of the building blocks here is building a trustworthy government objectively, and then dealing with citizens in a way that respects them, that allows the challenge to occur in a setting where challenge is acceptable. And I’ve done a lot of research about ways in which motivated reasoning can be changed, given certain kinds of structures of discussion and debate and obligation, that allow people to raise their concerns and then object to them and then learn more. So, I’m going to stop there and give Michael time because I know we’re running out of time.


BOLLYKY: Great, Michael.


PETERSEN: Yes. So, I will try to do this quickly. I don’t think that trust and nationalism is the same. I think nationalism may be one route to also have some kind of trust in each other. But I think the more sensible route is through the building of good institutions, and then you are able to have a trusting community, even without strong national identity or at least nationalistic identity. I think it’s—the point about motivated reasoning is an important one. I think it doesn’t—you cannot just fix these things with good communication. You really need to, in the end, deal with the underlying structural problems that are creating the polarization in the first place, which also means that if we want more trusting societies, then there’s a lot of deeper problems that we need to get fixed. And I think social inequality is probably the biggest that we need to deal with.


BOLLYKY: Margaret, did you want to?


LEVI: It’s not just social inequality. It’s the history of how different peoples have been treated and by whom. I mean there are a lot of—but I totally buy your point, that there’s underlying biases that are realistic and have real justifications for distrust of government, for science, for messengers, and we have to really face up to those, and that’s part of the responsibility of a trustworthy government is to actually address those things, in my view, and us as citizens.


BOLLYKY: Great. I was struck in the limited research we’ve done around trust and looking at interpersonal trust, in particular, how correlated it was—again, this is just one survey instrument—with economic inequality and government corruption, which does suggest some of the underlying factors as you mentioned, as well.


I could go on for at least several more hours. I’d love to drill down more and hope to have that opportunity with Margaret and Michael at a later date. But I hope you’ve enjoyed this event. I certainly learned a lot, and I’m very grateful to our speakers for coming and joining us today on this important topic.


LEVI: Thank you, Thomas, and thank you very much, Michael.


PETERSEN: Thank you very much.

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