This study of the communication processes between public health and frontline clinicians during the H1N1 pandemic provides useful information for enhancing communication during the COVID-19 pandemic.

Public health authorities rely on clinicians to make appropriate decisions when caring for patients, and clinicians refer to public health for guidance on how to handle disease spread. Communication between the two is particularly critical during a rapidly spreading pandemic and is essential to any public health emergency response plan. Data from previous epidemics suggest that national and local sources of information are often redundant and overwhelming. For example, the volume of emails received was too great for most clinicians to process efficiently. The current communication process is multidirectional, redundant, relies on daily action, and requires effort to be expended by personnel at many organizations.

Action-oriented messages should contextualize information and use short, structured messages. Clinicians typically consult public health websites, but not frequently enough to keep up with frequent changes, and prefer that their institutional source provide guidance about testing and treatment. The most important suggestions for public health leaders are to communicate with frontline clinicians by:

• Limiting email to a single credible source
• Identifying new information so clinicians do not have to search for it
• Noting when local recommendations differ from CDC recommendations and explaining why differences exist