How Public Health Can Better Manage Uncertainty
June 16, 2025 | Sam Jarvis
For Iowa, March 8, 2020, marked the first laboratory-confirmed case of COVID-19. From that point, public health workers across the nation experienced similar problems. Information changed rapidly with little to no notice, causing distrust in public health messaging and forcing health agencies to regain credibility as best as possible through swift action and communication. Public health workers had to learn to balance personal well-being with managing a public health emergency for an extended period. We cycled through emotions such as fear, anxiety, anger, resentment, depression. We felt the rush of adrenaline when new challenges emerged and the crashes afterwards. We burned out and learned that self-care and mindfulness can only go so far — there is only so much an individual can do in a system or environment that lacks the necessary support for success.
Today, public health experiences new challenges. While not a novel respiratory virus, we are seeing significant changes in the public health landscape at all levels of government, from funding cuts, reductions in workforce, communications challenges, and many unknowns for the future of our health agencies. This uncertainty can bring up many emotions for the public health workforce and it is the duty of public health leaders to help staff navigate the challenges of the day.
So how does one grab on to a moving train? Drink from a fire hose? Walk and chew gum? Chop wood and carry water? First, admit that it is neither simple nor possible to describe with a benign platitude. Unprecedented? Yes. Second, dust off those after-action reports and use the lessons learned from the pandemic to aid in shifting mindset to crisis leadership and adapting to a changing environment — we need to scale our response now.
Crisis leadership principles can help teams shift into this new mindset and find stability amid uncertainty. It may be helpful to emphasize the following:
- Command and control: State the overall direction of the response, whether that is managing by objectives or otherwise. Establish the cadence of reporting or sharing information and adjust accordingly. Plan to check in to make sure expectations are clear from time to time.
- Accountability: Incident management requires delegation. If your team is taking on other duties, ensure folks stay accountable to you and to each other. Make a point to check in and proactively address concerns. By not addressing accountability when stress is high and workloads ever increasing, you risk morale.
- Prioritize the well-being of your team and yourself: Focusing on priorities can help you better manage your team’s time, but it can also take away from opportunities to listen to the concerns of your team and monitor your ability to be empathetic and positive. While navigating this transition, make time to check in, be flexible, review the latitude you have to support their needs at work, and how you can appropriately support their needs outside of work. Make sure the people supporting the mission are given the tools and resources to do the work.
Applying Principles from Preparedness Trainings
Many public health professionals are required to undergo training for the Incident Command System (ICS) and the National Incident Management System. These trainings provide valuable principles that leaders can utilize during periods of significant change:
- Incident Action Planning: Standing up a response structure may require dedicated staff to gather and analyze incoming information. Delegate planning and meeting preparation. Set a cadence and expectation of when agenda items should be sent and when they will be distributed. This will assist in keeping everyone informed and keeping track of action items and follow-ups. Your plan should support the objectives you have prioritized.
- Common Terminology: Not everyone has experience with federal or state policy changes or the legislative process, so what they are hearing and seeing may be unfamiliar. Play Schoolhouse Rock. Avoid acronyms. Your jurisdiction’s legislature likely has the schedule and process mapped out to share already. Not everyone has memorized bill numbers, so take the time to explain pieces of legislation and how they impact your team.
- Integrated Communications: Recall how fast information changed during the pandemic and how important it was to maintain awareness of changes, share information, and stay connected with partners. Your multi-sector partners likely feel similar, so stay in touch and remember there is strength in numbers.
- Information and Intelligence Management: With changes coming quickly and from many different sources, situational awareness is critical. Work with your team to gather, analyze, and assess what information is necessary to act on, monitor, or ignore. Looking at ICS as a model, ICS is ‘modular.’ You may want to consider focusing individuals or teams on specific topics or sources. Invest the time to provide context on current or local events to your team to help them understand what is happening.
- Management by Objectives: What do you want to achieve? Is it addressing fear of the unknown? Is it ensuring everyone is informed of recent changes? Is it maintaining morale? Choose your priorities and make a clear plan as best as possible.
Yes, ‘it’s another marathon’, so pace yourself, stay hydrated, listen to your body, set realistic expectations, and take care of yourself. When time is short, stress is high and the landscape changes quickly; simple acts like these become more difficult to do. If you are not at your best, you risk your ability to respond and act. Luckily, we are not faced with significant crises every day, but we are still recovering from the strains of the pandemic. During this uncertain period, let’s embrace what we have learned and take these tactics forward into the unknown.