importance of communication during pandemic essay

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Communicating Through the Coronavirus Crisis

• Paul A. Argenti

Identify your key constituents and tailor your message appropriately.

In a fast-moving crisis, it’s important for leaders to communicate with their key constituencies, early and often, and with empathy, honesty, and transparency — even when you don’t have all the answers. Start by putting together a centralized communication team. While decentralized communication be may desirable in large, complex organizations, in an emergency or fast-moving situation, you need a crisis communication team composed of key leaders.  From there, develop messaging for key constituencies, including your employees, customers, shareholders, and community. The author offers tips for communicating with each.

In these difficult times, we’ve made a number of our coronavirus articles free for all readers. To get all of HBR’s content delivered to your inbox, sign up for the Daily Alert newsletter.

The coronavirus epidemic seemed far away for me until last week. Then came news reports about someone infected in New Hampshire. Rumors started to spread, closely followed by questions: How can we find out more information? Should we send the kids to school? The next day, we discovered in both the local and national news that the infected person, a resident at our local hospital, had attended a party with students from the Tuck School, where I teach, bringing the crisis right to my office door. Classes and events were canceled and all international travel was suspended for the university. My mind was racing. Should I go in to work? Is it OK to buy lunch here? Are we prepared to quarantine at home? How long will this go on?

• PA Paul A. Argenti is Professor of Corporate Communication at Dartmouth College’s Tuck School of Business in Hanover, New Hampshire. He is the author of Corporate Communication , 7th edition (McGraw Hill, 2016) and Corporate Responsibility (Sage, 2015).

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How covid changed the way we communicate, research & innovation.

In 2020, the COVID-19 pandemic drastically altered the lives of people around the world, and according to professors from the University of Richmond, it quickly introduced a new way of communicating with one another.

“The dramatic and sudden shift to synchronous online video formats like Zoom paradoxically made many people feel both connected and isolated,” said Elizabeth Outka, an English professor and an expert on pandemic literature. “Experts kept emphasizing that we should think of ‘physical-distancing’ rather than ‘social-distancing,’ but in fact, it often seemed that taking out the physical part also emptied much of the social part.”

The challenges COVID presented to communication inspired Kasongo Kapanga, chair of the department of languages, literatures, and cultures, to ask his fellow language experts this question: How has COVID-19 changed the way we speak to one another? It culminated in a Languages of Covid Symposium on campus this spring, featuring scholars from all over the world.

COVID highlights both the importance of communication and its fragility.

“The COVID-19 pandemic touched all aspects of our societies in such a short time,” Kapanga said. “Language is the conveyer belt of culture, and it was the main instrument that described, expressed, and translated what the world was experiencing.”

The symposium, organized by Kapanga, English language learning director Leslie Bohon-Atkinson, Chinese studies professor Gengsong Gao, and film studies professor Sonja Bertucci, brought together professors from across the globe to share research and insights. One presentation put a spotlight on how vulnerable the world is when social media is the primary form of communicating. For example, the Philippines had one of the world’s longest lockdowns, yet the government never used the specific word “lockdown.” This caused false information to spread about the severity of the COVID-19 virus in the country and case numbers to rise.

Another presentation explored how the word COVID has become so prevalent in our vocabulary that it begins to lose its meaning, which has caused people around the world to take the pandemic, and other global diseases, less seriously.

Outka moderated a panel about the pandemic’s effects on life and politics.

“COVID highlights both the importance of communication and its fragility,” Outka said. “The most effective forms of communication may still — as we see every day — convey inaccurate information and mislead.”

The two-day symposium also included a preview performance of Standing Together, Six Feet Apart , a new play from UR’s theatre department, two screenings of COVID-era films, and speakers from the biology and health studies departments.

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How The Pandemic Has Changed The Way We Communicate

NPR's Lulu Garcia-Navarro speaks with Amelia Aldao, a clinical psychologist in New York City, about how the pandemic has impacted the ways we communicate with one another.

Copyright © 2021 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

5 Lessons for Communicating About Coronavirus

• March 17, 2020
• By Susan Krenn | Johns Hopkins Center for Communication Programs Executive Director

The coronavirus pandemic has put the business of risk communication front and center. Every day, it seems, we are getting mixed messages from our leaders, messages that differ in their tone and content depending on who is talking.

In a situation full of unknowns, as with the early days of the Ebola outbreak in West Africa five years ago, sometimes communication is all we have. Good communication lets people know what they should do, how they can protect themselves and others and helps them balance their fears with concrete information they can use.

Here are some communication lessons to keep in mind as the coronavirus interrupts life as we know it. So much has already changed, with the closure of schools, restaurants and gyms, many workers being asked to stay away from the office, the cancellation of major life celebrations such as weddings and graduations and directives to keep our distance from one another. What is key is that we focus on how to help one another navigate the way forward.

• Build trust: People need information from sources with expertise and they need to hear from trusted public health experts at regular intervals. If incorrect information is shared, experts need to correct the record quickly to ensure that trust is maintained. And when too much time passes between communications, people tend to fill the void with inaccurate information from unreliable sources. Be honest about what you know – and don’t know – in a crisis.
• Have one set of messages: All spokespeople must be on the same page. This is crucial so that people know exactly what to do to reduce the spread of the virus. Otherwise, people make up their own minds about how to behave – which won’t slow the spread of disease.
• Counter myths and misinformation: Ignoring rumors and hoping that they dissipate on their own is a poor course of action, especially in a crisis. Create a system to dispel myths and correct the record by sharing the clear, accurate messages that experts have agreed on.
• Promote action: In an unprecedented crisis, some people just don’t know what to do and why to do it. Being anxious right now is completely normal, but we need to balance that with the ability to act to prevent paralysis. Giving them concrete things to do calms anxiety and promotes a restored sense of control. We’ve already seen some people change social norms, such as avoiding hugs and handshakes upon greeting. Our trusted leaders need to role model this behavior and talk about what else people can do to protect themselves such as vigorous handwashing, avoiding public events and settings and keeping your distance from others, especially older people who are particularly at risk for complications.
• Be empathetic: We are all in this together and we need communication that reflects this. The unknowns are scary, but helping people understand that they need to take action for the greater good can help foster community.

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A leader’s guide: Communicating with teams, stakeholders, and communities during COVID-19

This article is part of a series Leadership in a crisis: Responding to the coronavirus outbreak and future challenges . It draws together McKinsey’s collective thinking and expertise on five behaviors to help leaders navigate the pandemic and recovery. Separate articles describe organizing via a network of teams ; displaying deliberate calm and bounded optimism ; making decisions amid uncertainty ; and demonstrating empathy .

Crises come in different intensities. As a “landscape scale” event, 1 Herman B. Leonard, “Against desperate peril: High performance in emergency preparation and response,” in Communicable Crises: Prevention, Response, and Recovery in the Global Arena , Deborah E. Gibbons, ed., Charlotte, NC: Information Age Publishing, 2007. the coronavirus has created great uncertainty, elevated stress and anxiety, and prompted tunnel vision, in which people focus only on the present rather than toward the future. During such a crisis, when information is unavailable or inconsistent, and when people feel unsure about what they know (or anyone knows), behavioral science points to an increased human desire for transparency, guidance, and making sense out of what has happened.

At such times, a leader’s words and actions can help keep people safe, help them adjust and cope emotionally, and finally, help them put their experience into context—and draw meaning from it. But as this crisis leaps from life-and-death direction on public health and workplace safety to existential matters of business continuity, job loss, and radically different ways of working, an end point may not be apparent. While some may already be seeking meaning from the crisis and moving into the “ next normal ,” others, feeling rising uncertainty and worried about the future, may not yet be ready for hope.

COVID-19’s parallel unfolding crises present leaders with infinitely complicated challenges and no easy answers. Tough trade-offs abound, and with them, tough decisions about communicating complex issues to diverse audiences. Never have executives been put under such an intense spotlight by a skeptical public gauging the care, authenticity, and purpose  that companies demonstrate. Leaders lack a clear playbook to quickly connect with rattled employees and communities about immediate matters of great importance, much less reassure them as they ponder the future.

Against this frenzied backdrop, it would be easy for leaders to reflexively plunge into the maelstrom of social-media misinformation, copy what others are doing, or seek big, one-off, bold gestures. It is also true that crises can produce great leaders and communicators, those whose words and actions comfort in the present, restore faith in the long term, and are remembered long after the crisis has been quelled.

So we counsel this: pause, take a breath. The good news is that the fundamental tools of effective communication still work. Define and point to long-term goals, listen to and understand your stakeholders, and create openings for dialogue. Be proactive. But don’t stop there. In this crisis leaders can draw on a wealth of research, precedent, and experience to build organizational resilience through an extended period of uncertainty, and even turn a crisis into a catalyst for positive change. Superior crisis communicators tend to do five things well:

• Give people what they need, when they need it. People’s information needs evolve in a crisis. So should a good communicator’s messaging. Different forms of information can help listeners to stay safe, cope mentally, and connect to a deeper sense of purpose and stability.
• Communicate clearly, simply, frequently. A crisis limits people’s capacity to absorb information in the early days. Focus on keeping listeners safe and healthy. Then repeat, repeat, repeat.
• Choose candor over charisma. Trust is never more important than in a crisis. Be honest about where things stand, don’t be afraid to show vulnerability, and maintain transparency to build loyalty and lead more effectively.
• Revitalize resilience. As the health crisis metastasizes into an economic crisis, accentuate the positive and strengthen communal bonds to restore confidence.
• Distill meaning from chaos. The crisis will end. Help people make sense of all that has happened. Establish a clear vision, or mantra, for how the organization and its people will emerge.

Give people what they need, when they need it

Every crisis has a life cycle, and emotional states and needs vary with the cycle’s stages. In a recent article, our colleagues framed the COVID-19 crisis in five stages : resolve, resilience, return, reimagination, and reform. These stages span the crisis of today to the next normal that will emerge after COVID-19 has been controlled. The duration of each stage may vary based on geographic and industry context, and organizations may find themselves operating in more than one stage simultaneously (exhibit).

With such variation in mind, communicators should be thoughtful about what matters most in the given moment.

Every crisis has a life cycle, and emotional states and needs vary with the cycle’s stages.

• In a crisis’s early stages, communicators must provide instructing information to encourage calm; how to stay safe is fundamental. In COVID-19, governments and major media outlets first focused on clear, simple instructions about physical distancing and “lockdown” guidelines. Companies focused on new operational rules regarding time off, overtime, and operational changes.
• As people begin to follow safety instructions, communication can shift to a focus on adjusting to change and uncertainty. Asia, where COVID-19 struck early, offers some helpful insights. One survey in China, for example, showed that a marked decline in people’s energy during the early stages of the epidemic reversed as they acclimated to increased anxiety and the blurring of work- and home-life boundaries. 2 McKinsey surveyed senior executives of large Chinese companies, along with employees from those organizations, in eight industries, from March 12–18, 2020; 1,300 people responded to the survey. Savvy communications directors responded by evolving their messaging from health basics to business recovery.
• Finally, as the crisis’s end comes into view, ramp up internalizing information to help people make sense of the crisis and its impact. For the current public-health crisis, it’s still too early to glean the shape of this broader perspective, although “silver lining” articles about families drawing closer together and other topics have been making their way into the media.

Want to know what people need? Ask them.

Standard tools and serendipitous conversations and moments of connection can help leaders check in on their people:

Schedule unstructured time. Add 15 to 30 minutes at the beginning or end of a meeting to tap into what’s on employees’ minds.

Run a quick pulse survey. Ask one simple question: How are you feeling? Include a comments box for elaborating.

Invite input on big decisions. When possible, include people in the process of choosing paths forward. Offer options. Community dialogue can shape the right decision.

Use digital and analytics tools. Two-way listening solutions enable employees to share concerns over email or text. Natural-language software then produces major themes for managers to review, act on, and monitor.

Host “well-being check-ins.” Schedule time for people to come together. These sessions can host up to 150 people at a time. Breakout features in some apps can create smaller groups for more in-depth conversation.

Solicit questions. When preparing town halls, give employees a chance to submit questions in advance (anonymously is ideal). Or offer the community the option to “vote up” the questions they most want answered. Use chat functionality to allow questions.

Engage change agents. If you’ve identified influencers or change agents, deploy them. Provide forums for them to hear from peers. Adjust your communications to reflect this new input.

The COVID-19 outbreak is a complex crisis made up of multiple trigger points—health, policy, the economy—and leaders should tailor their communications to the stage of the crisis their stakeholders are experiencing, and to what people need most in the moment (see sidebar, “Want to know what people need? Ask them”). 3 Adapted from David L Sturges’s seminal 1994 work on crisis communication, “Communicating through crisis: A strategy for organizational survival,” Management Communication Quarterly , February 1, 1994, Volume 7, Issue 3, pp. 297–316. Scenario planning  becomes important to help anticipate where employees and communities may be in dealing with the crisis, and the appropriate messaging that can help them as the crisis unfolds.

Communicate clearly, simply, frequently

At a crisis’s onset, audience attention is finite; new, disruptive inputs overwhelm a person’s ability to process information. High levels of uncertainty, perceived threats, and fear can even lead to “cognitive freezing.” 4 A body of research shows that people generally suffer from information overload; for more, see Martin J. Eppler and Jeanne Mengis, “The concept of information overload: A review of literature from organization science, accounting, marketing, MIS, and related disciplines,” Information Society , 2004, Volume 20, Number 5. Put simply: the more complicated, abstract, or extraneous information is right now, the more difficult it will be for people to process it.

Leaders may be inclined to defer to governments and media outlets for clear and simple safety instructions. Don’t. Employers often underestimate how much their employees depend on them as trusted sources. When public-relations firm Edelman asked workers in ten countries what they considered the most credible source of information about the coronavirus, 63 percent of respondents said that they would believe information about the virus from their employer, versus 58 percent that trusted government websites or 51 percent that trusted the traditional media. 5 Edelman trust barometer 2020 special report: Trust and the coronavirus , Daniel J. Edelman Holdings, 2020, edelman.com.

To convey crucial information to employees, keep messages simple, to the point, and actionable. Walmart published its 6-20-100 guidance: stand six feet away to maintain a safe physical distance, take 20 seconds for good hand washing, consider a body temperature of 100 degrees Fahrenheit the signal to stay home from public activity. Slack CEO Stewart Butterfield focused on personal care in reassuring employees stressed over work. “We got this,” he said. “Take care of yourselves, take care of your families, be a good partner.” 6 Catherine Clifford, “CEO of multibillion-dollar company Slack to employees amid coronavirus: ‘Don’t stress about work,’” CNBC, March 26, 2020, cnbc.com.

When communicating clear, simple messages, framing and frequency matter:

Dos, not don’ts. People tend to pay more attention to positively framed information; negative information can erode trust. Frame instructions as “dos” (best practices and benefits) rather than “don’ts” (what people shouldn’t do, or debunking myths). 7 Building on Daniel Kahneman and Amos Tversky’s seminal 1979 prospect theory, more recent research has examined the impact of highlighting gains and benefits when communicating health information. In previous epidemic outbreaks, such as Zika, yellow fever, and West Nile virus, research shows that interventions highlighting best practices were more effective than those focused on countering misinformation or conspiracies.

Repeat, repeat, repeat. Communicators regularly underestimate how frequently messages must be repeated and reinforced. In a health crisis, repetition becomes even more critical: one study showed that an audience needs to hear a health-risk-related message nine to 21 times to maximize its perception of that risk. 8 Lu Liu, Xi Lu, and Xiaofei Xie, “Inverted U-shaped model: How frequent repetition affects perceived risk,” Judgment and Decision Making , 2015, Volume 10, Number 3. Fortunately, employee appetite for regular, trusted information from employers during COVID-19 is high. In one study, some 63 percent asked for daily updates and 20 percent wanted communications several times a day. 9 Edelman trust barometer 2020 special report: Trust and the coronavirus , Daniel J. Edelman Holdings, 2020, edelman.com. So, establish a steady cadence, repeat the same messages frequently, and try mantras, rhyming, and alliteration to improve message “stickiness.”

The CEO doesn’t have to be the chief delivery officer. During a crisis, it’s best if the message comes from the person viewed as an authority on the subject. For business continuity, that person may well be the CEO. But for other topics, people may prefer to hear from a health expert, the leader of the organization’s crisis-response team, or even their own manager. Provide common talking points for all leaders and empower communication—via town halls, through email, text messaging or internal social media platforms.

Choose candor over charisma

After establishing baseline safety requirements, leaders must help individuals cope emotionally with the trauma of sudden change and adjustment to a new, postcrisis normal. (COVID-19 threats to health and safety are likely to linger for some time, so new messages should be layered atop regular safety reminders.)

Leaders trying to help employees adjust after trauma need a reservoir of trust. Those who fail to build trust quickly in crises lose their employees’ confidence. People expect credible and relevant information; when stakeholders believe they are being misled or that risks are being downplayed, they lose confidence. To build trust, leaders should do the following:

Focus on facts—without sugar coating. Differentiate clearly between what is known and unknown, and don’t minimize or speculate. In crises like the one we’re facing now, “the facts” may include bad news about the state of the organization or changes that will be painful for people. Research shows that some leaders, used to feeling highly effective and in control, avoid acknowledging uncertainty and bad news because they find it stressful or guilt inducing, or they fear negative reactions from an audience. 10 Research shows that leaders are often uncomfortable giving bad news; for more, see Robert J. Bies, “The delivery of bad news in organizations: A framework for analysis, Journal of Management , 2013, Volume 39, Number 1, pp. 136–62. But unfounded optimism can backfire. In 1990, during the United Kingdom’s mad-cow-disease crisis, a government minister fed his daughter a hamburger in front of TV cameras and declared that British beef had never been safer, despite evidence to the contrary. Rather than boost morale, this effort only further eroded public trust in the government’s response. 11 David Robson, “Covid-19: What makes a good leader during a crisis?,” BBC, March 27, 2020, bbc.com.

When you are not able to communicate with certainty—for example, about when physical distancing and travel restrictions will be lifted—avoid hard and fast estimates (for example, “There’s a 60 percent chance that we’ll be back to normal by September.”). Instead, be explicit that you’re sharing an opinion, acknowledge uncertainty, and give the criteria you will use to determine a course of action (“It’s my hope that we are back online in the fall; however, that is far from certain. We will be following government guidance when making decisions for our business.”)

Be transparent. Transparency builds trust. Research shows that transparent operations improve perceptions of trust and that communicators perceived to have good intentions are more likely to be trusted, even if their decisions ultimately turn out to be wrong. Give people a behind-the-scenes view of the different options you are considering. For example, many governments, including Canada and the Netherlands, have begun publishing extended timelines during which protective measures will be in place. Whether or not those timelines hold true, such difficult messages to deliver ultimately serve to build greater trust among listeners.

Involve your audience in decision making. When making operational decisions, involve stakeholders. For example, many universities have informed students that commencement this year will not take place as planned. Rather than canceling commencement outright, several universities have instead used short, simple communication to elicit students’ ideas for staging commencement differently, preserving some of commencement’s positive energy.

Demonstrate vulnerability. Judiciously share your own feelings and acknowledge the personal effects of emotional turmoil. Research shows that demonstrating vulnerability, such as grief over shared losses or authentic feelings about the impact of changes on employees, can help build trust.

Mind what you model. What you do matters as much as what you say in building trust, and scrutiny of leaders’ actions is magnified during a crisis. Recently, some leaders have been called out for setting “do as I say, not as I do” examples. Scotland’s chief medical officer resigned after public uproar when she was caught visiting her second home during lockdown. Hosting a videoconference from the office might seem like a good way to project normalcy—but won’t for those attending who are locked down at home.

Build resilience

As the COVID-19 health crisis turns into a lingering financial and economic crisis, uncertainty and doubt will challenge efforts to restore business confidence. Leaders will face a critical period in which they will need to instill resilience in people and tap sources of hope, trust, and optimism in order to unlock creativity and build momentum for the future. Channeling positive sentiments and encouraging a sense of broader community will be critical elements in building that momentum. 12 For more on positive psychology in the workplace, see Fred Luthan and Carolyn M. Youssef, “Positive organizational behavior in the workplace: The impact of hope, optimism, and resilience, Journal of Management , 2007, Volume 33, Number 5, pp. 774–800.

Celebrate the positives. Sharing positive stories and creating uplifting moments are important building blocks in reigniting resilient spirits. It may seem counterintuitive, but often this approach begins by acknowledging loss. Denying or averting loss can make it more likely that people focus on negatives, especially in times of crisis. However, it is possible to counterbalance the negative effects of stress and loss by channeling positive emotions.

Denying or averting loss can make it more likely that people focus on negatives, especially in times of crisis.

Highlight how your organization is responding to the crisis with stories about how people are adapting to new ways of working. Or recount how your organization is contributing to the global COVID-19 response. Show appreciation for the challenges people face. For example, the “Clap for our carers” movement in the United Kingdom is a public display of appreciation for the National Health Service (NHS), which is now being replicated every night at 7 p.m. in New York City. Many companies have posted videos on social media thanking their employees. Especially important is expressing gratitude to those in the organization who are leading frontline responses or who face threats to their safety. In addition to acknowledging them publicly, having one-on-one conversations with them or sending personal thank-you notes can go a long way toward making people feel part of something important and meaningful, which in turn helps build resilience.

Help people to help. Helping others is a great way to improve well-being and reduce stress. 13 Adam Grant, Give and Take: Why Helping Others Drives Our Success , New York: Viking, 2013. Amid crisis, people look for ways to contribute. For example, following the 9/11 attacks, Dell connected with employees by channeling their desire to offer help. Service and response teams worked around the clock, drawing on Dell’s customer purchase records, to offer customers immediate assistance in replacing lost computers and equipment. Such steps helped employees struggling with grief and anger to focus on others, give back, and link the customer’s experience to everyday work.

Build community. It’s important to rebuild a common social identity and a sense of belonging based on shared values, norms, and habits. 14 For more on leadership and shared identity, see S. Alexander Haslam, Michael J. Platow, and Stephen D. Reicher, “ The New Psychology of Leadership: Identity, Influence and Power ,” Routledge, 2010. Research suggests that social bonds grow stronger during times of great uncertainty. Leaders encourage people to come together under common values of mutual support and achievement. Queen Elizabeth II has called upon all Britons to unify and identify—in discipline, resolve, and fellowship—in the face of COVID-19. “The pride in who we are is not a part of our past, it defines our present and our future,” she said. 15 “The Queen’s coronavirus speech transcript: ‘We will succeed and better days will come,’” Telegraph , April 5, 2020, telegraph.co.uk.

Any effort to create a shared social identity must be grounded in a sense of support for others. Practical ways to encourage this when people are working remotely include book clubs, pub quizzes, happy hours, exercise classes, chat groups, competitions, and so on. Complement this kind of broad outreach with one-to-one communication via phone, email, or video to individuals or small teams. Arrange a virtual breakfast, an end-of-week celebration, or even video “tours” of each other’s workspaces.

Out of chaos, meaning

As people adapt, effective leaders increasingly focus on helping people to make sense of events. 16 For more on sensemaking, including the importance of leadership, see Marlys Christianson and Sally Maitlis, “Sensemaking in organizations: Taking stock and moving forward,” Academy of Management Annals, 2014, Volume 8, Issue 1, pp. 57–125. The search for meaning is intrinsic to recovery from trauma and crisis. For many, the workplace is a powerful source of identity and meaning. Research has shown that meaning and associated well-being can explain up to 25 percent of performance. 17 Thomas A. Wright, “More than meets the eye: The role of employee well-being in organizational research,” Oxford Handbook of Positive Psychology and Work , Oxford University Press, 2009, pp. 143–54, oxfordhandbooks.com. Leaders can shape a meaningful story for the organization and help people build their own stories, invoking common culture and values as touchstones for healing and strength. In their messaging, they underscore a shared sense of purpose, point to how the organization can rally at a generation-defining moment, and indicate new paths to the future.

Leaders can take the following steps to help people move from making sense of events to deriving meaning from them:

Set clear goals and ‘walk the talk.’ Early on, be clear about what your organization will achieve during this crisis. Set a memorable “mantra”—the two or three simple goals around which people should rally. Then take actions to realize those goals, because you communicate by what you do as much as by what you say. For example, during the COVID-19 crisis, Best Buy has defined a dual goal to protect employees while serving customers who rely on the company for increasingly vital technology. The company has made clear that employees should only work when healthy, and that those who feel sick should stay at home, with pay. US stores have instituted “contactless” curbside service or free doorstep delivery. 18 “Best Buy committed to providing products people need,” Business Wire, March 21, 2020, businesswire.com.

Connect to a deeper sense of purpose. Explore ways to connect the disruption employees face to something bigger. For some organizations, this may dovetail with the goals of an ongoing transformation, such as serving customers in new ways. For others, meaning can be found in a deeper, more collective sense of purpose or mission. For example, the chief surgeon at one New York hospital closed an all-staff memo by reminding people that “[patients] survive because we don’t give up.” 19 Craig Smith, “COVID-19 Update from Dr. Smith,” Columbia University Irving Medical Center, March 27, 2020, columbiasurgery.org. In the United Kingdom, the government appeals to strong national sentiments with the simple message: “Stay home, protect the NHS [National Health Service], save lives.”

Foster organizational dialogue. While it’s important to shape a story of meaning for your organization, it’s equally important to create a space where others can do the same for themselves. Ask people what conclusions they are drawing from this crisis and listen deeply. Some possible questions: Have there been unexpected positive outcomes of this crisis for you? What changes have you made that you would like to keep once the crisis has ended?

The immediacy and uncertainty of the coronavirus crisis tempts leaders to “shoot from the hip” in communicating with anxious stakeholders or making strategic moves. Effective communicators will take a deep breath and remember the basics while acknowledging what is unique about this moment. Relying on these practices will help team members stay safe and infuse understanding and meaning in communities, helping to carry the organization through the pandemic with a renewed sense of purpose and trust.

Ana Mendy is a partner in McKinsey’s Southern California office, Mary Lass Stewart is an expert in the Chicago office, and Kate VanAkin is an expert in the London office.

The authors wish to thank Aaron De Smet, Wojciech Kurda, Carlos Miranda, Mihir Mysore, Joe Spratt, Mrinalini Reddy, and Andrew Samo for their contributions to this article.

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Science communication in the COVID-19 pandemic

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Cleaning and disinfection measures are important for the control of COVID-19. Credit: MuchMania

In the COVID-19 crisis, science communication has emerged as a powerful tool for managing public health. In China, where new cases are waning, science communication played a vital role in the public health response. The national response was well supported by the China Association for Science and Technology (CAST). It houses a science communication department, serving as the bridge between researchers and the public to promote science understanding.

During the pandemic CAST has focused on helping the public understand, avoid and navigate through COVID-19. Emphasizing transparency and openness, it quickly developed science communication campaigns, and ensured they reached every corner of China via all media channels, from print, radio and TV, to online. As the compulsion to quarantine slowly recedes in China, the lessons of how to mount effective science communications will endure.

Prioritizing rapid and reliable information

Perhaps one of the most visible changes in the age of COVID-19 is the widespread adoption of face masks. Early in the pandemic, social media was awash with conflicting information about facemasks. People were sharing ideas about how to ‘sanitize’ surgical masks for repeated use, or even to create their own masks.

To educate the public on the proper use of masks, CAST organized a series of articles and a live Q&A session. Led by Xiangyu Jin, a textile researcher from Donghua University in Shanghai and a representative for the China Textile Engineering Society, a member institution of CAST, the communications directly addressed the most frequently asked questions about masks, from their composition, structure, to their appropriate use and care.

Another need made obvious by the COVID-19 crisis is for reliable expert insights on disease and efforts to control it. To relay information quickly, CAST organized first-hand online reports about front-line healthcare workers, including some contributed by medical personnel themselves.

One such contributor was Tao Wang, who co-led the medical aid team to Wuhan from Shanghai East Hospital of Tongji University. Informed by his work in hospitals, Wang, who was one of CAST’s top ten science communicators in 2017, emphasized the importance of social distancing and recommended staying home. He co-authored two online disease prevention manuals, one for home-quarantined citizens, and another for young students, covering basic knowledge and facts about the coronavirus, and tips for staying healthy while at home, like how to maintain hygiene, exercise, and care for pets.

“For a public health crisis as complex as this, we may be unprepared, but our experiences will assist with improving our medical system for emergency response,” Wang explains.

Jinning Wang, from Chongzuo People’s Hospital in Guangxi province, was another contributor. She leads the hospital infection control team, which implements measures from sewage control to medical device disposal for cross-infection prevention. The hospital infection-control measures and procedures she described could be applicable to the home environment.

To ensure a steady reporting stream, CAST’s science communication team applied a flattened crisis management structure for more fluid operation. It held daily exchanges with regular contact points from its 210 national and 32 provincial associations. CAST’s extensive local networks also enabled access to the most remote regions. In southwest China’s Yunnan province, where a third of the population is comprised of ethnic minorities, scientific content is made available in multiple local languages. More than 100 trucks were used to transport around 10,200 illustrated pamphlets to remote villages where internet access may not be readily available.

In China’s Zhejiang province, multi-level science communication measures are taken for disease prevention and control:

• The provincial government passed a bill to contain the outbreak, which specifically encourages media platforms to prioritize popularizing scientific knowledge.

• More than 2,680 social media posts on home quarantine and personal hygiene information went online in February, read by 443 million viewers.

• Six online training sessions were organized for more than 3,000 employers from 600-plus companies, with advice for overcoming financial and health crises.

• Mental health counselling hotlines were established in 11 cities of the province; among the four helplines set up by the provincial mental health association, one is dedicated to medical staff and patients in Hubei province.

Addressing mental health at home and work

As weeks of quarantine stretch into months, mental health can suffer. Many universities and medical institutions in China developed online counselling, mental health lectures, and helplines. Lin Lu, head of Peking University Sixth Hospital, filmed a video series to share perspectives for coping with mental problems amid the COVID-19 outbreak based on his psychiatric expertise.

“As numbers of infections and confirmed cases rise, misinterpretation of all the information will cause panic, anxiety and insomnia,” Lu says. “Maintaining daily routines and a regular schedule to ensure adequate sleep, a healthy diet, and at least half an hour of exercise daily, helps relieve anxiety and strengthen immunity.”

Equally important is alleviating stress for medical staff and infected patients. Interventions offered range from psychological counselling, to drug treatments. Care also extends to patients with pre-existing chronic diseases. Online Q&A sessions with medical experts, for instance, were arranged for lung cancer patients who had to postpone hospital treatments, which helped ease their anxiety.

Engaging industry and encouraging global collaboration

Beyond public health, effective science communication can help to drive economic activity in the wake of a pandemic. One affiliation of CAST, the Chinese Society of Forestry, organized WeChat groups for farmers, answering questions about planting and production management during the pandemic, sharing science-based tips. For office workers, other industry associations of CAST are sharing back-to-work best practices, such as how to use air conditioning in office buildings, or to address material shortages.

Communication of latest research developments is vital, and requires global collaboration. CAST is working with more than 140 international science and technology organizations to share resources and information. In March, Gang Wan, chairman of CAST, led a Sino-Swedish video conference to improve science and technology exchange and form a joint task group for combating COVID-19.

Researcher-level collaboration is also encouraged. Meng Fan, a professor at Northeast Normal University, and a member of the Chinese Mathematical Society, leads a team of researchers from multiple universities in northeast China to collaborate with York University, in Canada, on mathematical modelling of disease dynamics. They have explored the availability of healthcare resources, impact of delayed diagnosis, and effects of city lockdown, and other prevention and control strategies, informing local disease prevention and control.

“We need to enhance large-scale collaborations, between industry and academia, various sectors, and different countries in this critical moment,” said Jinpeng Huai, executive vice president of CAST. “It’s time to strengthen mutual understanding, trust and support across borders, and to contribute towards building a healthy community with a shared future.”

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Chapter 8: COVID and learning

8.5 The effect of online learning on communication during COVID-19 (synthesis)

Anonymous English 102 Writer

February 2021

Have you ever thought about how a virus   could change the habits of the world, especially in education? The crisis of the COVID-19 pandemic hit all over the world and has completely changed education. Some colleges refused to switch from the traditional teaching style to virtual classes. Many argue about this issue and how to deal with these new circumstances; some of them claim that the coronavirus is a good turning point that can open our eyes to a new style of learning. Others, however, prefer traditional, in-person learning. So, I am interested in learning how Covid-19 affects communications and our lifestyle specifically between the years 2020-2021 because our education system is impacted by this crisis   and I am   also   interesting to find the results and the studies that people have done about this topic.   I was surprised to see the number of studies   discussing COVID-19 that have already been published.   

The article “Online and Remote Learning in Higher Education Institutes: A Necessity in Light of COVID-19 Pandemic” by Wahab Ali discusses how higher education is being affected by COVID-19; specifically, the article describes the shift to online learning, difficulties students face, and the challenging teaching environments.   Ali argues   that virtual learning is more  effective than traditional learning , he   discuss   the difficulties that faced the students,   which caused a lot of challenges in the teaching   environments   ,   due to the rapid technological development beyond the crisis that led people to turn to technology in order to study and   communicate with each other effectively   (16). Also, some colleges give tools to the students   in order to   help them study effectively and give them the opportunity to study and communicate (16).   He relates to Gee’s   secondary discourse when he claims that in this   period of time, all people, especially students, will easily adapt to online learning due to   their   big knowledge, skills and   familiarity   with technology,   so he   stats that   the new technology   affects our communications in our daily   life style,   and how our education under this pandemic   allow   us to learn a   new ways   to communicate   (Ali   17).   If, for example, students want to contact their teachers, they will have to learn how to send formal emails; but, the knowledge of sending emails and communicating online is already ingrained in them. However, some   universities closed because they could not create a good environment for their students to learn. Ali encourages authorities and teachers to provide more information and to be prepared to improve the education system, strengthen their plans to provide more   effective lectures, and give students the opportunity to understand their lectures (17). He refers to Gee’s article, “The Oral Mode is More Narrowly Useful,” because both mention that the development of technology has major impacts upon society and communication; Gee emphasizes in his article the importance of learning new methods and how to deal with technology. The oral mode refers to spoken language during face-to-face classes. Gee and Ali also have the same opinion about the importance of learning new   technology. In addition, Ali motions in his article that some universities, such as New York University, were prepared for rapid change and met all their students’ needs for online classes by giving them tools and technology (19); successful adaptations require prior plans and an awareness of all changing circumstances (19).   

Moreover, an article by Deepika Nambiar,   “The   impact of online learning during COVID-19: students’ and teachers’ perspective” discusses the impacts of online learning on the communications between the students and their teachers. She argues that interactions between   them depend on their perspective and experiences of online learning (1); she includes a study with a survey method to collect data from universities in Bangalore to determine educators’ and teachers’   prescriptives   because education has a special place and plays a big role in India (1). She observed that rapidly switching the education system in India to be online has a very big  impact on the students’ interactions and communications due to the lack of required methods and apps for virtual learning (7); students were adapting to take their lecture in-person   even though   some colleges give tools to the students. Even so, they cannot   make every aspect of online   education equal; for example, not all students have access to reliable internet, which immediately   puts them at a disadvantage. This rapid switch affects their performances, grades, and attendance, lowering their ability to effectively participate during class time (7). Also, online learning reduces students’ understanding of lectures and prevents them from physically interacting in their labs or researching (7). Nambiar states in her article that “the results of the survey showed that 86.9% of the teachers reported that they preferred classroom teaching method more than online teaching mode” and “11.8% preferred online classes” (4). So, online learning prevents teachers from understanding their students’ understanding of the material which allows them to know the effectiveness of their materials and method they use. Also, it minimizes their ability to individually contact their students to evaluate their levels. Furthermore, teachers had difficulty adapting to an online format while still teaching effectively (Nambiar   2). Teachers also confirmed that online learning is an evidence of the evolution that allows them to teach from anywhere, but it has harmful effects on their interactions with students and prevents them from engaging with their students physically (7). It allows students to have more absences due to the lack of internet services or poverty. Lastly, teachers must spend many more hours preparing their lectures because online learning has a more formal form (7). Overall, this study shows how online learning affects students and faculty and discusses all negative aspects that the authorities   should be aware of when they are making the rules for the education systems.   In order to   obtain a comfortable environment for the students to learn and support the teachers, authorities   must create strong strategies to improve learning under this pandemic (10).  

Furthermore,   Settha   Kuama   in “Is Online Learning Suitable for All English Language Students?” begins by explaining how online   learning affects students who are studying the English language.   Kuama   states that, despite all the advantages of online learning due to its flexible environment, English learners have faced many difficulties throughout online learning such as the “cognitive challenge,” which includes understanding apps’ dynamic functions in order to succeed (65). Students also have trouble organizing their time to ensure they never miss their due dates and watch their lectures, which don’t include any attendance grades.   In addition, according to Aydin (2011), students may have “computer   and Internet   anxiety,” anxiety caused by a poor internet connection or slow computer, which also prevents them from having a comfortable space to study. Also, students are used to asking instructors questions and studying with their peers, and online learning prevents them from having these opportunities (Kuama   65). This article divides students into two groups: the students who succeed and those who struggle   Kuama   states in this article that successful students have a high level of self-regulation, know how to study effectively, and are aware of their responsibilities. They check their homework daily and use the internet to learn new studying strategies   in order to   study effectively. On the   other hand, the students that   do not succeed   in their studies do not learn any strategies to help them during their studies (69). But overall, both kinds of students agree that face-to-face learning is an opportunity to interact with each other, especially because the English language depends on conversations between students and their instructors and group work. Additionally, students will get more motivation from their peers (73). Moreover,   Kuama   discusses through the article that,   in order to   give all the students a quality online education, they   have to   have the opportunities to   learn about the online programs and apps (74).   Also,   students who have a low efficiency in   English   have   to   improve their English skills in order to   communicate   and participate with others (74).   

James Gee’s article “What is Literacy” attempts to describe literacy by describing   discourse, the effective way of using words to communicate with each other and write our own   thoughts (23). Gee defines literacy as being able to use a set of words for multiple purposes   and in numerous settings (23). Where these settings are defined as discourses, and they are   categorized into primary and secondary discourses and even these types of conversation can be   broken down. For example, a primary discourse is that way of speaking that you mostly acquire   from your family and the people around you at   birth. An example of some primary   discourses includes being in a certain country, playing with a friend, or speaking with family   members around us: these examples are described as languages a person acquires for free (22).   Secondary discourses are uses of   a language that people actively and primarily; it requires effort,   practice, and experiences, and a person does not grow up speaking in the dialect. Examples can   include the way we speak when working as a team in our workplace or if we want to engage in a   new community with a new group we have to learn their language and their styles in order to   deal with   them.  

Works Cited    

Ali, Wahab. “Online and remote learning in higher education institutes: A necessity in light of   COVID-19 pandemic.”   Higher Education Studies   10.3 (2020): 16-25.    

Gee, James Paul. “What is Literacy?”   Negotiating academic literacies: Teaching and learning   across languages and cultures   (1998): 51-59.    

Kuama,   Settha. “Is Online Learning Suitable for All English   Language   Students?.   “   PASAA:   Journal of Language Teaching and Learning in Thailand   52 (2016): 53-82.   Nambiar, Deepika. “The impact of online learning during COVID-19: students’ and teachers’   perspective.”   The International Journal of Indian Psychology   8.2 (2020): 783-793.  

Understanding Literacy in Our Lives by Anonymous English 102 Writer is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License , except where otherwise noted.

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Sounds of Silence: How the Pandemic Has Impacted Our Communication Skills

Face-to-face communication and in-person socialization have suffered over the past year.

Pandemic Impact on Communication Skills

Every year since 1927, the month of May has been designated "Better Hearing & Speech Month" to promote awareness about communication disorders and the wide array of effective available treatment opportunities.

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Though the month has long passed, the need this year is greater than ever – all year long.

Changes to Our Way of Life

The pandemic has turned our lives upside-down. In early 2020, we had to transition from brick-and-mortar to virtual systems overnight . We jumped from our business offices to working from home and from in-person medical visits to telehealth. We embraced streaming services, takeout from restaurants and virtual holiday celebrations.

The timing of the pandemic was uncanny. Americans actually had the infrastructure to support it; we had become accustomed to online banking, Amazon deliveries and FaceTime chats with our out-of-town friends and relatives.

What a different scenario from 2014, when I came up with my business plan to create a virtual speech therapy company, called Great Speech Inc. Before the pandemic, our ability to conceive life virtually was not on the public's radar and was indeed groundbreaking. Today, telehealth and telemedicine are not only mainstream, but expected.

What we were not prepared for was the infectious nature and deadly capacity of this virus and how it affected face-to-face communication and in-person socialization. We sheltered in place, worked from home and Zoom-schooled our children. We found new ways to connect, share ideas around virtual conference tables and enjoy after-work activities. Our children were jolted from their daily school routines of sitting face-to-face in classrooms, participating in after-school activities and enjoying sleepovers, parties and play dates. With parks closed and field trips canceled, socialization and language development opportunities were unnaturally limited.

Face Coverings Complicate Connection

Beyond the day-to-day disruption, mandatory mask-wearing complicates our ability to communicate even further. Masks can make it hard to breathe, project our voices and use facial expressions to share our emotions.

As social creatures, we naturally crave connections and facial expressions are an essential part of non-verbal communication. It gives us the cues we need to promote conversation and establish and maintain social relationships.

We have all struggled to communicate with a mask. I personally have experienced the stress of making myself understood, particularly in a store with a lot of background noise. For the hearing-impaired, the combination of wearing a mask has been extraordinarily challenging. Unable to lip read, and without the visual cues of nonverbal communication, this segment of the population has been at an extreme disadvantage.

Communication Struggles Are a Universal Crisis

Most of us will bounce back from these challenges. The concern is for those who culturally, financially or geographically have limited access to health care services even during non-pandemic times.

Promoting better speech and hearing awareness is key in addressing these social determinants of health. Resources that enhance quality of life can have a significant influence on population health outcomes.

According to the Centers for Disease Control and Prevention , there are 34.2 million Americans diagnosed with diabetes. The National Institute on Deafness and Other Communication Disorders approximates 46 million Americans experience some form of communication disorder and 37.5 million Americans report having some form of hearing disorder. And these were the numbers before COVID. Yet, "diabetes is associated with substantial clinical and economic burdens" on patients and on the U.S. health care system, while communication disorders are not.

As a country, we spend billions of dollars treating diabetes which is the seventh leading cause of death in the U.S. Perhaps it's the mortality factor which naturally garners more awareness. Though communication disorders may cost the U.S. up to 186 billion dollars per year and may impact an individual's physical, social, educational and vocational health, the awareness is surprisingly limited.

What's Next

We need to create awareness for those who are not in grave danger yet are medically impaired and give a voice to those who cannot effectively speak for themselves.

I strongly suspect we will see the number rise for post-pandemic communication disorders. I have personally seen a dramatic increase in the inquiries in my virtual speech therapy practice; other therapists are reporting a similar increase. Think of the havoc COVID-19 wreaked on the larynx and vocal cords of those who were intubated, the front-line workers who had to work with masks and overuse their voices. Let us not forget those students who were not diagnosed during this school year with a speech or language delay.

The needs for communication remediation are not just limited to COVID-related issues. With the medical advances and increased survival rates of stroke patients, victims of car accidents and others who have sustained traumatic brain injuries, the State of Texas alone has guesstimated a 32% increase in speech therapy demand by 2028.

Awareness and Advocacy Are Key

While promoting awareness is key in remediating the problem of lack of access and the lack of education about the efficacy of virtual speech therapy , advocacy is also needed. Health care professionals should be encouraged to ask questions about communication issues and patients need to be empowered to express their need for services. The addition of communication concerns to the health care provider-patient conversation may be the powerful advocacy tool needed to propel the awareness to the level needed for action.

We are making strides with insurance companies who have been reluctant in the past to cover telehealth services but rose to the occasion during COVID for two reasons:

• One reason was that traditional delivery of services was impossible.
• The other reason is that consumers did not accept denial as the final act, but used it as an opportunity to continue the conversation and broaden the coverage for services.

Demand is one of the driving forces for change. Awareness and advocacy are equal partners.

By raising awareness, increasing demand and promoting advocacy, we can address communication disorders – both those related and unrelated to the pandemic – and promote the promising opportunities available for remediation by the speech and language therapy community.

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Communication in the Time of COVID-19: Some Reflections on Ethics

• Markkula Center for Applied Ethics
• Ethics Resources
• Ethics Spotlight

Out of the outbreak of COVID-19 have come, among other challenges, many ethical dilemmas around communication.

two people talking by telephones connected to the earth

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Rohit Chopra is an associate professor in the Department of Communication at Santa Clara University and a Faculty Scholar at the Markkula Center for Applied Ethics. Views are his own.

Along with its massive costs in terms of human lives, impact on families, and economic devastation, the ongoing global crisis caused by the COVID-19 pandemic will force us to confront many deeply cherished beliefs and assumptions, for instance, about individual self-interest and societal obligations, the relative value of economic and social rationales for particular policy actions, and our responsibility to our fellow human beings. The crisis will also foreground the issue of the civic and ethical responsibility of different sectors of social, cultural, and economic life towards both the national collective and the global community that we inhabit. When the proverbial dust settles, organizations and corporations involved in any aspect of communication, from legacy media firms to the social media platforms, should necessarily be central to this conversation as should the communication policies of government agencies, hospitals, and the like. 

The case for such reflection is not just a function of the current crisis. Legacy media, such as print and television, have long been the object of criticism for prioritizing profits and sensationalism at the cost of serious reporting. Social media platforms have received significant attention in the last few years given their role in spreading fake news and their weaponization in undermining elections and democratic processes across the world. The Cambridge Analytica scandal involving Facebook and the use of WhatsApp to foment violence against minorities in India are two obvious examples. Complicating this situation is the fact that in many countries, traditional journalism is in a state of crisis, caused in no mean measure by the impact of social media firms, their professed commitment to some chimera of neutrality, and the readiness of state actors to adopt these platforms for their own agendas. Yet all of this has come to a boil in a very real sense over the past few weeks as the problems caused by the spread of the virus have been compounded by missteps in communication and, to an extent, by the very structure and political economy of the global media system.

In broad strokes, these are the communication patterns that have emerged, seen here in the U.S. as well as internationally.

Social media has been a double-edged sword, a source for both vital information—from experts and those on the ground—and fake news, such as cures for the virus or fake videos of Wuhan circulating on WhatsApp. Well before the shift in the view of authorities in the U.S. about the necessity of wearing masks, the idea was circulating on social media and has clearly had an impact. As of Wednesday, April 1, N95 masks were selling in a San Francisco hardware store for the criminal price of $40 each. By the morning of April 2, all face masks were sold out at Home Depot. 

A thorny ethical challenge raised by social media discourse is that legitimate, informed insights from credible sources are mixed in with conspiracy theories generated by various fringe subgroups, radical libertarians who see government as the enemy, and the like. Social media firms like Facebook and Twitter have also long played a reprehensible game of strategically and inconsistently invoking either user safety or freedom of speech to suit their profit-seeking ends or to comply with the dictates of a particular government. Critics of the practices of social media firms have long maintained that the platforms need to take far more responsibility—or need to be made to bear such responsibility. That becomes more than urgent now as the COVID-19 virus heralds another aspect of the reality we have to live with going forward.

The mainstream print and broadcast media, whether in the U.S. or India, have not, for the most part, broken any stories or presented any radically new information about the COVID-19 virus and its impact. Their reporting has mostly been second-order, a reorganization and filtering of statistics, statements by authorities, and projections of deaths. While most stories put out by the mainstream media seem to have nothing significantly troubling from an ethical point of view, the headlines, however, have tended toward the sensational, for instance, by presenting the number of people likely to die. Such facts are technically not incorrect, but, often, on reading the stories, it emerges that these figures are based on one model or one study or subject to a certain rate of spread or noncompliance. There seems to be a thinness to the news about what is surely an extraordinary, if terrible, historical event. This may be a function of the damage suffered by the profession over the last decade or so, with the evisceration of newsrooms and shrinking of investigative journalism. Or it may just be that we are in the midst of the event without perspection yet. Whatever the reason, this should drive home the need for more rigorously trained journalists in many areas, including public health and medicine. 

A final point pertains to the incoherent stream of communication from the American president and the chorus of voices, often not in tune, from assorted federal authorities. Dr. Anthony Fauci has emerged as a natural and reassuring authority, but a significant part of his job seems to be recontextualizing Donald Trump’s statements, which have ranged from xenophobic to blustering, and optimistic to grim. The absence of an official point person for crisis communication and the mixed messaging from the president and the White House has, arguably, contributed more to the panic and hoarding—after an initial period of cavalier indifference in much of the country—than have any pronouncements about the seriousness of the situation. The Center for Disease Control has guidelines for developing a crisis communication plan and strategy but these have not quite been followed over the last week.

The same pattern of miscommunication has also been seen in many other countries from the UK to India, with the confusion made worse by conflicting views expressed by doctors in one society and the World Health Organization. For the next pandemic, something along the lines of a global crisis communication protocol, apposite and required for a global crisis, will be a necessity. Implementing it will be a challenge, no doubt, conflicting as it may with national interests and directives. But given our shared vulnerability as a species it may be a necessary if not sufficient condition for dealing appropriately with the next such event.

Communication During a Pandemic

Importance of effective communication during COVID-19 infodemic

Affiliations.

• 1 Department of Community Medicine, NRI Academy of Medical Sciences, Guntur, Andhra Pradesh, India.
• 2 Department of Community and Family Medicine, All India Institute of Medical Sciences Mangalagiri, Andhra Pradesh, India.
• PMID: 33110769
• PMCID: PMC7586512
• DOI: 10.4103/jfmpc.jfmpc_719_20

The impact of COVID-19 on vulnerable groups would rely in part on the quality of communication regarding health risk and danger. Strategic planning should take full account of the way life conditions, cultural values, and risk experience affect actions during a pandemic. Concept of information education communication, Social behaviour change communication, social marketing usually technology and media is recapitulation. Ignorance with sociocultural, economic, psychological, and health factors can jeopardize effective communication at all levels. We summarized the framework for effective communication during pandemic. Understanding and practicing various communication strategies is crucial for physicians and health care workers to develop therapeutic relationships with COVID-19 patients. Addressing psychology in all people is vital during a pandemic and effective communication network is key to it. Effective communication, if ignored, will generate gaps for vulnerable populations and result in added difficulty in combating COVID-19 pandemic.

Keywords: COVID; Communication; corona; information; message; pandemic.

Copyright: © 2020 Journal of Family Medicine and Primary Care.

Publication types

Exploring the interplay between individual and family functioning during the COVID-19 pandemic: a cross-sectional study

• Open access
• Published: 07 May 2024

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• Valentina Lucia La Rosa   ORCID: orcid.org/0000-0002-6619-6777 1 ,
• Miriana Tornatore 1 &
• Elena Commodari   ORCID: orcid.org/0000-0002-7647-8743 1  

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Family relationships are central to an individual’s development and influence their emotional, relational, and social trajectories. Optimal family functioning, encompassing emotional connections, communication patterns, and coping mechanisms, is pivotal to the well-being of individual family members, especially during challenging periods such as the COVID-19 pandemic. From this perspective, this study, conducted during the second wave of the COVID-19 pandemic in Italy, assessed the interplay between individual and family functioning. Utilizing Hill's ABC-X model, we explored how the pandemic (stressor) impacted family dynamics (resources), perceived individual affectivity and family efficacy (perception), thereby influencing family quality of life (outcome). Four hundred and four participants completed a battery of standardized questionnaires to evaluate perceived individual affectivity during the pandemic, family quality of life, family dynamics (cohesion, flexibility, and communication), family conflict, family efficacy, and family coping strategies. Positive affectivity was associated with better family quality of life and more adaptive family coping strategies. The sample reported a low family quality of life and low family cohesion, flexibility, and communication during the pandemic. A positive sense of family cohesion, flexibility, and communication was associated with better individual well-being, better family quality of life and efficacy, and less conflict. Family communication was the strongest predictor of family quality of life in the study sample. In conclusion, our results emphasize the importance of strengthening family and individual resilience in transforming post-pandemic challenges into psychological and familial growth opportunities.

Avoid common mistakes on your manuscript.

Human development encompasses physical, cognitive, and psychosocial growth throughout an individual's life cycle (Bornstein, 2018 ). Changes in one of these developmental areas often impact the other throughout life as they are interconnected and overlap (Sigelman & Rider, 2018 ).

Family relationships play a pivotal role in individual development, influencing the emotional, relational, and social trajectories (Morris et al., 2007 ; Shigeto & Voltaire, 2020 ; Sigelman & Rider, 2018 ). A supportive family fosters harmonious development from infancy through adulthood, affecting everything from early social skills to resilience against psychopathological disorders in later life stages (Butler et al., 2022 ; Chu et al., 2010 ). The family remains a cornerstone for support and development throughout the lifespan, from childhood through adolescence to adulthood (Bonnie et al., 2019 ; Shigeto & Voltaire, 2020 ; Wood et al., 2018 ). From this perspective, optimal family functioning, covering emotional bonds, communication, and coping strategies, is fundamental to individual psychological well-being (Bornstein, 2018 ; Olson, 2011 ). In a positive family environment, members work together as an interconnected unit to overcome difficult situations and conflicts, activating coping and resilience skills, especially in times of crisis (Kao & Caldwell, 2017 ).

From a developmental perspective, the COVID-19 pandemic can be considered a non-normative life event, that is, a life event that is significant, unpredictable, and unexpected and that does not follow a predetermined developmental pattern of the life cycle (e.g., natural disasters, death of a family member, illness) (Koulenti & Anastassiou-Hadjicharalambous, 2011 ). From this perspective, the pandemic has disrupted the regular course of individual and family dynamics (Fernandes et al., 2021 ). As global lockdowns reshaped social interactions, there were profound implications for mental health and interpersonal relationships (Luttik et al., 2020 ; Passavanti et al., 2021 ). While confinement-strained, family ties also underscored the importance of family cohesion in navigating shared traumas (Luttik et al., 2020 ).

According to the Family Stress Model (FSM), as formulated by Hill ( 1949 ), families experience stress when encountering various life events or challenges, such as financial difficulties, health issues, or interpersonal conflicts. These stressors can disrupt equilibrium within the family and lead to a series of reactions and adjustments. Hill's theory emphasizes that families strive to maintain stability and adapt to stress through coping strategies and support networks (McKenry & Price, 2005 ). Family quality of life is deeply influenced by the individual well-being and satisfaction of its members, making it a crucial outcome to assess (Brown & Brown, 2014 ). Therefore, studying the interplay between individual family members and their broader social contexts is essential for understanding how stress affects family dynamics and relationships. From this perspective, a pandemic can be considered an external stressor that affects the family system. To cope with the challenges of the pandemic, families need to actively balance external pressures with their coping strategies and belief in their ability to address challenges, thus developing resilient strategies and ultimately achieving family well-being (Crandall et al., 2022 ; Wu & Xu, 2020 ).

Several studies have evaluated the main dimensions of family functioning during the COVID-19 pandemic. A recent study on family functioning in Portuguese families showed that some families are more vulnerable to stress than others (Fernandes et al., 2021 ). In particular, family functioning was enhanced among the members who maintained balanced levels of cohesion and adaptability. These individuals can adapt and shift between different levels during crises, unlike those at the most extreme levels, which are deemed unbalanced (Fernandes et al., 2021 ). Other studies have underlined two opposite consequences of the pandemic on family quality of life: family conflict increased, but family cohesion represented an essential protective factor that could mitigate stress consequences and protect family well-being and resilience (Zeng et al., 2021 ). Communication is another dimension of family functioning that can relieve stress and represents an effective strategy for facing the COVID-19 pandemic (Hall et al., 2022 ; Zeng et al., 2021 ). Family coping is also an important construct to be investigated during critical periods such as the COVID-19 pandemic to understand how the family responds to stressors and adverse life events and how such coping strategies affect family functioning and the well-being of family members (Fogel et al., 2022 ). Recent studies have reported that family members may employ various coping strategies to deal with the stressors of the pandemic (Kusnadi et al., 2022 ). Some opt for cognitive or appraisal-centered approaches to shift their perspective on COVID-19 and re-evaluate how it affects their families’ daily lives. Others have used problem-focused coping techniques to address the challenges posed by the pandemic within their families (Wu & Xu, 2020 ). In particular, using positive coping strategies empowers family members to enhance their capacity to withstand distress and to improve their families’ quality of life. Fogel et al. ( 2022 ) showed that positive cognitive appraisal was a protective factor against a significant decrease in family quality of life during the pandemic.

Although the link between individual and family functioning is well established, there is a noticeable gap in research on understanding these dynamics during unprecedented events, such as pandemics. Most studies conducted during the COVID-19 pandemic have approached this issue from an individual perspective; however, a comprehensive exploration encompassing both individual and family dimensions in the context of a global crisis is scarce. Moreover, few studies have investigated the coping construct in the family dimension, as most have focused on individual coping (Kusnadi et al., 2022 ). Therefore, studies on this topic are critical to understanding the relationship between pandemic stressors and family quality of life.

In light of these considerations, it is essential to investigate how families coped with COVID-19 and their relationships with their functioning and quality of life. Furthermore, it is also relevant to assess the interplay between family functioning and the individual well-being of family members during a global crisis such as the pandemic.

Theoretical framework of the study

This study was guided by the FSM, which offers a comprehensive framework for understanding family dynamics under stress, particularly during the COVID-19 pandemic (Reich et al., 2023 ). More specifically, Hill's ABC-X model helps examine how families navigate COVID-19-related stress, delineating the interplay between the stressor event (A), the family's internal and external resources (B) to manage the crisis, the family's perception and interpretation of the stressor (C) and the resulting crisis outcome (X).

Several recent studies have effectively utilized Hill's FSM to analyze the impact of the COVID-19 pandemic on family structures and dynamics (McGill et al., 2022 ; Prime et al., 2020 ; Reich et al., 2023 ; von Suchodoletz et al., 2023 ). This growing research has demonstrated the model's robust applicability and relevance in contemporary contexts. Aligning with these research trends, our study employed Hill's model to explore the various outcomes (X) observed in families during the pandemic.

In the context of our study, as shown in Fig.  1 , the COVID-19 pandemic serves as the stressor event (A), fundamentally altering families' daily lives and routines. Our investigation focused on how families mobilize their resources (B), including cohesion, flexibility, communication, conflict, and coping strategies, to confront the challenges of the pandemic. Moreover, we examine the critical role of perceived family efficacy and pandemic-related individual affectivity (C), significantly shaping family responses and coping strategies for dealing with the crisis. Finally, we considered X (crisis outcomes) as the specific way in which family quality of life has been affected by the COVID-19 pandemic, resulting from the interplay between the stressor event (A), the family's resources (B), and the perception of the stressor (C).

Application of Hill's Family Stress Model to the COVID-19 pandemic

Study aims and hypotheses

This study aimed to analyze family and individual functioning during the COVID-19 pandemic in Italy using Hill's ABC-X model. We focused on the interplay between the pandemic as a stressor (A), family dynamics such as cohesion, flexibility, communication, conflict, and coping strategies as resources (B), and perceived family efficacy and individual affectivity during the pandemic (C). In particular, this study explored how these factors collectively impact family quality of life (X).

Based on these study's aims, the following hypotheses were formulated as follows:

H1: Family dynamics (B)–cohesion, communication, flexibility, and conflict–positively influence family quality of life (X). More robust family dynamics predict better family quality of life.

H2: Perceived pandemic-related individual affectivity (C) correlates with family quality of life (X) and family dynamics (B). Positive pandemic-related individual affectivity is associated with better family quality of life and healthier family dynamics, while negative affectivity is linked to higher conflict and avoidance coping.

H3: Robust family functioning domains (B), positive perceived pandemic-related individual affectivity and high perceived family efficacy (C) lead to higher family quality of life (X), showcasing effective adaptation to pandemic stressors (A).

Materials and methods

Study design and participants.

This cross-sectional study was conducted during the second wave of the COVID-19 pandemic in Italy. During this period, the restriction measures varied according to the virus spread rates in different regions, vaccination status, and possession of the Green Pass (a certificate required in Italy to gain access to specific activities and attest to COVID-19 vaccination, recovery from disease or a negative COVID test). The participants were subjects who resided in Italy and agreed to respond to an online survey distributed through the main social networks. Exclusion criteria included individuals not living in Italy, under 18 years of age, unable or unwilling to provide informed consent, and with diagnosed psychiatric disorders. Participation in the study was voluntary, anonymous, and without remuneration. Online informed consent was obtained before participants answered the questionnaire.

The study protocol was drafted according to the Declaration of Helsinki, the Ethics Code for Italian psychologists (l. 18.02.1989, n. 56), Italian law for data privacy (dlgs 196/2003), and the Ethics Code for Psychological Research (March 27, 2015) approved by the Italian Psychologists Association. Furthermore, the Institutional Review Board of the Department of Educational Sciences of the University [omitted for peer review] approved this study.

The online questionnaire comprised 71 multiple-choice questions, and its completion required approximately 15 min.

The first section of the questionnaire consisted of 11 sociodemographic questions about gender, age, marital status, education, employment, online work during the pandemic, contracting COVID-19, COVID-19 cases in the family, hospitalization for COVID-19 of participants and family members, and family bereavements due to COVID-19.

The second section consisted of 60 items. Participants were asked to respond to items drawn from validated questionnaires using an approach already adopted in psychological and health research (Lanza et al., 2010 ; Mantziki et al., 2014 ; McGee et al., 2015 ).

In selecting the items to be included in the survey, the objectives of the study were clearly defined, with a focus on assessing the impact of the COVID-19 pandemic on family and individual well-being, and an extensive review of the existing literature was undertaken to identify validated questionnaires assessing the constructs of interest.

Criteria for item selection were established based on the research objectives and constructs of interest. These criteria included the relevance of each item to the pandemic context, the ability to represent best the underlying constructs, and consideration of survey length and respondent burden. Subject matter experts in family psychology were engaged to review the selection of items to ensure content validity, providing insight into the appropriateness and relevance of the selected items to the measured constructs, particularly in the context of the pandemic.

Using the established criteria and expert feedback, a preliminary selection of items was made from the identified validated questionnaires. Where necessary, selected items were adapted to fit the context of the pandemic and the study population better. To ensure the construct validity of the adapted scales, confirmatory factor analysis (CFA) was performed, and Cronbach's alpha was calculated for each scale to ensure that the selected items consistently measured the intended constructs.

Perceived individual affectivity during the COVID-19 pandemic was assessed using the Questionnaire on positive and negative emotions related to the experience of the COVID-19 pandemic , which has already been validated in adolescents and young adults (Commodari & La Rosa, 2020 ; Commodari et al., 2021 ). Participants were asked to complete a Likert-type scale that focused on their personal feelings regarding their cognitive, physiological, and behavioral states. Each item (e.g., “In this period in which I must stay at home, I feel well physically”; “In this period in which I must stay home, I am tense and I feel tight”) was scored on a five-point Likert-type scale ranging from 1 ( not at all ) to 5 ( most of the time ). The scale measures two affective dimensions: “ negative affectivity ” and “ positive affectivity.” A high score corresponds to an increased perception of negative or positive feelings. Confirmatory factor analysis was also performed to assess the validity of the structure of the questionnaire. Regarding the model for the “negative feelings,” all the goodness of fit values were satisfactory (RMSEA =. 08; SRMR = 0.04; CFI = 0.93; TLI = 0.91). The same result was obtained for the model of the “positive feelings” (RMSEA = 0.06; SRMR = 0.03; CFI = 0.96; TLI = 0.93). Furthermore, both scales showed good reliability in the study sample (negative feelings: Cronbach’s α = 0.81; positive feelings: Cronbach’s α = 0.75).

Eight items on individual perception of family quality of life were formulated based on the Italian version of the Family Quality of Life Survey (Brown et al., 2006 ) and adapted to the context of the COVID-19 pandemic. Specifically, the items included in the questionnaire were related to the impact of family members' health status, support received from health services, and relationships within the family on family quality of life (“ I consider my family's health important to my quality of life and that of other family members ,” “ I worry about the health status of my family members ,” “ I am overall satisfied with the health status of my family members ,” “ I consider the support provided by the National Health Service to be important for my family's quality of life ,” “ I am overall satisfied with the support provided to my family by the National Health Service ,” “ I consider family relationships important for my family’s quality of life ,” “ I believe that the members of my family are committed to maintaining good relations with each other ,” “ I am overall satisfied with the relationships within my family ”). Each item was scored on a five-point Likert-type scale ranging from 1 ( not at all ) to 5 ( most of the time ). A high score indicates a high level of family quality of life. Confirmatory factor analysis showed that the factor structure of the questionnaire was appropriate (RMSEA = 0.06; SRMR = 0.08; CFI = 0.95; TLI = 0.94). The scale's reliability in this study was also good (Cronbach’s α = 0.80).

Sixteen items on the three main dimensions of family functioning were selected from the Italian adaptation of the Flexibility and Cohesion Evaluation Scale – IV Edition (Olson, 2011 ; Visani et al., 2014 ), which consists in its original version of 42 items. Specifically, the items with highest factor loadings for each dimension were selected: six items assessed cohesion, defined as the emotional bond between family members (e.g., “In my family, we support each other, especially in difficult moments,” “We feel too close to each other”); six items assessed flexibility, defined as the quality and expression of leadership and organizations, role relationships, and relationship rules (e.g., “In my family, rules are established together,” “In my family, it is important to follow the rules”); four items assessed communication, defined as the positive communication skills used within the family system (e.g., “I feel I can freely express my problems to my family,” “Each of us tries to understand the feelings of other family members”). Each item is rated on a five-point scale ranging from 1 ( not at all ) to 5 ( most of the time ). The goodness-of-fit measures for all dimensions were satisfactory (cohesion: RMSEA = 0.03, SRMR = 0.05, CFI = 0.98, TLI = 0.98; flexibility: RMSEA = 0.03, SRMR = 0.05, CFI = 0.99, TLI = 0.99; communication: RMSEA = 0.05, SRMR = 0.02, CFI = 0.97, TLI = 0.91). Furthermore, all subscales showed good internal consistency in our sample (cohesion: Cronbach’s α = 0.86; flexibility: Cronbach’s α = 0.83; communication: Cronbach’s α = 0.84).

Four items on family conflict were selected from the Brief Family Relationship Scale (Fok et al., 2011 ), which consists in its original version of 19 items. Specifically, the items with the highest discrimination parameters were selected to represent best the underlying construct (“ In our family, we lose our tempers a lot ,” “ In our family, we often put down each other ,” “ In our family, we are really mad at each other a lot ,” “ In our family, we raise our voice when we are mad ”). Then, the selected items were adapted to the pandemic context. Each item was rated on a five-point scale ranging from 1 ( not at all ) to 5 ( most of the time ). The scale showed satisfactory goodness of fit (RMSEA = 0.04, SRMR = 0.04, CFI = 0.92, TLI = 0.98) and good reliability (Cronbach’s α = 0.78) in the study sample.

Ten items on family coping strategies were adapted from the Coping Orientations To Problem Experienced—New Italian Version (Sica et al., 2008 ), which consists in its original version of 60 items assessing individual coping strategies. Specifically, the core items for each coping style were selected and then adapted to the family context during the pandemic. Items were chosen as follows: two items for social support strategies, which consist of sharing the resolution of problems with both family members and the external environment (“ We seek support from each other ,” “ We ask for help from those who have had similar experiences to ours ”); two items for avoidance strategies, which consist of behavioral and mental detachment to escape the critical situations (“ We recognize that we cannot deal with the situation and abandon all attempts to act to solve the problem ,” “ We pretend it did not happen ”); two items for positive attitude strategies, which consist of the attitude of acceptance and positive reinterpretation of stressful events (“ We try to learn something from experience ,” “ We try to find something positive in what happens ”); two items for problem orientation strategies, which consist of planning and using appropriate problem solving strategies (“ We are deeply committed to cope with the problem ,” “ We try to devise strategies on what to do ”); two items for transcendent orientation strategies, which consist of using humor and religion to cope with difficult situations (“ We try to find comfort in religion ,” “ We joke about the situation ”). Participants responded to each item on a 5-point Likert scale ranging from 1 ( not at all ) to 5 ( most of the time ). Confirmatory factor analysis showed a good questionnaire structure (RMSEA = 0.06, SRMR = 0.06, CFI = 0.97, TLI = 0.93). The scale's reliability in the study sample was also acceptable (Cronbach’s α = 0.77).

Four items on individual perception of family efficacy were adapted from the General Self-Efficacy Scale (Schwarzer & Jerusalem, 1995 ), which consists in its original version of 10 items assessing individual self-efficacy. In particular, we selected the items that had the highest discrimination parameters best representing the underlying construct (“ Thanks to our resourcefulness, we can handle unforeseen situations” ; “ We are confident that we could deal efficiently with unexpected events”; “We can remain calm when facing difficulties because we can rely on our coping abilities”; “If we are in trouble, we can think of a good solution” ) and adapted them to the family context during the pandemic. Each item was rated on a five-point scale ranging from 1 ( not at all ) to 5 ( most of the time ). Confirmatory factor analysis showed that the factor structure of the questionnaire was appropriate (RMSEA = 0.03; SRMR = 0.04; CFI = 0.94; TLI = 0.94). The reliability of the scale in this study was also good (Cronbach’s α = 0.86).

Statistical analyses

Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 25.0 (IBM Corporation, Armonk, NY). The study methodology adhered to the Journal Article Reporting Standards (Kazak, 2018 ). The materials and analysis code for this study are available by emailing the corresponding author. The study design and analysis were not pre-registered.

No data were excluded from the analyses, and no outliers were identified. The necessary sample size was calculated using G*Power 3.1, targeting power of 0.90, with 19 predictors (the maximum number included in the multiple linear regression), and α set at 0.05. The aim was to detect a minimum effect size of f 2  = 0.15, which was indicative of a medium effect, as outlined by Cohen ( 1988 ).

A CFA was performed to test the measurement model for each scale. The goodness of fit was evaluated using the Root Mean Square Error of Approximation (RMSEA < 0.05), the Standardized Root Mean Square Residual (SRMR < 0.08), and the Comparative Fit Index and the Tucker-Lewis Index (CFI and TLI > 0.90). Cronbach’s α was used to assess the reliability of the scales and was considered acceptable when > 0.70.

The scale scores were obtained by summing the answers given to the individual items. Higher scores represent higher levels of the variables. Median cut-off points were used to distinguish between low and high scores for each variable.

The Kolmogorov–Smirnov test was used to assess the normal distribution of the variables. Continuous variables with normal distribution are presented as mean (M) and standard deviation (SD), while frequencies and percentages describe categorical variables. The scores were divided into high and low, assuming the median was the cut-off.

Correlations between continuous variables were evaluated using Pearson’s correlation coefficient. In addition, a multivariate analysis of variance (MANOVA) was performed to explore the relationship between sociodemographic variables, individual affectivity, and family functioning. Finally, a multiple regression model was run to identify family quality of life predictors during the COVID-19 pandemic. Specifically, family quality of life was the dependent variable in the regression model. The predictors entered into the model were sociodemographic variables, family functioning, and individual affectivity.

Sample characteristics

In total, 404 participants completed the questionnaire. Of the participants, 65.6% were women, and the mean age was 36.52 ( SD  = 15.43, range = 18–76). Most of the participants had a high school diploma (43.8%) or a degree (40.6%) and were students (34.7%). Furthermore, 54.0% of the sample were single, and 40.8% were married or cohabiting. Only 14.9% had contracted COVID-19 during the study period, and only five were hospitalized. In contrast, 33.9% reported cases of COVID-19 in their families, of which 27 were hospitalized. Finally, 7.7% experienced family losses due to COVID-19. Table 1 reports all the sociodemographic characteristics of the sample.

Questionnaire scores and correlations between study variables

Based on the median cut-off points of the questionnaire scores, most participants reported low family quality of life, family functioning, and family efficacy. Most of the sample reported low levels of family conflict (70.0%). Regarding pandemic-related individual affectivity, 62.1% reported low positive affectivity, whereas 47.0% reported high negative affectivity.

All variables investigated were significantly correlated (Table  2 ). In particular, the most significant correlations were observed between the family quality of life and family communication ( r  = 0.554, p  < 0.001), family quality of life and family efficacy ( r  = 0.507, p  < 0.001), family cohesion and family flexibility ( r  = 0.591, p  < 0.001), family communication and family efficacy ( r  = 0.680, p  < 0.001), family communication and social support coping strategies ( r  = 0.592, p  < 0.001), family communication and problem orientation coping strategies ( r  = 0.559, p  < 0.001), and family efficacy and adaptive coping strategies (social support: r  = 0.659, p  < 0.001; positive attitude: r  = 0.628, p  < 0.001; problem orientation: r  = 0.731, p  < 0.001).

Individual affectivity, family well-being and dimensions of family structure

Three-way MANOVA showed significant main effects of cohesion [(F (10, 387) = 4.88, p  < 0.001, η 2  = 0.11)], flexibility [(F (10, 387) = 4.87, p  < 0.001, η 2  = 0.11)], and communication [(F (10, 387) = 15.98, p  < 0.001, η 2  = 0.29)] on individual affectivity and family well-being. However, this interaction effect was not statistically significant.

Table  3 reports the differences in scores of individual well-being, family quality of life, conflict, efficacy, and coping based on the dimensions of family functioning. Higher family cohesion, flexibility, and communication levels are associated with better individual well-being, higher quality of life and family efficacy, and lower family conflict.

Individual affectivity and family variables

The two-way MANOVA test showed significant main effects of positive affectivity [(F (11, 390) = 6.18, p  < 0.001, η 2  = 0.15)] and negative affectivity [(F (11, 390) = 6.72, p  < 0.001, η 2  = 0.16)] on family quality of life. However, the interaction effect was not statistically significant [(F (11, 390) = 0.50, p  = 0.90)].

Analyzing the specific scores, participants with high positive affectivity reported significantly higher scores for family quality of life ( p  < 0.001), cohesion ( p  = 0.003), flexibility ( p  = 0.006), communication ( p  < 0.001), and efficacy ( p  < 0.001). Furthermore, participants with high positive affectivity showed significantly higher scores for social support ( p  < 0.001), positive attitudes ( p  < 0.001), problem orientation ( p  < 0.001), and transcendent orientation ( p  = 0.001) than participants with low positive affectivity.

Participants with high negative affectivity reported lower scores for family cohesion ( p  < 0.001) and flexibility ( p  = 0.005) and higher scores for family conflict ( p  < 0.001) than participants with low negative affectivity. Furthermore, high negative affectivity was associated with higher scores on the coping avoidance strategy ( p  < 0.001) and lower scores on the positive attitude coping strategy ( p  = 0.02).

Family functioning and sociodemographic characteristics

The results of two-way MANOVA showed a significant overall main effect of gender [(F (6, 393) = 4.96, p  < 0.001, η 2  = 0.07)] and age groups [(F (12, 788) = 2.19, p = 0.01, η 2  = 0.03)] on family functioning variables. However, the interaction effect between gender and age groups was not statistically significant [F (12, 786) = 1.45, p  = 0.14]. Specifically, women reported higher scores for family quality of life ( p  < 0.001), family communication ( p  = 0.03), and family efficacy ( p  < 0.001) than did men. Furthermore, women reported lower scores for family conflict ( p  = 0.007) than men. Regarding age groups, the Bonferroni post-hoc test showed that the 18–28 age group reported lower scores for family cohesion than the 29–49 ( p  = 0.002) and the > 50 ( p  = 0.03) groups and lower scores for family flexibility and communication than the 29–49 age group ( p  < 0.001). Finally, they reported higher scores for family conflict than the 29–49 age group ( p  < 0.001).

MANOVA also showed a significant overall main effect for gender [(F (5, 394) = 4.64, p  < 0.001, η 2  = 0.06)] but not for age groups [(F (10, 790) = 2.19, p  = 0.61, η 2  = 0.01)] on family coping strategies. However, the interaction effect between gender and age groups was not statistically significant [F (10, 788) = 0.94, p  = 0.50]. In particular, women reported higher scores for social support ( p  = 0.005), positive attitude ( p  = 0.002), and problem orientation ( p  = 0.03) than did men. Furthermore, women reported lower scores for avoiding coping strategies ( p  = 0.007) than men.

Regarding marital status, the MANOVA results showed a significant main effect on family functioning variables [(F(18, 1117) = 2.44, p  = 0.001, η 2  = 0.04)] but not on family coping strategies [(F(15, 1093) = 0.73, p  = 0.76)]. In particular, the Bonferroni post-hoc test showed that single people reported lower family cohesion scores than married or cohabiting people ( p  = 0.003). Furthermore, family communication scores were significantly lower for single people than married or cohabiting people ( p  = 0.02). Finally, single people reported higher scores for family conflict than married or cohabiting people ( p  = 0.03).

No significant differences regarding the educational level and employment were found.

Family functioning and COVID-19 variables

MANOVA tests showed significant differences in family variables between participants affected by COVID-19 and those without the disease [(F (6, 397) = 2.36, p  = 0.03, η 2  = 0.03)]. Specifically, people who contracted COVID-19 reported higher scores on family flexibility ( p  = 0.003) and communication ( p  = 0.017) than those who did not contract the disease. Furthermore, regarding family coping strategies [(F (5, 398) = 3.22, p  = 0.007, η 2  = 0.04)], people who contracted COVID-19 reported higher scores for positive attitudes ( p  = 0.002) and problem orientation ( p  = 0.02) than people who had not contracted the virus.

Furthermore, people who had cases of COVID-19 in their families reported higher positive attitude scores than people who did not ( p  = 0.03). No other significant differences were found in the presence of cases of COVID-19 in the family. The presence of bereavements in the family due to COVID-19 was also not associated with significant differences in the study variables.

Predictors of family quality of life in the study sample

Multiple regression analyses were used to investigate the study sample's family quality of life predictor variables. Preliminary analyses were conducted to ensure that the assumptions of normality, linearity, multicollinearity, and homoscedasticity assumptions were not violated.

The regression model explained 41% of the variance (R 2  = 0.410, F = 12.54; p  < 0.001). The independent variables that contributed the most to explaining the family quality of life score were family communication ( β  = 0.32, p  < 0.001), positive affectivity ( β  = 0.19, p  < 0.001), gender ( β  = 0.12, p  = 0.006), and avoidance coping strategy ( β  = -0.11, p  = 0.038). Table 4 shows all the regression analysis results and the contribution of each independent variable.

This study aimed to explore the interplay between individual affectivity and family functioning within the framework of Hill's Family Stress Model during the COVID-19 pandemic, trying to understand how the non-normative event of the pandemic changed the family structure and the quality of family relationships and how these changes affected the psychological well-being of family members.

As hypothesized, our results underlined the role of the pandemic as a significant stressor (A) that alters family dynamics and individual well-being. Furthermore, the pivotal role of family resources (B) – cohesion, flexibility, and communication – has been confirmed in managing the impact of the pandemic. Consistent with our hypotheses, stronger family dynamics (good cohesion, flexibility, and communication levels) were correlated with better individual and family well-being, supporting the model's emphasis on resources in crisis management. This finding aligns with the ABC-X model, demonstrating that robust family dynamics can mitigate the adverse effects of stressors.

The influence of individual affectivity on family functioning is also evident. In fact, positive affectivity was associated with better family quality of life and adaptive coping strategies, while negative affectivity was correlated with increased family conflict and avoidance strategies. These findings illustrate factor C of the model, in which individual perceptions and emotional responses shape family crisis outcomes (X). Furthermore, these data are in line with a developmental perspective that considers individuals and families as interconnected systems and individual development and well-being as the result of multiple variables, including the functioning of the family system (Kail & Cavanaugh, 2018 ; Morris et al., 2007 ; Shigeto & Voltaire, 2020 ; Sigelman & Rider, 2018 ).

Most of our sample reported a low family quality of life and low family cohesion, flexibility, and communication. Furthermore, the levels of family efficacy in our sample were low, confirming a reduced sense of family cohesion during the pandemic that does not allow the family to work collectively to achieve shared goals (Kao & Caldwell, 2017 ). When comparing the mean scores on the questionnaire, people with COVID-19 reported lower scores on perceived family flexibility and communication. The pandemic, especially the direct experience of COVID-19 within the family, seems to have a significant impact on the family organization due to uncertainty and new rules to be observed and on communication between family members, which is more difficult due to tension and fear over the possible outcomes of the disease (Prime et al., 2020 ; Soejima, 2021 ). Furthermore, participants who had contracted COVID-19 reported less use of adaptive family coping strategies, such as positive attitudes and problem orientation, confirming that the disease also affects family ways of coping with stress, with negative consequences on the well-being of both the individual and the entire family system (Prime et al., 2020 ). Instead, people who had cases of COVID-19 among their family members reported higher positive attitude scores than those who did not. This result may seem counterintuitive, but likely, households that have had to cope with cases of COVID-19 have probably had to adapt, acquire more knowledge about the disease, and provide mutual support during the healing process (Au et al., 2023 ). This communal struggle may lead to an increased competence and a more positive outlook on overcoming future obstacles. Indeed, it is possible to suppose that increased family resilience in the face of the pandemic may contribute to this positive attitude: in particular, the direct impact of COVID-19 within a family could stimulate a 'fight or flight' response, where the choice is often to fight back through positive thinking and resilience-building practices (Gayatri & Irawaty, 2021 ). Also, we found a significant positive correlation in our sample between positive attitude and social support, so we can hypothesize that an adequate social support network may contribute to a more positive attitude in coping with cases of COVID-19 in the family. However, this coping style was not found to be as significant as positive attitude. Therefore, other variables not explicitly investigated in this study, such as resilience, positive thinking, optimism, and social support, may significantly predict the use of more adaptive coping mechanisms, as widely highlighted in several studies conducted during the COVID-19 pandemic (Budimir et al., 2021 ; Lasota & Mróz, 2021 ; Lee, 2023 ; Leslie-Miller et al., 2021 ). Future research should address this point in greater detail.

The presence of grief in the family for COVID-19 did not seem to be significantly associated with the variables investigated in our study. This result contrasts with data from the literature that underlines how the family experience of grief was profoundly altered during the pandemic, especially during the lockdown (van Schaik et al., 2022 ). In the early stages of the pandemic, family members infected with COVID-19 died alone, and funerals were forbidden for some time. Therefore, families were prevented from sharing their grief and elaborating on it through symbolic rituals (Burrell & Selman, 2020 ; Imber‐Black, 2020 ). However, the relatively small number of reported bereavements in our sample may have influenced our results and limited their generalizability beyond the study sample. Furthermore, the study was carried out later in the pandemic when funeral bans were no longer in force, favoring more adaptive management of family grief.

Contrary to expectations, our sample's perceived family conflict level was low. This finding contrasts the literature on the topic, which shows that lockdowns and long periods of forced family cohabitation are responsible for a significant increase in family conflict (Fosco et al., 2021 ; Sinko et al., 2021 ). A possible interpretation of this finding is that the family coping strategies used in our sample were mainly adaptive, representing a protective factor against the risk of escalation of family conflict.

Other significant findings concern the role of sociodemographic variables such as gender and age. Regarding gender, women reported a higher family efficacy and quality of life and fewer family conflicts than men. Furthermore, women reported more adaptive family coping strategies than did men. However, at the same time, being female was associated with lower levels of positive affectivity and higher levels of negative affectivity. Therefore, the perceptions of family and individual well-being were contradictory among the women in our sample. In this regard, our study aligns with the findings of Rania et al. ( 2022 ), which highlight the critical role of gender in shaping family well-being. Women in our Italian sample, similar to the Italian sample of the study by Rania and colleagues, reported high family efficacy and quality of life, highlighting their central role in maintaining family stability during the crisis. However, this apparent family resilience came at a personal cost, as the same women experienced lower positive affectivity and higher negative affectivity. The contradiction between subjective well-being and family functioning may reflect a socio-cultural dynamic in which women's increased family responsibilities during the lockdown may have exacerbated personal stress despite the outward appearance of effective family coping strategies (Epifanio et al., 2021 ). For this reason, women in our sample might perceive a lower individual psychological well-being but good family functioning during the pandemic and use more adaptive family coping strategies than men. These findings suggest a complex interplay between gender roles and family dynamics during this pandemic, which deserves further study.

Regarding the role of age, our findings contrast with those reported by Fernandes et al. ( 2021 ). Specifically, in our sample, participants in the 18–28 age group reported higher levels of negative affectivity and worse perceived family functioning and quality of life. However, this finding is consistent with the literature on the psychological consequences of the pandemic, highlighting the more detrimental impact on young people who experience greater uncertainty about their future than on adults. More specifically, this finding may be due to the increased pressures this age group faces, which includes many new parents who are dealing with the challenges of raising children in such uncertain times (Rania et al., 2022 ). On the other side, the same study by Rania et al. shows a significant percentage of young people over the age of 18 still living with their parents (30.1%), underlining the tendency of young Italians to live with their families for longer due to the greater difficulties in joining the labor market compared to young people in other countries (Manacorda & Moretti, 2006 ; Menniti et al., 2000 ). This delay in the outflow from the family of origin by young Italians could explain their more negative perception of family relationships and higher levels of conflict within the family during the pandemic.

Single people reported lower family cohesion and communication scores than married or cohabiting people. Furthermore, they reported more family conflict than married or cohabiting people. These data confirm the findings of Fernandes et al. ( 2021 ), according to which Portuguese singles reported lower family functioning values during the COVID-19 pandemic. This result can also be explained by considering the family structure of countries such as Italy and Portugal. In these countries, the family is characterized by strong ties based on the mutual aid of all its members. Family units are very different but tend to be small and nuclear (Amaro & Neves, 2016 ). Therefore, this may explain the worse perception of the quality of family relationships in single people than in married or cohabiting people. These data should also be further investigated by comparing them with those from countries characterized by different family cultures.

In the context of Hill's ABC-X model, our findings showed that family quality of life (X) was intricately linked to how families navigate the stressor of the pandemic (A), the resources (B) they possess or lack, and their perception (C) of the crisis. According to the regression model results, family quality of life was significantly predicted by high levels of family communication, positive perceived individual affectivity, and low use of avoidance coping strategies, which indicates effective management of the pandemic's stress and partially confirms our hypothesis. These results underscore the model's assertion that the outcome (X) is not merely a result of the stressor itself but a complex interplay of family dynamics, resources, and perceptions, highlighting the nuanced nature of family adaptation and resilience during crises.

Strengths and limitations

This study has several strengths. First, it explored a timely topic considering the significant psychosocial impact of the COVID-19 pandemic on both individuals and families. At the same time, this study adopted a developmental perspective aimed at investigating the interdependence between individual and family well-being and identifying not only risk factors but also protective factors that can transform the pandemic event into an opportunity for individual and family development and empowerment. Second, we used a battery of questionnaires with good psychometric properties in our sample. Furthermore, the study was conducted in a period characterized by the adoption of less stringent restrictive measures than during the first wave of the pandemic in Italy. Therefore, the results allow us to take a snapshot of individual and family well-being during this transition and adaptation phase after the total closure of the first COVID-19 lockdown.

However, this study had some limitations. The first notable limitation of this study was the absence of a pre-pandemic baseline for comparison. This baseline would have provided a clearer picture of the pandemic's impact on family dynamics beyond what can be inferred from the absence of a traditional control group. Another significant limitation of this study is its cross-sectional design, which does not allow causal relationships between variables or capture changes in variables over time. However, convenience sampling did not allow for an adequate sample balance concerning sociodemographic variables such as gender, marital status, and employment. In particular, females prevailed significantly over males in the study sample. This finding may be related to the sampling strategy used in the study and the more active role of women within families, which is typical of Italian culture.

Regarding the measurement tools used, the study used a modified version of existing scales to better fit the specific context and objectives of the research. Although these modifications were made with rigorous methodological considerations, they nevertheless introduce potential limitations in terms of the validity and reliability of the scales. Consequently, the results of this study should be interpreted with caution when considering their generalizability to other contexts or their comparability with studies using fully validated scales. Future research should aim to validate these modified scales further in different settings to increase their robustness and applicability. In addition, comparisons with other studies using the original versions of these scales should be made carefully considering the potential differences introduced by the modifications.

Finally, using an online questionnaire may have introduced bias by excluding older individuals who face more significant challenges in using electronic devices. Furthermore, although the study focused on participants' perceptions of their family relationships, it did not compare evaluations from individuals within the same households. Further studies are needed to better investigate family functioning during the COVID-19 pandemic, considering the role of additional psychological variables such as resilience, optimism, and perceived social support, as well as of sociodemographic variables such as the presence of children, family members with physical and/or intellectual disabilities, and older people to care for.

Theoretical and practical implications

The results of our study highlight the complex dynamics of family resilience and individual psychological responses in the context of a global health crisis. The fact that individuals with COVID-19-affected family members exhibited positive attitudes suggests a complex interplay between adaptive perceptions and coping mechanisms. These adaptations may stem from increased empathy, solidarity, and shared purpose within families, promoting resilience and a positive outlook in the face of adversity. Theoretically, our findings highlight the importance of social support systems and adaptive coping strategies in mitigating the psychological impact of pandemics. In practice, these findings have profound implications for developing targeted interventions to enhance family resilience. Policymakers and practitioners can use this understanding to design community support programs that strengthen family cohesion and individual coping strategies during health crises.

Future research should explore the longitudinal effects of family-based resilience strategies and their effectiveness in different socio-economic and cultural contexts. The role of virtual support networks and digital communication tools in maintaining family cohesion and individual well-being during periods of isolation deserves further exploration. We recommend developing public health policies prioritizing mental health services and support for families affected by COVID-19. Educational programs that equip families with stress management and communication tools may further empower individuals to cope more effectively with the challenges posed by the pandemic.

In conclusion, our study places the COVID-19 pandemic within Hill's ABC-X Model as a significant stressor that has led to varied outcomes in family and individual well-being. However, in addition to being considered a traumatic and stressful event, the COVID-19 pandemic might also be a critical transitional event that can promote the maturation of the individual and their family, as it allows the reorganization of relationships and the development of new and more adaptive ways of coping with stress. Therefore, from a life-cycle wellness promotion perspective, the pandemic event can be considered an opportunity to mobilize novel coping and resilience skills rather than only a traumatic event associated with adverse psychological outcomes.

Our findings emphasize the importance of further research on the long-term psychological impact of the pandemic, focusing on how family resources and perceptions influence coping and resilience. Such insights are crucial in designing interventions that bolster family and individual resilience and transform the pandemic's challenges into psychological and familial growth opportunities.

Data availability

The dataset generated and analyzed during the current study is not publicly available because of the Department's privacy policies but is available from the corresponding author upon reasonable request.

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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Valentina Lucia La Rosa and Miriana Tornatore. The first draft of the manuscript was written by Valentina Lucia La Rosa and Elena Commodari, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Lucia La Rosa, V., Tornatore, M. & Commodari, E. Exploring the interplay between individual and family functioning during the COVID-19 pandemic: a cross-sectional study. Curr Psychol (2024). https://doi.org/10.1007/s12144-024-06058-6

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