Trust in government and other institutions is said to play a key role in the success of pandemic response. Mistrust and distrust can therefore impede the effectiveness of response measures, leading some countries to fare worse than others despite similarities in epidemiological context and health system infrastructure. So, how exactly does this relationship between trust and successful pandemic response work? What key things should be done to strengthen trust? Insofar as trust has an historical element and can take significant time and effort to build, what can governments and public health authorities do during a crisis when operating with low levels of public trust? Finally, what is the difference between promoting trustworthiness as opposed to promoting trust, and what is the relevance of this distinction for pandemic response efforts?