Image courtesy of Global Times
2020 has been defined by COVID-19; a year in which citizens, governments and medical first-responders found themselves in a whirlwind of unprecedented pandemonium. Adding to the confusion have been patterns of broken communication leading to speculation, discrimination and mismanagement of a lethal virus.
To compare global responses and contrast them against each other would be inequitable or else would require a deep-dive into factors impacting a country’s individualistic capacity to respond to a pandemic including healthcare, density of population, financial stability and prior experience managing disease control. However, cross-cutting similarities between nations did exist where common failures to communicate important messages to the public seemed recurring. It is these commonalities which merit scrutiny. One these shortcomings is the fragmented communications I experienced personally while residing in the United Kingdom and during the post-Minuwangoda cluster in Sri Lanka.
The importance of communicating risks during a crisis
Crisis communications in the wake of an outbreak isn’t an entirely new phenomenon. Over the years, experience managing public health and safety in cases of airborne virus strains such as SARS and MERS have helped frame a set of principles to be implemented. Ideally, a rapid response to such situations presents a longer time-frame for control opportunity. While this time frame offers an opportunity for governments to work towards minimizing socio-economic turbulence and coordinate with respective authorities to mitigate risks, it is also a vital period to gain the trust of the population. The WHO underscores five key principles when managing crisis communications; be right, be first, build trust, express empathy and promote action. Ensuring the provision of transparent and credible information helps support the preparation of populations (especially vulnerable groups) to face potential health threats and respond to them adequately.
Coordination
Information that is shared during a crisis of this magnitude is sensitive and crucial towards strategizing community resilience. Communication coordination is essential. Developing a structure enables risk communication messages to be shared efficiently among partners and engage with local community networks. Failing to do so within the rapid response time-frame leads to a lack of essential guidelines and creates doubts in leadership[1]. Bearing this in mind, streamlining vital messaging through a single, official source is a recommended place to begin. National media platforms and supporting partners can connect with the nucleus, making it easier to obtain and disseminate uniform information from a credible source. Not only does this prevent the misinterpretation of official bulletins and news updates, it also creates a singular database which is readily available for all stakeholders to access and use accordingly.
Providing information in this manner also relies on the receiving capacity of the respective communities. Relevant authorities must take into account data which highlights households which own smartphones, televisions or radios and if so, whether messaging is provided in all three official languages across converging platforms. In cases where media communication is restricted, the onus lies on authorities to provide alternative sources from which despite restrictions (such as the lack of a working television or smartphone) households can remain updated and aware[2]. A central database carrying the responsibility of compiling necessary information lays a solid foundation for authorities to begin a robust line of accountable crisis communication.
Public campaigns in the UK were predominantly publicized both online and televised regularly. Updates were published on government websites and reproduced on social networks reaffirming whichever campaign slogan was ongoing. Real-time updates and additional guidance for citizens were accessible via the NHS website. Sri Lanka’s news updates were predominantly received via text message; either by a subscribed news group or a government source. According to Sri Lanka’s Preparedness and Response Plan for COVID-19, a singular entity for dissemination of information has not been appointed. Instead, the obligation lies with “local government authorities, corporate sector […], telecommunication networks, [and] the Department of Government Information” to quote a few. However the Health Promotion Bureau maintains an updated trilingual website with information ranging from protective measures to IEC materials for students. The nation’s public communication extends to mass media, social media, a 24/7 hotline, IEC materials and public addressing systems to reach residents at a community-level.
Communicating empathy
Mismanaged communications in the United Kingdom was witnessed during the onset of the pandemic. Whether intentional or otherwise, Prime Minister Boris Johnson’s national address, in which he calmly stated that “families are going to lose loved ones” was either an insight into the government’s blatant disregard towards the common person or a poorly timed underestimation of the impact of the virus. The lack of empathy is worth noting as a missing piece of the puzzle. Communications during a crisis requires more than relaying information to the public; it also involves managing fear and uncertainties that naturally generate within the populace. Failing to do so results in situations similar to those witnessed across the UK during the initial stages of the pandemic where an uninformed scramble to purchase toilet paper and hand washing soaps lead to a shortage of essential items.
The lack of empathy was also evident in Sri Lanka’s media coverage of the pandemic. Alarmist headlines were commonplace where more focus was directed towards COVID-19 positive cases rather than recoveries. The microscopic focus on patients paved the way for poor censorship which in many cases resulted in the blatant violation of the privacy of several patients who had tested positive for virus symptoms. News articles and social media posts which were laced with discrimination and promoted fear-mongering. One such incident was when a garment worker in Sri Lanka’s free trade zone was reported to have contracted the virus. WhatsApp groups lit up with her leaked personal information; full name, national identity number and details of hometown. The lack of empathy that arose with the vilification of patients meant that individuals who tested positive or were suffering from tell-tale signs were hesitant to come forward for treatment fearing disregard for privacy in addition to being penalized for a situation outside their control. Incidents of “runaway patients” were frequent, and one could argue that this was by no fault of their own. The effect of patients being reluctant to admit to virus symptoms meant that potential for community spread was greater and thus, untraceable. Such ostracization has also led to police brutality in cases where patients have been chased after and physically manhandled by the authorities.
In such situations, the correct course of action is to promote consistent messaging that demystifies the virus. While it is important to sanitize and wear a mask, it is equally imperative for the public to know how and why the virus spreads and therefore patients should not be discriminated against. Regular messaging on cross-cutting media platforms is the most efficient way to distribute verified information, including visual messaging in public locations through posters and billboards.
While ensuring that patients aren’t wrongly portrayed, it is also vital that official communications convey reassurance; a crucial element for communities whole have never before faced a pandemic of this nature and thus are more prone to panic.
Promote action
Sri Lanka was building a repertoire for efficiently rallying to mitigate the spread of the virus. Images of tri-force led sanitation programs and strict security measures carried out for quarantine travelers entering the country spread across multiple media platforms. Coupled with continued confidence in the local medical system (despite the disproportionate numbers of beds in ICU across the island) the initial stages of COVID-19 in Sri Lanka seemed to be well under control. Boris Johnson displayed similar confidence in his country’s healthcare system, boastfully claiming that “We have a fantastic NHS, fantastic testing […] Our country remains extremely well prepared” when reality was far from such bombastic claims. Promoting action towards containing the virus, or what was initially popularized as “flattening the curve,” is not limited to the actions carried out by experts and additionally has more to do with ensuring that the general public are engaging in safe practices. While slogans to sanitize and keep two meters apart were publicized, it wasn’t frequent enough to promote adequate action to follow. Mask wearing, as vital as it is, was not widely practiced nor encouraged. Additionally, Sri Lanka was in the process of preparing for its parliamentary elections, touting successfully-led elections in South Korea as validation for implementing the same. However, despite establishing socially-distanced ballot centers, the actions of parliamentarians and their supporters disregarded basic safety and health regulations. This resulted in widely broadcasted events where large public gatherings were permitted, in which very few participants wore masks and social distancing was non-existent. What was promoted instead were live telecast rallies and election meetings where candidates spoke to a sea of voters, who could only be likened to sardines in a tin can. “Practice what you preach” was not a notion widely seen or stimulated, thus promoting very little action to protect the people.
The UK’s approach towards tackling the virus seemed overly simplified to a dangerous degree when the Prime Minister shook hands with COVID-19 patients on live TV and claimed not to be affected by the virus (a statement which would later be proven wrong). Such nonchalance, mirrored by the actions and rhetoric of a nation’s leader, sets a dangerous precedent for its citizens. It raises a green flag towards complacency, disputing fact and logic which are needed during a health emergency of this magnitude[3]. Considering the above Sri Lanka’s confidence in its healthcare system and response to containing the virus was rightfully seen as better than its global counterparts; hospitals were not yet overwhelmed and where Heathrow was faltering in its duty to sanitize airports and socially distance travelers, Sri Lanka had a small arsenal of men and women decked in PPE gear spraying the walls of the Bandaranaike International Airport with every foreign arrival. While this would eventually lead to overconfidence and underestimation of the virus’ spread within the country, the people were at ease knowing that while the rest of the world scrambled to resist the pandemic, their tropical island home wasn’t threatened.
Clear (consistent) messaging
Mixed messaging, especially at short bursts, is confusing and inconsistent. The UK’s coronavirus campaign began with the slogan “Stay home-Protect the NHS-Save lives” which before long transformed into “Stay alert-Control the virus-Save lives.” The latter allowed free movement outdoors within the parameters of social distancing. This was soon clouded by the “Eat out to help out” initiative, a glaring contradiction where instructions to socially distance were overshadowed by the need to eat out to keep the economy afloat. Alongside this was an abrupt campaign to curb obesity, which tied itself as being an added risk factor to contracting the virus. The convoluted, paradoxical messaging distributed among the country over a period of less than 6 months was a cacophony of mood swings, leaving many people wondering why no one was wearing masks and dining out in areas that were already amber lit.
According to the COVID-19 response document published by Sri Lanka’s Health Promotion Bureau (HPB), “responsive, transparent and consistent messaging” is included as a key step towards establishing authority and trust. However, the consistency is debatable. The HPB Twitter account has been noted as a trilingual platform intended for the purposes of consistent messaging. However, the account’s Twitter updates during the months leading to the most recent cluster indicated a lapse in communication.
There was a notable reduction in the frequency of tweets and updates between August to September 2020 leading up to the nation’s largest reported cluster in October, 2020. Which raises the question: does a connection exist between the lack of consistent communication and rise in the number of patients?
Month Frequency of posts
| October | 12 |
| September | 3 |
| August | 9 |
| July | 30 |
| June | 23 |
Clear communication is convincing and convenient, both for the authorities and the people receiving it. Recent curfews set in place within the Western Province of Sri Lanka (where larger clusters of the virus were reported) were widely communicated but not clarified. As a result, a large flow of traffic began moving out of the Western Province. Whether holidaymakers intending to savor the long weekend or families wishing to return home, the lack of directive on whether or not citizens could leave the province before the curfew began resulted in potential asymptomatic carriers moving away from an already at-risk geographical location. A 1,000-member task force has since then been deployed to monitor returnees after curfew is lifted; an effort that could have been curtailed if instructions had been clarified and communicated to all residents of the Western Province.
Evidence-based information
Factual evidence needs to be incorporated in all communications, backed by simplified scientific explanations in layman’s terms. This supports the reduction of the inevitable spread of fake news and at times, fatal remedies that crop up as a result of misinformed panic. Lives lost by the conviction that bleach will dispel the virus or a false sense of assurance generated by the frantic brewing of ayurvedic remedies[4] is connected with the lack of verified information and uncertainty led by fear. The latter paved the way for snake oil salesmen to slither out of the woodwork, resulting in a burgeoning business of steaming equipment that surely works well in keeping the respiratory systems healthy but does nothing to prevent the virus. Sri Lanka’s current trend of denial when it comes to the community spread of the virus leaves a treacherous gap in vital information. In doing so, the urgency of the pandemic is undermined once more, allowing free movement of both symptomatic and asymptomatic carriers at a rate greater than what would take to contain the virus.
Media management
An imperative cog in the communications machine is the media. They are the link between citizens and government officials, relaying confirmed news and updates in real time. Both the UK and Sri Lanka struggled in their relationship with respective local media entities. As of late in the UK, daily briefings are being held with journalists dialing in via a video link. Responses to their questions during these briefings were notably vague. Follow up questions were often cut off. The government went so far as to call out journalists and media groups on Twitter, citing claims of scaremongering or sharing fake news, claims that could have been avoided if communication had not been limited to a one way street. Instead of providing credible news, what resulted was a divide between the government and media organizations during a period where strong cooperation between the two institutions would have helped citizens tremendously. A strictly hierarchical approach to communication does very little good as it means that any information that could have been provided to journalists is lost under a barrage of unintelligible responses.
Media ethics in Sri Lanka were a jarring state of affairs, resulting in fear mongering and the vilification of patients and their families. A local news channel featured a segment in which a young student who had lost his mother to COVID-19. The young boy had been sitting for a competitive scholarship exam at the time of his mother’s demise and had therefore been unaware of her death. Maximizing on the tragedy, a media agency chose to record the moment in which the news was broken to the boy, blurring his face but capturing his wails and tearful responses in an interview which was telecast nationwide. It was also commonplace to feature photographs of patients who had tested positive on television and print media, villainizing both the virus and those who had contracted it. This included situations where people had run away from hospitals either out of fear or by an error. Defaming patients by presenting them as criminals in the media constructed a damning rhetoric for COVID-positive patients. Many hesitated from stepping forth to admit their symptoms – an additional burden towards confirming actual numbers and attending to those who could be suffering symptoms of the virus but were too afraid to reach out for help.
After nearly a year of COVID-19, we must ask ourselves what has worked and what hasn’t. The nature of the virus remains as erratic as the behaviors of the human beings it infects. What remains to be done is to continue tried and tested methods (both in the lab and within communities) to safeguard the populace. States will face a challenging task of moderating and managing communications in the months to come. Shortcomings have existed, which one could argue were inevitable. However, if so, it serves us well to learn from this and adapt with efficiency towards better practices. Empathetic, fact-based information, complemented by positive action and media management will be a recurring need in the months to come. A pattern of stable communication between authorities and the population plays a developing role in protecting the people and curbing the spread of the virus between geographical borders. Well established, strategic communications plans will play an urgent role in facilitating a lasting impact on our ability to bring the pandemic under control.
[1] Failure to act efficiently was a striking feature of the UK’s response to COVID-19. Despite confirmed cases of the virus and several reported deaths, neither an action plan or an official statement was made until several days of poorly-managed speculation had passed.
[2] According to Sri Lanka’s COVID-19 Response Plan, communities facing communication barriers are to be supported on the ground by relevant PHIs and government officials in order to stay updated on life-saving information, while also being able to reach out for medical support.
[3] Similar nonchalance is seen in the actions of the US President, Donald Trump, who only recently donned a mask himself, stirring repeated controversies as he denied factual evidence of the rising number of COVID-19 deaths in the country.
[4] Which strengthens the body’s immune system but in reality will not kill the virus (WHO, Sri Lanka)