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Pandemic communications: what have we learnt?

Introduction by Croakey: As we anxiously watch unfolding news on the latest COVID outbreak in Victoria, it becomes ever-more urgent to address the widely canvassed failings of the national vaccination rollout, in particular the lack of an effective communications strategy and campaign.

It is hard to fathom why this has not been forthcoming.

Back in November last year, public health experts released a detailed document to guide the design and implementation of a COVID-19 vaccine program, with specific recommendations for broad and tailored communications campaigns, as per below.

The report also noted that the provision of well-crafted messages is not enough in itself as vaccination behaviours are shaped by many factors, including access, cultural beliefs, community, a person’s identity and their norms, education, and socioeconomic status, as well as by philosophical beliefs.

Meanwhile, an analysis of Croakey’s early coverage of the pandemic and public health communications makes clear that concerns about the quality of pandemic communications are not new, identifying five key themes to help improve them.

The article below is based upon a presentation to the recent Preventive Health Conference 2021, which was prepared by Dr Melissa Sweet, Dr Summer May Finlay and Associate Professor Megan Williams, with input from other members of Croakey Health Media. (See here for a Twitter wrap of other #Prevention2021 presentations).


Melissa Sweet, Summer May Finlay and Megan Williams write:

We begin by acknowledging the Country from where this presentation was developed, and where it has been viewed. We pay our respects to other Aboriginal and Torres Strait Islander nations, to Elders past, present and emerging, and to Aboriginal and Torres Strait Islander colleagues, including those whose work has helped to inform this analysis.

In this paper, we present a preliminary analysis of the first 100 articles that Croakey published on the pandemic that discuss public health communications.

They were published between 28 January 2020 and 18 September 2020 – accounting for 30 percent of the 332 articles on the pandemic that we published over that period.

The 100 articles in our sample included:

  • News articles by journalists
  • Opeds by academics, NGOs, health professionals, and others
  • Cross posts from The Conversation and other publications, including blogs
  • Some articles were published via the Croakey Conference News Service – notably our coverage of VicHealth’s Health Reimagined webinar series
  • One article included in the analysis was sponsored content from the Australian Commission on Safety and Quality in Health Care.

 

The tweet above, which was included in the first article Croakey published on the pandemic, on 28 January 2020, is a reminder of how significant Twitter has been during the pandemic. Most of our articles included embedded tweets or links to Twitter threads.

The methods for the solutions-focused thematic analysis included:

  • critical reflection on key documents, including ACCC Digital Platforms Inquiry, the News Media Bargaining Code, and The United Nations Declaration on the Rights of Indigenous Peoples
  • discussion among team members
  • selection of core high-level themes
  • selection of quotes and other items to exemplify the five themes identified.

1. Challenging communications environment

 

The COVID-19 pandemic has occurred in a uniquely challenging communications environment.

It is challenging for governments and other actors to deliver clear messages in rapidly evolving situations where there is a high degree of uncertainty and an overwhelming volume of scientific, medical and health literature, both reviewed and unreviewed.

The complexity of the Australian health system, and the division of responsibilities between jurisdictions and longstanding politicisation of health also add to the challenges.

The task is even more difficult in a toxic, poorly regulated information environment distinguished by contested, polarised and fragmented public spheres, and an “infodemic” of misinformation and disinformation.

Decades of neoliberalism has weakened wider civil society, undermined the public service, and reduced the capacity of many public agencies and the community sector to deliver services, including communications services.

Source: How misinformation about 5G is spreading within our government institutions – and who’s responsible

During the pandemic, political and business leaders, mainstream media and digital platforms have spread misinformation and disinformation.

The pandemic has also shown the need to improve health literacy.

As Associate Professor Lesley Russell wrote on 6 July 2020, in The Health Wrap:

The coronavirus infodemic has highlighted that poor health literacy is an underestimated public health problem globally – both for individuals and also for organisational health literacy.”

Other authors wrote that millions of Australians do not have sufficient health literacy to understand complex COVID-19 communications, and this problem is exacerbated by the failure of governments to enact best practice in communications – they gave the Federal Health Department website as an example of this.

Rarely has it been more important for communities to have trusted, reliable news sources.

Yet the COVID-19 pandemic has threatening the viability of many media organisations, leading to closures and journalism job losses. Hardest hit have been rural, remote and regional communities, whose needs are not always well reflected by metropolitan-based media outlets.

At the same time as partisan corporate media has spread distrust, racism and division, the ABC been slashing staff, services and programs, while globally, the decline of press freedom has been documented in many countries.

Another key theme identified in our analysis are wide-ranging concerns about governments’ pandemic communications.

2. Concerns about public health messaging

Concerns about government communications, to both the general public and health sector, were raised repeatedly and can be summarised as:

  • Lack of transparency
  • Inconsistent, contradictory and confusing messaging – between and within governments
  • Delays in messaging
  • Information gaps
  • Politicisation of communications.

Other concerns have included:

  • Failure to engage the community as partners in preparation and communications
  • Failure to foster a collective response based on solidarity and reciprocity rather than individualism
  • Messaging that has been impractical and out of touch with reality of many people’s lives and circumstances. As one author wrote: “No advice is provided for people who don’t have stable and safe housing, regular employment, a car, a mobile phone, internet access, the capacity to deal with a short-term lack of income, or the ability to purchase and store bulk foods.”

3. Leadership by the Aboriginal and Torres Strait Islander health sector

On a more positive note, a third theme identified in our analysis is the leadership of Aboriginal and Torres Strait Islander people and organisations.

The leadership shown by the Aboriginal and Torres Strait Islander health sector and community groups was a strong theme across many articles.

Key points relevant for communications included:

  • The importance of self determination, including in governance and decision making. The Aboriginal and Torres Strait Islander Advisory Group on COVID-19, which informs national policy making, works on principles of shared decision-making, power-sharing, two-way communication, self-determination, leadership and empowerment.
  • Articles highlighted the importance of responses centring Aboriginal and Torres Strait Islander perspectives and cultures and of ensuring cultural safety, equity and inclusion of Indigenous knowledges
  • Innovation and flexibility in communications enabled messaging tailored to local context and languages, using multiple formats, including graphics, videos, Facebook, Instagram, TikTok, and other social media channels.
  • The sector developed messaging that emphasises cultural strengths, solidarity and resilience, including respect and care for Elders.

One clear lesson from the COVID-19 pandemic is that the wider health system has much to learn from the successes of the Aboriginal Community Controlled Health Organisations sector and Indigenous health leadership.

The sector was also a strong advocate for communities, including when governments were slow to act or silent on critical issues.

4. Silences