Pearls and Irritations

The Covid-19 crisis poses an unprecedented challenge for mass communications in Australia, and has posed new challenges for campaigns to persuade the population to change behaviour to reduce health risk

. Why the Covid communications challenge is different

In times of crisis, governments need rational and credible communications. COVID-19 is a particularly complicated situation. The usual political spin is unable to keep up with rapidly evolving information about this virus and effectively communicate government policy responses to limit its spread. The COVID-19 (coronavirus) pandemic is acute and pervasive. Epidemiological evidence is evolving/changing at the same time that policy responses are being developed. This poses the challenge of simultaneously adjusting policy solutions whilst also clearly articulating these changing responses to the public.

The first tranche of Covid-related mass media communications in Australia delivered national messages to increase hand washing, maintain ‘social distance’, stay-at-home, and self-monitor potential coronavirus symptoms. The campaign saturated mass media channels, online and social media, as well as being disseminated by politicians and media outlets.

As the epidemiological and clinical evidence changed, expert opinion also changed. Should we close schools incrementally, immediately or not at all? Should we implement broader short-term shutdowns or phase in restrictions over time to reduce movement in the community? A further complication was that any policy response would take a minimum of 1-2 weeks before evidence if it worked. A fortnight incubation period is a very long time given the degree of public anxiety and need for policy responses. The rapidity with which we should implement the shutdown has been hotly debated by experts, by the media and the general public. But views have evolved, and incremental restrictions have been imposed.

The mainstream media have turned unresolved issues and government’s evolving policy responses into major news items. Australian media has promoted stories that inspire fear, love , loathing and heroism. The media sanctifies healthcare workers or people doing local and neighbourly acts of kindness, and vilifies people still attending barbecues or beaches or other congregations of individuals. Above all, the media relies on expert commentators who in Australia seems to possess a plethora of individual opinions promoting a myriad of social, economic and health solutions, some of which are unrelated to the current crisis. This deluge of infotainment is divisive, and is worsened by polarised or fringe views disseminated through social media. This is different to the situation in countries where the national ethos is more collectivist or compliant, and government and expert scientist views readily accepted. Such countries quickly achieved widespread social distancing.

There have undoubtedly been some missteps in the communication process, and some examples where communications became politicised or jingoistic. There is no uniquely “Australian response” to Covid. However, an added concern has been our federated system, where different communications emanated from the national Australian government and from state governments, and experts across jurisdictions disagreed. This contributed to message confusion and delayed the implementation of solutions. Despite these early mistakes, State and Federal Governments and experts seem to be improving their message consistency over time [as observed in early April].

Previous mass media campaign successes in Australia are not sufficient

Australia has an excellent record in promoting public health messages through mass media campaigns. Campaigns supporting seatbelt legislation, anti-smoking campaigns, and those opposing drink-driving have been remarkable public health success stories over the past three decades. However, these campaigns had both a mass media communications element and a regulatory, policy or enforcement component. For example, with tobacco, taxes were increased, regulatory measures to limit smoking in public spaces were introduced, and a clear consistent enemy, the tobacco industry was identified and universally condemned. This has led to major decreases in the prevalence of smoking in adults and young people, and decreases in road trauma related deaths…. but these successes required decades of sustained social marketing and regulatory responses! The immediate need with coronavirus is for overnight behaviour change at the population level. If we achieve at least 90 or 95% of the whole population practising social distancing well, the rates viral transmission may be attenuated. For previous well-funded campaigns, we might have persuaded 1% of the population to stop smoking or be screened for bowel cancer – small, cumulative successes.

The Covid campaign aims to rapidly raise community awareness of coronavirus, increase community fear (a persuasion strategy to enforce social distancing, that may have indirect side-effects of increasing community anxiety) and to change individual and societal behaviours almost overnight. This is an extraordinary social marketing challenge. The campaigns will need to balance fear-arousal over time. How long can people remain ‘alarmed’, and the contrary argument, what degree of alarm is essential to motivate recalcitrant members of society to rapidly change their behaviour ?

Governments have focused societal well-being and health as a primary goal, with economic survival packages as a concomitant policy. We should give credit to Governments and to our public health workforce (in addition to our frontline clinical workforce) for delivering flexible communications to the community and to patients regarding emerging coronavirus risks, providing ever-changing information to the public, and for implementing rapid policy changes. Some countries have done much less well in the communications arena.

One remaining area of contention is the speed of implementation of regulatory and enforcement actions. The communication language has remained gentle, “encouraging” people to stay home, but should be stronger, “people must stay home”, and providing enforced negative consequences for those that still aggregate in larger groups or travel for Easter holidays.

The end of the epidemic is not the end of the need for mass communications

Finally, the marketing challenge will continue for the rest of 2020. Even if the epidemic of new cases shows a plateau and then declines within 3 to 4 months, the community risk will not be over. After the initial epidemic period, ongoing communication efforts will be essential to persuade people that life will not return to “business as usual”, and maintenance of some societal restrictions will be likely for a post-epidemic transition period. People, possibly fuelled by inappropriate media stories and social media notions that the “epidemic is over”, may relapse quickly back to previous behavioural patterns. Hence, the need for clear communications and a regulatory framework beyond the end of the formal “epidemic”. This challenge is beyond current Government attention, as their overwhelming priority is containment strategies that may prevent our health system from being overwhelmed. But the mass communications required during this extraordinary period are unprecedented, needs to remain flexible, apolitical, evidence-based and sustained. For a long time.

Adrian Bauman is Emeritus Professor of Public Health, Sydney University

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