{"id":46952,"date":"2020-03-24T10:30:49","date_gmt":"2020-03-24T09:30:49","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=46952"},"modified":"2020-03-25T19:32:43","modified_gmt":"2020-03-25T18:32:43","slug":"lesley-henderson-covid-19-we-are-yet-to-witness-a-cohesive-government-communications-strategy","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/03\/24\/lesley-henderson-covid-19-we-are-yet-to-witness-a-cohesive-government-communications-strategy\/","title":{"rendered":"Lesley Henderson: Covid-19\u2014we are yet to witness a cohesive government communications strategy"},"content":{"rendered":"<p class=\"standfirst\">The public&#8217;s response to &#8220;social distancing&#8221; is a government communications failure, says Lesley Henderson<\/p>\n<p><!--more--><\/p>\n<p><span style=\"font-weight: 400\">In an unprecedented move, the UK\u2019s prime minister Boris Johnson announced <\/span><a href=\"https:\/\/www.bbc.co.uk\/news\/uk-52012432\"><span style=\"font-weight: 400\">strict new curbs on life in the UK<\/span><\/a><span style=\"font-weight: 400\"> to curtail the spread of covid-19. The public must now <\/span><span style=\"font-weight: 400\">stay at home except for shopping for necessities, exercise, medical need and travel to and from essential work. Police can enforce these restrictions and disperse gatherings of more than two people (who do not live together).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">This decision comes in the wake of images of <\/span><a href=\"https:\/\/www.independent.co.uk\/news\/health\/coronavirus-pubs-social-distancing-young-people-self-isolate-a9411371.html\"><span style=\"font-weight: 400\">young people partying in crowded pubs and nightclubs<\/span><\/a><span style=\"font-weight: 400\"> and <\/span><a href=\"https:\/\/www.theguardian.com\/world\/2020\/mar\/21\/disaster-waiting-to-happen-visitors-flock-to-skegness\"><span style=\"font-weight: 400\">families visiting seaside resorts<\/span><\/a><span style=\"font-weight: 400\"> over the weekend. These were at odds with the UK government\u2019s advice to \u201cflatten the curve\u201d of covid-19 by \u201csocially distancing\u201d from other people<\/span><span style=\"font-weight: 400\">. Iconic beauty spots such as Snowdonia National Park were reportedly <\/span><a href=\"https:\/\/www.bbc.co.uk\/news\/uk-wales-51994504\"><span style=\"font-weight: 400\">busier than at any time in living memory<\/span><\/a><span style=\"font-weight: 400\">.<\/span><span style=\"font-weight: 400\"> These stories have attracted sharp reactions from angry observers on social media. A Twitter hashtag dedicated to this behaviour simply branded it <\/span><a href=\"https:\/\/twitter.com\/hashtag\/selfish?lang=en\"><span style=\"font-weight: 400\">#selfish<\/span><\/a><span style=\"font-weight: 400\"> and described the people involved as #<\/span><a href=\"https:\/\/www.standard.co.uk\/news\/health\/covidiots-twitter-trend-social-distancing-self-isolation-a4394826.html\"><span style=\"font-weight: 400\">COVIDIOTS<\/span><\/a><span style=\"font-weight: 400\">. On the one hand, it seems extraordinary that some members of the public did not appear to take the covid-19 pandemic seriously. On the other hand, their response can be more usefully seen through the lens of a government communications failure. It is worth contextualising this by considering what we already know about the dynamics of health, risk messaging, and public behaviour.<\/span><\/p>\n<p><span style=\"font-weight: 400\">So what are some of the communication challenges specific to covid-19?\u00a0 Firstly, regardless of whether the g<\/span><a href=\"https:\/\/www.bbc.co.uk\/news\/science-environment-51892402\"><span style=\"font-weight: 400\">overnment has changed tack in response to changes in \u201cthe science<\/span><\/a><span style=\"font-weight: 400\">\u201d<\/span><span style=\"font-weight: 400\">, the UK public has been faced with rapidly changing messages. These have been \u201ctop-down\u201d and frequently conflicting. The government initially focused on public health messages, such as the \u201ccatch it, bin it, kill it\u201d campaign and advised anyone who was unwell with a fever or cough to remain at home and not go to work or attend school. This shifted to warnings that over 70\u2019s should place themselves in quarantine and shifted again to focus on risks to children (infectious but mainly unaffected). This confusing discourse was accompanied by fragmented school closures (total closures in Ireland, partial closures in Scotland, no closures in England). This means public health messages about the need for appropriate social distance were circulating at the same time as parents were expected to adhere to the usual regulations concerning school attendance. It is little wonder then that people could see no obvious problem with their children, or themselves, attending social events. After all they had been free to mix as usual in schools, universities, offices, pubs and hotels all of which remained open for business.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">It also seems extraordinary that little planning has been focused on public communications, given that it is mostly accepted that <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4248563\/\">media campaigns can change a population\u2019s health behaviours<\/a><span style=\"font-weight: 400\">. For example, the HIV and AIDS crisis of the late 1980s is synonymous with the notorious government education campaign, <\/span><a href=\"https:\/\/placingthepublic.lshtm.ac.uk\/2018\/05\/20\/remembering-the-dont-die-of-ignorance-campaign\/\"><span style=\"font-weight: 400\">Don\u2019t AID AIDS (more usually termed the Don\u2019t Die of Ignorance<\/span><\/a><span style=\"font-weight: 400\"> campaign or simply the \u201ctombstone\u201d campaign). This official campaign might have increased awareness of AIDS, but it also terrified people and managed to mobilise further stigma against already marginalised groups. The more recent swine flu epidemic attempted to encourage hand washing, and respiratory hygiene under the slogan <\/span><a href=\"https:\/\/www.gov.uk\/government\/publications\/catch-it-bin-it-kill-it-respiratory-and-hand-hygiene-campaign-2011\"><span style=\"font-weight: 400\">Catch it, Bin it, Kill it<\/span><\/a><span style=\"font-weight: 400\"> public health campaign. <\/span><span style=\"font-weight: 400\">The message was unsophisticated but <\/span><a href=\"https:\/\/www.amazon.co.uk\/Pathological-Lives-Disease-Biopolitics-RGS-IBG\/dp\/1118997603\"><span style=\"font-weight: 400\">it fitted into existing public understandings of risk<\/span><\/a> <i><span style=\"font-weight: 400\">(\u2018coughs and sneezes spread diseases\u2019<\/span><\/i><span style=\"font-weight: 400\">) and an inbuilt disgust at people coughing in public spaces particularly on trains and buses.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">In our contemporary media landscape, we have considerable tools at our disposable, well beyond health education leaflets posted through our letterbox. There is a unique opportunity for engaging diverse groups by learning from global awareness strategies. We have a variety of niche personalised messaging opportunities. Different platforms can engage audiences and entertain\/educate (<\/span><a href=\"https:\/\/www.mohfw.gov.in\/Corona_comic_PGI.pdf\"><span style=\"font-weight: 400\">cartoons<\/span><\/a><span style=\"font-weight: 400\">, <\/span><a href=\"https:\/\/www.bbc.co.uk\/news\/entertainment-arts-51912510\"><span style=\"font-weight: 400\">soap opera<\/span><\/a><span style=\"font-weight: 400\">, <\/span><a href=\"https:\/\/www.complex.com\/music\/2020\/03\/psychs-uk-drill-song-spreadin-coronavirus\"><span style=\"font-weight: 400\">UK drill music<\/span><\/a><span style=\"font-weight: 400\">, <\/span><a href=\"https:\/\/www.insider.com\/coronavirus-memes-people-joking-about-covid-19-to-reduce-stress-2020-3#some-people-are-fighting-feelings-of-isolation-with-work-from-home-memes-1\"><span style=\"font-weight: 400\">memes<\/span><\/a><span style=\"font-weight: 400\">, <\/span><a href=\"https:\/\/www.independent.co.uk\/arts-entertainment\/films\/news\/coronavirus-simon-pegg-nick-frost-shaun-of-the-dead-psa-video-self-isolation-nhs-guidelines-a9413616.html\"><span style=\"font-weight: 400\">comedy<\/span><\/a><span style=\"font-weight: 400\">). The fact that we are yet to witness a cohesive government communications strategy is alarming given the unprecedented crisis we are facing.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">This gap is even more surprising as <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/03\/11\/slowing-down-the-covid-19-outbreak-changing-behaviour-by-understanding-it\/\"><span style=\"font-weight: 400\">changing public behaviour lies at the heart of solving the crisis<\/span><\/a><span style=\"font-weight: 400\">. Familiar \u201chandwashing\u201d tropes are being intertwined with new advice regarding physical contact. The emphasis on the term \u201csocial\u201d as opposed to \u201cphysical\u201d distancing was a significant error because proximity does not align with social connection\u2014ask any sociologist, anthropologist, or even a teenage gamer. We are being required to make sense of unfamiliar terms (\u201cflatten the curve\u201d, \u201cshielding\u201d) prompting many people to seek clarification, for example, on the differences between self- isolating and quarantine. At the same time, recent \u201cpro-social\u201d, \u201cpro-environment\u201d behaviours need to be unlearned as they present new risks.\u00a0 Thus, delivery drivers will not accept plastic bags for recycling, and nor will shops refill reusable coffee mugs. Spending more time in nature has only recently been promoted in terms of positive benefits to our well-being and now we are being warned that it is safer for us to stay in cities and towns.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Fortunately, although covid-19 might be new, we already know a great deal about how best to communicate with diverse groups.\u00a0 Even so making a positive impact on behaviour, as opposed to reaching large numbers of people, is complicated. We need only look at the history of anti-drugs education, a classic &#8220;top down&#8221; approach to educating the public to find extreme examples of <\/span><a href=\"https:\/\/www.talkingdrugs.org\/5-anti-drugs-campaigns\">misguided health advertising campaigns<\/a><span style=\"font-weight: 400\">\u00a0failing to connect with their target audiences (iconic images\u00a0<\/span><a href=\"https:\/\/www.alamy.com\/stock-photo-part-of-the-heroin-screws-you-up-drug-awareness-campaign-1986-poster-71451975.html\">became ironic \u201cpin ups<\/a><span style=\"font-weight: 400\">). With the prospect of a safe vaccine still some time away, the role of the media is critical. Media representations\u00a0<\/span><a href=\"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/s12889-016-3594-8\">play a vital role<\/a><span style=\"font-weight: 400\"> in informing public and policy opinions about the causes (and solutions to) ill-health. The media focus to date has been on the threat posed by so-called outsiders which fits neatly with a post-Brexit narrative and the British popular press. A related part of the problem is the intangible nature of a threat from an invisible virus. Any successful campaign needs to make covid-19 visible with some attempts at this by inventive users on social media through short films illustrating how covid-19 can spread through touch or conversely be reduced through self-isolation.<\/span><\/p>\n<p><span style=\"font-weight: 400\">We also know that public health campaigns that fail to account for structural and material inequalities create challenges. Campaigns to encourage members of the public to compel their healthcare provider to wash their hands (prompted by SARS or H1N1)\u00a0<\/span><a href=\"https:\/\/www.tandfonline.com\/doi\/10.1080\/09581596.2018.1453126\">do not work<\/a>,<span style=\"font-weight: 400\">\u00a0because they fail to address differences in power between patients and professionals. Requests to work from home, to connect online, and distance from close family members ignore power differentials and assume social and cultural capital that is unevenly distributed in our population.\u00a0 So far, messages have assumed that audiences are \u201cblank slates\u201d ready to be the recipients of health advice. Still, we know that understanding social practices, as well as <\/span><a href=\"https:\/\/www.theguardian.com\/world\/2020\/mar\/04\/fake-coronavirus-tweets-spread-as-other-sites-take-harder-stance\"><span style=\"font-weight: 400\">myths and misconceptions<\/span><\/a><span style=\"font-weight: 400\"> that are circulating, are vital to successful public health communications.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The final challenge, which is perhaps the most pervasive is undoubtedly that of promoting collective responsibility to the population rather than to the individual. Audiences have grown used to industry strategies campaigning around the \u201cprinciple of choice\u201d\u00a0 which has been used to dismiss concerns, for example, regarding the\u00a0<\/span><a href=\"https:\/\/www.tandfonline.com\/doi\/10.1080\/09581596.2015.1021298\">global marketing practices of Big Food.<\/a><span style=\"font-weight: 400\"> UK audiences witnessed Boris Johnson\u2019s apparent struggle with the idea of restricting personal freedom to contain the epidemic. These messages are clearly at odds with his libertarian beliefs, and successful communication requires trust in an authentic messenger (which is why the video message <\/span><a href=\"https:\/\/www.irishnews.com\/coronavirus\/2020\/03\/22\/news\/-we-are-frightened-please-stay-at-home---watch-this-moving-video-message-from-belfast-respiratory-team-1875334\/\"><span style=\"font-weight: 400\">from NHS Belfast respiratory team<\/span><\/a><span style=\"font-weight: 400\"> may reap some rewards).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Media can undoubtedly help create new community norms, engage audiences in novel ways and bring about social change, but without recognising the social and cultural context in which covid-19 communications are being constructed, received, and distributed these are unlikely to succeed.<\/span><\/p>\n<p><i><strong>Lesley Henderson<\/strong> is reader in sociology and communications in the Department of Social and Political Sciences, Brunel University London. She lectures on Sociological Approaches to Health at the London School of Hygiene &amp; Tropical Medicine<\/i><i>.\u00a0<\/i><\/p>\n<p><em><b>Competing interests:<\/b><span style=\"font-weight: 400\">\u00a0None declared.<\/span><\/em><\/p>\n<p><span style=\"font-weight: 400\">Twitter @lesleyhenders<\/span><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The public&#8217;s response to &#8220;social distancing&#8221; is a government communications failure, says Lesley Henderson [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/03\/24\/lesley-henderson-covid-19-we-are-yet-to-witness-a-cohesive-government-communications-strategy\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":46954,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[236],"tags":[],"class_list":["post-46952","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nhs"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - 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Household isolation, social distancing, working from home, avoidance of public gatherings have been recommended while public transport has been reduced as part of protective measures to reduce the spread of the disease. The government decided to close schools across Britain from Monday and legislated UK coronavirus bill which gives public health, immigration and police officers powers to detain anyone suspected of having Covid-19 as well as additional powers to close premises and ban public gatherings. 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