{"id":2320,"date":"2020-04-21T10:00:17","date_gmt":"2020-04-21T09:00:17","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-humanities\/?p=2320"},"modified":"2021-07-23T09:45:03","modified_gmt":"2021-07-23T08:45:03","slug":"make-covid-19-visuals-gross","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-humanities\/2020\/04\/21\/make-covid-19-visuals-gross\/","title":{"rendered":"\u201cMake COVID-19 Visuals Gross\u201d"},"content":{"rendered":"<p><strong>Provocation by Kristin Marie Bivens and Marie Moeller<\/strong><\/p>\n<p>The Center for Disease Control and Prevention\u2019s (CDC) medical illustration that represents the novel coronavirus has become the emblem of COVID-19 and the pandemic. In a recent <a href=\"https:\/\/www.google.com\/search?tbs=sbi:AMhZZis8O_1ppV7hN0x6YjeApFK6ysTpnk6-MhFFZVNOaMdN1mrX0iFZHQE2O0cCJj8HmVzFx8Lr_1JSJj9F-XJrsnGfTWyC2XqqPbRlgMwSoEkCalNjbcwiddo0AStPyMhDXNLmgIcu6EGR10YpgeSTX824YWm0lW6gY8yzdN-5pf30JhxLv9IqlQULyriXSnEj7jK_1TWezU-kJhXY0Kat69JSCai8lD3EVyRlagyp_1xsWiW0-MGcj6tkelSNLx1kAWn-JVHTtAeyTBuxPR46FSHHRlMViwNm3-rmM-zKh5A51ouoWmnzhWkw89CTwEDMQDWLPPTJfRQc5Lm7cb6JxYMeFcXvSbEhxA&amp;hl=en\">reverse image search<\/a>, the image returned 5,260,000,000 results in 1.84 seconds. These numbers<span class=\"ILfuVd\"><span class=\"e24Kjd\">\u2014<\/span><\/span>over five billion<span class=\"ILfuVd\"><span class=\"e24Kjd\">\u2014<\/span><\/span>suggest that the CDC\u2019s image of the novel coronavirus has visually proliferated and regularly accompanied information about COVID-19. In an interview with <em>The New York Times<\/em>, two medical illustrators<span class=\"ILfuVd\"><span class=\"e24Kjd\">\u2014<\/span><\/span>Alissa Eckert and Dan Higgins<span class=\"ILfuVd\"><span class=\"e24Kjd\">\u2014<\/span><\/span>were awarded responsibility for rendering the CDC\u2019s coronavirus illustration, or the \u201c<a href=\"https:\/\/www.nytimes.com\/2020\/04\/01\/health\/coronavirus-illustration-cdc.html\">spiky blob<\/a>.\u201d Eckert revealed they were tasked with designing \u201c<a href=\"https:\/\/www.nytimes.com\/2020\/04\/01\/health\/coronavirus-illustration-cdc.html\">something to grab the public\u2019s attention<\/a>.\u201d And although it appears the \u201cspiky blob\u201d and its uses have continued to expand internationally, the COVID-19 medical illustration is a scientifically-oriented representation that misses the opportunity to humanize and contextualize the novel coronavirus (COVID-19).<\/p>\n<figure id=\"attachment_2321\" aria-describedby=\"caption-attachment-2321\" style=\"width: 1227px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-2321\" src=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2020\/04\/Bivens-Kristin-Marie-and-Marie-Moeller-PHIL-ID-23311.jpg\" alt=\"This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. A novel coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19); CDC\/ Alissa Eckert, MS; Dan Higgins, MAMS.\" width=\"1227\" height=\"688\" srcset=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2020\/04\/Bivens-Kristin-Marie-and-Marie-Moeller-PHIL-ID-23311.jpg 1227w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2020\/04\/Bivens-Kristin-Marie-and-Marie-Moeller-PHIL-ID-23311-300x168.jpg 300w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2020\/04\/Bivens-Kristin-Marie-and-Marie-Moeller-PHIL-ID-23311-768x431.jpg 768w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2020\/04\/Bivens-Kristin-Marie-and-Marie-Moeller-PHIL-ID-23311-640x359.jpg 640w\" sizes=\"auto, (max-width: 1227px) 100vw, 1227px\" \/><figcaption id=\"caption-attachment-2321\" class=\"wp-caption-text\">This <a href=\"https:\/\/phil.cdc.gov\/Details.aspx?pid=23311\">illustration<\/a>, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. A novel coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19); CDC\/ Alissa Eckert, MS; Dan Higgins, MAMS.<\/figcaption><\/figure>\n<p>The medical illustration of the \u201cspiky blob,\u201d while scientifically accurate and visually pleasing, avoids conveying the exigency of the current pandemic, the urgency of enacting certain behaviors during this global health crisis, and the human toll it is exacting across the globe. To humanize the virus, we recommend graphic and even grotesque imagery to show how COVID-19 interacts with bodies. We argue that it is in the public\u2019s best interest to humanize COVID-19 and its accompanying visuals. Our contention is that the image does no favors imparting the urgency of COVID-19 health and measures (e.g., <a href=\"https:\/\/www.who.int\/gpsc\/clean_hands_protection\/en\/\">washing hands regularly<\/a> or <a href=\"https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/advice-for-public\">social distancing<\/a>). Humanizing the virus and what it does to our bodies might involve making visuals related to the novel coronavirus grotesque and graphic; however, by humanizing the visual and representing the human cost more accurately and grotesquely, it is likely the visuals and the <a href=\"https:\/\/webaim.org\/techniques\/alttext\/\">alternative-text<\/a> will be more powerful, influential, and accessible for the public.<\/p>\n<figure id=\"attachment_2329\" aria-describedby=\"caption-attachment-2329\" style=\"width: 1259px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-2329 size-full\" src=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2020\/04\/Bivens-Kristin-Marie-and-Marie-Moeller-Graphic-Smoking-Packaging-p1e63m9k0082r7v92t3o324ds.jpg\" alt=\"\" width=\"1259\" height=\"803\" srcset=\"https:\/\/blogs.bmj.com\/medical-humanities\/files\/2020\/04\/Bivens-Kristin-Marie-and-Marie-Moeller-Graphic-Smoking-Packaging-p1e63m9k0082r7v92t3o324ds.jpg 1259w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2020\/04\/Bivens-Kristin-Marie-and-Marie-Moeller-Graphic-Smoking-Packaging-p1e63m9k0082r7v92t3o324ds-300x191.jpg 300w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2020\/04\/Bivens-Kristin-Marie-and-Marie-Moeller-Graphic-Smoking-Packaging-p1e63m9k0082r7v92t3o324ds-768x490.jpg 768w, https:\/\/blogs.bmj.com\/medical-humanities\/files\/2020\/04\/Bivens-Kristin-Marie-and-Marie-Moeller-Graphic-Smoking-Packaging-p1e63m9k0082r7v92t3o324ds-640x408.jpg 640w\" sizes=\"auto, (max-width: 1259px) 100vw, 1259px\" \/><figcaption id=\"caption-attachment-2329\" class=\"wp-caption-text\">Cigarette Packaging Health Warning Imagery<\/figcaption><\/figure>\n<p>In \u201c<a href=\"http:\/\/writeprofessionally.org\/info-design-2017\/files\/2017\/01\/cruel_pies_voss_dragga.pdf\">Cruel Pies: The Inhumanity of Technical Illustrations<\/a>,\u201d Sam Dragga and Dan Voss argue that \u201c<a href=\"http:\/\/writeprofessionally.org\/info-design-2017\/files\/2017\/01\/cruel_pies_voss_dragga.pdf\">in certain rhetorical situations<span class=\"ILfuVd\"><span class=\"e24Kjd\">\u2014<\/span><\/span>especially in the reporting of human fatalities<span class=\"ILfuVd\"><span class=\"e24Kjd\">\u2014<\/span><\/span><\/a><a href=\"http:\/\/writeprofessionally.org\/info-design-2017\/files\/2017\/01\/cruel_pies_voss_dragga.pdf\">conventional illustrations offer inhumanity as though it were objectivity<\/a>.\u201d In presenting the \u201cspiky blob\u201d as scientifically accurate, yet disconnected from the body, illustrators encourage humans to see COVID-19 as not us, when all signs point to that this \u201cspiky blob\u201d transmits almost solely because of us. We recommend COVID-19 visuals follow Dr. Kathryn Dreger\u2019s humanizing approach from \u201c<a href=\"https:\/\/www.nytimes.com\/2020\/04\/04\/opinion\/coronavirus-ventilators.html\">What You Should Know before You Need a Ventilator<\/a>.\u201d She explains that while a healthy lung feels like \u201c<a href=\"https:\/\/www.nytimes.com\/2020\/04\/04\/opinion\/coronavirus-ventilators.html\">putting your hands in a bowl of whipped cream<\/a>,\u201d a COVID-19 lung becomes like a very stale marshmallow. As Dreger reports, one intensive care physician articulates that ventilating a patient with COVID-19 is \u201c<a href=\"https:\/\/www.nytimes.com\/2020\/04\/04\/opinion\/coronavirus-ventilators.html\">like trying to ventilate bricks, not lungs<\/a>.\u201d These descriptions provide stronger, more humane and accessible imagery of COVID-19 bodies.<\/p>\n<p>Since COVID-19, its transmission (e.g., <a href=\"https:\/\/www.medpagetoday.com\/infectiousdisease\/covid19\/85315\">spread through oral-fecal contact via flush activated toileted plumes<\/a>), and its impact on the human body is grotesque, beyond humanizing visuals, we recommend making COVID-19 images graphic and grotesque. Much like <a href=\"https:\/\/www.tobaccofreekids.org\/assets\/global\/pdfs\/en\/WL_status_report_en.pdf\">the anti-tobacco campaigns<\/a> <a href=\"https:\/\/www.tobaccofreekids.org\/assets\/global\/pdfs\/en\/WL_status_report_en.pdf\">in 118 countries<\/a> that provide <a href=\"https:\/\/www.vox.com\/2015\/4\/8\/8371613\/graphic-warnings-on-cigarette-packs-are-changing-the-smoking\">graphic warnings to reduce tobacco use<\/a> on packaging or the <a href=\"https:\/\/www.cdc.gov\/std\/training\/picturecards.htm\">CDC\u2019s explicit depiction of Sexually Transmitted Disease (STD) on Picture Cards<\/a>, graphic and grotesque visuals create provocative images that show the potential consequences of tobacco use and unprotected sexual encounters. In both cases, the graphic visuals elicit visceral responses and shape behaviors and actions. For example, visitors to <a href=\"https:\/\/www.cdc.gov\/std\/training\/picturecards.htm\">the CDC STD site<\/a> can see \u201c<a href=\"https:\/\/www.cdc.gov\/std\/training\/picturecards\/Penile-discharge-gonorrhea.pdf\">penile discharge [from] gonorrhea<\/a>.\u201d The image is accurate, graphic, and explicitly shows those who can see what penile discharge from gonorrhea looks like.<\/p>\n<p>Given the above, in addition to including alternative text for those with visual impairments, we encourage that creators of COVID-19 visuals to:<\/p>\n<ol>\n<li><strong>Highlight Human Impact:<\/strong> a scientific image of COVID-19 is not particularly persuasive. Grounding images with bodies makes clear that the virus is indiscriminate; such an approach creates community-oriented behaviors.<\/li>\n<li><strong>Make It Gross: <\/strong>detailed, accurate, and graphic visual representations and descriptions of COVID-19 are more effective for shaping public behaviors. Showing visceral consequences of COVID-19, viewers become more aware of and attuned to COVID-19 bodily realities.<\/li>\n<li><strong style=\"font-size: 1rem\">Include Alternative Text<\/strong><span style=\"font-size: 1rem\">: <\/span><a style=\"background-color: #ffffff;font-size: 1rem\" href=\"https:\/\/webaim.org\/techniques\/alttext\/\">alternative text<\/a><span style=\"font-size: 1rem\"> for screen readers and those who have visual impairments and disabilities. Alt-text should include detailed descriptions of images, metaphors for content understanding, and contextual information.<\/span><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p><a href=\"https:\/\/www.kristinbivens.com\/\" target=\"_blank\" rel=\"noopener noreferrer\" data-auth=\"NotApplicable\">Kristin Marie Bivens<\/a><em>\u00a0is a medical rhetorician who studies the\u00a0circulation of information from expert to non-expert audiences in critical care contexts (e.g., intensive care units, sudden cardiac arrest, and opioid overdose).\u00a0She is currently working on a monograph manuscript about how sounds shape care in hospital contexts, like neonatal intensive care units.<\/em><\/p>\n<p><a href=\"https:\/\/www.uwlax.edu\/profile\/mmoeller\/\" target=\"_blank\" rel=\"noopener noreferrer\" data-auth=\"NotApplicable\">Marie Moeller<\/a><em>\u00a0is a medical rhetorician studying how documentation from non-profit medical institutions and medical advocacy organizations shapes the lived experiences of the audiences to which it is disseminated. Her work appears in a variety of rhetoric and technical communication journals and collections; she is currently collaborating on a Technical Communication Quarterly\u00a0special issue regarding the marginalization of bodies in health and medical rhetoric.<\/em><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Provocation by Kristin Marie Bivens and Marie Moeller The Center for Disease Control and Prevention\u2019s (CDC) medical illustration that represents the novel coronavirus has become the emblem of COVID-19 and the pandemic. In a recent reverse image search, the image returned 5,260,000,000 results in 1.84 seconds. These numbers\u2014over five billion\u2014suggest that the CDC\u2019s image of [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-humanities\/2020\/04\/21\/make-covid-19-visuals-gross\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":345,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[15020],"tags":[15068,15104],"class_list":["post-2320","post","type-post","status-publish","format-standard","hentry","category-provocations","tag-blog","tag-covid-19"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>\u201cMake COVID-19 Visuals Gross\u201d - Medical Humanities<\/title>\n<meta name=\"description\" content=\"&#039;It is in the public\u2019s best interest to humanize COVID-19 and its accompanying visuals.&#039;\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-humanities\/2020\/04\/21\/make-covid-19-visuals-gross\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u201cMake COVID-19 Visuals Gross\u201d - 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