The Novel Coronavirus (COVID-2019) Outbreak: Amplification of Public Health Consequences by Media Exposure

"During an ongoing threat from a novel disease outbreak, timely updates from trusted sources about the relative risk of contracting the novel disease versus a more common one are critical. Without them, public fears may escalate, fuel rumors, and provoke stress responses."

In the midst of a health crisis such as the COVID-19 pandemic - particularly when the disease is a novel one - the public depends on the media to convey accurate and up-to-date information in order to make informed decisions, such as about health-protective behaviours. This paper reviews research suggesting that repeated media exposure in such times of crisis can lead to increased anxiety, heightening stress responses that can lead to downstream effects on physical and mental health. The paper draws from work on previous public outbreaks (i.e., Ebola and H1N1) and other collective trauma (e.g., terrorist attacks), where media coverage of events had unintended negative consequences for those at relatively low risk for direct exposure. Drawing on this analysis, it offers recommendations for the media, members of the public, health officials, and researchers with respect to communicating effectively during a public health crisis.

As reported here, studies have demonstrated that both the amount and type of media exposure affect psychological responses to a community-wide traumatic event. For example, researchers found that people who reported the highest media exposure to the Boston Marathon bombings in the United States (US) reported higher acute stress than did people who were directly exposed to the bombings. People with the greatest concerns may seek out more media coverage of an event (or an outbreak like COVID-19), further increasing their stress response. Furthermore, exposure to graphic images that included blood was associated with heightened posttraumatic stress and fear of the future 6 months after the Boston Marathon bombings, both of which were positively associated with poor functioning.

One of the issues particularly salient in the case of COVID-19 is the uncertainty and ambiguity associated with the disease threat, which is exacerbated by the fact that much information is unknown (let alone the potential for ineffective communication of what is known). Research conducted in the context of the H1N1 outbreak indicated that increased uncertainty and feelings of uncontrollability linked to ambiguous communication led to increased anxiety. Similarly, data collected during a school shooting in the US found that during the crisis, when official updates were not provided, rumours proliferated and psychological distress increased. When ambiguity is combined with an invisible threat, such as a virus, fear and worry may be ramped up even further and can contribute to the spread of misinformation as people reach out to others on social media, for example, in an effort to voice and assuage their confusions and concerns.

Along those lines, the authors suggest that "Emergency management agencies tend to underuse social media as a source of risk communication. Strategic social media use (e.g., hashtags) may be an effective way for agencies to communicate accurate information to the public during times of crisis..." In addition to the need to ensure the responsible use of social media to prevent and/or correct misinformation, the authors recommend that:

• The media convey information without sensationalism or disturbing images;
• The public avoid speculative stories and limit repetitious exposure to media stories that provide little new information, while staying abreast of critical updates provided by authoritative sources such as the World Health Organization (WHO) or the Centers for Disease Control and Prevention (CDC);
• Healthcare providers, as trusted community agents, seek to temper hysteria that may thwart the overall public health effort while communicating practical advice that individuals can implement to protect themselves from contagious viruses (e.g., washing hands, social distancing); and
• Researchers investigate questions regarding effective risk communication during the COVID-19 outbreak, particularly with respect to the use of social media.