14 Oct 2009 Source:
SciDev.Net
Fang Xuanchang, Jia Hepeng
and Katherine Nightingale
Sensationalism is no
substitute for sound science when reporting disease outbreaks, say Fang
Xuanchang, Jia Hepeng and Katherine Nightingale.
A pandemic or large
disease outbreak is always hot news, thanks to the race to research it,
uncertain results, vivid details about treatment, attempts to prevent its spread
and of course an element of fear.
The initial stages of an
outbreak, especially, provide good opportunities for journalists. There are many
researchers and doctors to interview, an abundance of news 'hooks' as health
officials and researchers deal with the situation, and an unusual readiness of
editors to run science stories.
But to report a disease
outbreak responsibly, you must not only make sense of early reports and often
hazy information, but also follow up the story comprehensively in the long term.
And this must always be
done by applying critical thinking and taking a scientific approach. The science
�
together with the wider social and economic perspectives � is essential to
producing good stories about pandemics.
Swine flu � influenza A(H1N1) � has already thrown up
some classic examples of bad science journalism, such as Egyptian journalists
reporting 'experts' saying that infected pigs could end up in the food chain as
cheap beef (see Media and government to blame for Egypt swine flu chaos).
What follows is advice on
how to avoid repeating these mistakes. The tips are all the more important in
developing countries, where resources are scarce and the challenges of
communicating important information are great.
In such countries,
responsible public health messages are crucial to easing the burden of a disease
on vulnerable health systems. Get the basics right
First, give your audience
the correct meaning of words they will frequently hear and read. For example, a
'pandemic' means a disease that has spread on a global scale, not necessarily
that it is deadly. Scientists talk about the 'virulence' of a pathogen, but what
does that mean to laypeople? Use straightforward, accurate explanations that are
not alarming.
Health organisations may
provide information and factsheets about the pathogen and the best ways of
dealing with it. Government agencies should provide information about the number
of cases in a country and, if appropriate, the number of deaths.
Try to report these
details using your scientific knowledge. Does the death rate seem higher than
that of other diseases? Is the pathogen a new strain of an existing foe or
something new? The way you frame these facts can point your reporting in the
right direction. Key questions in the early stages
Often, a layperson's
immediate reaction to hearing about a new disease is, "How will it affect
me and the people I love?" No science journalist can answer this, but you
can communicate the risk a disease poses.
First, you need to be
familiar with recent research into similar diseases. For example, a knowledge of
H5N1 bird flu will help to cover A(H1N1) flu, as much of the research (and
researchers) �
will also be relevant.
There are some key
questions to bear in mind.
The A(H1N1) virus: when a
pathogen first emerges, scientists must race to find out about it
Flickr/hitthatswitch
What do scientists know?
In the early stages of any
disease outbreak, there will be many unknowns but there will often be a wealth
of scientific knowledge about the type of pathogen or similar strains.
Pandemics and sudden
disease outbreaks, by their nature, are usually caused by new pathogens � or at least new strains
of them. Scientists won't necessarily know how they behave.
They do know a lot about
influenza, so the current A(H1N1) flu outbreak is not too much of a mystery � though obviously no one
can predict the future. But when SARS emerged in 2003, scientists knew very
little, as it was a new virus.
Say what scientists do and
don't know but try not to cause panic. Scientists don't necessarily need all the
details about a pathogen to find a treatment that works, and it is unrealistic
to expect scientists to have information about every possible disease at their
fingertips.
When less is known, the
possibilities are greater but it does not mean they are inevitable: A(H1N1) flu
could combine with H5N1 bird flu but that doesn't mean it will.
How many cases will there
be? How many people might die?
Researchers must model how
many people they think could be affected or killed by a disease outbreak so that
countries can prepare their health systems effectively. Be careful not to report
predictions as certainties �
that is sensationalist and does not give the audience any idea of how such
models work. They are the best estimates calculated from a selection of factors
and can only be as good as knowledge at the time.
Be cautious of certain
scientists making sensational claims about large death tolls � the more serious the
disease, the more money they may receive for their research.
So, always try to analyse
the factors contributing to the estimates of death tolls � don't focus solely on
the numbers.
Try also to keep a disease
in perspective. Many reports about the A(H1N1) flu pandemic have failed to
compare the disease's death toll with others that may have more of an impact.
With a new influenza
pandemic there is a tendency to compare it with previous pandemics, particularly
the most dramatic ones. Remember to report current outbreaks in the context of
today's health systems and science.
For more about how to
communicate risk see SciDev.Net's guide Communicating statistics and risk.
How is the infection
passed on and what can I do about it?
State what is known about
how the disease is spread and ask a scientist or public health official � or a range of them � to explain if
transmission methods are unclear.
You should also report how
it isn't spread. Industries can be damaged by people falsely believing a product
is involved in disease transmission. Sales of poultry decreased at the height of
the H5N1 avian flu scare because people wrongly thought the disease might be
passed on by eating it.
You can give your audience
information about how they can protect themselves, particularly with simple
measures. With HIV, messages should be about practising safe sex; with
influenza, handwashing.
Simple public health
messages, such as the importance of handwashing, are vital in poorer countries
Flickr/ESP
Reporting what people
shouldn't do can be almost as important. For example, there is little evidence
that face masks can protect members of the public against flu. Companies may
well be promoting products for which there is little or no evidence of
effectiveness.
It is also important to
avoid running too many stories. Important public health messages should not be
lost because people are turned off by too many similar stories that don't seem
to offer any new information. Build trust with sources
Using reliable and
informative sources will make your stories stand out, as well as helping you
navigate the plethora of data, some of which can be conflicting.
Developing relationships
with scientists who trust you is crucial. Regular conversations can bring new
angles to stories, as well as inform you how they intend to follow up their
research. In some countries, governments may try to hide the number of cases or
deaths �
as with SARS in
You can also return to the
same sources to give you an idea of how the outbreak is perceived by scientists
over time. If they are changing their minds about the severity of a disease then
it is worth letting the public know.
It is also a good idea to
build relationships with government sources. This can be difficult to do in
developing countries. More information about building relationships can be found
in SciDev.Net's guide How to report on science policy. The long-term view
When the public gets most
of its information about a disease from the media, they can be forgiven for
thinking it has disappeared if the news stories dry up. While it is important
not to overwhelm people, they should also know if there is still a threat.
Keep the key questions
above in mind and try to see whether the answers have changed as new information
comes to light.
In addition, the time
after an initial flurry of coverage is an opportunity for in-depth reporting � assessing a
government's response, for example, or looking at how research into the disease
has advanced science in general (or whether vital resources have been diverted
from other areas).
Tracking the development
of any new drugs or vaccines against a disease can also be productive. In
Part of a Chinese SARS
prevention poster
Flickr/Oldtasty The wider
context
A pandemic or large
disease outbreak is not just a scientific issue and you may find yourself
covering economic and social topics you are less familiar with.
For example, China News
Weekly has covered A(H1N1) flu more deeply by assessing the transformation of
public health strategy in
Reporting on pandemics can
mean dealing with social issues such as unprotected sex and multiple sexual
partners, as with HIV, and inequalities in access to drugs. HIV also has
economic implications because it has wiped out generations in some developing
countries. Think globally, act locally
Finally, a pandemic may
appear remote to people far away from the first known outbreaks. But the WHO
declared swine flu a pandemic less than two months after it began circulating
widely and air travel has played a major role in transmission.
The challenge is to make a
global story locally relevant. A case of the disease may not yet have occurred
in your country, but you should be letting people know about it, what they can
do to protect themselves and what the authorities are doing.
It is responsible to
inform people in the possible path of a disease �
but equally important to ensure that stories don't seem like a countdown to
disaster.
Fang Xuanchang is the
science editor of China News Weekly. Jia Hepeng is the editor-in-chief of
Science News Bi-Weekly and former