Bill Maher is an American political commentator and television host of a talk show “Real Time” flighted on HBO. Recently he launched into a monologue on this show, as is his wont, addressing the issue of media reporting on the COVID-19 pandemic. Always controversial and provocative I enjoy his take on various issues with an understandable focus on America and things American. The monologue entitled, “Give it to me straight Doc!” started me thinking about the manner in which the South African media has and continues to report on the COVID-19 pandemic.
Maher referred to the penchant of media to focus on the negative referring to their approach that, “If it bleeds, it leads” and a reference to the manner in which media in the US has dealt with COVID-19 as “panic porn”. Interestingly he focused on reports from the American Centre for Disease Control and Prevention (CDC) that indicate that the chance of hospitalisation after acquiring a COVID-19 infection is low at only 1-5%, that the risks of COVID-19 transmission from surfaces is not greater than 1:10,000 and further that beaches rather than being a COVID-19 risk are safer places than elsewhere given the positive effects of sunlight, fresh air and wind. He juxtapose these facts with measures that authorities and politicians have imposed. His statements that if “you lie to the people even with a very good cause, you lose their trust” and that he didn’t want politics mixed with medical and decisions resonated with me.
Given that Bill Maher is not an infallible source of factual information or certainly not without some bias, perceived or otherwise, I did some fact checking. From the World Health Organisation (WHO) website “Mythbusters” I gleaned the following: (1) Most people who get COVID-19 recover from it and have mild to moderate symptoms. (2) Despite consistent evidence as to SARS-CoV-2 contamination of surfaces and the survival of the virus on certain surfaces, there are no specific reports which directly demonstrate “fomite transmission” i.e transmission of the virus from physical objects such as surfaces to people. (3) Water or swimming does not transmit COVID-19. (4) The likelihood of shoes spreading COVID-19 is very low and finally on lighter note which South Africans will undersatnd (5) that eating garlic does not prevent COVID-19 … a previous Minister of Health would be very upset to learn this!
Elsewhere on the WHO website, the oft repeated fact that age and co-morbidities increase the risk of hospitalisation and death is confirmed. The CDC website reflects rate ratios of infection, hospitalisation and death relative to a 5-17 year-old age reference group. This clearly indicates that the rate of hospitalisation and death related to COVID-19 infection climbs rapidly after the fifth decade of life. Both WHO and CDC refer to the co-morbidities that increase the risk of more severe COVID-19 infection and, while I will not list these here, the impact of obesity on an increased COVID-19 risk is noteworthy given the frequency of obesity within many communities, including South Africa. Long before the COVID-19 pandemic the risks associated with obesity and the concomitant lifestyle illnesses have been the subject of many public health strategies without noteworthy success.
To return to the media which was the focus of Bill Maher’s monologue, the negative focus of COVID-19 reporting has been and remains striking. Not surprisingly, infection numbers, hospitalisations, deaths, visuals of ambulances, gowned and masked figures, overcrowded wards and intensive care wards have dominated daily news reports, most recently with images from India related to the increase of infections in that country. In this country even minor increases in the numbers of cases are reported, despite a lack of statistical significance, inferring directly or indirectly another wave of infections about to envelope the country. As of the 4th May 2021, the latest National Department of Health report published on social media indicates a total of 1 586 148 infections with 1 501 656 recoveries (95%) and 1187 new cases and a further 59 deaths bringing the total recorded deaths to 54 511. The Medical Research Council has reported that the actual total of COVID-19 cases and related deaths is in all likelihood somewhat higher. I would in no way wish to minimise the impact of a single death on the family, friends and colleagues of that person, but these statistics bring into sharp focus the magnitude pandemic in South African terms taken against the total South African population of around 60 million.
As Bill Maher argues, the “if it bleeds, it leads” approach to reporting on the COVID-19 pandemic is tantamount to scare tactics that have been utilised in public health messaging related to smoking, drugs, alcohol and AIDS with limited success. I recall as a practising physician posters with pictures of black lungs on a clinic wall with an anti smoking message that became part of the background and were largely ignored by both staff and patients. The literature on the effectiveness of scare tactics as part of public health messaging is mixed but on balance it appears that the consensus, as reflected in a 2004 US National Institutes of Health (NIH) statement, is that scare tactics are ineffective in promoting a public health message and may have a potentially damaging effect. So could it be that the “panic porn” approach has to such an extent blunted the national psyche, that news bulletins day after day reflecting infection numbers and deaths and politicians, including the President, together with scientists who have become media personalities speaking about COVID-19 now have little or no impact. How many South Africans now when faced with COVID-19 related news reports simply switch off the radio or TV, skip to the next page of a newspaper or as was reflected in a video circulated on social media of a group in a bar dancing, singing and drinking simply ignore the President delivering a COVID-19 related address on TV in the background? As with the picture of the black lungs on the clinic wall, I fear that COVID-19 with numbers and statistics has become part of the background and are ignored.
At times apparently irrational actions by government, on which I have written previously, have eroded to an extent the trust and belief of many South Africans in government. The most recent delays in effectively implementing an immunisation campaign have done little to sustain public confidence in the ability of the government to deliver on what has been promised. While it is true that there were factors outside the control of government, the fact that public trust had been previously eroded has done little to now promote belief and confidence. The prominent role of politicians during the COVID-19 epidemic both here in South Africa has prompted many to wish that politics and politicians could now recede into the background. One wonders what positive benefit is derived from politicians welcoming the arrival of a batch of vaccines, inspecting, with the media in tow, a facility producing vaccines or prospective sites where the vaccine will be administered. In the words of Bill Maher, many now wish that medical advice and politics should not be mixed. Rather than political grandstanding let those involved in the hard yards of procurement, logistics and finally administration of the vaccine do their work and ensure that the population, particularly those most at risk are vaccinated in the shortest time possible.
People are sadly no longer receptive to statistics related to infections, hospitalisations and deaths. Instead they would rather see in the media long queues of people, hopefully appropriately socially distanced, waiting to be vaccinated. More encouraging to the national psyche would be statistics on the Department of Health website, in addition to the 95% recovery rate, of the large and increasing numbers of people vaccinated per day and the percentage of the population as a result protected against the risks of COVID-19 infections. Rather than an expert telling us that COVID-19 will be with us for years to come, true as that may be, and emphasising for the umpteenth time the threat of the “third” or “fourth” wave, could a different message be that once the population is vaccinated life can return to a semblance of normality? Is it possible that more positive messages after more than a year of the focus on the negative, would engender greater cooperation from communities?
I, for one, pray that in the not too distant future the day dawns when the positive outweighs the negative and that the time when health experts and politicians no longer feature in COVID-19 related media columns and television news reports will soon be upon us!
