The coronavirus response is as much a social issue as it is a health issue
Flight MH107 from Kuala Lumpur landed a little after 11 am on Wednesday, one of only four flights to arrive at Shahjalal International Airport that morning. As the passengers trudged through the arrival terminal, they had to pass through a thermal scanner. Health officials standing nearby watched for signs of elevated body temperature. A man wearing a mask collected health forms that the passengers had filled out.
“Stay at home for two weeks,” a woman in a white apron said. Then the passengers were allowed to leave the terminal. No one explained the urgent necessity of home quarantine or the practical details of how it would work.
Outside the concourse hall, the passengers hugged and shook hands with friends and relatives who had come to meet them, oblivious of the fact that they could be passing on the dreaded coronavirus.
“I don’t have any problems, I’m fine!” one man said. “No one said I shouldn’t touch other people.”
Lack of information and misinformation have characterized Bangladesh’s coronavirus response so far. And let’s be clear about one thing: Community resistance is one of the biggest obstacles right now to stopping COVID-19.
People are not aware that they can be transmitting the virus before showing any symptoms. People are still congregating in large numbers at parties and religious gatherings. On any given street in Bangladesh, people are blithely sneezing, spitting, and coughing, with no concern about the danger that kind of behaviour poses to others around them.
The virus of misinformation threatens to complicate and frustrate the efforts to fight COVID-19.
From a rapid scan of social media, here’s a snapshot of rumours and misinformation circulating:
λ The COVID-19 is a man-made virus and therefore represents a conspiracy
λ The virus represents the wrath of God because of the reported persecution of Uighur Muslims in China and therefore Bangladeshi Muslims are safe from it
λ The virus is a punishment for sins and only sinners will be affected
λ Muslims who perform ablutions five times a day are safe
λ Young people are immune from the virus and therefore don’t need to be concerned
λ The COVID-19 is similar to the common cold
λ Bangladesh has a hot, tropical climate and so the virus won’t spread here
λ Thankuni (scientific name Centella asiatica) commonly known as Indian pennywort, can cure COVID-19
Misinformation and rumours are particularly dangerous during a health emergency because they drive people to take the wrong decisions. Rumours can be destructive to public order and undermine confidence in the official response. They can lead people to ignore health advice.
But just as COVID-19 cannot be defeated by the government alone, the misinformation virus cannot be tackled with a law enforcement response. Arresting people for posting about coronavirus on social media is not the answer as it can deepen suspicion of a cover-up.
The way to combat misinformation and rumour is to carefully track, analyze, and re-engage the community with verified information and a well-crafted counter-narrative.
The spread of coronavirus in Bangladesh is as much a communication failure as anything else. Despite advance warning, there was no risk communication plan and no consistent messaging. As we saw from the anecdote above, health officials have not given specific information to people arriving at the ports of entry. For people coming from corona-affected countries, there was no communication material on how to protect themselves and their families.
Non-specific advice such as “please be careful when you go out” is worse than useless. Advice such as “avoid crowds” or “stay home” is not enough. Communication during a public health emergency has to be specific, factual, and easy to understand -- especially when it comes to changing personal and social behaviour.
Experience has shown that quarantines will be violated or dissolve into violence if affected communities are not given clear reasons to comply.
We must realize that the coronavirus response is as much a social issue as a health issue, and the value of early, genuine communication with communities cannot be overstated.
We don’t have the robust health care system that China or South Korea has, so our biggest protection would be personal precautions and community-based preventive measures. In short, we need to try to change people’s behaviour at an individual and social level.
Communication must be a key element of any crisis or emergency preparedness plan. We should have social and behaviour change communication (SBCC) and risk communication activity planning, including communication plan development for every stage of the COVID-19 response.
SBCC is a communication approach that facilitates changes in knowledge, attitudes, and beliefs, and promotes desired healthy and safe behaviours and practices. Successfully changing behaviour often takes many months and years, but during a public health emergency, heightened awareness and fear of diseases can drive quicker change.
For COVID-19, the mechanism for social and behaviour change communication can consist of three distinct, but interrelated, pillars:
λ Social mobilization, which will engage individuals and communities primarily through community influencers, public address systems, localized campaigns, distribution of communication materials, and discussions within social media groups and other community initiatives
λ Media/communication, which will focus more on communication through national spokespersons and media, and reporting from print, TV, radio, and other broadcasts
λ Misinformation tracking and debunking, which will follow a track-verify-engage method
Communication with the communities is not just about public service announcements or PSAs. Effective social mobilization involves a two-way dialogue, listening to community concerns, as well as taking into account community structures and acknowledging traditional community coping strategies and influences on behaviour.
Two examples of community-based communication channels that could be useful:
λ Social influencers, artists, comedians, actors, athletes, and religious leaders to help spread the word about social distancing
λ Short animation on personal hygiene and social distancing that can be disseminated through social media
An SBCC and risk communication plan must be formally incorporated into Bangladesh’s national response, alongside more typical components such as supplies and logistics, surveillance, and clinical care. Messaging about Covid-19 should be consistent with national and global efforts.
Once the community is informed, engaged, and mobilized, community surveillance initiatives, such as a community task force, can help enforce home quarantine and alert the health ministry to possible outbreaks.
Government officials, civil society organizations, religious and community leaders, mass media, district health teams, community influencers, and social media influencers should be working together in communicating with communities and the social mobilization effort.
Bangladesh cannot let the misinformation virus derail its Covid-19 response.
Syed Zain Al-Mahmood is a media and communication expert.