The 2009 A(H1N1)v flu pandemic in the media

Talk given at 2nd European Conference of Science Journalists, 03 November, 2015
View/download the presentation slides from my Slideshare account.

The story which I am going to present for you, concerns me personally. My wife became pregnant with our first child in the summer of 2009, the middle of the H1N1 flu (or swine flu, if you want) epidemic. We are both biologists, but still, the controversial information presented in the media made us uncertain. As an effect of the radically contradictory views about the efficacy and safety of vaccine (which were presented as equal scientific positions), my pregnant wife had not been vaccinated for a long time. In a country having the arguably best vaccination system in the world with own vaccine-producing capacity. Her gynaecologist was clearly against vaccination, saying that the immune system of pregnant women are stronger, the vaccine was not tested before so the whole campaign is a big experiment on humans. At the end of the first trimester she was luckily vaccinated and did not get flu, everything was fine. But the fact that almost every pregnant women and their families went through the same crisis shows the great role of the media in acute crisis communication.
The media was accused of enhancing the fear of the disease out of sensationalism, on purpose, while not paying enough attention on the importance of prevention. Afterwards even WHO blamed the media, saying „the media was a contributing cause of heightened risk perceptions among the public”. Meanwhile groups against vaccination basked in the sudden media attention, their messages were often treated the same as those of the epidemic experts. After six years, maybe we can see more clearly what characterized the behaviour of the media during the pandemic, what were their faults and probably what did right.
As you all know between the spring of 2009 and spring of 2010 a pandemic swept over the world, caused by a similar type of influenza virus that caused the 1918 pandemic (or Spanish flu). Estimates say that ten to twohundred million people got flu and twohundred eighty thousand died of it (eighteen thousand fivehundred deaths were proven in lab). In Hungary one hundred and thirtyfour deaths were connected to the flu, 5 of them were pregnant women. Only sixteen percent of Hungarian pregnant women were vaccinated, contrary e.g. the ninetyfive percent of pregnant women in Stockholm. Finally, contrary to the initial fears, the pandemic was not that deadly, the mortality rate was 0.03, while it was hundreds of times higher during the 1918 pandemic. Naturally,a search for a scapegoat was started, many assumed some underlying cause and financial interest behind the “raise of panic”. And accused the media for being its tool.
Naturally, from the identification of the virus in Mexico and the initial quick spread of it, the media handled it at first place, was on the cover pages almost every day. In the last years more European media research group studied the content of these articles, searching for biased opinion, sensationalism and signs of political interest. Two researchers from Medical Research Council prepared the comprehensive analysis of British papers. They examined eight newspapers for a year, classifying them as serious, middle-market tabloid and tabloid. The found 5647 articles containing the expression H1N1. This means 1.93 articles per paper per day, including Sundays. The articles were categorised as alarmist, reassuring or neither, based on their typical expressions and titles.
As you can see, the number of published papers did not follow the number of new cases in the UK. In the spring of 2010, despite there were only a very few British patients, lots of articles were published. Then in the summer with the first wave of the UK epidemic the number of published paper increased. However during the second wave the interest of media significantly decreased, then at the beginning of 2010 practically ceased.
Content of the articles also changed during the months of the pandemic. In the beginning the articles were mostly about the global effects of the spread of the flu, then after the first national cases and deaths the emphasis naturally shifted to the situation in the UK. Contrary to preliminary expectations the articles characterized by the well-established methods were neither alarming nor reassuring, they can be considered as factual, not clearly aiming to influence the readers’ opinion.
According to public surveys one-third of the people applied some kind of prevention, washed their hands, carried a tissue, avoided public transport, etc. However hardly half of them said that they would vaccinated themselves if needed. The most comforting thing for people were that the news about the flu disappeared from the papers. This latter phenomenon clearly shows the two-way effect of the readers’ interest and the choice of topic in the media. If something is not abundant in the papers, people assume it is not important any more.
In another research media researchers from Amsterdam University reviewed the studies about the representation of H1N1 pandemic in media. They could indirectly form a global picture, as European, Chinese, American even Australian papers and TV-channels were included into the analyses. Their main point of interest was how much the media dramatized the evets. „Media coverage has been defined as dramatizing if it exaggerates existing risks, if it awards it with a disproportionate amount of attention considering the actual relevance of the threat (media hype) or if coverage portrays the (health) threat primarily based on arousing or emotional language as well as based on emotion-evoking formal features rather than factual ones”. Their method was similar to the other, expressions, indicators derived from the choice of topic were used to define a level of dramatization in an article.
According to their experience the published articles mostly dealt with the threat of the pandemic, while the prevention and the effectiveness of the counter-measures received little attention. But most research did not confirm the dramatic voice of the articles, rather they mostly proved factual.
According to my knowledge, only one thesis that was made at the Corvinus University investigated the reaction of the Hungarian media, but it did not used any statistical methods to test its hypotheses, so the conclusions must be handled cautiously. The thesis investigated the articles that were connected to the flu and were published in the two largest Hungarian daily newspapers. These articles had two main characteristics that were not typical in other countries. First that as the pandemic proceeded, the topic became more political. In the articles about the flu, the role of the experts and medical doctors shifted to politicians. The pandemic and the counter-measures taken became the subjects of internal political debates, mostly because the elections in Hungary were in the spring of 2010.
The other characteristic is that from the moment that the vaccination was ready and practically unlimitedly accessible, the articles were at least as much about the assumed (and not confirmed) side-effects of the vaccine as about the flu itself. People were highly uncertain about the vaccination and the uncertainty were transferred and enhanced by most of the articles.
Although officials and doctors did not object the vaccination in public, in private conversations many of them handed over the narratives of the groups that assume conspiracy everywhere. Off the record even one high-ranking epidemic specialist suggested me not vaccinating my pregnant wife. This phobia against flu vaccination decreased since then and in the next years there were hardly any mass-resistance against the vaccination – despite that they contain the vaccine against the H1N1 flu virus as they did on the turn of 2009/10.