Public health professionals trying to provide the nation with facts about the spread of coronavirus are battling a wave of misinformation, as they wrestle with the first major British health crisis of the smartphone era.
Officials are providing regular updates to the media on the spread of the infection, but at the same time half-truths about the best way to treat the illness are already going viral on WhatsApp and other messaging services.
Some are suggesting dubious herbal remedies, while one viral message – which claims to be advice from an uncle who is a Chinese doctor – mixes standard best practice with unverified claims about how best to kill the germs.
The World Health Organization is recommending that people take simple precautions to reduce exposure to and transmission of the Wuhan coronavirus, for which there is no specific cure or vaccine.
The UN agency advises people to:
- Frequently wash their hands with an alcohol-based hand rub or warm water and soap
- Cover their mouth and nose with a flexed elbow or tissue when sneezing or coughing
- Avoid close contact with anyone who has a fever or cough
- Seek early medical help if they have a fever, cough and difficulty breathing, and share their travel history with healthcare providers
- Avoid direct, unprotected contact with live animals and surfaces in contact with animals when visiting live markets in affected areas
- Avoid eating raw or undercooked animal products and exercise care when handling raw meat, milk or animal organs to avoid cross-contamination with uncooked foods.
Despite a surge in sales of face masks in the aftermath of the coronavirus outbreak, experts are divided over whether they can prevent transmission and infection. There is some evidence to suggest that masks can help prevent hand-to-mouth transmissions, given the large number of times people touch their faces. The consensus appears to be that wearing a mask can limit – but not eliminate – the risks, provided it is used correctly.
While the inherently private nature of WhatsApp makes it hard to track the spread of such material or judge how many people are reading it, some of the posts seen by the Guardian use the standard language of internet chain letters and urge people to forward the advice to friends and family – circumventing the official health communications in the same manner that has allowed anti-vaccination movements to flourish online.
Prof David Harper, a former chief scientist at the Department of Health, said the UK’s established communications strategy for a public health crisis is to have a trusted medical figure rather than a politician deliver regular updates to the public.
He said this approach worked well during the 2009 influenza pandemic: “It was decided early on that the designated person would be very visible even if there was very little to say. If no one is saying anything then it becomes a cause of concern. It’s much better to be visible and be seen by the public, even if it’s just to repeat what’s been said or say there’s not been much change.”
What is Covid-19 - the illness that started in Wuhan?
It is caused by a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals. Many of those initially infected either worked or frequently shopped in the Huanan seafood wholesale market in the centre of the Chinese city.
Have there been other coronaviruses?
Severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals. In 2002, Sars spread virtually unchecked to 37 countries, causing global panic, infecting more than 8,000 people and killing more than 750. Mers appears to be less easily passed from human to human, but has greater lethality, killing 35% of about 2,500 people who have been infected.
What are the symptoms caused by the new coronavirus?
The virus can cause pneumonia. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties. In severe cases there can be organ failure. As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work. Recovery depends on the strength of the immune system. Many of those who have died were already in poor health.
Should I go to the doctor if I have a cough?
UK Chief Medical Officers are advising anyone who has travelled to the UK from mainland China, Thailand, Japan, Republic of Korea, Hong Kong, Taiwan, Singapore, Malaysia or Macau in the last 14 days and who is experiencing a cough or fever or shortness of breath to stay indoors and call NHS 111, even if symptoms are mild.
Is the virus being transmitted from one person to another?
China’s national health commission has confirmed human-to-human transmission, and there have been such transmissions elsewhere.
How many people have been affected?
As of 4 March, the global death toll was 3,190, while more than 93,000 people have been infected in more than 80 countries.
The death toll has passed 3,000 in China, where there have been over 80,000 cases. South Korea, the nation worst hit by the outbreak outside China, has had 5,328 cases. More than 44,000 people in China have recovered from Covid-19.
There have been 87 recorded cases and no fatalities to date in the UK. There are 53 confirmed cases in Australia, with two deaths.
Why is this worse than normal influenza, and how worried are the experts?
We don’t yet know how dangerous the new coronavirus is, and we won’t know until more data comes in. The mortality rate is around 2% at the centre of the outbreak, Hubei province, and less than that elsewhere. For comparison, seasonal flu typically has a mortality rate below 1% and is thought to cause about 400,000 deaths each year globally. Sars had a death rate of more than 10%.
Another key unknown is how contagious the coronavirus is. A crucial difference is that unlike flu, there is no vaccine for the new coronavirus, which means it is more difficult for vulnerable members of the population – elderly people or those with existing respiratory or immune problems – to protect themselves. Hand-washing and avoiding other people if you feel unwell are important. One sensible step is to get the flu vaccine, which will reduce the burden on health services if the outbreak turns into a wider epidemic.
Is the outbreak a pandemic?
A pandemic, in WHO terms, is “the worldwide spread of a disease”. Coronavirus cases have been confirmed outside China, but by no means in all 195 countries on the WHO’s list. It is also not spreading within those countries at the moment, except in a very few cases. By far the majority of cases are travellers who picked up the virus in China.
Should we panic?
No. The spread of the virus outside China is worrying but not an unexpected development. The WHO has declared the outbreak to be a public health emergency of international concern. The key issues are how transmissible this new coronavirus is between people, and what proportion become severely ill and end up in hospital. Often viruses that spread easily tend to have a milder impact. Generally, the coronavirus appears to be hitting older people hardest, with few cases in children.
Harper, now a fellow at Chatham House, said there is some risk that people become “desensitised” if they are provided with too much information on how many people have been infected without sufficient context, but that transparency improved public trust.
A decade on this approach is being challenged by the radically changed media environment. Major social networks, aware of past criticism of their role in spreading untruths and hysteria over health issues, have moved to get ahead of the problem and are actively engaging with the UK government to provide information.
Both Facebook and Twitter are promoting official NHS guidance, providing links to NHS advice in users’ feeds and when they search for coronavirus-related terms. Google, often the first port of call for health advice, is promoting official advice.
The BBC, having spent recent months being attacked and stonewalled by the government, is emphasising its role in disseminating accurate, timely information about public health issues, with a spokesperson pushing the fact its coverage reaches millions of Britons with official guidance.
“We know the public turns to the BBC at times like this,” said a spokesperson, pointing out that nine of the corporation’s 10 most-read stories online during the past week were about the virus. Also highlighted was the decision to make a special public information programme on the outbreak on Monday night.
For a government that has put great weight on bypassing traditional media outlets, the outbreak has forced it to reconsider its relationship with the broadcaster. On Saturday a government minister was heard giving an interview on Radio 4’s Today programme for the first time since the general election, breaking a No 10-imposed boycott to deliver an update to the programmes’s millions of listeners. And on Tuesday health secretary Matt Hancock appeared on the same programme ahead of the publication of the government’s so-called ‘battleplan’ to combat the spread of the virus.
Lord Kerslake, a former head of the civil service, said he still believed the government’s communications efforts were insufficient, and had been damaged by political boycotts of Today and ITV’s Good Morning Britain. “You are reliant on communications in these situations, and need every media outlet necessary. You certainly shouldn’t be boycotting programmes, frankly that’s pretty feeble,” he said.
Kerslake added that not enough ministers had appeared in the media to support Hancock, who has been leading communications efforts on coronavirus almost single-handedly in the past few days. “No criticism of Hancock, but if I was him, I’d want a bit more back-up.”
Harper, the former Whitehall official, accepted that Boris Johnson’s decision to call a meeting of the emergency planning committee Cobra may be partly for media consumption. But he said it also helps reassure the public about the seriousness of the issue: “In this case, the prime minister is seen to be in control. It is important that the machinery and the accountability for taking the decisions are seen. We have to be careful not to be too hung up on who’s doing what at what point.”
Additional reporting by Elle Hunt.
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