Unmasking Covid’s amateur hour

I HAVE a confession.

I was a Covid head girl — that person who would confront you on the street if you weren’t wearing a mask, or accuse you of irresponsibility if you hadn’t been vaccinated.

And if you didn’t agree, I was quick to reply: “But science says …”

However, after recently researching the communication chaos surrounding the pandemic, I began to feel a little embarrassed by my past self-righteousness. 

I should have approached scepticism with greater empathy and understanding. Considering the way authorities and scientists worldwide bungled critical pandemic messages, it’s surprising the disease didn’t claim more than seven million lives.

For instance, in April 2021, Pfizer CEO Albert Bourla said in a tweet that the company's vaccine was 100% effective against Covid-19 in South Africa. The truth was that the vaccine's full effectiveness applied to one specific strain out of several variants of the virus, not to all existing strains.

The tweet ignored crucial context and fuelled distrust in Pfizer, providing fodder for local conspiracy theorists who believed vaccine manufacturers were lying. It didn’t help that we soon discovered vaccinated individuals could still get sick, that the vaccine had some serious (albeit exceedingly rare) side effects, and that we would need a second dose, then a third, then a fourth…

On top of that, we had the bewildering saga of mask mandates. Initially dismissed as unnecessary, masks soon became compulsory. Then they could be discarded if you had been vaccinated, then they became mandatory again. The controversy over their efficacy remains unresolved.

The ground perpetually shifted under our feet, and with each shift confusion deepened, creating an ever more fertile breeding ground for disinformation and conspiracy theories.

To be fair, Covid-19 was uncharted territory. The scientific landscape changed each time more data became available, so we can’t reasonably blame scientists for frequently revising their recommendations.

“It was like building an aeroplane while trying to fly it,” explained Professor Gregory Poland, director of the Mayo Clinic’s Vaccine Research Group in the US.

Yet, there were many missed opportunities to proactively address and mitigate public scepticism and confusion. If scientists had shown more humility about what they knew and did not know, they might have inspired greater trust. If authorities had taken seriously all the studies predicting widespread vaccine scepticism, they could have launched campaigns to enhance public confidence well in advance of vaccine availability. I counted nine such studies in South Africa alone.

American vaccinologist Dr Saad Omer, director of the Yale Institute for Global Health, captured the chaos well when he called the pandemic communication amateur hour.

And yes, perhaps things would have gone differently for us in South Africa had it not been for the corruption scandal that erupted in the midst of the pandemic involving the health minister and a company awarded a communication contract.

In my heart, I am still a Covid evangelist. I even wear a mask when I step into a pharmacy or hospital. But I, too, felt uncomfortable about my fourth jab, as by that time the messages about vaccination had changed so quickly and frequently that it became increasingly difficult to separate fact from fiction.

What steps can we take to prevent a future pandemic again catching us off guard, leading to similar levels of confusion and disinformation? While it is easy to comment with 20/20 hindsight, there remain valuable lessons to be learned from Covid’s communication amateur hour.

Lesson 1: There’s nothing wrong with a degree of science scepticism

Scientists will be the first to tell you that science needs scepticism to survive. Critical questioning leads to more rigorous research, new insights and better solutions.

Yet, during the pandemic, there was little patience with people who had concerns about Covid and vaccines.

There are more than enough legitimate reasons to harbour scepticism towards science. It can indeed sometimes appear fickle: one day, coffee and wine are hailed for their health-boosting properties, the next they’re implicated in cancer. Then there’s the myriad of contradictory messages about fats and sugars.

History is studded by numerous instances of unethical science: from the Nazis’ inhumane experiments on Jewish people during World War 2 to the apartheid-era Project Coast, South Africa's covert chemical and biological warfare programme. In the US, a troubling array of experiments have been conducted on vulnerable populations without their consent or with harmful consequences.

Against this backdrop, it’s hardly surprising that the emergence of Covid-19 was met with suspicion directed at the scientific community and fears of a concealed agenda. In a survey spanning 15 African countries, many people said they believed the West viewed Africa and its poor populations as experimental subjects for Covid vaccines.

For the next pandemic: Although lack of trust in science is understandable, it can also be perilous, stalling scientific innovation and, in the context of a pandemic, severely undermining efforts to protect public health.

But science distrust is not irrational. It is constructive, serving as a crucial check, fostering progress and accountability. Even when it’s not at its most constructive, concerns are often understandable.

The relationship between individuals and science has roots far deeper than logic: distrust in governments and institutions, own fears and lived experiences, education, political and religious beliefs and sociocultural contexts all play their part. Throughout the pandemic, these deeply human aspects were largely overlooked, neglecting the nuanced reasons behind people's attitudes towards science and health measures.

Future strategies should keep this in mind. Instead of focusing just on the science, they should also consider psychological, social and political concerns.

In South Africa, the Afrikaans trade union Solidarity got it right. When research showed most vaccine sceptics were Afrikaans-speaking, the union leader Flip Buys was publicly vaccinated and Solidarity conducted its own research on the vaccines to help mitigate distrust.

Lesson 2: Experts should try to be more humble

One of the more perplexing aspects of the pandemic was the absolute confidence with which some experts dished out instructions about a virus they were still getting to know. It’s an old habit of doctors and public health institutions — and a refrain often heard in South Africa: “Don’t question, just trust us. We know the science.”

For instance, I remember a doctor complaining to the media that he was frustrated by his patients and their concerns. After all, he was the expert and they were the laypeople.

This mindset contributed to the growing discomfort among the general public towards directives, leading to a disregard for Covid safety protocols.

For the next pandemic: Transparency, humility and clarity ought to be paramount. “Science says” is not proof of anything.

At last year’s Nobel Prize summit in the US, communication experts explained to the audience of scientists how to communicate more effectively to promote public trust. In essence, they advised being forthright regarding 1) what they knew, 2) why this knowledge was important, and 3) what they still had to learn.

For example, as soon as new information becomes available, they could communicate it as follows: “This is what we know now. We did not know it at the time, but this is how we learned it. Our previous advice — that healthy people don’t need masks — was based on the belief that asymptomatic people cannot spread the virus, but now we know they can.”

This approach minimises the risk of the public perceiving scientists as unreliable, inconsistent or deceitful by conveying the message that “science learned” rather than “science lied”.

Lesson 3: Our voice is important, even though we’re not scientists

A notable irony of the pandemic was that despite the public being the primary audience for Covid-related communications, our feedback was often overlooked. This was also evident in South Africa, where there were instances of particularly unreasonable restrictions, including the prohibition of specific groceries and merchandise.

Thankfully, not all experts adopted such an approach. As the government's Covid policy began to unravel, individuals such as Professor Shabir Madhi from Wits University took proactive steps to maintain open lines of communication with the public. He made concerted efforts to answer questions and provide updates through various media outlets.

For the next pandemic: Contemporary models for science communication not only emphasise the importance of respecting public opinion but also advocate for active public involvement in scientific decision-making.

This implies that authorities and scientists need to include the public in  discussions about their decisions to maximise the chances of successful implementation.

Thus, the president may host as many televised “family meetings" as he wishes, but without incorporating two-way communication these efforts will not be effective.

Taiwan learnt its pandemic lessons after its encounter with severe acute respiratory syndrome in 2003. When Covid came along, the government not only engaged in nearly daily and transparent communications with the public but also listened to and acted on solutions proposed by citizens. For instance, tech-savvy civilians played a crucial role in assisting the government to counteract disinformation as soon as it emerged. The country had one of the lowest infection rates in the world at the start of the epidemic.

Lesson 4: Pharmaceutical companies prefer profits to people

The disclosure last year that the South African government had to pay more for vaccines than some wealthier nations confirmed what people had long suspected: during a global crisis, pharmaceutical companies were primarily focused on maximising their profits.

This, and the fact that Pfizer had to face legal action by the US Food and Drug Administration before agreeing to release its vaccine data, sent vaccine conspiracy theorists into a frenzy.

Due to the monopolisation of vaccine production by a select few companies holding patents, swift distribution was seen in affluent countries, forcing less wealthy nations to the back of the line. When the US was already rolling out the third dose, a mere 7.5% of people in Africa had received their first dose.

The greed and continuous obfuscation by pharmaceutical companies undoubtedly cost lives and, once again, created fertile ground for misinformation to flourish.

For the next pandemic: Governments must collaborate to ensure that a handful of pharmaceutical companies do not monopolise access to medications that have the potential to save millions of lives worldwide. After all, these drugs are developed with government support, meaning public funds. If patents are removed, vaccines can rapidly be made available to everyone globally, allowing pandemics to be contained as effectively as possible.

Transparency about vaccine safety should be practised from the start, for example: “This side effect was unforeseen because it did not show up during clinical trials. Here is why the vaccine remains a safer option than getting the disease itself.”

This approach communicates that pharmaceutical companies were not inept or deceitful; there were simply things they still had to learn.

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The pandemic could have been managed so much better on so many levels, not just locally, where the approach initially showed promise but eventually deteriorated into ineffective government communication, corruption and bizarre scientism (where an approach is made to seem credible through an exaggerated reverence for what is considered “science").

In many countries, the pandemic was exploited for political purposes. Populist and authoritarian leaders leveraged it to consolidate their power and eliminate opposition.

Donald Trump's America — where the leading Covid expert, Dr Anthony Fauci, became the target of a politically motivated hate campaign — demonstrated that not even democracy could protect against the political exploitation of a deadly disease. In October 2019, a Johns Hopkins report found that America was the best prepared of 195 countries to handle a pandemic. Ultimately, the country that is home to  4% of the world's population accounted for nearly 16% of Covid deaths.

One can only speculate how many lives were sacrificed due to inept communication, the quest for political advantage and the resultant misinformation that spread globally. Let's hope everyone has learnt the essential lessons, enabling us to stand together next time in a spirit of selflessness, transparency and integrity, with the shared goal of preserving lives.

Sources available on request. Email vanzyl@icon.co.za.

Two unforgettable lockdown music videos

The International Opera Choir of Rome’s virtual performance of Va, pensiero from Nabucco (Verdi) beautifully captured the longing and sorrow of the era. It was among the first virtual performances during the lockdown, created at the onset of the pandemic shortly after Italy, the first (and most severely hit) country in Europe, went into lockdown on March 9, 2020.

My other favourite from the time is the upbeat earworm #TsekCorona!, a Covid rendition by David Kramer of Welcome to Cape Town. It was made by a group of celebs to encourage South Africans to stay at home.

♦ VWB ♦

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