How to cover the Zika virus responsibly
I don't know of any journalist who sets out to scare people, but reporters may unintentionally alarm their audiences with shoddy coverage of Zika — a virus that's entered a frenzied news cycle that may lead to panic and ineffective overreaction.
It's time we start thinking carefully about the headlines and images we use to cover this story. Context is critical, and there are important local stories to be told that don't emphasize the virus' doom and gloom.
So much has happened in just the last few days, so I want to catch you up on the Zika virus story and link you to some official data. I also have some ideas for stories that could work for newsrooms across the United States.
The CDC added new urgency to the Zika story Friday when it issued new guidelines advising people who have traveled to infected areas not have sex — or at minimum unprotected sex — with a pregnant partner for the duration of the pregnancy.
— Esquire Magazine (@esquire) February 5, 2016
In reality, the recommendation only applies to couples with a man who has been to an infected area.
Also Friday, Brazilian health officials said Zika has been deemed "active" in saliva and urine of infected persons. But it does not, despite reports to the contrary, mean that they know the virus can be transmitted by kissing. I thought it was particularly responsible of The Wall Street Journal to tweet a quote rather than using some generic image of a mosquito or worse, a kissing couple.
— Wall Street Journal (@WSJ) February 5, 2016
Your readers, viewers and listeners are being exposed to daily stories that the World Health Organization has declared a "global emergency," that the virus is "spreading explosively," that Florida has declared a state of emergency in multiple counties and that women in affected South American countries are being told that they should avoid getting pregnant for two years. Some are even calling on the International Olympic Committee to delay the Olympics in Rio. The government of Tonga declared a Zika emergency. American Samoa and Samoa also warn that they have seen Zika cases, and that Pacific travelers should protect themselves.
What scares people most?
Dr. Barbara Reynolds is a crisis communication expert at the Centers for Disease Control. A year ago she helped me lead a seminar to help journalists who were trying to cover the Ebola story responsibly. Reynolds created the following chart to help journalists think through how they report crisis stories.
[caption id="attachment_395389" align="alignleft" width="1462"] Reynolds' chart.[/caption]
The chart opened my eyes to why some stories — especially those that are health-related — captivate the public, while some larger health problems don't:
- Stories that recommend people take action but don't require them to are less scary. The more governments force people to act, the more upsetting the story becomes. So stories that explain ways to prevent being exposed are less scary than stories that do not. Health officials in Brazil have told people to use mosquito repellant. But Aedes aegypti, the mosquito linked to Zika (scientists call them the virus' primary vector) does not react to some repellants.
- Man-made emergencies, such as a nuclear attack or biological accidents, are far scarier than natural incidents, like the mosquito-borne virus. Journalists should remember — and emphasize — that Zika is rarely lethal. Until now, the virus has been considered "mild," with nearly 80 percent of the people who have it showing no symptoms at all.That might be why Zika didn't get much attention when it spread throughout Yap Island (Micronesia) in 2007. Nearly three-fourths of the island's residents were infected. None died.
- Statistical stories are less scary than anecdotal stories. Statistics show that the flu, West Nile virus, H1N1 (also known as swine flu) and even Eastern equine encephalitis are far more deadly and dangerous than Zika is at the moment. A new outbreak of H1N1 cases made news in Europe this weekend. But those diseases are not "new" and and don't produce scary headlines of human suffering. When we take the "new" out of context, we create the potential to cause alarm. Two people in Brazil have gotten Zika from blood transfusions, and American blood suppliers are advising people traveling from the infected areas of South America not to donate blood for 28 days. But those two cases shouldn't discourage the general public from giving blood if they meet a supplier's guidelines.
- When an emergency only affects adults, it tends to get a lot less play.
One reason the Zika story has captured so much recent attention is its possible link to babies being born with unusually small heads.
— National Geographic (@NatGeo) February 3, 2016
The link, to this point, is not proven. Yet images of babies and distraught mothers raise emotions nonetheless.
- As journalists write stories linking Zika to sex, travel and the Olympics, the story turns more exotic. Last week, Texas health officials announced the first known case of the virus being spread in the U.S. To add to the "newsworthiness" of the story, the case came from a man who had recently traveled to an infected area, then had sex with a woman in Texas. She was infected.
Zika also has business implications. News of the virus landed on airline companies that were already facing financial headwinds. Mexico, a popular destination for cruise ships and spring break celebrations, is trying to reassure spring travelers.These two aspects of the story — its international reach and its extension into our private lives — make it simultaneously more compelling and increasingly unnerving for readers.
Focus on prevention
Zika is not an Ebola-sized problem. It's not killing whole villages. Nobody is being stopped at borders, and there's no need for emergency medical workers to wear so-called "space suits" that prevent exposure to deadly diseases.
But the Ebola crisis did teach us key lessons that can be applied to the Zika outbreak, said Dr. Art Caplan, a medical ethicist.
"We learned from Ebola that it is expensive to treat your way out of epidemics," he said. "Prevention is better."
That's partly because of the lack of treatment alternatives. Even a fast-tracked vaccination would take two years to get from the lab to market, Caplan said. In that time, the virus could and probably would mutate.
"Usually vaccines take five years to bring to market," Caplan said. "Think of it, once you find a vaccine that works, you have to build a factory to produce it, then distribute it. Whatever the drug companies could produce will not be ready in time for the summer Olympics in Rio."
In fact, Caplan says the International Olympic Committee should consider delaying the Olympics. In an article for Forbes, Caplan noted that the negative media attention around Zika will likely cause a decrease in attendance.
By the time the Games roll around, many fans aren’t likely to attend. The media will report on nothing but mosquitos and birth defects, more than a few athletes and coaching staffs will balk at competing in Rio, and Brazil will be sinking further into debt trying to battle an epidemic while paying for the Games.
The IOC needs to either move the Games, postpone them, or cancel them. Prevention is the best course in the face of a serious threat to humanity.
Brazil's sports minister said delaying or canceling the Olympics "is not in discussion."
The CDC has not issued guidance on whether athletes or tourists should attend the Olympics, but Reynolds reminded me that by the time the Aug. 5 Games roll around, the weather will be cooler. Brazil will be in winter then. That's when mosquitos are less plentiful.
Mosquito control stories
Now would be a good time to dig around in your city, county and state budgets to see what your governments are spending on mosquito control before Zika arrives. A little research will produce interesting stories about how mosquito control programs are repeatedly funded then cut.
Journalists might look to coverage of Florida for examples of these stories. Florida is making a big deal about how much it's doing to fight mosquitos, but only a few years ago it cut the mosquito research budget and closed a significant research lab.
Similar stories play out in state after state. The prevention funds usually follow some new crisis. Here is documentation of how, 100 years ago, exactly the same scenario played out in St. Petersburg, Florida, my home. The threat then was yellow fever. And health officials were facing budget cuts to mosquito control.
Amy Vittor, an assistant professor of medicine at the University of Florida, wrote about the waxing and waning interest in mosquito control in an opinion piece for TIME:
In Latin America, continental mosquito eradication campaigns in the 1950s and 1960s led by the Pan American Health Organization conducted to battle yellow fever dramatically shrunk the range of Aedes aegypti. Following this success, however, interest in maintaining these mosquito-control programs waned, and between 1980 and the 2000s the mosquito had made a full comeback.
Meaningful control requires persistent prevention work, not just crisis response.
Ethics and society stories
Zika raises some interesting ethical issues. Caplan wonders if the Catholic Church will lift its ban on birth control in Zika-infected countries where women are being warned not to get pregnant. On Friday, the United Nations Human Rights office said contraception and abortion should be available in those infected countries. Zeid Ra'ad al-Hussein, UN High Commissioner for Human Rights, said dissenting views ignore "the reality" of reproductive biology and society.
In situations where sexual violence is rampant, and sexual and reproductive health services are criminalized, or simply unavailable, efforts to halt this crisis will not be enhanced by placing the focus on advising women and girls not to become pregnant.
Find the balance
Keep this story in perspective. Dengue, right now, is far more devastating than Zika. According to the CDC, "With more than one-third of the world’s population living in areas at risk for infection, dengue virus is a leading cause of illness and death in the tropics and subtropics. As many as 400 million people are infected yearly."
West Nile virus showed up in 48 states in 2015 involving more than 2,060 cases. According to the CDC, "about 1 in 5 people who are infected will develop a fever with other symptoms. Less than 1% of infected people develop a serious, sometimes fatal, neurologic illness."
Watch the language you use in your reporting. Be especially careful not to use words like "crisis, scare, emergency, deadly" unless it is part of a quote. Then explore whether the words really hold up under examination.
Watch your "visual language" too. I am starting to see the same mosquito in a test tube image and the same sad mothers and crying babies images being used over and over. When the story is about that woman and that baby, then the image can be essential and illustrative. But we should not reduce these people to generic file images and artwork, as Talking Points Memo does in the following tweet:
— Talking Points Memo (@TPM) February 5, 2016
The Zika story is growing, what we in journalism call "legs." It has all the elements of a captivating story. It is a bit mysterious, it could affect newborns, pregnant women are at risk. The story incorporates sex, international travel, Olympics and creepy looking insects. There is no vaccine and there are new uncertainties about how this spreads. Cover the story but don't make it worse than it is.