‘We became sceptics’: general public narrative on pandemic influenza, viral media and public health 19 July 2012 MRC Social & Public Health Sciences Unit Glasgow Dr Mark Davis Senior Lecturer School of Political and Social Inquiry

Overview Introduce theory and the research questions Methods Present interview extracts Discussion

Theoretical frame Risk society Politics of fear and consent Media on pandemics –The 2009 pandemic as media event –Outbreak narrative –Identity and power

Research questions How do members of the general public engage with media on pandemic influenza? What are the implications of such engagements for public health? What do these engagements and implications suggest for how we are governed more generally?

Methods Melbourne, Sydney and Glasgow (n=105) –(Interviews n=50) –(10 Focus groups n=55) Purposive criteria –Healthy –Pregnant in 2009 –Lung disease/immune disorder –71+ years Advertising and snowballing Thematic analysis

Purposive criteria x city

What I want you to do now is think a little bit about 2009 swine flu. What can you remember about it? Peter: Publicity. A bit of a panic. And going about my own business thinking it’ll never affect me anyway 'cause I’m not flying overseas and I’m not associating with people that I might think might have it. Pretty simplistic but yeah. But get on with life. Liz: Yeah. I remember similar too like the Asian countries seemed to be affected by it, [Yeah] I remember. And thinking it could be scary if you, you start to think that things are passed on from animals to humans, [Yeah] and, and how they mutate. But I wasn’t alarmed, but I can remember a lot of publicity and probably a lot of bad publicity about how very dangerous it was, and how easily, and how it was spreading.

[later] Peter: Always panic. Always bad news. Always more people being affected by it or a particular person who’s come into Australia who’s got it and they’ve been isolated. And there’s always a panic, you know, ‘any second now’. The press were waiting I think with bated breath, hoping that a million people would drop dead so it could sell more papers. And it’s just build up of panic. That’s, that’s what I remember and thinking, “It can’t be that bad. We haven’t been warned to wear masks or anything else. So, you know, it’s just a beat- up, basically.” [later] Peter: So we became sceptics. (Liz and Peter, both 51-60, healthy, Melbourne)

Themes Media hype as the problem Viral media Scepticism

Media hype as the problem

Anne: And they (the govt) should make sure there’s a public awareness campaign about whatever it is [Yeah] that alerts the public to there is a problem. [Yep] Gary: I s'pose it would be nice if we could somehow stop the spin doctors from spinning the problem [Yeah] up much higher than it really is. Anne: That’s right. So do you feel that happened around the swine flu? Anne: Yes. I don't have any hesitation about that. [Yep] They, the, the spin doctors certainly got into the thing. And I suspect some of the medical supply people also [Right] added to the panic. (Anne (61-70) and Gary (71+), Melbourne)

Do you know anybody that was effected by it? Dave: No. No? Dave: No, I’ve read a couple of reports, b-b-b-but because, the ironic thing about it is that after all the publicity that it got about ‘oh we’re needing to spend money on this and get this’ and ‘we’re going to have a pandemic and it’s going to be wiping out the planet’ eh if someone actually got swine flu it was news-worthy in the in fact that nobody was getting it so therefore when someone got it was a headline ‘Woman Dangerously Ill” because she’s contracted swine flu’ I: Right

Dave: …eh whereas it wasn’t because it was letting people know that swine flu was here it was the fact that ‘well we’ve at least got one that’s got it!’ (laughs) Do you think that people were rejoicing or something? Dave: (laughs) No, no, I think that, like, b-b-because it was an unusual occurrence, and the papers did spend a bit of print on the problems that the medical profession – and I say that loosely – and whoever it was or whatever area is designed to look after the health of a nation when something like this threatens eh, and because it had been hyped up so much and eh it just fizzled out (laughs) eh, not that the swine flu fizzled out because it never seemed to fizzle to start with! (Dave, 61-70, healthy, Glasgow)

Yeah … Today Tonight or something like that. Alex: I never believe anything … (0:21:01) their journalism? Alex: It’s a poor excuse. No, but I mean if the, if the ABC seven o’clock news said there’s a pandemic happening in Victoria, I’d believe it. I mean I, I’d probably be aware that they’d probably embellished it a little bit because you have to make it seem worthwhile news [Yeah] to, to report it. It’s no use, even the best journos, it’s no use saying, “It’s a problem but it’s probably gonna be alright.” That’s, that’s not a story, is it? That’s just (0:21:37). (Alex, 31-40, CF, Sydney)

Viral media

So how did you hear about the swine flu? What sort of stuff did you hear about it? Natalie:The media beat-up on the news. News stories everywhere. Yeah, I guess it’s what came across the news and the papers, and things like that. Jason:Yeah, that’s about it, yeah. News, all over the news. A hot topic for a couple of weeks.

So what sort of things were you hearing on the news? Natalie:Pandemic. [Yeah] How scary it was. Jason:It’s spreading. People are dying. First case in Australia. [Yeah] First this, first that. Everything was just … Natalie:It sounded a bit like the movie Outbreak. I mean it’s quite exciting to hear words like that. [Laughter] But … ‘airborne’, you know. Quite exciting. It was, it seemed like a big beat-up but definitely there was a lot of presence in the media about it. (Focus group, 21-30, healthy, Melbourne)

Sarah: So initially, I think it was just on the telly and it was, it just seemed to be every day it just seemed to be going up a level and up a level and then… and you know for me you know I suppose the fear was just building and building with it you know thinking, ‘Oh God, what’s going to happen? You know is everybody going to, is it going to be a real…’ I don’t know I think as well people were talking about…the fact that it was wasn’t effecting over 60s the same way kind of seasonal flu would, so they were likening it to an outbreak when they were exposed to it, is that right? And they would have immunity to it or something, so it felt kind of as if they were talking about previous pandemics as well, I can vaguely remember that.

And how did you feel about that? Sarah: Well every day I went round here I survived it so! On one hand you’re kind of I remember on one hand thinking (sarcastically) ‘It’s the flu...we’ll be fine’. On another hand you’re hearing it’s a pandemic and you’re pregnant and you’re in an at risk group and you’re going to get immunized, but I suppose I probably did have quite a struggle with it, you know whether to get immunized or not. (Sarah, 21-30, pregnant, Glasgow)

Scepticism

Deb: I think if media beefs-up something too much, it makes people blasé about things. [Yeah] And so you’ve gotta be careful with that. [Yeah] But then if they use statistics properly, [Yeah] which is what they’re saying, then people can sort of make their own decision. [Yeah] So as long as the facts are coming through with how many cases and where then people can sort of make a judgement on how bad they think it really is. [Yeah] Yeah. And then that would determine how they act and whether they’re gonna be a bit more, you know, cautious about it or not. (Deb, 31-40, Healthy, Melbourne)

Peter: And at first they were saying “Oh old people are at risk and very young people” and then I can remember there was another part come out in the news I didn’t read any medical journals about it or anything but, it was saying ‘Oh, people over 80 will be ok because they were here the last time there was a-a-you know a pandemic with the same type of flu with swine flu so they’ll already have the antibodies in their body’ but then I read something else saying that you don’t get antibodies for viruses and you’re thinking “Well who do you believe here?”

And I’m like that with most media things anyway, I’m always very, very sceptical – I studied psychology so you, you need to question anything anyway. I’m probably doing that better talking than I was on paper! (laughs) Yeah, I mean I wasn’t like (mock worried voice) “Oh God, we’ve got a pandemic coming and it’s going to be Armageddon!” (Peter, 41-50, Healthy, Glasgow)

Maude: ---yes, until you kind of present yourself at the doctors with symptoms, I think then there was...but even there I think the symptoms...the information I got was that the symptoms seemed to vary, you didn’t really...you know I remember going on the uhm, just having a look at out of interest on the NHS website saying ‘Is this flu?’ you know ‘Is this swine flu?’ you know kind of a self diagnosis page that they have and...

I was just putting different things in and trying different combinations and everything I put in seemed to say ‘You may have swine flu,’ ‘You may have swine flu’ you know and it didn’t seem to matter what combination you put in or how many boxes you ticked or how many boxes you didn’t tick the same information page just seemed to come up saying ‘You may have swine flu, these are the precautions you should take’ So again I just thought well--- (Maude, 31-40, pregnant, Glasgow)

Discussion Scepticism (not fear) framing engagements with pandemic influenza General public position themselves as critical consumers (how can public health engage such publics?)

Discussion Pessimistic view –More subtle politics of fear –Consent is obtained even when the public is sceptical Optimistic view –Critical, participatory public health