COVID-19 has accelerated many troubling trends, from inequality to anti-vaxxer activism, and harmful misinformation is no exception. One study in August estimated that nearly 800 people have died globally from alcohol poisoning because they seem to have believed a rumor that drinking very concentrated alcohol would combat the disease. That same month, a report by the activist NGO Avaaz found that health misinformation appeared to garner more engagement on Facebook than content from institutions like the World Health Organization (WHO).
So far, policymakers and academics have mostly focused on measuring and fighting what WHO Director-General Dr. Tedros Adhanom Ghebreyesus has called an “infodemic” of misleading and potentially damaging COVID-related messages online. Combating this infodemic frequently comes down to ensuring that misleading content is expeditiously taken down. But the emphasis on takedowns obscures the role that government communication can play: Consistent, reliable, and digestible communications from public officials can make a substantial difference in keeping the public informed. A big-data study in the Journal of Medical Internet Research about online searches and purchases of questionable treatments during the first hundred days of COVID-19 in twelve countries concluded that “the public is highly responsive to governmental risk communication during epidemics.”
In mid-September, I published a report, co-authored with Ian Beacock and Eseohe Ojo, that explored the principles behind democratic health communications in nine jurisdictions around the world (Senegal, Taiwan, South Korea, Germany, Sweden, Norway, Denmark, New Zealand, and Canada). South Korea and Taiwan stood out for their use of technology both to understand what their citizens were thinking and to prevent the health disinformation spreading as it did in Europe and North America. Both South Korea and Taiwan have focused on providing consistent reliable information around COVID-19 via as many channels as possible to make public health institutions the first port of call for citizens. By finding effective ways to reach as many residents as possible, South Korea and Taiwan have made poor-quality information much less of a problem than elsewhere. Their experiences in dealing with the infodemic provide five important lessons for policymakers.
1. Communications strategies are key
South Korea and Taiwan both institutionalized communications strategies as an integral part of their response to epidemics. The Korean Centers for Disease Control contain an Office of Communication that is mandated to “perform communication in the emergence of infectious diseases.” Long before COVID-19 hit, this office had already built substantial capacity to send out messages through multiple channels, such as a secure emergency text message system. Taiwan’s emergency Central Epidemics Command Control has cooperated with the National Communications Commission to generate materials for myriad platforms, including broadcast media, YouTube, memes, and even downloadable cartoon stickers of the health minister. Taiwan’s CDC has answered individual concerns on Facebook, Line (a popular messaging app), and a telephone hotline. The CDC’s official Line account also offered a Q&A service: By May, more than 2.2 million people had subscribed to the account. By delivering messages on the different platforms being used by citizens, these institutions met residents on the platforms they were already using and found creative ways to alleviate individual anxieties.
While these countries’ low case counts are not due to communications alone, clear messaging has helped to create much more compliance. South Koreans have complied much more with health guidelines during COVID-19 than five years ago during the MERS crisis: One study found dramatic increases in compliant behavior compared with 2015. On the other hand, messaging has not reached all communities, with two of South Korea’s major outbreaks stemming from churches resistant to government guidelines.
2. The importance of openness and transparency
Both jurisdictions have adopted openness and transparency as core values. When masks were running low during the first months of the pandemic, Taiwan’s digital minister, Audrey Tang, helped to develop a map showing the real-time supplies of masks in pharmacies, which were distributing face coverings. This helped to avoid panic-hoarding. South Korea supplied real-time information online about COVID patients, allowing individuals to assess the likelihood that they had been in contact with infected individuals in their area.
South Korea has also adjusted its approach to openness, though selectively. After an outbreak at a gay nightclub in late April, it appeared that many clubgoers were reluctant to be tested because they feared being outed. The government responded by enabling anonymous COVID tests. By contrast, the South Korean government has proven far less responsive to the members of the Shincheonji and Sarang Jeil churches, which seeded major outbreaks in April and August respectively. The infamous patient 31 was a member of the Shincheonji church and became a superspreader, leading to more than 5,000 cases. Rather than adapt its approach to encourage Shincheonji members to get tested and prevent the spread of COVID-19, the South Korean government doubled down, even arresting the leader of the Shincheonji Church of Jesus sect in August on grounds that he had hampered contract-tracing efforts. After the virus rapidly spread through the conservative Sarang Jeil congregation in August, authorities dispatched hundreds of police officers to track down its members for testing, an indication the government has yet to learn how to modulate its approach in containing the virus while avoiding alienating some religious groups.
3. Equitable information access
Effective communications only happen with equitable access to information. This means infrastructure and computer equipment. The Taiwanese government has spent nearly $7.5 million on digital infrastructure, such as improving cellular and internet services for rural areas. The South Korean Ministry of Education lent internet devices and laptops to many of the over 200,000 students who did not have access to that necessary hardware for online schooling. Because both countries are already highly digitized, they could spend comparatively little to reach near 100% digital access in their populations.
These efforts to ensure equitable access to information stand in marked contrast to the United States, where an estimated 42 million Americans lack access to broadband, according to a February report by Broadband Now. Many of those Americans live in rural areas and are more likely to be Black or Hispanic, exacerbating existing racial and economic inequalities. With online schooling and work in many parts of the United States, this lack of basic infrastructure is further deepening divides.
4. Guidance for online resources
Fourth, education about online resources can be directed at any demographic that is struggling to understand the online world. The digital divide in South Korea is more about age than resources. Over 97 percent of South Koreans own a smartphone or computer, but many older Koreans have trouble navigating the online environment. To address this issue, the South Korean government is working to create one thousand digital education centers. As Yoojung Lee, who researched South Korea for my report put it, “by implementing these types of access programs, South Korea is laying a foundation for digital equity beyond the pandemic.” Such education can also forestall false beliefs.
It is early days to assess these programs. But other research suggests that they could be effective. Disinformation and media manipulation scholars point to the importance of teaching people how to evaluate online material generally to “inoculate” them from poor-quality information. Such education programs could easily happen through NGOs, charities, or youth groups teaching seniors as well as any state-led initiatives.
5. Spotlight public-health officials
Like most of the other countries in my recent report, South Korea and Taiwan adopted a clear division of labor between public health officials and politicians around communications. In most cases, public health officials detailed the current scientific thinking and public health guidelines, while politicians discussed the meaning of the pandemic. South Korean and Taiwanese politicians have often framed the pandemic in democratic terms. In June, President Tsai Ing-wen said that Taiwan could “control the spread of the virus without sacrificing our most important democratic principles.” South Korean President Moon Jae-in has emphasized that Koreans have “demonstrated democratic solidarity and cooperation” in addressing Covid-19. But most importantly, Presidents Moon and Tsai have let public health officials take the lead on communicating the latest public health guidelines. Communications units have then amplified those messages through as many channels as possible.
Both countries restructured their public health approach to epidemics after issues with SARS in 2003 in Taiwan and MERS in 2015 in South Korea. These new approaches included clearer decision-making structures. The reforms after 2015 in South Korea placed primary responsibility for epidemics in the hands of the Korean Centres for Disease Control and Prevention (KCDC). To ensure political clout, the KCDC’s director was promoted to the level of a deputy minister. Meanwhile, in Taiwan, the main policymaking body, the Executive Yuan, can approve the creation of a rapid-response Central Epidemics Command Control (CECC) within the Ministry of Health and Welfare, as it did on January 20 this year. The CECC coordinated responses among government ministries, created coherent messaging, and helped to ensure that communications were not entirely top-down. These reforms placed primary decision-making in the hands of health officials, but have left space for politicians to give meaning to the experience of the pandemic.
It would be wishful thinking to hope for the current U.S. federal government to adopt many, or any, of these strategies. But other levels of governments, for example the states, could learn from this approach. State governors who have become the primary face for communications should think long and hard about stepping back to allow public health officials much more time at the podium. States could build out health communications staff to provide information on a wider range of channels, including social media platforms. This could mitigate some confusion by providing a consistent trusted source. There may be opportunities to build real-time heat maps around cases in schools, for example, to build trust with families. Real-time resources build trust through transparency. States can also learn to adapt any approaches based on the experiences of vulnerable or marginalized populations, as South Korea did for the LGBTQ community.
There are two final and crucial lessons from Taiwan and South Korea. First, so many of the changes that enabled a successful response happened over the last few years. Rapid response is possible and it can substantially alter outcomes. Second, technology clearly mattered for these two countries’ responses. But technological solutions only worked because they were based on values of openness, trust, and transparency.
Heidi Tworek is an associate professor at the University of British Columbia and a non-resident fellow at the German Marshall Fund of the United States.
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