Emergency communication during the Sars-Cov-2 pandemic: interview with Mario Pappagallo

We are pleased to present an interview with Mario Pappagallo, a professional journalist who has been dealing with medical-scientific information since 1980, editor in chief of URBES magazine, president of the European Urban Health Communicators Network (EUHCNET) and vice-president of Web Health Information Network (WHIN).

D. What elements characterised the communication of the emergency to citizens at the outbreak of the Sars-Cov-2 pandemic in Italy?

MP. Already at the beginning, the WHO had raised the alarm of an infodemia risk, i.e. an information epidemic, which in Italy had its maximum expression at the outbreak of the Sars-Cov-2 pandemic.

Both newspapers and social networks had started to give news, albeit confused, but trying to provide it as correctly as possible: my feeling was that there was a search for information, but at the same time they were trying not to put out fake news. Normally the opposite happens; instead, there has been an absolute silence of disinformation experts in Italy. The fake news came from abroad, slightly later; some of it was fed by the United States, for example, on the genesis of the coronavirus, or on methods to prevent and cure it. Everything has been seen, including deaths from bleach gargles or intoxication.

Good or bad, however, none of this has happened in Italy, even though we read about everything and more. There was some information that revolved around possible remedies, but it was information triggered by the scientific world anyway (think of the discussion about malaria medicine, for example, or other easily available drugs). The information in Italian newspapers and social media, in the so-called first phase, was quite correct, but then a strange, anomalous thing happened: there was a run-up to the pre-sentialism, to the protagonism, by experts in infectivology, respiratory diseases, virology, immunology.

The protagonism was induced by the fact that these experts went on television, then bounced on social networks, and then tried to appear as much as possible; in Italy, there was the appearance of an exceptional number of experts, compared to other countries. And it was this protagonism that created an infodemia in Italy: a succession of information and counter-information, coming from the scientific world, that confused public opinion. Let’s think of the debate on the mutation or the “end” of the coronavirus following the lockdown, the debate on the use of masks.

Another characteristic of communication in the first phase of the pandemic was the presence of politics: the discussion between the government and the regions was strongly influenced by the political side to which they belonged, as was the discussion on social issues.

In general, the coronavirus weighed politically, and not only in Italy. The weight of the pandemic – and of the non-control of the pandemic – is still evident in the United States. Here, however, the divergence was not so much between scientists as between politics and science: the attempt to silence the CDC, the quarrels between Fauci and Trump appeared on the political and media scene. Moreover, on a global level, the fear of losing money, of the lowering of the GDP, in short, everything concerning the economic sphere was the object of information, fear, agitation, without taking into account that we are a global reality: this aspect, more than Italy, was touched by Sweden, which chose not to impose a national lockdown in order not to penalize the economy, thinking at the same time to reach the so-called herd immunity: today, both herd immunity and the economy have failed in Sweden, since exports have been blocked. These are speeches, therefore, that should be made from an international perspective.

D. How has communication changed during the “second wave” from a scientific, political and public opinion point of view?

MP. Although the disputes between some experts continued, the second phase was characterised by a greater calm from a political point of view: the political sides were slightly dampened, but the strategic mistakes became more evident. The weight that the cuts made to healthcare in some Regions have had is undeniable, and running for cover immediately – also given the tortuous nature of the Italian bureaucracy – is very difficult: anaesthetists are still not found, beds are not found. Months after the first wave, we found some Regions completely unprepared: what happened in the first wave in the Northern Regions was neither caught nor organised, from the health point of view, in those Regions that had been less impacted. Many doubts passed unnoticed, such as the restructuring of intensive care after the years of the outbreak of AIDS. On the other hand, these doubts could have been better analysed in order to arrive prepared for the second wave, which today sees a decline in the number of infections, but a greater mortality: and yet, during the summer, they told us that the virus had died.

It is precisely at the end of the first wave that real fake news begins to appear, which is even picked up by the “official” press, which sometimes appeared to be lacking in verification. To give an example, recently the news spread that the Cardiology of St. Camillus in Rome would have closed down due to the contagion of nurses and doctors on the ward; in fact, there were, but not enough sick people on the staff to shut down Cardiology – and yet, the news was picked up by a well-known daily newspaper and bounced back on the social media, creating disinformation.

In this second wave, therefore, we have stumbled upon what had not happened in Italy in the first: that is, the errors of information. The deniers emerged more clearly, claiming that the coronavirus does not exist; the No Vax reappeared, while they had remained silent in the first wave. It has to be said that the announcements and counter-announcements made by the pharmaceutical companies that are working on vaccines against the coronavirus are affecting this epidemic more than in the previous ones, and this is evident at the level of financial transactions: if the correct ones are working correctly, it is also true that we have seen unscrupulous games in the pharmaceutical world. At the same time, we are witnessing an exorbitant sale of sanitising products and devices, which nobody writes about from a scientific point of view; smartwatches arrive, which can detect pressure, heartbeat and oximetry: but who checked and approved them?

D. Based on your experience, what went well in this communication to citizens and what could have been done differently?

MP. The lack of uniformity of information was one of the main problems from the point of view of communication; probably, calling in the technical-scientific committee of journalists who are experts in medical-scientific communication – in addition to the already present press officers, who, however, report what is said, do not work on the contents – would have helped to go in this direction, just as a less “disruptive” communication by experts from the scientific and epidemiological world would have dampened the information and counter-information movement.

As for other professions that could have been called into question, urban planning experts have been completely absent from the Italian debate, unlike what happened in the United States and Northern Europe: New York, to give an example, is a city that is redesigning itself, in which urban planners are creating more open spaces, new mobility, bars and shops will increasingly project outwards. The architects are designing the anti-pandemic city of the future, where greenery can be restored, areas where air can circulate. In Italy, there are a few approaches to Milan, but there is no political line, and for the most part this is a theme that for the time being passes over in silence.

It would have been appropriate to question social scientists about the damage of the pandemic on communities as well as on mental health: there are increasing difficulties at individual, cohabitation and couple level.

In short, there has been a great deal of attention to scientific discourse, but there has been little attention to the organisational and social elements.

However, the question remains that, as a population, we have a poor scientific culture, a very low education in biology, science, statistics. We have a tendency to inform ourselves on the internet, but then we do not know how to interpret what we read. I think that, at the same time, we need a register for those who write about health and science on the web, so as to give an indication to the population as to who has the basis to write correctly and who gives a distorted or wrong interpretation. This should have been done long ago, not now, but nobody has ever thought about it. It is not just journalists who write on the web: so how many of those who currently write on the web refer to professional ethics?

It must be acknowledged that writing about medicine and science is penalizing for journalists themselves, also in economic terms: and if this is an uphill road, how many chances are we that everyone will do even expensive verifications? Think, for example, of the cost of subscriptions to scientific and trade journals. In the absence of specialised journalists, the tendency is to quote the experts’ quotes, but so we go back to the starting point: if the expert expresses a partial thought, reporting it without verifying it and contextualising it creates a bubble, creates that movement of information and counter-information we were talking about at the beginning.

Ultimately, this mechanism also undermines the credibility of science: if two experts play “one against the other armed”, the first damage is done to science, to the benefit of deniers, conspirators and those who create disinformation.

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