Ghana continues to show leadership in our response to the coronavirus pandemic. Our public health team with the support of the entire country, bar the few flouting the social distancing rules, have rapidly scaled up testing, contact tracing and case management within the persistent financial and resource constraints. The bold decision to shut our borders and to quarantine every citizen returning home in facilities fully funded by the government is particularly commendable. Many developed countries have avoided mandatory quarantines because of cost and have resorted to voluntary self-isolation of their returnees.
An important feature of our COVID-19 response has been the routine updates by our government and public officials through the Information Ministry’s “Ministers Press Briefing on COVID-19”. These sessions including the president’s national updates have received commendations as it has criticisms. A few have questioned the government’s positive messaging or framing approach and have sought to encouragethe government to use a bit of “fear” or “emotive” messaging to drum home the severity of the disease. I want to throw a caution here. History has shown that using fear to elicit desired public action can sometimes be counter-productive especially for diseases that tend to stay with us for longer than we might have anticipated. A case in point is the HIV/AIDS pandemic and Ebola outbreak. While fear may push people to adopt the public health action quickly, it can create stigma over time. We currently are seeing the manifestation of stigma in our societies as reported in our online portals. People are avoiding persons who are known or suspected to have the disease out of fear of getting the disease and dying from it.
I do agree that this is not the time for individual heroic efforts,as the scale of our response requires collective action and support. However, to build public trust and effectively achieve the communication objective of people adopting the recommended public health behaviours, we need to have a “face” for our national response. In that regard, I think there are two aspects of our communication that requires immediate review and action – the messengers who deliver our key messages and the timing (frequency) of the messages.
First, I submit that the director general (DG) of the Ghana Health Services should be the face of our response: the one source of truth. In his absence could be the Director of Public Health of the health service. Since health is the overriding reason for these media sessions, we should begin every session with the DGs report. His presentation will provide the up-to-date information on cases, trends, and respond to ongoing misinformation or rumours along with a clear sense of direction for the entire health system’s response.
Secondly, we are rapidly learning that a whole nation’sresponse to COVID-19 is not just a health sector response, but equally an economic one. COVID-19 is threatening economies and wiping out jobs. The impact of poverty on people’s health could be as harmful as the disease itself, if not even worse. The more reason we need to hear from our government officials. However, the current approach where we have more than two ministers and public officials from other sectors speaking to the government’s economic response in a day can be overwhelming to listeners. At worst, this creates confusion and blurs the lines between a factual presentation aimed at informing the public and the usual politicking where the aim is to win public sympathies. A better approach is to have one government official a day. This could be the president or one of his delegated authorities for example the vice president, the finance minister or any other minister as appropriate. The president’s intermittent national addresses could cease and merge into these daily briefings. Having the president speak at such sessions reassures the citizenry of how important this is to the government, offers journalists the opportunity to interrogate our response and demonstrates transparency and accountability to the public.
Third, is the timing and/or frequency of the media stand up sessions. Frequent and consistent updates is the cornerstone of a successful risk communication strategy. The current twice a week update seems to be creating an information gap, which allows mis/disinformation to fester. For instance, the recent releases of the “high” number of new confirmed cases has created unnecessary panic within our communities. If briefings were held daily the numbers would be less dramaticand a lot easier for the average person to make sense of how the disease is spreading. Giving the rapidly evolving nature of our response and the thirst for accurate information, can we revert to daily briefings with just two speakers – the President or his representative and the DG or his representative? These daily sessions could be 30 minutes long with a 15 to 25 minutes question time. Sessions are held at the same time every day of the week, for example at 10am each day. Reducing the number of speakers to two will make these sessions shorter, more straightforward to the point and sustain listeners interest in these briefings.
Risk communication beholds public officials to engender the trust of their communities. That, at all times, officials must be clear, candid and communicate with confidence to inspire action. Making the health presentation the focus of these media briefings will nurture public trust in our public health officials and ultimately lead to the desired health outcomes. When done well these briefings will become, as expected, the single most important source of COVID-19 related information. One that the entire country will look up to, flocking to our television, radio or online portals at 10am daily for accurate, reliable and trusted information on how our dear country is winning the battle against the pandemic.
The writer is a Public Health Specialist who lives and works in New Zealand.