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New contagious diseases are scary. They frighten us because they are unknown and unpredictable. The ongoing outbreak of the novel coronavirus has received extensive media attention, coverage that can tell us a lot about how uncertainty in the face of such an epidemic can all too easily breed fear.
For about a decade, I have been studying the role of emotions in journalism, including in the coverage of disasters and crises. Media coverage is vital to our shared conversations and plays a key role in regulating our emotions, including fear.
While fear is an emotion that we frequently experience as individuals, it can also be a shared and social emotion, one which circulates through groups and communities and shapes our reactions to ongoing events. Like other emotions, fear is contagious and can spread swiftly.
Media coverage sets the agenda for public debate. While the news doesn’t necessarily tell us what to think, it tells us what to think about. In doing so, the news signals what issues merit our attention. Research has consistently shown that when issues receive extensive media coverage and are prominent in the news agenda, they also come to be seen as more important by members of the public.
The current outbreak has been much more prominent in media coverage than recent epidemics, including Ebola. For example, a Time Magazine study shows that there were 23 times more articles in English-language print news covering the coronavirus outbreak in its first month compared to the same time period for the Ebola epidemic in 2018.
My own research suggests that fear has played a particularly vital role in coverage of the coronavirus outbreak. Since reports first started circulating about the new mystery illness on January 12, and up until February 13 2020, I have tracked reporting in major English-language newspapers around the world, using the LexisNexis UK database. This includes almost 100 high-circulation newspapers from around the world, which have collectively published 9,387 stories about the outbreak. Of these, 1,066 articles mention “fear” or related words, including “afraid”.
Such stories often used other frightening language – for example, 50 articles used the phrase “killer virus”. One article in The Telegraph newspaper was typical of this fear-inducing language, in describing scenes on the ground in Wuhan shared on social media:
Mask-wearing patients fainting in the street. Hundreds of fearful citizens lining cheek by jowl, at risk of infecting each other, in narrow hospital corridors as they wait to be treated by doctors in forbidding white hazmat suits. A fraught medic screaming in anguish.
Tabloid newspapers such as The Sun and The Daily Mail, were more likely to use fear-inducing language. For example, The Sun’s coronavirus liveblog routinely refers to the virus as a “deadly disease”.
Many stories offered local angles by reporting on fears in local areas affected by the outbreak. In the UK, this led to a particular focus on Brighton, where several cases have been reported. For example, a story in The Times suggested:
Conversations about miniature bottles of antibacterial hand sanitiser are normally far from a mainstay of lunchtime pub chitchat. However, such is the anxiety over the coronavirus that locals in The Grenadier in Hove yesterday readily admitted to changing their hand-washing routines.
Other reports localised the story by discussing the impact on Chinese-owned businesses. The Manchester Evening News, for instance, reported that: “The fear of coronavirus is hitting businesses hard, with some reporting a 50 per cent drop in custom since the outbreak. And Chinese Mancunians report suffering more racial abuse.”
A number of stories, by contrast, sought to temper fears and provide reassurance. For example, Singaporean prime minister Lee Hsein Loong was widely quoted in cautioning against panic:
Fear can make us panic, or do things which make matters worse, like circulating rumours online, hoarding face masks or food, or blaming particular groups for the outbreak.
Fear can be catching
Research on coverage of earlier disease outbreaks show a similar emphasis on fear. In the case of the SARS epidemic in 2003, a study by historian Patrick Wallis and linguist Brigitte Nerlich found that “the main conceptual metaphor used was SARS as a killer”.
Along the same lines, media scholars Peter Vasterman and Nel Ruigrok examined coverage of the H1N1 epidemic in The Netherlands, and found that it was marked by the “alarming” tone of its coverage. Like the coronavirus, these historical outbreaks were characterised by uncertainty, breeding fear and panic.
To put these observations into perspective, it is instructive to look to a comparison to coverage of seasonal influenza, which is estimated by the World Health Organization to kill 290,000 to 650,000 people around the world every year. Since January 12 2020, world newspapers have published just 488 articles on the seasonal influenza without mention of the coronavirus.
In sharp contrast to coverage of this novel coronavirus, fewer than one in ten stories about flu (37 of 488) mentioned fear or similar phrases.
The prominence of fear as a theme in reports of the coronavirus suggests that much of the coverage of the outbreak is more a reflection of public fear than informative of what is actually happening in terms of the spread of the virus.
The Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel 2019 (commonly known as the Nobel Prize for Economics) has been awarded to Abhijit Banerjee, Esther Duflo and Michael Kremer “for their experimental approach to alleviating global poverty”. Through the award, the Nobel committee recognised both the significance of development economics in the world today and the innovative approaches developed by these three economists.
Global poverty continues to be a massive challenge. The award follows Angus Deaton, who received it in 2015 for his contributions to development economics – the field that studies the causes of global poverty and how best to combat it – particularly, his emphasis on people’s consumption choices and the measurement of well-being, especially the well-being of the poor.
Well-developed theory can highlight what causes poverty and, based on this, suggest policies to combat it. But it cannot tell us exactly how powerful specific policy measures will be in practice. This is precisely where the contributions of Banerjee, Duflo and Kremer lie. The Nobel citation gives several examples of their impact, including how their research has helped education, health and access to credit for many in the developing world, most famously in India and Kenya.
Consider, for example, child mortality and health – issues of immense significance in the developing world. Theory can tell us that women’s empowerment is important for child health and mortality outcomes, but cannot tell us which policy will be most effective in combating this. It could be a focus on educating mothers, or access to healthcare, or electoral representation, or marital age legislation.
Perhaps, more importantly, theory cannot tell us how large and significant the impact will be of these various policies. And this is where the significance of the Nobel Prize this year comes in.
A new, experimental approach
The fundamental contribution of Banerjee, Duflo and Kremer was to develop an experimental approach to development economics. They built a scientific framework and used hard data to identify causes of poverty, estimate the effects of different policies and then evaluate their cost effectiveness. Specifically, they developed randomised control trials (RCTs) to do this. They used these to study different policies in action and to promote those that were most effective.
Starting in the mid-1990s, Kremer and co-authors started a series of RCTs on schooling in Kenya, designing field experiments to evaluate the impact of specific policies on improving outcomes. This approach was revolutionary. The experiments showed that neither more textbooks nor free school meals made any real difference to learning outcomes. Instead, it was the way that teaching was carried out that was the biggest factor.
Studies by Banerjee and Duflo, often together with Kremer and others, followed. They initially focused on education, and then expanded into other areas, including health, credit and agriculture.
Banerjee and Duflo were able to use these studies to explain why some businesses and people in less developed countries do not take advantage of the best available technologies. They highlighted the significance of market imperfections and government failures. By devising policies to specifically address the root of problems, they have helped make possible real contributions to alleviating poverty in these countries.
Banerjee, Duflo and Kremer also took significant steps towards applying specific findings to different contexts. This brought economic theories of incentives closer to direct application, fundamentally transforming the practice of development economics, by using practical, verifiable and quantitative knowledge to isolate causes of poverty and to devise adequate policy based on behavioural responses.
The impact of these developments upon real world development outcomes are immensely significant. Their work, and substantial amounts of research that followed it, established evidence on fighting poverty in many developing countries. And they are continuously expanding their horizon of contributions, which now also includes climate and environmental policy, social networks and cognitive science.
The 2019 Nobel Prize for Economics is also significant for reasons of inclusivity. The impact generated by Banerjee, Duflo and Kremer’s approach has come about very quickly – actually, in less than two decades. This explains why, at the age of 47, Duflo is the youngest-ever recipient of the economics Nobel. She is also only the second woman to be awarded the prize (after Elinor Ostrom in 2009). Banerjee, who is also her husband, is the third ever non-white recipient (after Arthur Lewis in 1979 and Amartya Sen in 1998).
In a recent issue of the journal Nature, Göran Hansson, head of the Royal Swedish Academy of Sciences that awards the Nobel, highlighted measures to address the imbalance in gender and ethnicity among winners. He said “we are making sure to elect women to the academy” from which the prize-awarding committees for the chemistry, physics and economics Nobels are drawn.
The pipeline to this achievement is important. The first woman to win the John Bates Clark Medal for top economists under 40, an important indicator of who will be awarded the economics Nobel in the future, Susan Athey, only did so in 2007. Esther Duflo was the second winner in 2010. Since then, women winners of the Clark medal have been more frequent. Of course, award decisions are made strictly on significance of contributions. But, based on this evidence, perhaps Athey, Amy Finkelstein (who won the medal in 2012) and Emi Nakamura (who won it in 2019) will not be far behind.
Over the last two decades, Venezuela has entered a deep socioeconomic and political crisis. Once recognised as a regional leader for public health and disease control, Venezuela’s healthcare and health research infrastructure has fallen into a state of collapse, creating a severe humanitarian crisis and a major outbreak of infectious disease.
This week, we published the first comprehensive assessment of the vector-borne disease outbreak that is assailing the country. Vector-borne diseases are those spread by insects – mosquitos, sand flies, kissing bugs and others. The “we” is a global consortium of authors, many of whom are Venezuelan doctors and academics working in the country under exceptionally difficult conditions. Others include Colombian, Brazilian and Ecuadorian academics who are witnessing the crisis unfold: Venezuelan refugees on the streets of their cities, diseases (malaria, Chagas disease, measles, diphtheria) spreading through porous land borders, and regional disease outbreaks of unprecedented proportions.
I first travelled to Venezuela in the early 2000s to study Chagas disease, a single-celled parasite spread by the kissing bug, a blood-sucking insect that infests the walls of adobe houses. Chagas disease is a silent killer. Once infected, the parasite can lie dormant for decades in its human host before causing fatal heart disease in middle age.
You can’t travel to Venezuela, including to the communities where I worked in the Llanos (plains) of the west, without being entranced by the beauty of the landscape and the friendliness of its people. From the laboratory in the Institute of Tropical Medicine in Caracas, where I was taken under the wing of Professor Hernan Carrasco and his team, dancing salsa between the benches on a Friday night, to the villages where we slept under the stars in hammocks while the inhabitants sang joropo music, it is a thoroughly welcoming place.
Venezuela is also a place of extreme inequality. You only have to look up from the glitzy streets of downtown Caracas to the mud and brick ranchos clustered on the hillsides above to appreciate that. It is this inequality that drove the socialist revolution, and while times were good – and oil prices high – much of Venezuela’s wealth found its way into the hands of those who needed it most. Declining oil prices, corruption and mismanagement have changed all that. Alongside economic collapse has come a collapse in basic healthcare, an exodus of medical professionals, and a massive upsurge in disease.
At the core of the infectious disease crisis in Venezuela is the lack of reliable data. Either through denial, a lack of resource, or both, the Venezuelan state is reneging on its responsibility to report on the extent of current outbreaks. The purpose of our recent review was to draw together fragmented information from Venezuelan civil societies, researchers, international organisations and neighbouring countries to get the best estimate of what is actually going on. Over 400,000 cases of malaria in 2017, 15% of the rural population infected with Chagas disease, surging dengue, Chikungunya and Zika infections. The picture is grim.
Health is highly politicised in Venezuela and working as a researcher is not without risk. My collaborators have been threatened with jail and having their medical licenses suspended simply for reporting outbreaks in the scientific literature. The Institute of Tropical Medicine where I worked has been raided by colectivos (community organisations that supports the Venezuelan government), microscopes smashed, medical records destroyed, hard drives ripped out of computers.
The centre of the current malaria epidemic in southeastern Bolivar state is also the centre of state-sponsored illegal gold mining in Venezuela. The tonnes of gold recently shipped by the Maduro regime to Russia and Turkey is soaked in the sweat and blood of poor Venezuelans, sleeping with their families beside mosquito-infested mining pits. Drawing attention to this malaria epidemic is drawing attention to the ecological and humanitarian disaster in this region where mercury is polluting pristine rivers and thousands are dying for want of antimalarial drugs that the government will not or, more likely, cannot supply.
Venezuelans are resilient and resourceful people. The Venezuelan researchers still living and working in the country are a testament to that, as is the support they receive from the diaspora of Venezuelans forced to live abroad. In recognising the regional aspect to the crisis, the spillover of disease in the region and the millions of refugees, we hope our review will galvanise international organisations to act. I’m optimistic that we are reaching a turning point in a crisis ten years in the making. I fervently hope the spirit of Venezuelans will break through. I hope that scientists will dance salsa again – and soon.