Breaking News: coronavirus pandemic in Bangladesh, people’s reaction to media coverage and perception of health systems preparedness

Highlights:

• This study was done to explore the reactions of the readers and TV viewers on published news in selected dailies and selected health-related programmes aired in selected TV channels to get an idea on how people reacted to, and digested and accommodated, the breaking news on COVID-19 pandemic as it evolved over time. Besides, their perceptions regarding attempts made by the govt. and the health systems to tackle the situation was sought. The study was done during   ___ 
• At the initial stage of denial, newspaper readers reacted from their belief that corona is the wrath of God; readers believed that coronavirus would not affect Muslims, especially those who worship Allah regularly. Moreover, the authority (political leaders and top bureaucrats) was also claiming that coronavirus would not come to BD and even clamoured that BD people were ‘more powerful than corona’. Most of the readers and viewers commented and asked for the forgiveness of Allah to protect everyone from coronavirus, after reading or hearing any news related to its transmission and spread in BD or any other country.
• Some readers and viewers were confused about the signs and symptoms of corona and they were scared, therefore, they sought relevant information from the media in the form of comments and questions online e.g., they frequently asked the media what to do if they had only fever; Some of them were confused about where to stay safe during this pandemic, whether in Dhaka or should go back to their home town. 
• Majority of them were sarcastic and displayed lack of trust in the way govt. handled the situation from the very beginning, including an evaporation of trust in the health systems itself as a whole; Regarding the actual no of positive cases in BD, most of the readers and viewers opined that govt. was hiding the actual no of positive cases. 
• Most of the time, the readers accused the political leaders, especially the Health Minister, for not taking quick, appropriate and adequate measures for preparing the hospitals to receive and treat COVID-19 suspect or confirmed patients e.g., arranging for adequate no. of quality PPE, isolation bed, ICUs, oxygen cylinders, adequate and balanced workforce of frontline health workers etc..
• The readers and viewers' comments indicated that they were skeptical about news which mentioned that the hospital beds were prepared for corona treatment; besides, they expressed doubts that even if the hospitals were prepared, doctors may not provide treatment; rather they will escape away from the corona patients as there was lack of PPEs.
• About violation of home-quarantine and lockdown measures by people and returnees from abroad, many of the newsreaders and TV talk show viewers blamed people for their lack of awareness regarding the corona pandemic. Some of them mentioned that the knowledge didn’t reach at the community level and few of them even urged to take drastic measures such as impose curfew in the country; 
• Most consumers of the newspapers write-up or TV programmes appreciated the attempts by the physicians’ to build awareness on coronavirus infection and COVID-19, though some criticisms were also there. Reacting to the news regarding the cancellation of leave for health workers during this corona pandemic, readers raised questions about the workers' safety issues as well as some of them requested the authority to provide adequate personal protective equipment to all health professionals.

Conclusions

·         Denial and faith-based reactions: At the beginning, the usual ‘denial’ syndrome dominated people’s reactions and the reactions were mainly reflected their religious beliefs; This gradually faded with time as the infection started spreading among the population; 

·         Coping the disaster with sarcasms: Another coping mechanism used by the people was to digest the alarming news with a pinch of sarcasm, and try to shake off some of the burden of anxiety and uncertainty;

·         Gaps in communicating clear messages about the disease and its prevention created confusion among the people and opened the floodgate of all types of ‘rumours’ to fill-in the gaps;

·         Concerns with measures to quarantine the returnees from abroad including in-effective home quarantine: the issue of poorly managed quarantine due to lack of assertiveness of the concerned agencies to implement its own decisions precipitated sharp criticism from the people; this helpless scenario made people critical of the govt. and its political leadership, especially for failure of providing stewardship in this moment of national crisis;

·         Lack of trust in health systems and its preparedness to respond to COVID-19 was the single most major casualty as revealed by people’s reactions; the pandemic has severely shaken people’s trust in the system which they perceived as incompetent, corrupt, and non-responsive;

·         People were mostly sympathetic of the frontline health workers, especially the physicians, and expressed concerns for their personal protection when managing COVID-19 patients; however, some were critical of them in the initial stage when physicians were reluctant to go near the patients without appropriate personal protection equipment (PPE);

·         Further research is necessary how online resources, including social media resources, can be used in eliciting people’s responses and perceptions on various aspects of health system and health care services.

Recommendations

·         There is a huge need for reliable and evidence-based information among the people to overcome various incorrect messages and rumours. A focused, culture-sensitive and context-specific IEC campaign should be organised with outreach to people in all parts of the country;

·         The science behind COVID-19 and its secular and universal nature should be emphasized in the audio-visual and print media in a manner understandable to the common people so that they are motivated to practice preventive hygiene and social measures;

·         The major casualty of the pandemic is people’s trust in health systems. The poor readiness of the health systems has resulted in people’s aversion to seek care from hospitals for non-COVID-19 illnesses. Good governance in hospital management, equipping hospitals with necessary resources including human resources, and health system responsiveness will go a long way in re-building the lost trust, necessary for effective health outcomes;

·         Factors like health system governance, social determinants of health and stewardship are beyond the remits of this study but are nonetheless important as their reactions and comments reflected and also for developing a pro-poor health system towards achieving UHC by 2030.

[From a draft report of an on-going study]