The earliest stages of the COVID-19 pandemic created a unique clash between two contrasting human interests: physical and psychological health. On one hand, people had a psychological need to connect with other people to create a sense of community during uncertain times. On the other hand, people wanted to protect their physical health by avoiding contact with others to as much as possible. These clashing interests indicate why virtual communications, such as zoom, became more popular. As humans, we generally like to avoid uncertainty. Dr. Bianchi notes that, even if our decision is not economically sound, many people will choose it if they are certain of the outcome. With so many unknown questions at the outset of the COVID-19 pandemic, how did people find certainty?

Dr. Bianchi highlighted the phenomena that occur within society that help people cope with uncertainty. One example that occurred during the pandemic was the spread of misinformation. At times when research could not uncover answers relating to COVID-19, people looked for answers on their own. Even if some of these answers were not true, they appealed to people by creating a sense of certainty. Another example discussed by Dr. Bianchi involved people engaging in tasks to regain control over something during pandemic uncertainty. During lockdown periods, people would often reorganize their home, join clubs, or set aside a specific time for a hobby. Knowing that such activities would be there at a set time gave people a sense of certainty, improving mental health. As Bianchi notes, these examples are not specific to the pandemic.

Dr. Dittmann took a slightly different angle in her research, studying COVID-19’s impact on people’s desire to create economic equality. During the pandemic, wealth disparities only grew, as lockdowns favored larger businesses that could afford to operate online. Her study sought to answer whether this changed society’s perception of wealth distribution and whether they would be more likely to advocate for improving it. Dr. Dittmann found that those who were personally harmed by the pandemic were much more likely to advocate for economic equality than those who were not. It was interesting to see how moral values changed because of COVID-19,  and whether these changes will be permanent.

HIV/AIDS was, and continues to be, a unique pandemic. As such, it has set precedent for public health communication that has been echoed today during the COVID-19 pandemic. Sandra Thurman’s lecture on her experiences during the early stages of HIV/AIDS highlights those similarities and allows us to point out the differences.

One major similarity between the HIV/AIDS and COVID-19 pandemics that was apparent in Thurman’s lecture includes the use of well-liked public figures to raise awareness and address misconceptions. From a psychological standpoint, having a familiar face discussing an unfamiliar topic generally makes listeners feel more at ease, and thus more likely to listen to the subject matter. To provide some examples, actor Rock Hudson became an early supporter of HIV/AIDS awareness. This was especially important during a time where the virus was still very unknown and was being overlooked by the highest levels of government. Desmond Tutu, a famous human rights activist and Nobel Peace Prize winner, also spoke publicly about groundbreaking HIV/AIDS drug research. In the early 1990s, Magic Johnson rose to become a public advocate on the ongoing pandemic, dispelling the idea that the virus was only spreading among gay men. During the COVID-19 pandemic, we have seen similar methods of public health outreach. For example, celebrities such as Queen Elizabeth, Dolly Parton, and Ryan Reynolds shared videos of their vaccination to various media platforms. As a side note, this concept is not new; Elvis Presley shared his Polio vaccine on live television to encourage the public to get vaccinated as well. As Thurman noted, public figures should be carefully selected to avoid mixed messages.

Another commonality between the two pandemics is the increase in community building activities. As Thurman noted, the AIDS memorial quilt event in 1987 was a massive gathering in honor of those who lost their lives to the virus. 35 years later, it continues to be an annual event that brings those impacted by the pandemic closer together. Although we have not experienced an event for COVID-19 on a similar scale, smaller communities were able to get together to help raise awareness and improve treatment for the virus. For example, volunteers from Emory helped set up and administer testing sites. Later on, volunteers also worked at vaccination sites in areas with lower vaccination rates, hoping to educate people on potential benefits.

One key difference between COVID -19 and HIV/AIDS was the quickness of national awareness. Due to the nature of the virus, the faster methods of communicating information, and the more immediate recognition of the virus by government officials, public health responses were much quicker and robust during the COVID-19 outbreak. Although there is still room to improve, public health outreach has improved significantly since the early stages of HIV/AIDS.

Public health scholars have acknowledged several reasons why disease does not impact all groups equally, both globally and within the U.S. Dr. Steven Thrasher takes a deeper dive to research these reasons in his book, The Viral Underclass, where he lists twelve “vectors” that create disparities in cases during viral outbreaks. One reason that particularly stood out to me was unequal prophylaxis. Lack of access to treatment was highlighted on a national and international level during the COVID-19 pandemic. For example, those with lower-income jobs within the U.S. are less likely to obtain health insurance, which would fund COVID-related care. Internationally, higher-income countries were the earliest purchasers of COVID vaccines and were therefore able to vaccinate more people sooner. A lack of access to treatment has been linked to higher rates of infection and death. Therefore, those without the means to obtain prophylaxis are more exposed to COVID, although this same reality could apply to any disease.

            Dr. Thrasher highlights unequal prophylaxis as a strong contributor to the viral underclass, but local governments, countries and even international organizations have taken steps toward resolving this inequity. For example, vaccine initiatives such as COVAX, along with the World Health Organization, have helped distributed hundreds of millions of COVID vaccinations to lower-income countries. Earlier this year, many countries have worked, though the World Trade Organization, to grant a TRIPS waiver, which suspends international IP rights of pharmaceutical producers in order to improve vaccine production in lower-income countries. Furthermore, some individuals have traveled to different cities, states, and countries to help provide better testing and treatment access to communities that need it most. Although Dr. Thrasher correctly notes that unequal prophylaxis creates disparities in disease treatment, methods to help the viral underclass have been effective and growing across the world.

After discussing public health communication primarily through the internet, it was interesting to hear Dr. Musa Dube share her experience spreading awareness on HIV/AIDS at a time before the internet existed. During the initial increase in HIV/AIDS cases, many communities in various countries throughout Africa stigmatized the virus. Additionally, religious figures across the continent would claim that the virus was a punishment for those who sinned. Because the early association between HIV/AIDS and homosexuality, many communities of worship believed the virus to be a disease for those who were gay. Rather than bring people together to combat the virus, this narrative worsened the problem by creating a false explanation on how the virus was spreading. Combating the stigma on HIV/AIDS was an especially difficult challenge for two main reasons. First, religious figures, who were trusted by many community members at the time, created division between those with and without the virus. Because people already believed the virus was targeting those who were gay, educating them otherwise was especially challenging. Second, information did not spread as quickly as it does today, making it more difficult to combat perceptions of HIV/AIDS.

Despite these obstacles, Dr. Dube helped change the narrative surrounding HIV/AIDS throughout Africa. She realized that priests and other members of the church were not trained on dealing with HIV/AIDS because it was a new phenomenon. Therefore, rather than become adversarial with religious figures, she used them to echo the proper information about the virus. Dr. Dube found textual evidence in the Bible supporting the proposition that Jesus was infected with HIV/AIDS. When religious figures began to share this message to churchgoers, they helped humanize the virus to people who previously viewed it as a punishment. Because these figures had persuasive power within their respective communities, educating one priest could in turn educate hundreds, or even thousands of people. An additional catalyst to Dr. Dube’s theological mission was the fact that HIV/AIDS became more prevalent in Africa, even affecting some religious leaders who once believed the virus was for those who have sinned. As a result, people were more willing to become educated on how to avoid transmission and treat virus in an effort to rebuild their communities.

Dr. Dube’s use of religious figures to spread awareness about a pandemic may seem outdated in a secularizing society, but her methods could still be just as powerful in certain communities across the globe. For example, during the COVID-19 pandemic, some religious institutions spread narratives regarding vaccines or testing that conflict with current scientific knowledge. With over 80% of the world population associating with a religion, Dr. Dube’s methods would likely be effective in corrective misrepresentations regarding COVID-19.

Public health communication is approached with caution because of its ability to shape perception of diseases and how they should be handled. This is especially the case when communications are being displayed in front of a national, and even global audience. As Susan Channa discussed in our recent lecture, public health experts try to ensure that all circumstances surrounding a communication are displayed in a way to best understand their contentions. For example, offering a conclusion, followed by three arguments with supporting points for each has been psychologically proven to resonate best with readers and listeners. Deploying methods such as bridging, hooking, and flagging are commonly used by experts to pull a conversation in a direction toward the expert’s desired talking points. Experts will even customize their zoom background so listeners can focus on their words without distraction.

Even with preparation, some public health communication may fail at the execution stage. This was evident during the earlier stages of the COVID-19 pandemic, where the CDC failed to make clarifications upon discovery of new evidence surrounding the virus. To illustrate some examples, the CDC initially stood by the position that face masks are not preventative, but later recommended them for multiple years. Quarantine periods for those sick with the virus changed from 14 days to 10 days, then to 5 but with qualifications. The CDC issued a later tweet that contradicted its 5-day period, and the director stated that the shorter quarantine period was fueled in part by a desire to “keep society functioning.” Additionally, the COVID map change on the CDC’s website created the perception that case numbers dropped considerably nationwide in one afternoon. Although the changing recommendations were likely based on new information, contradictions like these caused distrust among the public. Even with up-to-date information, infographics such as the vaccination activities chart that we viewed seemed to confuse readers. Thus, the CDC’s handling of COVID-19 outreach should emphasize the importance of well-prepared and well-executed public health communication.

With proper preparation and execution, public health institutions can gain credibility with the public. Because of communications efforts spearheaded by Susan Channa and other professionals during the COVID-19 pandemic, Emory University significantly increased its prominence in the public health field. Those speaking on behalf of the university were prepped to deal with reporters, utilizing different techniques to get their points across. To provide one example, Channa notes that interviewees have more flexibility to shape the narrative with a less experienced reporter, but also that reporters could play ignorant to catch inconsistencies. Because Emory professionals were equipped to handle COVID communications on a wide scale, they improved the university’s standing in public health discussions at a time when there was greater opportunity to fill information voids.