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#BTColumn – Better COVID-19 messaging needed

by Barbados Today Traffic
6 min read

The views and opinions expressed by the author(s) do not represent the official position of Barbados TODAY.

by Dr. Colin Alert

The issues created by the COVID-19 pandemic, and more particularly issues arising with the rollout of the COVID mitigation measures and the COVID vaccines, have generated a great need for messaging the general public. But whose responsibility is it to provide these messages?

In the separation of responsibilities in the health services in Barbados, “public health” is claimed as a responsibility by the Government. So, a simplistic answer as to who should be supplying the health education should fall on the Ministry of Health and Wellness (MOHW), especially since they apparently have easy access to the Government Information Service (GIS), the public information arm of the government.

Areas such as “Health Promotion and Disease Prevention” should use medical education as one of the tools to educate the general public. One of the catch-phrases we have been hearing in the response to this pandemic is that we are “following the science”. One popular scientific approach to getting out successful messages involves the use of focus groups. A focus group is a research tool used to collect data through group interaction.

Small groups of individuals are used to identify and explore how people think and behave. Focus groups, if properly implemented, would allow, for example, the MOHW to put out appropriate messages to successfully ‘promote’ the COVID vaccines. From the outside, there is little evidence that focus groups were utilised prior to the launch of the COVID vaccination campaigns.

The result: significant vaccine hesitancy in our communities, with persons latching onto the phrases like “herd immunity” to suggest that the MOHW is treating people like a group of cattle, and using this as an excuse to push back against the vaccine. And the vaccine hesitancy is also fuelled by a torrential stream of vaccine ‘misinformation’ in the social media, with little or no effort being made to counter this fake news. In fact, misinformation, fuelled by the social media, has almost become a separate public health challenge, and is as dangerous as the COVID-19 itself.

In Barbados, the government appointed a COVID-19 “Public Advisor” in September 2021, but to date the scope of responsibility of this post has not been defined by the public appearances and pronouncements. It is also not clear how this office will interact with the other officers who are funded from the public purse to perform this important task of public messaging: optimistically one hopes that a serious and sustained educational campaign targeted at COVID and counteracting the COVID misinformation emerges.

At this point it seems that a daily supply of a series of numbers, the COVID-19 daily dashboard, which may be statistically accurate, is having little or no effect in changing people’s attitudes and behaviours. BAMP, the Barbados Association of Medical Practitioners, has had a public profile during this pandemic.

Initially BAMP was involved in the “pure” medical education about COVID-19 and its medical consequences, targeted towards the general public, but this role has evolved to speak more about public health policy towards COVID-19 as the government introduced various strategies to combat COVID-19, and less about the medical effects of COVID and COVID mitigation measures.

The resources available to the MOHW include a large number of doctors and other health care workers employed by the government, in primary and tertiary health care centers. It may be that their terms of employment, implicitly or otherwise, forbid them from speaking in a public forum, so this resource is not being utilized in important public health promotion or education efforts.

Apart from workers employed by the government, the other large “rgoup” of health care workers work in the private practice, in a fee-for-service system. This set of health care workers have their own “private” patients; because they work in the private system, they generally show little interest in contributing to public education.

It is not clear whether the restrictions placed on “advertising” by a law called the 2012 Medical Professions Act serves as a deterrent to physicians who work in private practice from participating in public education. Whatever the reason, there is a deafening silence from doctors who work in private practice in contributing to public health efforts.

On the other hand, there is general agreement that people are more likely to listen to doctors who they know, and with whom trust has been developed over many years: the family physician. However, there is one family physician, Dr. Adrian Lorde, self-described as “primary care physician on the forefront on the battle against COVID-19”, who almost single handedly has taken on the handle of public educator here in Barbados.

Since the start of the COVID-19 pandemic, he has produced over 160 short (5-minute) videos, generally circulated via Whatsapp, targeting the general public in offering some education on various aspects of COVID-19.

He has also appeared on radio, television and in a number of zoom webinars, all offering free education to the general public. Hats off to Dr. A. Lorde. He is almost our own Dr.
Fauci. These videos fill a massive void created by inactivity of our public health officials.

Our daily radio call-in programs are bombarded by persons asking questions about COVID-19, or sharing information that runs contrary to conventional medical wisdom. Most of the moderators, not medically trained, generally do not attempt to challenge most callers except those with the most extreme concepts like some conspiracy theories; but in doing so many pieces of misinformation go unchallenged, and many simple medical questions go unanswered.

There is no doubt that many doctors will claim that education of the general public is not in their job description, and/or they are just too busy to do public patient education. After all, the government hires officials to do this task.

“An ounce of prevention is better than a pound of cure.” Available evidence suggests that our curative services are stressed out to the max: almost 900 persons in government isolation facilities, almost 7000 persons isolated at home, and more COVID deaths in the last two months than in the previous 16.

Three hundred new cases every day, the unvaccinated dying twenty times faster than the vaccinated, but these numbers alone are not apparently having effect on people’s behaviour. We are in a very dangerous place. Better health messaging is urgently needed to combat COVID-19. We are all on the same boat: if the boat sinks, we all drown.

We need all hands on deck, and those hired to do a task to come forward now. A sustained effort is needed to change people’s attitudes and behaviours. Far too many of our population are still “waiting to see” what tomorrow may bring. Tomorrow may be too late.

Dr. Colin V. Alert, MB BS, DM. is a family physician and associate UWI family medicine lecturer.

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