This article was first published in The Sydney Morning Herald on March 12, 2020.
Alarmist headlines. Politicians downplaying danger. Skirmishes over loo paper. Nothing is surprising to those of us who worked on the last global health crisis: the 2014 Ebola outbreak.
A crazy panic gripped the world and crippled the economies of the entire African continent. What is surprising is how little the governments that funded that effort, including Australia, learned from the crisis.
The government’s $30 million national information campaign, announced on Wednesday, is way overdue. It will be critical now that the government gets it right. As the virus runs away from efforts to contain it in countries around the world, public awareness of how to avoid infection will be all that will protect those most vulnerable and slow the transmission enough to give health systems a chance to cope.
It is critical that the campaign is clear, engaging, constant and delivered by trusted sources. News that doctors are receiving confusing advice from the federal government and different state health authorities on who to test, when, where and how, does not encourage confidence that the government will get it right.
This was hit home for me in a bathroom at Melbourne airport last week when an air steward rushed by me to rinse her hands, without soap. She would be handling the drinks and food of hundreds of people that day.
At the next sink I washed my hands as we were taught by public health trainers in 2014. As project manager and editor at the BBC charity BBC Media Action, I was part of a multi-billion dollar UNICEF-led communications effort that trained West African media and leaders in Ebola health messaging. To impress upon us the need for proper washing, trainers waved a special light over our hands. My fingertips, wrists and fingers teemed with bacteria.
The length of time you wash is just one factor. To reach all the surfaces you need to wash properly as shown in World Health Organisation posters.
As COVID-19 now reaches 110 countries, a public awareness campaign on that scale is needed everywhere, including Australia. Other countries have been faster to get the right messages out. A coronavirus TikTok dance challenge from Vietnam – which has gone, yes, viral – is a great example.
For Ebola we created dramas, jingles, social media pages and talk shows that informed audiences about how to get treatment and avoid the virus. Trust was critical. West Africans had no more faith in politicians than Australians do. We aired people they trusted: community leaders, doctors, clerics, sporting heroes, musicians and Ebola survivors.
We helped journalists to resist sharing rumours and to play their roles as reliable purveyors of the factual information their audiences needed. Bathrooms in clinics, schools and public buildings displayed posters with bold, clear prevention measures. West Africans learned to stop touching each other and to isolate sick people. In the end it was the actions of informed people that stamped out the chain of transmission.
The spectre of an Ebola pandemic was rightly terrifying. In the early days almost 90 per cent of patients died. Broken health systems were overwhelmed. Bodies lay in the streets. Ebola quickly spread to 14 countries and was on a path to infect 1.4 million people when world leaders stepped in with a $6bn emergency response, unprecedented in size, to help West Africa’s fragile governments stamp out transmission.
But COVID-19 is far more dangerous than Ebola. Ebola has a higher mortality rate, but it is far less easily spread. Ebola is not spread by coughing. By the time patients are infectious they’re mostly too sick to move. COVID-19 is spread by coughing and patients are contagious without knowing they’re infected.
Ebola killed 11,000 people in 2014-2015 but the number of infected patients was fewer than 29,000. In the 10 weeks since COVID-19 surfaced more than 110,000 people have been infected in 110 countries. Almost 4000 have died. It will not take long before the COVID-19 death toll far exceeds Ebola.
Containing Ebola was frightening, relentless work. Containing COVID-19 will be harder. Bungled steps in countries outside China, especially in the United States, have made the task look almost impossible. A former BBC colleague shared a recent report from 25 World Health Organisation experts that echoed what our Ebola experience had taught us.
“Much of the global community is not yet ready, in mindset and materially, to implement the measures that have been employed to contain COVID-19 in China,” the report said. “These are the only measures that are currently proven to interrupt or minimise transmission chains in humans.”
I’ve mounted a one-person campaign telling everyone to stop shaking hands now. But our best hope is the sort of large public health education campaign that donors, including the Australian government, funded to fight Ebola. Without that, the economic costs of bans and quarantines will likely cause more suffering than the virus and more people will die unnecessarily.
Prue Clarke is Senior Executive Officer at the Judith Neilson Institute for Journalism and Ideas.
An electron microscopic image of the 1976 isolate of Ebola virus.