Journalists face some unique challenges when they try to report accurately on a major infectious disease outbreak like the one associated with COVID-19, according to professor Glen Nowak, director of the Center for Health and Risk Communication in the Grady College of Journalism and Mass Communication at the University of Georgia and a former director of media relations at the Centers for Disease Control and Prevention, including during the 2009 H1N1A influenza pandemic.
Below, Nowak provides his thoughts about the communication challenges facing journalists and the public when it comes to COVID-19 tests and testing.
Why has COVID-19 testing been in the news?
Diagnostic tests and testing are an essential part of an infectious disease outbreak response. After the first cases of new infectious disease have been identified, health care providers need to be able to quickly determine who else is infected, particularly other people who have similar symptoms, while public health officials need to quickly learn how many others have been infected, where infections and virus transmission are happening, and which people may be most likely to be infected and to have severe illness from their infections.
News media are interested in providing their audiences that information as quickly as possible. In the early stages of the COVID-19 outbreak in the U.S., testing also made the news because there were problems with the initial test that CDC provided to state labs. This caused delays in being able to identify patients with COVID-19.
Much attention has been given to the importance of testing, including because some countries, such as South Korea, have been able to quickly and extensively test people to determine if they are infected with the coronavirus that causes COVID-19 and as a result, slow its spread.
Why will COVID-19 testing continue to be of news media and public interest?
COVID-19 tests and testing will continue to be in the news for at least three reasons. One, President Trump has said that a goal going forward is for anyone who wants to be tested to be able to do so. This means many news media will continue to be doing stories about the availability of COVID-19 tests at the local and state level. The supply of COVID-19 diagnostic tests is currently well short of the number needed to achieve this goal and supplies vary considerably across the country.
Two, there is disagreement about who needs to be tested and who should be tested. Hospitals and health care facilities that are dealing with large numbers of infected and potentially infected patients do not have the ability to test people with mild or no symptoms. As a result, we can expect news media stories about who can and cannot get tested.
Third, the information gained from diagnostic tests increases medical, science and public health knowledge regarding where this new coronavirus is, how many infections it is causing, the types of symptoms and range of illness people who are infected experience, and the percentage of people who experienced severe illness or died from their infection. That knowledge, in turn, is used to make decisions about how to slow and prevent the spread of the virus.
What are some of the communication challenges that COVID-19 tests and testing bring?
COVID-19 tests and testing bring many communication challenges. One challenge involves competing messages regarding who should be tested and how the tests should be used. While the CDC has issued and posted specific recommendations regarding who should be tested, decisions about testing are at the discretion of state and local health departments and individual clinicians. Some are testing people who do not have known exposures to the virus or who have mild symptoms, while others are limiting testing to people in risk groups or who have significant symptoms.
A second challenge is that there are different types of tests and different testing methods. There is not a single COVID-19 test. Most of the COVID-19 test and testing stories have focused on diagnostic tests – that is, tests used to determine if a person is currently infected. There are many companies providing these types of tests, with the time it takes to get results ranging from as short as 45 minutes to as long as a few days.
Less attention has been given to efforts involving the development and use of tests that can tell whether a person has been infected in the past with this new coronavirus. These are typically blood tests that look for antibodies that indicate if a person was infected. These tests are important because they help provide estimates of how many COVID-19 cases have gone undetected. This type of testing increases understanding of how many people had no symptoms or symptoms so mild that they were not noticed.
As this information becomes available, there is a good chance it will increase significantly increase the number of confirmed cases and lower fatality estimates. It is essential to accurately convey this information without creating the impression that the increase in confirmed cases involves new infections.
When it comes to COVID-19 tests and testing, what advice do you have for the news media?
As more COVID diagnostic tests become available and used, it is important that journalists, news media outlets, the public and policymakers understand that different types and uses of testing will be done going forward. They also need to understand the reasons for using and not using diagnostic tests, especially as tests become more widely available.
Finally, it will be helpful for journalists and policymakers to understand the difference between using tests to make medical diagnoses versus the use of testing to learn more about the extent and spread of the virus, the characteristics of the virus, and the effectiveness of measures intended to slow or prevent the spread of the virus. Doctors and medical facilities need tests that accurately and rapidly provide a diagnosis.
Those tests may not be designed or able to provide the more detailed information that comes from laboratory tests and analyses. It is also likely the case that as the CDC builds a surveillance system designed to obtain and provide much greater information about this new coronavirus that effort will involve much testing of people who do not have symptoms or known exposure to the virus. Testing people who appear to be healthy will be essential for getting a better picture of how widespread this virus is and the percentage of infections with no or very mild symptoms.