Ebola reminds us perception is reality

Editor’s note: This piece originally ran in the Fall print edition of GJR.

As with other noisy public health topics, covering the ongoing Ebola crisis has posed several challenges. Journalists must have the facts right, of course, or risk irreparable damage to public understanding of the disease. But they also must decide how to deal with the myths others have unleashed. Is it better to raise the ghosts of erroneous beliefs to dismiss them, or to shun them entirely for fear of feeding panic?

This nagging question leads to another: What should be emphasized about such a novel and vivid threat that nonetheless poses little risk to Americans?

Ebola “truthers” and best practices

Conservative media lined up last fall to hype the hazard Ebola poses in the U.S., from the Washington Free Beacon to the Wall Street Journal editorial page. Their refrain: that an incompetent federal government couldn’t be trusted to handle an outbreak. Fox News especially hammered the argument, with Gretchen Carlson, Mike Huckabee and Donald Trump as a guest provocateur all making the case.

Sen. Rand Paul, despite his medical background, raised fears of a pandemic on par with the Spanish flu and the Plague.

They were all criticized for fear mongering, but as always, the initial claims likely reached larger audiences. And those are just the mainstream alarmists. Predictably, Twitter has been a hive of panicky speculation and conspiracy theories.

How to deal with this sensationalism? Christine Russell, writing for Columbia Journalism Review in October stressed credibility and expertise. It should be — and has been – national medical leaders and specialist beat reporters turning back the tide, she wrote.

Russell praised Dr. Anthony Fauci, an immunologist with the National Institutes of Health, for his appearance opposite Fox News anchor Chris Wallace. Wallace asked Fauci if the U.S. should ban flights from West Africa; if illegal immigrants entering across the U.S.-Mexico border would likely import Ebola; and whether the virus could serve as “a good bioterrorism weapon.” Fauci rejected all three, and in Russell’s words “gently chided” the anchor for the last two, which he called “far-fetched.”

Others have given their take on the big picture of the media’s Ebola obsession. Brendan Nyhan, a contributor for New York Times’ Upshot, offered an analogy in his October 10 piece: Driving to the airport is more dangerous than the flight, but we fixate on the fresh risk for evolutionary reasons. Ebola could have similarly distracted from more commonplace threats, such as seasonal flu.

Writing for the Guardian back in August, James Ball took a similar stance against out-of-proportion coverage. Flu is far more contagious and will kill between 250,000 and 500,000 people worldwide over the next year, he said.

Alice Walton at Forbes says it’s a problem of volume. The media reported every fever patient that’s had contact with West Africa, which yielded a slew of false positives, she wrote in October. “The narrative becomes, ‘This Is Everywhere!’” Dr. Ashish Jha, Director of the Harvard Global Health Institute, told Walton.

Walton advises discretion and context – showing audiences that the “hoopla” of each suspected case is precautionary.

The reality of news is journalists don’t know the trajectory the Ebola story will take.  But by recalling examples of other health controversies and being mindful of reader psychology, journalists can hope to mitigate potential harm.

Pandora’s anti-vax

The MMR (measles, mumps, rubella) vaccine controversy stands as an important precedent for reporting with disastrous public health outcomes. In 1998, the U.K. medical journal Lancet published a study claiming autism disorders could be caused by the MMR vaccine. That article’s results, which were reported widely, were then discredited as fraudulent. The press was called out as credulous in the process.

As a result of the coverage, vaccination rates plummeted in the U.K. and Ireland. Outbreaks increased, resulting in injuries and death. Previously controlled diseases returned to “endemic” status – self-sustaining in the population.

Even after the Lancet study’s drubbing, false balance persisted in news stories, to the outrage of medical researchers.

The anti-vax movement caught in the U.S., too, where there were over 600 confirmed cases of measles in 2014, the most in 20 years. In 2004 there were 37. According to the Center for Disease Control, 90 percent of this past year’s afflicted were unvaccinated.

Famously, Jenny McCarthy used her celebrity to trumpet the Lancet study’s claims, standing by its author even after his discrediting. Many in the media deplored McCarthy for her irresponsible actions, but she’s an illuminating case study — Once misinformation is introduced, erasing it can be a Sisyphean task.

Don’t think of an elephant 

A glance at the return of childhood diseases shows one bogus study continues to impact beliefs about vaccines. Pro-vax crusaders may feel as though they’re fighting fire with gas. The psychology of information processing can help explain why. 

People aren’t as objective as they like to believe. When we encounter new information, our past experiences bias how we perceive and store it. One example of our motivated reasoning is disconfirmation bias: To save mental energy, we’re critical of incoming information contradicting our prior beliefs, but uncritical of that which agrees. This may be one reason Jenny McCarthy is such a stalwart holdout.

Anti-vaccine sentiment endures despite investigative journalism that uncovered the Lancet study as a sham, and despite efforts of journalists since then to shame prominent anti-vaxxers – Why? Another piece of the puzzle could be ironic process theory. This phenomenon can be summed up in the phrase “don’t think of an elephant:” Trying to suppress a thought makes it surface. Denying false claims could spread them to those not paying close enough attention.

Perhaps even more discouragingly, George Washington University’s Emily Thorson has shown false beliefs can “echo,” even when corrections are well received. In her study, political corrections that readers fully accepted only reduced misinformation’s effect on attitudes by half.

Since exposure to inaccurate information produces subconscious associations the same as accurate information, it can continue influencing attitudes beyond its correction on the conscious level. And Thorson found exposure to only the correction can alter attitudes, too.

How not to argue

The way public health is implicated in Ebola coverage matters, too. Neurobiology and psychology have taught us that people are more likely to be persuaded by arguments that focus on potential losses than gains. Unfortunately, then, explaining the benefits of herd immunity might be less impactful than the distress of injecting infants with autism.

But the most successful arguments also might be weaker ones. People aren’t likely to change the beliefs that are wrapped up in their identity (such as political preferences, environmental attitudes, and yes, anti-vaccine stances) when your take-down is too strong. Arguments that are less threatening to someone’s self-concept are more likely to get through.

Research conducted by Dartmouth’s Brendan Nyhan (who penned the Times’ Upshot piece mentioned previously) and Exeter’s Jason Reifler shows avowing someone’s self-worth “can make them more willing to acknowledge politically uncomfortable facts.” Their findings can be extended to other closely held beliefs.

When asked to recall a time they felt good about themselves, Republicans were more likely to agree climate change is real, and Iraq War opponents were more supportive of the troop surge.

So coverage that doesn’t implicate readers’ identities is more likely to get through their mental defenses. That means stripping out partisan language and other phrasing that involves cultural divides.

These lessons don’t add up to a single through line or universal path to educate readers. But they can help journalists be mindful of how powerful their choices are, and how much each word matters.

Picking sides

Journalists have good reasons to step in and referee competing claims. LSU Manship School of Communication’s Ray Pingree led an experiment that found journalists can influence factual beliefs in the right direction.

The researchers discovered readers across the ideological spectrum were consistently amenable to journalists’ adjudications of the claims made by a news story’s rival sources. Those interventions also improved readers’ views of overall news quality while making them more likely to seek out more news in the future – a win-win for the public and the reporter.

Perception is reality 

Overblown fear pieces – such as those calling for a West African flight ban – could have wound up prolonging the Ebola epidemic. But taking on a dangerous claim, perhaps too stubbornly, may have backfired. And as we learned from the MMR vaccine-autism hoax, covering medical news related to Ebola with artificial balance could have produced long-term consequences.

But contextual reporting and doing the work of weighing evidence can earn journalists respect of their readers, if not save lives. In this case and many others, journalists must be conscious of perception as much as reality.