Forgotten key players in public health: news media as agents of information and persuasion during the COVID-19 pandemic.

Recently, the coronavirus disease 2019 (COVID-19) has been rapidly expanding across the globe. To respond to this pandemic, many countries are combining suppression and mitigation activities aimed at delaying major surges of patients and levelling the demand for hospital beds, while protecting the most vulnerable from infection. Bedford et al. state that ‘national response strategies include varying levels of contact tracing and self-isolation or quarantine; promotion of public health measures, including handwashing, respiratory etiquette and social distancing; and closing all non-essential establishments’. It is crucial for the public's health that information about these measures is accurately and quickly disseminated throughout the population. Currently, legacy news media (e.g. television, radio, newspapers) and social media are the main platforms through which this dissemination takes place. , However, there are several aspects related to the journalistic infrastructure on the one hand and on the reliance on news media as agents of information on the other hand that may (in)directly and inadvertently endanger the public's health in several ways.

Although the corona crisis is the biggest journalistic story in times, that same crisis is also directly crippling media companies. This is a paradoxical situation: news consumption, viewing and reading figures, visits and likes are sky-high, but contrary to what happens in ‘normal’ times, media turnover is dropping. As non-essential establishments are closed and (mass) events are cancelled, the demand for ads has dropped. Consequently, many news outlets are suffering from falling advertisement revenues. This loss may cause structural damage to many traditional news media and may signal a rapid shift to a more digitized media environment. Especially the need for local information provision and local connections is greater than ever, but the revenue model for local and regional news provision has completely collapsed as it is heavily dependent on advertising revenues from local small- and medium-sized enterprises.

The public's reliance on news media coverage to convey accurate information (i.e. more than statistics) increases during times of uncertainty and crisis – especially in the current context with large shares of the population working or locked down in their homes. The social distancing leads to increased anxiety or stress, which in turn has a detrimental impact on the public's physical and mental health over time, as evidenced by longitudinal studies following other health or societal crises. , The amount of news media exposure and the content of the news media coverage are related to public anxieties: overly sensationalized coverage (e.g. graphic imagery) is related to higher stress levels. Not all media types frame stories the same way, are equally trusted or have an equal impact on fears among the public. , Given the large presence of fake news and the growing distrust of the public in social media, legacy media remain important platforms for informing the public. The damage that legacy media are currently sustaining threatens journalists' positions, particularly the self-employed journalists and the freelancers, in their ability to accurately report the news.

Governments must take these problems into account and take measures. We urge policymakers to follow the example of the Netherlands, where a subsidy of €11 million has been made available to support local information provision. Readers are also invited to donate or to subscribe. Governmental support is imperative to sustain and uphold the journalistic infrastructure and maintain integrity and quality in news media, given their importance in the dissemination of information to the public. This, in turn, will have a major impact on public health in the context of the COVID-19 crisis. A weakened journalistic infrastructure, during times where people heavily lean on news media to provide them with facts and opinions, bringing expertise and explanations to the table, will potentially lead to increased reporting of ‘alternative’ or dubious content, which may result in the dissemination of potentially ‘dangerous’ views that jeopardize public health (e.g. faux COVID-19 treatments).a By ensuring that public information media remain strong and properly financed, governments also indirectly make an investment in the public's short- and long-term physical and mental health.

Policymakers face several challenges as they look ahead to loosening some of the restrictive public health measures that have been installed over the past weeks. Some European countries are cautiously looking ahead to what lies beyond the crisis and begin to make plans to lift some of the restrictions: steering legacy media will play a significant role in influencing people's behaviour, for instance, on how and when to wear respirator masks. Preliminary COVID-19 research on representative samples of the Flemish (Belgian) public teaches us that news media consumption – particularly on (public) television – is strongly related to support for public health measures. A clear communication strategy by the government will therefore be vital in ensuring that the public is well informed about when and how restrictions are lifted to avoid another wave of COVID-19. Minimizing sensationalized coverage, while at the same time actively engaging in debunking fake news, will be necessary to limit public anxiety and stress and facilitate a ‘normalization’ of societal life.