Messaging Fatigue and Desensitisation to Information During Pandemic.

To the editor,

The current COVID-19 pandemic which has afflicted more than 6 million people has led to many mental, societal and economic consequences (1, 2, 3). The physical and mental fatigue of frontline workers in places constrained by manpower shortage are well recognized. Public healthcare communication has played a crucial role in engaging the public to partake in this crisis. However, the challenges and repercussions of messaging fatigue has received little attention.

Repeated messages carrying reminders of safe distancing practices, hand washing, wearing of masks, stay home pleas, potential COVID-19 complications and daily updates of morbidity and mortality data through various national and professional mass media channels can result in messaging fatigue, (which refers to a state of being weary and tired of persistent exposure to similarly-themed information) for the intended recipients. The acute strike of COVID-19 and its rapid temporal evolution has led to an intense and incessant bombardment of the same repetitive messages everywhere and this inevitably increases the risk of mental fatigue and desensitisation to the news coverage after an initial anxiety period.

Messaging fatigue has been studied in healthcare messaging, such as behaviour modification in anti-obesity messages. Kim et al have illustrated how reactance of the individual can modulate the negative effects of message fatigue (4). Reactance refers to the feeling a person has of having their freedom to choose taken away from them, hence limiting their range of activities. As a result of the lockdown during COVID-19 pandemic, people may feel anxious, depressed and powerless that choices were further taken away from them, compounded by the need to conform to new behavioural rules and worries of potential loss of livelihood. Individuals from different backgrounds are likely to experience different reactance to repeat messaging secondary to confounding factors including personality, social and family responsibility, financial constraints, among others.

Information fatigue also has an impact on healthcare workers as well. In a randomized study involving 528 health care providers who received public health messages via email, fax, short message service or no messages at all, the investigators found that every increase of one public health message per week led to >40% decrease in the odds of the recipients recalling the message content (5). Hence, messaging fatigue from public health communication has potential negative impact on the general population, including healthcare providers.

Reactance is mediated by each of our individual needs for interactions and dependence within our social circle. Everyone reacts differently, and this could range from indifference to fatigue or clear hostility. We cannot ignore the basic need for human touch, face to face interaction and holistic environmental stimulation. The consequences of repeat messaging causing mental fatigue could aggravate a mind already impacted by living in an artificially constrained world akin to “living in a fish tank”.

The challenge is to effectively devise successful communications for a sustained period without message fatigue setting in and this encompasses the way we frame the method of communication (e.g. narrative versus non-narrative approaches). In a study of different ways of communicating healthcare messages, investigators have suggested that believability and reactance to the messages can be influenced by the persuasive intent (6).

Due to the extent and unprecedented nature of the current COVID-19 pandemic, there are no objective research data to assess the magnitude of the consequences of messaging fatigue. However, mass media reports of frustrated individuals during the prolonged lockdown period exhibiting anti-social/outlandish behaviour, disinterest or apathy or even wilfully breaking the law suggest that we may be just seeing the tip of the iceberg of the desensitisation and fatigue towards repeated news messaging on COVID-19.

Hence, we need to recognise potential public health communication related messaging fatigue, develop an efficient time frame for the messaging and its intent, focus on target groups with adaptable communication tools and evolve the messaging with changing circumstances, besides regularly addressing the concerns of the individuals and expressing appreciation for their sacrifice and perseverance.