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Understanding vulnerability through dialogue: two-way dialogue and inclusivity in COVID-19 communication

Since its emergence in 2019, COVID-19 has become a topic of daily conversation due to its wide-scale impact on all areas of our lives. Much of the language around the coronavirus is anchored around the word ‘risk’.

Medical and Governmental authorities have provided us with copious amounts of guidance regarding risk – often construed through the presence of underlying medical conditions and old age. However, as we come to acknowledge the sheer scale of the impacts of the coronavirus on society – whether epidemiological, cultural, political, or socio-economic – we must finetune our understanding of how these risks are magnified by vulnerability and where they intersect.

The coronavirus has acted to exacerbate existing inequalities and vulnerabilities within society. The distribution of harm is determined by these existing vulnerabilities, as is the manner in which the impacts materialise. The differences in coronavirus infection and mortality rates at regional and local levels demonstrate that underlying socio-economic factors and governmental policy significantly influence the severity of infection rates, exposure to the virus, ability to withstand the economic impacts, access to medical assistance and education for example. The COVID-19 pandemic, therefore, highlights the need to adopt an intersectional lens of the structural conditions that interact with the coronavirus, when developing response measures and deciding on how to prioritise.

So where to start? The near-universal reach of the coronavirus’ impacts means that the volume of issues to consider is a considerable challenge. Almost every demographic must be considered in a response plan and almost every activity and sector require targeted and specific policies to counter the impacts of COVID-19. The questions then emerge: how can we meaningfully appreciate the nuances of vulnerability when considering such far-reaching policy? How can we tailor our approaches to both understand and accommodate these disparate voices, these interwoven and entangled demands and needs?

Increasingly, the literature dedicated to these considerations has expanded, such as the UN Secretary General guidance highlighting the need for special emphasis on gender, on disability and on humanitarian settings. These statements moved beyond siloed approaches that treat these characteristics as uniform but place them as critical factors in appreciating the structural dynamics that produce the context in which individuals and communities operate. Importantly, recognising the diversity of contexts means recognising that access to information and necessary content of communications should differ depending on the characteristics of a community.

Within this context, COVINFORM will examine national government communication strategies and practices to communicate risk and utilise open data to paint a more holistic picture of vulnerability across selected European contexts.

Beyond a ‘one size fits all’ approach to risk communication

As we await the roll-out of a large-scale medical treatment or vaccine initiative, governments’ policy response has been focused on the communication of protective measures. Nevertheless, as highlighted above, the specific vulnerabilities of a community may impact the ability to access information or action the recommended advice. For instance, throughout the pandemic people in low-income households have been less able to self-isolate. An inability to do without income, a lack of suitable housing for prolonged isolation, a need to carry-out informal care obligations, among a host of other reasons, mean that these experiences must be taken into account. Moreover, recognising the higher probability that persons in marginalised communities will face these conditions demonstrates this need for an intersectional lens – perhaps as showcased by the structural conditions that lead BAME communities in the UK to have higher rates of COVID-19.

A lack of two-way communication and dialogue may mean that the needs and concerns are not captured and filtered into communication strategies. This two-way communication and dialogue, as recommended by the World Health Organisation, entails ongoing interaction with communities from the onset of the communication strategy, with the ultimate outputs being tailored to their needs. By failing to engage in such direct communication, the concern is that populations may be effectively excluded from COVID-19 communications and policy, acting to exacerbate their vulnerability and subject them to social stigma where they are unable to meet the generic standards set.

Shifting towards more inclusive communication processes

Two-way communication and dialogue with those receiving the communication is important “to understand risk perceptions, behaviours and existing barriers, specific needs [and] knowledge gaps.” Here, we can see a shift away from paternalistic approaches and towards a more inclusive process. By giving weight to the experiences and input of groups who will have their own understanding of where and how their vulnerability manifests it is possible to build a ‘bottom-up’ component in risk communication strategies.

To fill their knowledge-gap on at-risk communities, communication and dialogue strategies should be rooted in the community. Such approaches should seek to utilise contact points with trusted figures within the community, and organising procedures to obtain the direct opinions from the public, through key informant interviews and focus groups, rapid assessments and surveys as well as the media monitoring. These efforts will be invaluable for gaining the insights from and about hard to reach at-risk communities, such as homeless persons or irregular migrants.

Moreover, as communication strategies seek to create new behavioural norms, it is possible that those who cannot comply with these norms are blamed or criticised. This is particularly the case where those unable to comply will likely already come from marginalised communities already subjected to discrimination. In this respect, having a ‘one-size-fits-all’ that is calibrated to more dominant communities’ capacities risks exacerbating the marginalisation of those unable to meet these standards. As such, the messaging must be targeted to people on the basis of their risk levels and capacities in order to be actionable by the community. Failing to provide realistic advice may result in stigmatisation and potentially disillusionment with the COVID-19 strategies themselves.

On the more extreme end of the resultant consequences, communication strategies that are not attuned to vulnerabilities can include the perpetration of acts of direct violence on persons. For instance, language regarding the nature of the threat may also produce varying effects on communities. For instance, the discussions on the fact that the virus had originated in China (which the previous US government was particularly keen to emphasise) resulted in xenophobic attacks. In this sense, the political atmosphere where certain (and often marginalised) community groups are more susceptible to stigmatisation and xenophobic attack is directly relevant and point to a wider need to include these experiences in communication strategies. Ultimately, we will experience this pandemic differently. Our responses must react to the breadth of needs and challenges.

Authors: Peter Wieltschnig and Su Anson, Trilateral Research