How MERS-CoV Helped Overcome Communication Barriers in Qatar
Authors: Nour Mohamed Abdelrahman , Al-Hajiri Mohammed , Al-Romaihi Hamad Eid , Alyafei Salah , Al-Thani Mohamed Hamad , Al-Marri Salih Ali , Al-Kuwari Alia Hassan 
Published: July 2019

BackgroundAs a conventional type of communication, health education usually face several barriers that make its outcome fall short. Among many, lack of interest, distraction, and rejection are well documented barriers to engaging audience in a communication process leading to behavioral change. Despite the novel corona virus which was responsible for the Middle East Respiratory Syndrome (MERS-CoV) created public concerns, it, on the other hand, paved the road to effective health education via raising receivers’ attention. With the aim to highlight the context and factors attributed to educate the public during epidemics, this study documented how the outbreak of MERS-CoV offered valuable opportunities to communicate critical educational messages on the recommended preventive behaviors and practices.MethodsIn this retrospective study, we documented the timeline of MERS-CoV key events in Qatar, along with the disseminated health education messages that were captured by the print media during the period Sep 2012 through Nov 2013.ResultsThe media documented that one of the first two reported cases worldwide was a Qatari national. A significant turn of the public's risk perception about MERS-CoV took place when studies documented that camels are thought to play critical role in the virus transmission to humans. Six months after the identification of the first case, this relationship was confirmed when it was declared that the MERS-CoV was isolated from camels in Qatar, provided that raising camels is a social norm and an embedded cultural practice in the country and across the region. Nevertheless, MERS-CoV cases and deaths continued to be reported.Out of 153 news stories reported on MERS-CoV, 12 major developments either reporting confirmed cases or deaths were identified in Qatar. Two Press conferences, sixteen press releases, and two interviews were counted, all from competent authorities. As the novel virus captured the media attention, all aspects of the new virus were extensively reported, ranging from the basic information about the virus traits, the clinical signs and symptoms, treatment outcome of cases, to the ongoing researches, epidemiological findings of the most vulnerable persons, the zoonotic nature of the disease, and the recommended course of action. The public pressing demand for updates and information drove the media interest to arrange talk shows and interviews with the high health officials to give firsthand accounts about the virus and the prevention and control efforts.While fresh MERS-CoV cases were reported from The Kingdom of Saudi Arabia, fears were growing that Hajj season may allow for a large scale spread of the virus. The publicized health education messages at that time called upon the most-at-risk group to postpone going to Hajj and Umrah, be assessed for medical fitness, get vaccinated against seasonal flu, and avoid the crowded and badly ventilated areas. This group involved elderly and patients with chronic illnesses or impaired immunity. Afterwards, frequent hand washing and drinking pasteurized camel milk or consuming well-cooked camel meat was advised along with minimizing close contact with symptomatic persons.DiscussionThe timeline of MERS-CoV events along with the communication activities in response to them gave a strong indication about the correlation between the media interest and public concern of a particular subject in hand, and the opportunities created by this momentum to communicate key information and recommended course of action by the competent authorities to satisfy the public's needs on the other hand.Three main factors influenced how MERS-CoV was perceived in Qatar: its unfamiliarity, the epidemiological link to camels, and the way media had portrayed it. Like any other exotic risk, MERS-CoV's acknowledged unfamiliarity even to health officials seduced the media to fill the uncertainty vacuum by persistently focusing on the similarities with the deadly SARS epidemic that erupted in 2002, thereby allowing for scary scenarios to seed in the public's imagination. It was then announced that a kind of relationship had been established between the infected persons and camels before a Qatari scientific team declared that the life MERS CoV was isolated from an infected camel. The immediate result of this perceived risk was heightened public attention and interest. However, the repeatedly announced symptoms of suspected cases allowed for better identification and induced voluntary reporting of cases to healthcare facilities.Substantial proportion of the communication process usually devoted to achieve the preparatory steps of seizing the audiences’ attention besides making sure that the content matters to them. Whereas the public need for information was being satisfied through news releases and press conferences, health education messages constituted a prime ingredient of the communication content.Despite of the denial and stigma linked to the unfamiliar disease, the communicated health messages had a tangible influence on giving the target audience the information necessary to take decisions on the personal and community level. According to records of the medical Hajj committee, response to the pre-travel medical assessment and vaccination was remarkable. Patients complied with the isolation requirements. Nevertheless, Information, Education, and Communication (IEC) materials were not prepared prior to the press conferences, indicating missed opportunities.After all, no significant rejection to the recommended course of action was identified.Study limitationsAs this study was based on reviewing the content of print media, other types of mass media were excluded. Moreover, it was important to determine the extent to which the target communities relied on official press releases and press conferences to gain information related to MERS-CoV.ConclusionCouple of factors contributed to the successful engaging of the target communities to adopt the recommended course of action: the perceived risk of the novel virus which made the public highly attentive, the timing of the health education messages that usually coincided with the critical disease developments, and the assignment of credible well-known resource officials from the competent authorities. As the public uptake of behaviors recommended by trusted authorities tends to be very high during epidemics, efforts should be made on designing health education messages to be injected within media products like press conferences and press releases during early preparedness phases.