An empirical analysis of lay media coverage on influenza prevention pre- and post-COVID 19: Mask recommendations were previously rare, now ubiquitous
Authors: Prasad Vinay , Brown Elissa , Haslam Alyson 
Published: February 2023

AbstractImportanceConsistent, evidence-based communication is critical to building trust and maintaining credibility of public health agencies.ObjectiveTo identify any significant changes in the mainstream media’s presentation of public health advice for flu prevention before and after the COVID-19 pandemic.Design, Setting, and ParticipantsA systematic search in Factiva of top ten U.S. newspapers by circulation, using two search periods, 2018-2019 and 2021-2022. Articles with flu prevention advice were identified, abstracted for media outlet, reporter, date. Articles were coded for the specific advice provided.Main Measure(s)Number of recommendations for flu prevention, frequency of each recommendation; percent of recommendations aligned with CDC guidelines for each period. Changes in frequency of each recommendation. Differences determined using 2-proportion Z-tests, p-value 0.05 significance.Results128 articles with 244 recommendations for pre-COVID period; 122 articles with 296 recommendations post-COVID. 96.3% of recommendations in alignment with CDC guidelines pre-COVID. 63.9% of recommendations in alignment with CDC during post-COVID timeframe. Percentage of articles with advice to mask for flu increased by 1,494.8% (p=<0.00001). 14.5% decline in percentage of articles advising flu vaccine (p=0.002). 495.5% increase in percentage of articles recommending social distancing (p=0.001). 1,368.9% increase in percentage articles recommending increased ventilation (p=0.0004).Advice to cover cough/sneeze declined by 52.8% (p=0.041); advice to disinfect surfaces declined by 76.7% (p=0.038).Conclusions and RelevanceExpert advice on flu prevention as presented in top 10 U.S. newspapers changed significantly during the COVID-19 pandemic. The strategies discussed more frequently are not currently recommended by CDC. This is relevant information for public health leaders as they address ongoing issues of trust and credibility.Key PointsQuestionAre there significant differences between the mainstream media’s presentation of expert advice for flu prevention before and after the COVID-19 pandemic?FindingsA systematic search of the top ten U.S. newspapers by circulation found that the percentage of total articles with advice to use a face mask for flu prevention increased by 1,494.8% from the pre-to post-COVID period, while the percentage of total articles advising a flu vaccine decreased by 14.5%. Other significant findings include an increase in advice to social distance (494.5%), an increase in advice to improve ventilation (1,368.9%), a decline in advice to cover your cough (58.2%) and a decline in advice to disinfect surfaces (76.7%). The strategies discussed more frequently are not currently recommended by Centers for Disease Control (CDC) for flu prevention.MeaningSignificant changes in public health advice on flu prevention, as presented by high-circulation U.S. newspapers, occurred during the COVID-19 pandemic, resulting in less consistency with CDC recommendations for flu prevention.