The print press and its politicization of public health: The case of COVID-19

Abstract

This article is interested in the ways in which a serious public health issue, the COVID-19 pandemic, was used to categorize and reconfigure sections of the British citizenry into conformists and deviants. In constructing these categories, the print press was utilizing specific labels to identify those who were sceptical and noncompliant of preventative health strategies. Scepticism of Covid policy was reported along political lines, distinguishing between right-leaning conspiracy theorists who pose threats to health and safety, and those sceptics who were simply without access to accurate information and guidance. In its claims-making activity, the print media was portraying some concerns as more legitimate than other equally significant social issues. The politicization of a biological vector is not without serious implications for public health communication and, ultimately, compliance with disease preventative measures.

Keywords

COVID-19 politics public health journalism labelling framing

Introduction

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak, commonly known by the name of the disease COVID-19 given its year of discovery (V’Kovski et al., 2021) was detected in Wuhan, China in December 2019. The disease is airborne, transmitted through inhalation of aerosols that can remain suspended in air for hours (Jimenez et al., 2022) although this is not the sole mode of transmission. On 30 January 2020, the World Health Organisation (WHO, 2020a) declared the outbreak a Public Health Emergency of International Concern, declaring it a global pandemic by 11 March 2020 (WHO, 2020b). Accordingly, public health measures followed globally: lockdowns, individual quarantine and isolation, social distancing (Nerlich and Jaspal, 2021), mask mandates and vaccines after January 2021 (Breakwell et al., 2021). These prevention strategies have not been met with compliance by all citizens; many have reacted with denial of either the threat or existence of the illness (Lange and Monscheuer, 2021) because of widespread mistrust in the scientific establishment (Lee et al., 2021) inspiring anti-lockdown, anti-mask and anti-vax sentiments around the world.

Noncompliance with Covid rules has seen the emergence of labels toward some citizens as ‘deniers’ and ‘sceptics’ who pose threats to our population health in a dominant media representation unchallenged with alternative views (Jaspal and Nerlich, 2023). COVID-19 sceptics are defined as those who deny or downplay the seriousness of the illness (Latkin et al., 2021); some deny the existence of the pandemic (Pennycook et al., 2022; Stanley et al., 2021), others acknowledge its gravity but question aspects of the pandemic such as its origin (Banai et al., 2022; Schaeffer, 2020), and yet others minimize its seriousness viewing it as nothing significantly more serious than the common cold (Latkin et al., 2021; Pennycook et al., 2022). But absent in the labelling exercise is the nuance between those who question the scientific approach to policy and those who deny all aspects of the pandemic; the tone used to describe both as outright deniers signals ‘irresponsibility, recklessness and stupidity’ in an effort to delegitimize or demonize (Jaspal and Nerlich, 2023).

Covid scepticism in the United States has been associated with political conservatism (Latkin et al., 2021) and those who consume right-leaning media because they tend to endorse misinformation (Motta et al., 2020; Pennycook et al., 2022). Others have argued that in the Western European context it is ideological extremism on both ends of the political spectrum that is of significance, especially if there is political mistrust (Debus and Tosun, 2021) as is the case with anti-elite populists, with right-wing political ideology only playing ‘a subordinate role’ to populism (Eberl et al., 2021). On balance, far-right political attitudes are argued to be stronger predictors of Covid scepticism (Küppers and Reiser, 2022) especially when there is a combination of right-wing attitudes and populism (Juen et al., 2023). In the UK however, partisan politics does not appear to have any significant influence on Covid compliance measures (Harper et al., 2021; Pennycook et al., 2022).

Drawing from the examined literature and cursory reading of newspapers, this article examines how labels, including previously studied ones like Covid-sceptic, were used to socially categorise conformists from deviants. Howard Becker’s Labelling Theory (1963) and Spector and Kitsuse’s four stages of ‘Constructing Social Problems’ (1977) form the theoretical framework in studying the construction of a serious public health issue as a socio-political problem that warranted social categorisation. This study is illustrative of a media landscape in modern journalism within which outlets tailor information according to the ideological bent of sections of the public who are their consumers (Maddow, 2010). The power dynamics between journalists and their audiences have shifted with the advance of web analytics that monitor audience preferences (Deuze, 2003) situating audiences in a position to potentially set the news agenda (Bruns, 2003) where the interplay between the economic and political interests in the audience changes the very meaning of ‘the audience’ (Napoli, 2011) who may now decide what is newsworthy (Lasica, 2001). These shifts can explain the politicisation and polarisation in COVID-19 news coverage (Hart et al., 2020; Rothgerber et al., 2020); and polarized media coverage leads to a public whose opinions align with their respective political leaders rather than trust information from experts (Druckman et al., 2013; Bolsen et al., 2014).

Labeling a new class of outsiders

Labelling is designed to categorize and ostracize. It can hardly be seen to function for other purposes in sociopolitical contexts. Unlike other theories of deviance before it, labelling theory is not concerned with the causes of deviant behavior but with the societal reactions that follow. The focus is on which deviant acts inspire negative social reactions because it is these reactions that will lead to the readjustment of one’s self concept about their deviant status (Lemert, 1951), eventually becoming their master status (Becker, 1963). Perhaps the most prominent labelling theorist, Becker (1963) argues that no act is inherently deviant until it is labelled so. Whatever is considered deviant is not a quality of the act itself; it is social groups who create deviance ‘by making the rules whose infraction constitutes deviance, and by applying those rules to particular people and labelling them as outsiders’ (p.9). Thus, labels are words that possess a social categorization function. That is, a classification of individuals based on shared attributes (Stangor et al., 1992). Beyond their linguistic aspect, labels are words with consequences because language is not just descriptive; language constructs the social world by transforming descriptions into action (Austin, 1975) creating discourses that facilitate or constrain what can be said and by whom (Parker, 1992). Here, framing theory (which informs the methodology) is useful because it illuminates how labels can function in a news story when it is designed to frame some aspects of reality as more salient and memorable, so as to promote a particular problem definition, make moral evaluations, and recommend sanctions (Entman, 1993).

Becker refers to those engaged in the labelling process as ‘moral entrepreneurs’; moral crusaders who take the initiative to highlight the need for change and who from their position in the upper strata of society ‘typically want to help those beneath them to achieve a better status [even if] those beneath them do not always like the means proposed for their salvation’ (p.149). The lack of compliance to various Covid restrictions and preventative measures has recently inspired pejorative labels such as ‘denier’, ‘sceptic’ (Jaspal and Nerlich, 2023) and ‘Covidiots’ to refer to those who do not mask or isolate compared to those ‘civic minded’ (Capurro et al., 2022). These labels (or stigma) are effective because they have a discrediting effect (Goffman, 1963: 3) of any questioning or dissenting voices of those now identified as Outsiders. Labels enable a particular frame which is the ‘central organizing idea or story line that…suggests what the controversy is about’ (Gamson and Modigliani, 1987: 143). This is the ‘emphasis framing’ approach to framing theory, which focuses on difference in what is presented rather than how. Cacciatore et al., (2016) argue that this makes framing theory conceptually ambiguous and unable to measure impact on audiences the way an ‘equivalence-based’ approach would by examining how information is presented rather than its persuasive (what) value. This study employs both approaches: emphasis framing to examine different frames (what was presented), and equivalence framing to trace how the same issue was phrased/framed/packaged differently to present a particular narrative about a public health crisis. To be sure, in doing so, the study is not measuring public perception but exploring techniques of framing.

Culturally, if labelling is done correctly, the disapproval of an act rather than the individual can lead to better outcomes. Braithwaite (1989) argues that ‘reintegrative shaming’ that disapproves an act, to invoke remorse without outcasting or stigmatizing an offender can lead to law-abiding behavior. Contrarily, if sanctions seem unfair and disproportional to the harms caused by an act, it leads to defiance and more offending (Sherman, 1993). As such, rather than a uniform acceptance of the newly established public health rules to control COVID-19 spread, these newly created groups of Outsiders have instead become even more resistant. They are ‘the stigmatized sceptics’ who disengaged from those who have not been stigmatised, instead aligning themselves with like-minded others (Jaspal and Nerlich, 2023). When those who are labelled or perceived as ‘deniers’ experience exclusion from the political and scientific debate (Duan et al., 2020), it inevitably leads to noncompliance with preventive measures (Myrick and Chen, 2021) not least a mistrust of these exclusive institutions and their representatives. Mistrust in science and/or government institutions has previously been shown to have negatively impacted adherence to official preventative policies (Fisk, 2021) which is unsurprising when current and newly developing data or policy cannot be scrutinized without pejorative labels.

Media claims-making

To those referred as moral entrepreneurs by Becker (1963) Spector and Kitsuse (1997: 75) use the term ‘claims-makers’: individuals or groups with grievances ‘with respect to some putative conditions that result in social problems’. Claims-makers, like moral entrepreneurs, may assert their claim by way of verbal, visual or behavioural statements until a condition is taken seriously (Loseke, 2003). So, claims about an issue must be made such that it qualifies as a ‘social problem’ worthy of attention (Best, 1993) towards which decision makers can direct attention and about which the media can provide a platform where claims-makers ‘compete for legitimacy’ (Hansen, 2003). They will compete for media attention even if it means ‘talking across each other’ because it is through the media they can influence public opinion (Miller and Riechert, 2001) and those who make a compelling case are able to participate in the political agenda (Best, 2001).

In this, the media are not passive. It is the media which choose some claims-makers over others, actively participating in the construction and communication of an issue within specific news frames. Claims-makers are sources of necessary information and are therefore primary but the media, conceptualised as the secondary claims-maker by Best (1993), are with significant power to shape views and attitudes because it is through the media that public perception is influenced. And the media frames of preference – which issues deserve attention and what solutions ought to follow – are ideologically motivated and aligned (Hall et al., 1978). Spector and Kitsuse (1973: 145) propose a four-stage model to trace media claims about an issue enough to construct it as a social problem:

Stage One, groups assert the existence and offensiveness of some condition;

Stage Two some official agency responds to the claims;

Stage Three demands re-emerge, expressing dissatisfaction with the official response;

Stage Four alternative, parallel, or counter-institutions are established

This model traces the shift in problem diagnoses and the subsequent calls for solutions.

Methodology

Data collection

Newspaper coverage of the COVID-19 pandemic is very extensive. Accordingly, rather than analysing the entire coverage, this study will draw on key policy developments during the various stages of the pandemic to explore media representations following these key initiatives. This allows analysis of labelling and media claims-making after each disease prevention strategy during which different types of sceptics or deniers can be identified, depending on various developments within these periods: anti-mask, anti-lockdown, anti-vax.

The government introduced a policy of ‘social distancing’ to restrict physical contact (Guidance, 2020) formalising the lockdown on 23 March and giving police enforcement powers. The policy initiatives that marked milestones informed data collection of the press coverage therein. These milestones are available at the Institute for Government Timeline (2022) Web site:

1. Phase 1: 01 March 2020 – 21 September 2020

⁃ 11 March: WHO declares Covid a global pandemic

⁃ 23 March: PM announces the first lockdown ordering people to stay at home

⁃ 25 March: Coronavirus Act 0032020 gets Royal Assent

⁃ 26 March: lockdown measures come into force legally

⁃ 16 April: lockdown extended for at least 3 weeks, then conditionally lifted on 10 May

⁃ 23 June: relaxing of restrictions with 2 m social distancing after reopening of services

⁃ 14 September: extension of rules with ‘rule of 6’ gatherings allowing only six people

2. Phase 2: 22 September 2020 – 05 January 2021

⁃ 22 September: new restriction on with the onset of 2^nd wave by the 25 September

⁃ 31 October: second lockdown to prevent a ‘medical and moral disaster’ for the NHS

⁃ 05 November: lockdown in force until January 2021 with Tier 3 and four restrictions

3. Phase 3: 06 January 2021– 31 March 2021

⁃ 06 January: third national lockdown to be lifted on 22 February, leading to various stages of reopening with Step 1 ending end of March

The Guardian London is the first choice because it is the most read and trusted quality newspaper in the UK (Ofcom, 2020, 2023) with a very high circulation which has, arguably, significant authority in matters of public trust. The Daily Mirror, a tabloid, is the second newspaper in the sampling. Given that Covid scepticism has been associated with political conservatism (Latkin et al., 2021) and far-right attitudes (Küppers and Reiser, 2022) the two most left-leaning newspapers (YouGov, 2017) were chosen. Further, a cursory read of the most conservative newspaper, The Daily Mail, reveals a different tone focusing on lockdown fatigue and its crippling nature on the economy rather than on sceptical individuals.

The examined literature and the cursory read of the ubiquitous Covid-related news (e.g. concerns about misinformation) informed the following search terms on Lexis+: (conspiracy theor* or misinformation or anti-science or denier or sceptic or skeptic or anti-mask or anti-lockdown or anti-vaccination or anti-vax) and (Covid or Coronavirus) and (UK or England) and not (business live or briefing or China or Africa or US or Europe or Australia or sport or technology or business). The first bracket uses terms that are used as labels, as adjectives to assign attributes to those who are thereby socially categorised. Searching for these terms in The Guardian was confined to the periods of policy initiatives noted above:

1. Phase 1 (1^st lockdown): 49 relevant articles from a sample of 221

2. Phase 2 (2^nd lockdown & onset of a new wave): 40 from a sample of 124

3. Phase 3 (3^rd & final lockdown - start of restriction easing): 51 from a sample of 131

Excluded articles mentioned Covid and England but not any of the labels, i.e. sceptic. A further read of the headline and the context in which the search terms appeared (e.g. conspiracy theorists about Covid rather than in general) narrowed down the sample to those relevant for the study. Items such as community callouts or international news about world leaders’ handling of the pandemic were further excluded. The final sampling is: Phase 1 (n = 12); Phase 2 (n = 20); Phase 3 (n = 23). The same method was used to search for Mirror articles, which tended to be much shorter in length; these were checked online to ascertain they were not truncated stories and, when required, a fuller story was obtained from the online version on mirror.co.uk or pressreader.com. This time, there were duplicates manually narrowed down for relevant articles.

1. Phase 1: 22 relevant articles from 171 with duplicates

2. Phase 2: 32 from 113 with duplicates

3. Phase 3: 34 from 96 with duplicates

Further shortlisting as above, in light of the headline and the context in which the search terms appeared in the full article, led to a final sampling: Phase 1 (n = 14); Phase 2 (n = 19); Phase 3 (n = 17).

Analytic strategy – framing theory

The author analysed articles in the final samples of each phase employing line-by-line inductive coding of qualitatively meaningful units (Chenail, 2012) to extract ‘in vivo codes’ (Glaser et al., 1967) without a priori deductive assumptions about the function of codes (see supplementary file). Thereafter, themes were extracted drawing from Braun and Clarke’s (2006) 6-step method: 1) Familiarization of the data through multiple reads and initial memos; 2) Generating initial codes systematically collating data relevant to each code; 3) Searching for themes by collating codes with similar messages into potential themes; 4) Reviewing themes to check if they reflect the coded extracts and the entire data set composing that theme; 5) Naming themes to capture the overall message from constituent codes; 6) Final analysis of selected extracts, relating back to the study aims. Coding was based on ‘what the story is about’.

To ensure intra-coder reliability, data were coded multiple times with days in between until coding saturation; i.e., until the same codes were extracted consistently at different coding points and until repeated review of the data did not yield any linguistic elements belonging to identified codes in the context of the present study. The author prefers this option because it enhances reflexivity (Joffe and Yardley, 2003) and consistency in ways the inter-coder approach does not because it relies on reflexive discussions between coders in an attempt to reach an agreement, which would oversimplify coding (Morse, 1997). Coding is contextual: it occurs within the parameters of the reviewed literature and study aims. To achieve inter-coder reliability, the researcher would need to contextualise the data to inter-coders which is akin to teaching them how to code like the lead researcher.

Themes were inductively extracted by studying the composing codes; themes are those noteworthy connections in the data that address core aspects of the research aims (Kiger and Varpio, 2020). In this case, the aim was to investigate which repetitive patterns in the data, both manifest and latent, illuminate how labels were used to categorise citizens and in turn construct or frame a social problem of concern. For clarity, framing is the broad packaging device of constructing a story whereas a theme is the specific detail that helps build a frame. Thus, the thematic analysis helps identify a) the linguistic elements of a frame and b) the function of a frame. Firstly, a news frame can be measured by analysing the selection and placement of specific words (Entman, 1993) and its linguistic elements such as syntax, script and theme (Pan and Kosicki, 1993). Secondly, the function of a frame can be identified by the selection and salience designed to promote ‘a particular problem definition, causal interpretation, moral evaluation, and/or treatment recommendation’ (Entman, 1993: 52); i.e., a frame defines a problem by identifying the actions of a causal agent and associated costs; diagnoses causes by identifying who is creating the problem; makes moral judgments by evaluating causal agents and their effects; and suggests remedies/sanctions. Linguistic elements (e.g. syntax, semantics) were grouped within an article and between articles of the same time period (e.g. Phase1) systematically so that themes (components of a frame) emerged naturally with no a priori expectations. Thereafter, the function of the emerging frames was examined if it defined, diagnosed, made moral judgment or suggested remedies.

Analysis

This section explores the dominant news frames across the 3 phases, with excerpts as examples of the syntax, semantics, theme or rhetoric that functioned as frame elements to define what the story or ‘controversy’ (Gamson and Modigliani, 1987) is about. The frames are not artificially rooted in one phase but are instead overlapping, demonstrating the use of framing analysis in discerning editorial choices made in telling a particular issue within specific lenses. Studying the labels that help construct broad frames about this public health issue enlightens the values that were attached to these labels in the context of broader sociopolitical and public health issues. The emergent frames are: i) the perils of misinformation; ii) scepticism is politically oriented; iii) not all sceptics are deviant, as shown in Table 1 below.

Table 1.

Key themes and frames.

	Codes categories	Themes	Frames
Phase 1	1. Anti-mask sceptic	Theme 1: Noncompliance	The perils of misinformation: Noncompliance & risk to public health
	2. Anti-lockdown sceptic
	3. Anti-vax sceptic
	4. Sceptic (heightened by misinformation)
	1. Conspiracy theorists (i.e. misinformation)	Theme 2: Public distrust
	2. Misinformation (harms through social media)	Theme 2: Public distrust
Phase 2	1. Misinformation (about vaccine)	Theme 2: Public distrust	Scepticism is politically oriented
	2. Conspiracy theorists (i.e. misinformation)
	3. Sceptic (about speed of vaccine availability)
	4. Anti-vax (due to misinformation & scepticism)
	1. Anti-lockdown sceptics: Sanctions & politics	Theme 3: Sceptics & politics
Phase 3	1. Anti-lockdown: Sanctions, politics & rebellion	Theme 3: Sceptics & politics	Not all sceptics are deviant
	1. Anti-vax (due to misinformation)	Theme 4: Legitimate sceptics
	2. Conspiracy theorists (i.e. misinformation)
	3. Misinformation (but scepticism is legitimate)
	4. Sceptic (legitimate institutional mistrust)

Phase 1: The perils of misinformation

The first lockdown made entire populations subject to laws that restricted movement, introducing them to unprecedented control in liberal democracies (Thomson and Ip, 2020). Naturally, such deprivations of liberty during peacetime led to protest against the lockdown and other restrictive measures. Both newspapers reported on the ‘Covid sceptic’: those who were sceptical either about the existence or seriousness of the pandemic or the scale of the preventative measures, calling it a ‘hoax’ and a ‘scam’. Some even challenged for government scientific advisers to be sacked. Scepticism was manifested in noncompliant behaviours described as anti-mask, anti-vax, and anti-lockdown, with the latter receiving sanctions for protesting restrictions. The following are illustrative examples (headline underlined):

Thousands clash with cops at antivax demo; officers made 32 arrests among the crowd furious at…plans for coronavirus vaccines; banners called for government scientific advisers to be sacked and declared COVID-19 a hoax (Mirror, 20 September 2020)

More than 30 arrested during coronavirus protests in London; police have made 32 arrests during a demonstration…against coronavirus restrictions; more than a thousand people [at] the rally…among them…coronavirus sceptics; protesters airing grievances ranging from opposition to coronavirus lockdown measures and masks (Guardian, 19 September 2020)

Mistrust in authorities by some sections of the public was diagnosed to have been caused or exacerbated by conspiracy theories – an example of misinformation and its perils because the narratives are untrue. Misinformation refers to the incorrect beliefs people hold as fact (Kuklinski et al., 2000) which may be false, inaccurate or misleading information but can also be accurate information out of context (Treen et al., 2020). Disinformation is misinformation with intent to deceive. Of great concern in the coverage was the scale of the harm because misinformation was disseminated by those with wide reach for traditional media to compete:

Battling coronavirus misinformation in the age of social media - Myths and falsehoods spreading; health professionals [are] battling a wave of misinformation [during a] health crisis of the smartphone era; half-truths…already going viral; makes it hard to track the spread of such material…circumventing the official health communications (Guardian, 3 March 2020)

Indeed, misinformation on social media has managed to overshadow official public health communication (Romer and Jamieson, 2020) which is seen as fertile ground for sceptics and conspiracy theorists to assemble. As restrictions were easing with a 2m social distancing rule, the reopening of services, and the ‘rule of 6’ people gatherings, dissent to social distancing and masking rules was categorised as the behaviour of conspiracists, resulting in heavily policed anti-lockdown protests:

Piers Corbyn fined £10,000 for organising anti-lockdown rally; it drew a broad coalition of protesters from across the country from [the] so-called antivax and advocates of 5G and QAnon conspiracy theories (Guardian, 30 August 2020)

These labels are designed to reconfigure and socially categorise those who comply with public health strategies from those who do not, diagnosing the latter to be sceptics who consume conspiracy theories with no distinctions made between those who may be asking questions about unprecedented health matters or seeking clearer information, from those who were refusing to accept the pandemic existed. Ultimately, the implication of misinformation is risk to public health management because of institutional distrust and noncompliance. The print press, in particular broadsheets like Guardian, have the power to set the political agenda magnified by television news, which is the most important source for news for 75% of UK citizens (Ofcom, 2020). Almost a third of television news items derive from newspapers, doubling when discussed in bulletins (Cushion et al., 2015). Newspapers are opinion-leaders (Vliegenthart and Walgrave, 2008) and the emerging news frames in this analysis should be understood within the intermedia agenda-setting landscape.

Phase 2: Scepticism is politically oriented

By this stage, the second lockdown had come into effect as did the onset of a second wave. With the easing of the first lockdown and fewer restrictions, infections resurged giving rise to ‘the second wave’, making lockdown compulsory and subject to sanctions if breached. The ensuing coverage reported the various anti-lockdown protests across the country which were heavily policed and fined, placing this type of scepticism within a wider political game:

Nigel Farage and his allies in a low-key anti-lockdown protest…a fresh attempt to restore their political relevance; a belief that “the opposition won’t do any better”, and that the second lockdown was an overreaction; …hope to occupy a political space until now dominated by a few rebel Conservatives [and] conspiracy theorists; a mushrooming of anti-lockdown groups…often linked to radical or far-right sentiment or conspiracy topics, antivax or anti-5G (Guardian, 8 November 2020)

The Brexit party has applied to the Electoral Commission to change its name to Reform UK in a bid to rebrand the party, which has no elected representatives, as a voice in the anti-lockdown movement (Guardian, 2 November 2020)

Tier Chaos; around 100 MPs have joined the lockdown-sceptic Covid Recovery Group and many could rebel…having demanded on the lockdown's economic impact (Mirror, 30 November 2020)

Some of the protest organisers were concerned about civil liberties and whether the restrictions were effective. Attaching scepticism to senior leaders of the Conservative Tory party signalled that it was politically oriented and motivated. Linking a label to public figures is a useful ‘discursive mechanism in the media in order to draw attention and popularize courses of events’ (Höijer, 2011). It was also during this stage that Covid sceptics questioned the legitimacy of further restrictions and the speed at which the vaccine was developed and approved. Whilst these were not necessarily anti-vax campaigners peddling misinformation, their doubts were characterised as hindrance to vital public health advice because they will either give comfort to conspiracy theorists or are the manifestations of conspiracies. The persistent concerns over the perils of misinformation highlight the framing of these behaviours as threats to safety and the wider public health:

The spread of scepticism and misinformation about coronavirus and the development of a vaccine for it has raised questions about whether it will pose a threat to the goal of achieving widespread immunity (Guardian, 10 November 2020)

An emerging minor theme that dominates in the next phase is that of scepticism in the context of race: when sceptics were from ethnic minority communities, their doubts were legitimised because it was due to lack of information or clarity thereof rather than malicious peddling of misinformation or politically motivated protests. Clear and reliable information would change their behaviour:

People from minority ethnic backgrounds are less likely to take the coronavirus vaccine; however, …35% said they were likely to change their minds and get the jab if their GP gave them more information, compared with 18% of white people (Guardian, 16 December 2020)

…misunderstandings about the Pfizer vaccine…caused in part by poor communication from public health bodies (Mirror, 15 December 15 2020)

Black and Asian people bottom of Tory priorities; the people I know are not anti-vaxxers. They are not seduced by wild conspiracy theories on the internet; their concerns, however, are around history. Their real-world experiences (Mirror, 8 December 2020)

Ultimately, when the same issue (scepticism) is framed differently using labels to distinguish between types of sceptics according to political affiliation, it tends to lead to calls for punitive outcomes. As Mirror put it: ‘Laws need to be introduced to stop anti-vaccination campaigners spreading “disinformation” Labour has warned’ (15 November 2020).

Final phase: Not all sceptics are deviant

Whilst previously explored themes emerged again (anti-lockdown protests, political affiliation, and protest sanctions; conspiracy theorists and misinformation about Covid and the vaccine) ‘legitimate scepticism’ amongst minority communities was the dominant frame in this phase. The socio-political assistance minorities would receive to tackle hesitancy was welcome:

The government will provide £23m in funding to dozens of councils in England to help fight misinformation around coronavirus vaccines and to encourage uptake of the jab among more high-risk communities; a number of experts and politicians recently called for people in high-risk minority ethnic groups to be prioritised for immunisation, and for them to be targeted by publicity campaigns aimed at tackling vaccine scepticism (Guardian, 25 January 2021)

celebrities [] have joined forces to counter coronavirus vaccine misinformation in ethnic minority communities [because they were] being targeted by campaigners spreading anti-vaccine propaganda (Guardian, 25 January 2021)

Stars…are urging ethnic minorities to take the Covid vaccine when offered. A moving five-minute video launched this week aims to debunk vaccination myths which are feared could hamper roll out among minority communities (Mirror, 28 January 2021)

This community’s scepticism was justifiable because of the historical racial discrimination and ensuing institutional mistrust in public services like the National Health Service. In stark contrast, a different group of Covid sceptics were framed as right-wing, ‘subterranean’ and ‘peripheral’ creatures, rather than potentially also victims of misinformation in need of better public health communication or assistance:

The lockdown sceptics, it seems, are in abeyance; bursts of dissent about restrictions and the truth of the virus itself will doubtless continue, as proved by the awful spectacle of those people…seemingly dragged from the subterranean depths of social media into the everyday world, chanting “Covid is a hoax!” (Guardian, 10 January 2021)

Libertarian, anti-lockdown views that are peripheral to mainstream opinion. Not for the first time, the frame of a national debate has been skewed by small, well-amplified right-wing faction with disproportionate leverage over a Tory prime minister (Guardian, 17 February 2021)

Infections, hospitalisations and deaths wouldn't be falling if this ideologically deranged mob had its way. When they make Right-whinger Raab [] sound momentarily reasonable, you know they're really off the scale (Mirror, 15 February 2021)

Though a matter of public health, these labels have not existed in a socio-political vacuum. Whether there was compliance with official preventative measures depended, as it was framed, on political affiliation and harmful scepticism. Such exclusionary labels lead to institutional mistrust and noncompliance with disease management (Myrik and Chen, 2021; Fisk, 2021). Undoubtedly, heroes and villains will emerge. If scepticism was considered justified, there was a case of not so much ‘reintegrative shaming’ (Braithwaite, 1989) as ‘reintegrative informing’.

Discussion

Labelling and framing

It is crucial to study how a serious public health issue can be used to reconfigure various population groups into conformist and deviant categories. These have punitive policy implications that are ultimately designed to control behaviors deemed undesirable by elected and unelected moral entrepreneurs. The examined themes illustrate that a public health issue was framed within a political lens that identified those with sceptical views as threats to the health and safety of citizens conforming to disease prevention strategies. Noncompliance was organised within 3 main news frames which intersected public health with politics.

The dangers of misinformation were ultimately manifesting in various noncompliant behaviours identified by these labels: anti-maskers, anti-lockdown protesters and anti-vax conspiracy theorists. That they may have been seeking more information or clarification about a new and unprecedent phenomenon was not considered. Where there is no conformity with mainstream policies, the degree of scepticism is irrelevant dismissing the entire group as ‘deniers’ (Jaspal and Nerlich, 2023) or in this case conspiracy theorists. Nuance depended on the population group not on the (same) noncompliant behaviour; i.e. sceptics from ethnic minorities were not afflicted by extremist political views, but seeking more information. The political nature of this pandemic was a key element of the second frame: scepticism is politically oriented. Those who were right-leaning were characterised as conspiracy theorists with leaders who use noncompliance movements as political platforms of relevance or revival. In contrast, ethnic minority groups may be justified in their scepticism because of poor public health communication. The implication was that the conspiracies of the former group pose a threat to population health or, as Jaspal and Nerlich (2023) put it, ‘our’ safety. The third frame makes it clear that not all sceptics are deviant. Overlapping with themes of the earlier phase, it demonstrates that not only is Covid scepticism associated with right-leaning political ideology but also, sceptics differ in their moral value. As such, some deserve assistance and guidance from cultural and political leaders while others, the conspiracists in ‘subterranean depths’ and ‘peripheral’ to the mainstream ought to be subject to restrictive and punitive sanctions.

As Kahneman and Tversky (1984) illustrate, a different presentation of the same issue can lead to different outcomes because perception is ‘reference dependent’ (Kahneman, 2003: 459) and relies on how information is presented. This study is illustrative of the potency of equivalence framing: the harms of misinformation by any sceptic are logically equivalent in their impact on public health, but phrased differently in terms of deviant and legitimate sceptics, the same issue is framed differently to create binary narratives of compliance with different policy outcomes. In doing so, the collective function of these frames was to: define the problem of ‘misinformation’, diagnose the causes of this problem by identifying a specific group of noncompliant right-leaning sceptics and conspiracists, make moral judgments by evaluating the effects of misinformation and its associated harms for public health safety, and suggest remedies/sanctions against some in the form of sanctions, stigmatising labels, and exclusion from political discourse.

Media claims-making

Drawing from Spector and Kitsuse’s four-stage model, this section explores how the examined frames were used to construct the social problem of ‘noncompliance in the age of misinformation’. Representations of those who do not comply with Covid policies have generally focused on threat, blame, and burden leading to their stigmatisation and marginalisation (Nerlich and Jaspal, 2021). In Stage 1 of its claims making activity, the examined newspapers demonstrate active participation in how this issue was constructed by adopting the views of certain primary claims-makers and news sources over others, creating labels to categorize new groups of deviants to establish order. Key primary claims-makers include the government minister for vaccine deployment, the chief executive of the Race Equality Foundation, the opposition Labour party leader, various medical personnel and researchers, and police. Claims-makers such as Tory leaders and MPs were also used as sources but their views dismissed or caricatured.

The press was assigning blame to some citizens for hindering national public health goals. Blame involves a set of responses to ‘morally faulty actions’ which modifies the relationship with those blamed because there is a ‘moral relationship’ as citizens even if there is no personal element (Scanlon, 2013: 84–86). It enabled the politicization of a biological vector of disease when the expected Covid etiquette was absent or questioned. Having constructed the problem of scepticism and noncompliance as posing a threat to public health (Stage 1), officials responded (Stage 2) by introducing policing powers and penalties to control these behaviors which were not stringent enough (Stage 3) because they were not sufficient to control other types of threat, such as anti-vaxxers, requiring more restrictive measures (Stage 4) in the form of policing the cyberspace but also social ostracization and exclusion from political discourse with labels such as ‘conspiracy theorists’. Scepticism by right-leaning citizens became the requisite information in the categorization of a group subject to moral evaluation because various assumptions were made about group homogeneity that manifested in more complicated group dynamics than anticipated.

The reality is that most people tend to dismiss mis/disinformation or conspiratorial messaging and are instead more confused by the inconsistent messaging from government officials about emerging new rules and media miscommunication about the true impact of the pandemic or the uncritical reporting of official claims without scrutiny (Kyriakidou et al., 2020; Nielsen et al., 2020). Indeed, a UK Parliament report (2020) reveals the concerns of over 1100 experts over inaccurate reporting by the mainstream media or a dilution of official messages which were already conflicting and unclear. When health, media and government institutions cannot cohere on messaging, it raises questions about what role citizens should play in preventing disease transmission. Perhaps members of the media could consider employing some epistemic humility, particularly when they engage in market driven coverage biased toward their main audiences now in a position to, as Lasica (2001) argues, decide what is valuable and newsworthy. In such a terrain, ‘people will not develop any common fund of knowledge’ because they cannot ‘engage in civic talk [as] they will have nothing to say to each other’ (Baker, 1998: 365). A media industry that caters to its partisan audience by excluding undesirable information to its consumer base so as to maximise its profits (Bernhardt et al., 2008) raises questions about journalistic ethics, public perception of serious social problems and, in matters of public health, the extent of compliance with disease preventative measures.

Significance of the study

This is the first study of media representation drawing from labelling theory and claims-making over the longest period to date, providing insight into the politicised coverage of a pandemic by the two most left-leaning newspapers in the UK. Using methodologies such as framing and thematic analysis, and drawing from two theoretical frameworks, the study offers a unique start for academic scrutiny of an under-researched area pertaining to the implications of politically charged public health communication, labelling, and claims-making. Conducting thematic alongside framing analysis, which is a form of critical discourse analysis, makes the methodological approach thematic discourse analysis within a social constructionist epistemology. Further, the study adds to research that calls for the differentiation between emphasis versus equivalency framing (Cacciatore et al., 2016) by drawing from both approaches (by Kahneman and Entman) to examine news framing using specific labels to shape outcomes. Importantly, it shows that equivalence-based framing analysis needn’t solely be quantitative in the Kahneman tradition, which limits the approach, because how the same issue is used for different messaging can also be achieved qualitatively in studying framing techniques.

Further analyses with more newspapers across the country and the western liberal democratic world (given their shared political ideologies about civil liberties) would offer more insight, although given the politicised nature of this issue, it may be that it leads to data saturation with no meaningfully different frames in depicting sceptics. This is also why data collection was limited to the end of Step 1 of the easing of restrictions by 31 March 2021, because with further easing till the end of July, by which point most legal limits on social contact were removed and the final sectors of the economy reopened (e.g. nightclubs), most noncompliant behaviour would be redundant and the ensuing coverage will likely not reveal qualitatively different news frames than the ones explored here. This study merely provides a snapshot of the nature of politicised public health representation because what is reported in newspapers is amplified in television news, radio programmes and other means of public communication, and these could be subjects of future studies.

Conclusion

Members of the left leaning press - The Guardian and The Mirror - did not present a balanced representation of the public’s concerns, misunderstandings, and debates which has implications for effective public health communication aiming to prevent the spread of a disease. It would not be surprising if this resulted in mistrust of institutions (Fisk, 2021) and dissuade citizens even further, undermining disease preventative measures (Duan et al., 2020; Myrick and Chen, 2021) in a hegemonic media landscape. It reflects the state of modern journalism, tailoring information according to the ideological bent of their audiences. This matters as infections may spike seasonally, new strains develop leading to new waves, or should other epidemics and pandemics arise.

It is through the media, not government or health officials, that public perception and behavior is influenced in matters of a global health crisis (or any other social problem of concern). An inclusive media landscape with an epistemically modest press may prove useful in matters of compliance to disease prevention methods, particularly if these methods involve some concession of civil liberties.

Supplemental Material

Supplemental Material - The print press and its politicization of public health: The case of COVID-19

Supplemental Material for Supplemental Material - The print press and its politicization of public health: The case of Covid-19 by Meron Wondemaghen in Journalism

Footnotes

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Meron Wondemaghen

Supplemental Material

Supplemental material for this article is available online.

Author biography

Dr Wondemaghen is a Senior Lecturer in Criminology at the University of Hull. Wondemaghen is a multidisciplinary researcher and draws from Criminology, Criminal Law, Mental Health Law, Psychiatry, and Media Studies. Her research includes examining the policing of mentally ill persons in public spaces, the criteria of criminal responsibility for mentally ill offenders, and media framing of social issues including crime and mental illness. Wondemaghen is a heavy consumer of cinema, in particular the crime, thriller & espionage genres and has previously commented on the portrayal of mental or personality disorder in critically acclaimed TV shows such as ‘Breaking Bad’ and ‘Homeland'.

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