“The internet proved to be an invaluable tool for concerned citizens to use in challenging government secrecy,” Loh and her co-authors wrote.
Gabriel Leung, Hong Kong’s former undersecretary for food and health, says the SARS experience helped convince Hong Kong authorities of the need to be transparent with the public about the knowns and unknowns of an outbreak as it unfolds—well before a website such as sosick.org might challenge the government’s credibility. He applied the lesson during the city’s response to its next major public health emergency: an outbreak of H1N1, a deadly respiratory virus known as swine flu.
Swine flu was discovered in April 2009 in the USA, and at the time outbreaks had not been known to occur among humans. But as H1N1 quickly spread to Canada and Mexico, WHO declared it a Public Health Emergency of International Concern, and health officials on other continents braced themselves for its arrival.
It landed in Hong Kong in May 2009, when a 25-year-old Mexican tourist fell ill with swine flu in his hotel. Within hours, health officials had quarantined all of the hotel’s guests and deployed Leung to television stations to explain the rationale for a decision that was certain to make Hong Kong residents deeply anxious.
Internet-fuelled rumors about the disease proliferated, but Leung says he mostly stayed ahead of them by explaining the knowns and unknowns of the disease at daily press briefings, and by promising to show up every afternoon at the same time for as long as reporters had questions.
“So long as you keep your promise, people will not be susceptible, or as susceptible, to the rumor mill, because they know the maximum time they have to wait is 24 hours before you will come out and give the facts again,” he says.
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A daily press conference might have kept rumors and medical misinformation at bay during a health scare in the mid-2000s. But today, when fresh social media trends go viral every few minutes, a 24-hour information cycle can feel like an eternity. It can also challenge any official narrative that a health ministry tries to promote.
“Rumor mills will always be there … and social media by and large fuels that,” says Leung, now the dean of medicine at the University of Hong Kong’s School of Public Health. “It’s not all negative, but social media is fast, it’s furious.”
Swine flu, which killed between 150,000 and 575,000 people, was—according to a 2010 study in the journal PLOS ONE—the first global pandemic to occur in the age of Web 2.0, an era defined by ‘participatory’ web and social media. Since then, the dominance of social media has only increased, which has intensified the need for health officials to develop rapid online responses during health scares.
The challenge is now especially stark in countries, like Vietnam, where millions of people are flocking to Facebook or Twitter for the first time but health authorities are only just developing an online presence.