Public health and risk communication : the experience of the severe acute respiratory syndrome (SARS) epidemic and the swine influenza pandemic

Abstract

This study aims at enhancing the understanding of public health and risk communication through linguistic investigations of the use of modality to express risk and uncertainty in the discourses of the 2003 severe acute respiratory syndrome (SARS) epidemic and the 2009 swine influenza pandemic. The two incidents are both major public health threats confronting the world in the 21st century. The discourses of these two events are chosen in this study because the events exemplify serious public health threats: the disease causative agents - the SARS coronavirus and the influenza A (H1N1) were of novel nature; and in the initial periods of the disease outbreaks, there were no treatments and no vaccines available. These properties of the events are also observed in other public health threats, such as the Ebola outbreak in 2014, the Middle East Respiratory Syndrome (MERS) outbreak in Middle East and the Republic of Korea in 2015, and the recent Zika virus in 2016. The attributes of risk and uncertainty inherent to the discourses of these diseases pose an enormous challenge to public health authorities in terms of public health and risk communication on the nature of diseases, which is crucial for control of disease transmission and containment. As pointed out by the World Health Organization (2003b) , it is important to learn from the past and shape future strategies against subsequent infectious epidemics, and this study attempts to contribute with a linguistic approach. The linguistic resource of modality enables a writer/speaker to convey different degrees of certainty, and to express his/her stance or opinion or commitment to the truth of his/her proposition (Davidse & Simon-Vandenbergen, 2008; Halliday, 1994; Huddleston & Pullman, 2002). In the theories of systemic functional linguistics, Halliday (1994) takes the idea that polarity is a choice between 'yes' and 'no' and modality is various kind of intermediate degrees between the positive and negative poles. The indeterminacy on modality implies that the status of what is being said depends on the speaker's judgment or requests the judgment of the listener. Accordingly, the study derives a framework of systemic functional approach to modality for analyzing different level of certainty presented in the two incidents. The data set is a collection of approximately 217,000 words from a variety of sources including press updates and conferences held by the World Health Organization, newspaper reports and websites information concerning the 2003 SARS epidemic and the 2009 swine influenza pandemic. The texts were analyzed at the clause level, referring to the analytical framework modality, in terms of type of assessment, value, manifestation and orientation (Argamon, Whitelaw, Chase, Hota, Garg & Levitan, 2007; Halliday & Matthiessen, 2014). The analysis has identified the variety of levels and types of modality, including modal adjuncts, finite modals, interpersonal metaphors presented in projecting clauses presenting modality in the discourses of the two events. These linguistic features identified constitute the properties of risk and uncertainty communication in the discourses of the two public health threats. Results indicate that probability is the major type of modality presented in the discourses of the SARS epidemic and the swine influenza pandemic selected for the study. The SARS epidemic and the swine influenza pandemic have provided a good ground for studying issues of risk and uncertainty from a linguistic perspective. The detailed linguistic analysis shows how risk messages were conveyed to the public, in particular the language used to present risk and uncertainty. The study is practically valuable to public health authorities in the development of effective tools for better pandemic preparedness planning for credible communication to mitigate the impact in subsequent disease epidemics and pandemics. The study also theoretically adds to the body of knowledge and explores the theoretical contributions to current debates on modality, the discourses of public health and risk communication, with the framework of systemic functional linguistics.