COVID-19 information and misinformation

Meeting report

Opening remarks by Chairperson
The Chairperson said the meeting would focus on how to combat fake news and misinformation. In an age where information is shared rapidly, there was a fertile ground for fake and misinformation. This could lead to disorientation amongst the populace. Credible and verified government- issued information assisted in raising awareness during a public health emergency. Misinformation threatened public health, especially since vaccine hesitancy had shown rising trends. She recalled that vaccine hesitancy and the now much-vaunted run on toilet paper, had led to unnecessary violence. Information sharing is critical in the relationship between government and citizens.

Western Cape Provincial Government (WCPG) briefing
In his opening remarks, Western Cape Premier Allan Winde said that the province’s Covid-19 task team had the use of an entire research component. These structures had been replicated at district and local government level. The coronavirus task team comprised of diverse participants from government, civil society and business. The weekly digital press conference presentations (digicons) had assisted with risk mitigation. The same provincial plan had underpinned responses to the taxi violence. He applauded Members from across the political spectrum who had supported the WCPG awareness messaging by communicating with their constituents.

The Committee was briefed by Dr Harry Malila, Director-General in the Department of the Premier and senior officials. They informed the Committee that the communication strategy had been informed by what had emanated from communities. The province had also set up weekly digital communications (digicoms) that assisted in raising awareness. Western Cape had used a dashboard to track the coronavirus.

Discussion
Mr R Mackenzie (DA) noted the challenges the authorities faced, given language and other barriers. In view of this, he wanted to ascertain if WCPG had a sense that the populace still preferred traditional communication methods. He asked if WCPG had considered the use of TikTok as a communication method especially to Cape Flats youths.

Mr Mackenzie asked if WCPG had been able to cut through the misinformation. He acknowledged that WCPG had done a lot to combat the spread of misinformation around the vaccine, yet scepticism remained.

During a previous site visit to Mitchell’s Plain, accompanied by a professor, they had interacted with school children. It became apparent that confusion and misunderstanding still had a foothold.

He asked if WCPG had plans afoot to have more experts conduct school visits as part of combating misinformation. This would provide learners with the opportunity to engage directly.

Mr Sayed indicated that his questions had been covered by Mr Mackenzie.

Mr P Marais (FF+) spoke about how one sells this idea of vaccination. He did not readily accept medical advice from non-medical practitioners. WCPG had used ordinary vaccinated civilians to drive an awareness campaign. You cannot use target intelligent people that way. He called for a provincial government sponsored debate between those medical practitioners for and against the vaccine. That would be much more effective than labelling those medical practitioners that are against it as fake news. The decision is the citizen's alone. Ordinary people receiving contradictory information from medical practitioners was at the heart of the hesitancy. They continue to receive contradictory messages from medical practitioners. In his view threats against the unvaccinated were uncalled for. His friend had contracted COVID-19 even after receiving the vaccine. His friend had also developed blood clots as a result of the vaccine. He asked what should he tell his friend.

Western Cape Premier response
Premier Winde agreed with Mr Mackenzie's concern about a one-size-fits-all approach, especially towards communication to combat the Covid-19 pandemic. This stance had informed the WCPG strategy which rested on flexibility and responsible messaging. His government had a “Hotspot Management System” (HMS) which was replicated at district and local government level.

When these various districts and local governments had reported back on their individual combat strategies, vastly different approaches had been found. The Committee heard that in the area of Du Noon, it had been established that video content had been the strategy or medium of choice.

The individual reports also highlighted the social media reach and impact of the various strategies. In another example he referenced the approach of West Coast municipalities that had opted for the loud hailing medium.

In the Overberg region, each municipality had their own dashboard that contained pertinent information such as how many residents had registered and how many had been vaccinated. As a result, the process had almost developed into a sort of competition between the various municipalities in that district with the stated aim to eradicate the pandemic in communities. The Overberg region had recorded a 90% vaccination rate for residents over 60.

Learners played a pivotal role in the transmission of information to their grandparents. He linked his response to comments by Mr Mackenzie.

On the comments and questions raised by Mr Marais about vaccine hesitancy and government strategies, the Premier added that it had become apparent that citizens had to feel part of a collective, with every citizen involved.

Premier Winde agreed that professors and doctors remained the best source of information on the pandemic. The communication strategy of WCPG had been informed by the advice from medical experts. He once again referred to the dashboard that contained all the relevant information and statistics tracking virus prevalence in communities.

He stressed that the digicons had focused extensively on the prevalence of fake news. They have Frequently Asked Questions on the website. Through research, authorities had established which areas had high hesitancy rates. Targeted interventions, such as collaborations with religious leaders, remained a top priority. He recalled the vaccination launch with a public service announcement by Archbishop Desmond Tutu on the need to combat the rapid spread of the virus.

He stressed that doctors are the best but they cannot be the only communicators on the pandemic. Citizens need to see their fellow citizens are doing this. These programmes look at why there is a hesitancy to vaccinate and address those reasons. According to healthcare data, the highest uptake of vaccines is doctors – he would be worried if doctors were hesitant but they are not.

He conceded that debates on the efficacy of Ivermectin and Dexamethasone for the treatment of coronavirus had not yet subsided. He had tried to initiate a second round of trials, however these plans had been shelved after the knowledge institutions had expressed their disapproval. These knowledge institutions included both universities as well as the medical fraternity. WCPG had tried all the available alternatives and championed transparency and openness, in dealing with the coronavirus response.

Dr Saadiq Kariem, Western Cape Acting Head of the Health Department, echoed the Premier’s comment about the WCPG response to misinformation that had emanated from registered medical practitioners. WCPG had reacted immediately to the video by Dr Susan Vosloo.

Follow up questions
Mr McKenzie noted that various retail stores had their own in-house radio stations. To what extent had WCPG engaged these retail stores on the need for partnership in transmitting government's coronavirus response to citizens.

Mr Sayed said the premier had alluded to some of the misinformation and myths about the vaccine, that had permeated South African society such as microchips being placed inside of vaccines, as well as some doctors that had denounced the vaccine. He commended WCPG’s coronavirus and vaccine administration response under the stewardship of Premier Winde.

He asked if there had been any deliberations on making vaccines mandatory since summer was fast approaching. He surmised that business premises where clients intended to frequent, would certainly have a vaccination policy. He requested the Premier provide clarity on mandatory vaccinations.

Mr Christians noted that the ACDP would fight government attempts at making vaccines mandatory. The President had promised that no citizen would be forced to get vaccinated. Mandatory vaccinations had not been authorised by WCPG and he took exception to what Mr Sayed had said.

Mr Sayed interrupted Mr Christians and raised a point of order.

The Chairperson acknowledged the point of order by Mr Sayed.

Mr Sayed stated that he had never said that vaccines had been made mandatory, and had only referred to possible communication scenarios. He apologised for the disruption but he had to intercede and provide clarity, given the public nature of such meetings.

Mr Christians proceeded with the line that President Ramaphosa had not authorised mandatory vaccinations and non-vaccinated people could still access public spaces and venues.

Mr Marais commended the premier and his team for their outstanding work in managing the virus, as well as the implementation of the vaccination programme in the Western Cape. He wanted to ascertain if the provincial focus had been on curative or preventative measures and the boundaries between these two probabilities.

On a recent shopping trip to a supermarket, he had noticed that some staff had not been wearing their face coverings in the correct manner. These staff members had been loud and interacted on a regular basis with customers so they should be properly attired with suitable PPE worn correctly. It had been common cause that supermarkets remained a big source of new infections. He added that it had been useless to inform people to be suitably attired with the necessary PPE when these rules are not enforced. He wanted to know what WCPG had done to address this problem.

He asked why Cape Talk Radio and Good Hope FM had not been included in communications.

Western Cape Premier response
The Premier noted that the Coronavirus vaccine had not been made mandatory. It remained a personal choice. He expressed his exasperation at unnecessary protest action against the vaccine especially bogus claims of children being forced to be vaccinated when it is not even open to children.

This is a tough conversation but it is an interesting debate. Discovery has made it mandatory for its staff to be vaccinated. The administration is having that discussion internally about what is the WCPG stance on making it mandatory for its staff. These remained internal discussions. Other countries had already instituted mandatory policies. He would like to see the use of an e-passport for international travel as the vaccine card is not good enough. He was pleased that there is a discussion at national level to institute the EVDS system linked as a QR code to one's mobile phone so one could travel. What is so different about this vaccine as opposed to say the yellow fever vaccine, which is mandatory if you wanted to travel abroad? Discussions about a mandatory policy had gained momentum in all spheres of society and businesses.

Incentives are important. Businesses had now started to offer incentives to their staff to cooperate.
Game Stores now gives a discount if you show your vaccine card. One needs to incentivise and to promote vaccination as we have to protect the economy and our frontline workers. He was strongly for vaccinations as he want to see stadiums fill up again. Just recently the Cape Town leg of the World Rugby Sevens Series in December, has been called off due to the low vaccination rate. This means millions in lost foreign currency and how many jobs shed as well. However, vaccination is a personal choice.

We also cannot police our way out of this such as sending police to fine people in shopping malls that are not wearing their mask properly. This is individual citizen responsibility. However, people do have mask fatigue now so let us move to vaccinations and get to the finish line to protect the economy and people and there are choices about masks.

The Western Cape was currently leading in the country's vaccination drive and he called on the Western Cape population to play their part to best support efforts by the provincial government.

He did not know the radio ad spend but he had been and continues to be a regular on Cape Town area radio stations. He had a regular weekly spot on Cape Talk where he reported straight after the digicon. Prof Kariem had been a regular on Cape Talk Radio and all the radio stations remained important partners for WCPG.

Radio Good Hope had its Breakfast Show at the drive-thru vaccination drive in Athlone this week. Smile FM had run competitions that required a vaccine and the most important aspect of all of these collaborations had been that the stations had been funding these activities themselves. WCPG needed all hands on deck to win this war and beat this virus.

Dr Malila stated that WCPG and the Coronavirus Task Team strategy had been informed by what had emanated from consultations with the community. Research campaigns had been conducted on why people chose not to get vaccinated and where these people resided thoughout the province. The task team had liaised with districts on communication methods. WCPG had received funding from Provincial Treasury for campaigns and several donations from the private sector had also been received.

Dr Malila said the annual report at the end of this month would indicate all of these relationships that had been made with WCPG which included input and donations such as telecommunications companies who provided free SMSes and calls. The participation of the private sector had assisted government in cost containment as well as lessening the financial burden on the public purse.

The Chairperson thanked the Premier and the team for the comprehensive presentation. She wished them well in the work going forward and for the joint communications strategy as well.

The Chairperson introduced the Covid-19 Actuaries Group which had devised very successful strategies and communication on the data analysis and information about the Coronavirus spread across the world.

Covid-19 Actuaries Group
Mr Stuart McDonald, Co-founder of the Group, gave an outline about the formation of the voluntary group and the activities and successes of the group since its inception 18 months ago. The Group comprised 16 members, four of whom are South African. The Group used research modelling and put the information into the public domain as they were concerned about the general complacency about the virus as it had identified the possible severity of the virus on the human population. It gathered together actuaries, epidemiologists and longevity specialists to speak out proactively rather than reactively and clear up mainstream media misunderstandings It looked at excess deaths as a metric; the reproduction number using death and hospitalisations rather than a softer measure as number of cases; evidence about future waves and provided realistic death projections. It aimed to inform the objective truth about the pandemic. The media were useful in promoting the correct actuarial data to combat the misinformation. The Group was useful in vanquishing early sceptics of a true crisis. The benefits of vaccines were tracked and the mathematics simplified to help people understand that unvaccinated people were 10 times more likely to be hospitalised and to die.

Mr Louis Rossouw, Group Head of Research and Analytics, gave the South African perspective about the early lockdown, younger deaths, the fragile economy, numbers and projections. Data warehouses were set up which will be useful in the future. It provided guidance on how to approach emergent variants in risk mitigation. He also spoke about vaccine equity - saving 11 times more lives by sending vaccines to low-income African countries rather than using the vaccines as a booster in high income countries.

Discussion
Mr McKenzie said that the presentation was insightful and he asked if any modelling had been done on the future of the Covid-19 virus and when society would be able to return to normality. He pointed to the interesting facts about the mortality rate and asked if that rate would be impacted in the long-term by Covid-19.

The Chairperson said there had been quite a lot of recent chatter on social media about the emergence of the C.1.2 variant in South Africa. This was testament to excellent work by very competent and skilled South African genome scientists who were quick to identify the variant. However, the misunderstanding then arises that the variant emanated from here instead of spreading to South Africa. That leads to South Africa getting red-listed without recognition of its competency in genome identification.

Response
On mortality rates being influenced by the coronavirus, Mr MacDonald replied that this specific subject matter remained an area of interest for the Group as the coronavirus moves from a pandemic to an endemic state. As with other viruses, the coronavirus is not going to go away but will remain and blight us such as the cold and flu. Several of these viruses live in tropical areas and bounce to cold environment. One effective mechanism to deal with this would be the development of the vaccine and the necessary adjustments as it mutates. The future of mankind could be influenced by regular boosters for high-risk groups.
The coronavirus mutates less rapidly than the flu virus although it seems the immunity wanes more quickly and that this prompted discussions on the need for frequent boosters.

Once we reach the endemic stage with a combination of booster shots and public awareness, we might not be fully back to normal so authorities might decide it is sensible that masks should be worn on public transport, regular hygiene such as washing hands and reschedule certain mass events from winter to summer months. He did think we will see changes to our lives.

On the mortality rate being affected long-term by Covid-19. Death rates had fallen a lot in the past. In the short term, it would affect the mortality rate but he did not believe that in the long-term the mortality rate would be affected. A lot had been learnt from the waves of the coronavirus. It had eradicated the flu from the behaviour change which means far fewer flu deaths. There will be behaviour change. The public health measures had been moderately successful and behavioural change would be a necessary outcome to counter the long-term effects of Covid-19 and possible future waves. However, for the next few years, life expectancy might decline.

Mr Louis Rossouw, Group Head of Research and Analytics, said that he had written a piece on the alpha and beta variants when they emerged, and in that particular article he had spoken about genome surveillance. South Africa had excellent researchers, hence the country’s ability to identify the variants. Some articles centred around the hype rather than using reasonable caution. They try to deal with the disinformation as best they can. The Group had not been successful in combating disinformation. However, you get two types of disinformation: the sceptics and the alarmists. Whenever alarmists had been identified, the Group engaged with them saying it is not that bad. Rather than focusing on the extremes, we suggest they look at the uncertainty around those assumptions. There is potential for downside but there is also potential for marginal downside. It is difficult as a small volunteer group to battle against big media but there has been some successes.

Covid-19 Social Media Influencers
Dr Ridhwaan Suliman, Senior Researcher at Council for Industrial and Scientific Research (CSIR), spoke in his personal capacity about his experience engaging on tracking and communicating about Covid-19 trends on Twitter on @rid1tweets. This was to share analysis and trends but also to engage and receive information. He believed in using data to counteract fear, uncertainty, misinformation and conspiracy theories. He does not see himself as a social media influencer but using his applied mathematics knowledge to promote simple and clear accurate and unbiased messaging about the pandemic was critical by using clear graphs to visualise this. Being open and honest is critical. There are lot of reliable sources available. He mentioned the Western Cape dashboard as a very useful tool. A consistent public dashboard across indicators is appreciated.

Lessons learnt are to keep the messaging clear and simple; consistent and accurate reporting is paramount. Understanding the limitations of reporting using only case numbers – reporting test positivity rates is important. The general public at large should have regular access to government data. Seven-day numbers are better than daily to show trends. Treat the public as adults – you will get better buy-in and they gain agency to make informed decisions.

Mr Sugan Naidoo, High School Teacher and Twitter User on @sugan2503, said that at first it had been difficult to collate information as he had to conduct it manually as it did not show new cases and new deaths but only totals. This had led to frustration. All the information is there with government but it should be made readily available. This information should be centrally managed by a forum that collates and publishes all data. Being a teacher he understands how people view data and how one can overwhelm your audience with too much data and have them lose interest. Yet if there is not enough data you will not inform them sufficiently. He felt that his teacher experience influenced how he presented the data. He spoke about needing patience and compared the trolls to naughty school kids at the back of the class who want attention. He just ignores them.

Discussion
Mr McKenzie asked what legislators can do to make this government data more available. What is missing from the education system that needs funding so we get more technical experts out of the system.

Ms Wenger asked how long it takes them to put these tables and graphs together each day over two years and testimony to your resilience to continue with this as a public service.

Responses
Dr Suliman replied that the more data we have, the better. Provincial test numbers shared on a daily basis would be useful. The Western Cape made these statistics available via the provincial dashboard but it needs to be done for each province. He suggested reporting data by specimen date rather than reporting date is useful in understanding trends such as testing and Covid-19 deaths. Behind the graphics of the dashboard, to have the data downloadable would be useful.

On the question of education, he suggested having a level of education about data, numbers and statistics from a foundational level could be quite useful.

On the time he took to share information, it varied. He does not report daily. Sometimes it took an hour to collate information, whereas it could take several hours on other days. The preparation and collation of information for media and radio interviews could be the most time consuming and could take up to 20 to 30 hours a week during the waves.

Mr Naidoo replied that it had improved from the early days of the pandemic when everything had to be done manually. The National Institute for Communicable Diseases (NICD) now made some Excel files available. However, he wished it would make all Excel and CSV files available in some sort of a public forum – such as deaths and hospital numbers all the way back. It has all the information; otherwise it means you have to capture everything manually.

With education, it comes down to training. As a teacher, one sometimes found the teacher training is inadequate. He also wanted to see more science graduates attracted to the teaching profession. This would add much-needed strengthening of the South African education system. He was of the opinion that teacher training had to change a bit.

Mr Naidoo said he took a minimum of an hour to two hours each day to collate information. He had never been a good writer so formulating a clear summary took time before he posted on social media platforms like Twitter.

The Chairperson thanked Dr Suliman and Mr Naidoo and commended them for their commitment to raising awareness and keeping residents and citizens aware of what is going on.

The Chairperson thanked Members for their participation. She asked that they send their resolutions and recommendations by 12:00 on 6 September for discussion at the next meeting.

Meeting adjourned.