As the pandemic worsened in the United Kingdom during spring 2020, political disputes turned in a strange direction. The UK government started to claim that the UK’s Covid-19 statistics could not be compared with any other country. Politicians based this claim on a flawed interpretation of a Guardian article by statistician David Spiegelhalter, who had pointed out the complexity around international statistics. A few months later, in August, then US President Donald Trump would wave a sheet of paper in front of bemused Axios journalist Jonathan Swan, purportedly showing a statistical comparison that the United States was outperforming other countries in its response to Covid-19. Rather than mourning those who had died, politicians in some countries turned to fights over how to represent the toll of the pandemic authentically.
The focus on statistics became pervasive. We may all know someone (or we ourselves might be that someone) who pored over data dashboards, explored statistical comparison between countries on the Financial Times website, or eagerly checked the latest data releases for the area where we live. For many people living in British Columbia, 3 p.m. became a ritual time of day when they would watch a press briefing from Chief Medical Officer Dr. Bonnie Henry, discussing the latest number of Covid cases.“From the perspective of international institutions, statistics became the authentic mode to represent disease.”
But there is an even deeper question about why statistics and dashboards become so central, and whether they have helped or hindered an equitable approach to our current crisis. The fixation emerged from a longer history of how statistics became the main mode of conveying epidemiological information. From the perspective of international institutions, statistics became the authentic mode to represent disease. When it comes to addressing epidemics, however, risk communication requires very different tools than those preferred by international institutions. The concept of authenticity links together two parts of health communications that are generally seen separately—statistical data and people.
Many scholars have examined the growing importance of numbers and statistics in modern economics and international institutions.1See, for example, Morton Jerven, Poor Numbers: How We Are Misled by African Development Statistics and What to Do about It (Ithaca, NY: Cornell University Press, 2013); Theodore M Porter, Trust in Numbers: The Pursuit of Objectivity in Science and Public Life (Princeton, NJ: Princeton University Press, 1995); Daniel Speich Chasse, Die Erfindung des Bruttosozialprodukts. Globale Ungleichheit in der Wissensgeschichte der Ökonomie (Göttingen: Vandenhoeck & Ruprecht, 2013); Daniel Speich Chassé, “The Roots of the Millennium Development Goals: A Framework for Studying the History of Global Statistics,” Historical Social Research / Historische Sozialforschung 41, no. 2 (2016): 218–37; Jacqueline Wernimont, Numbered Lives: Life and Death in Quantum Media (Cambridge, MA: MIT Press, 2019). In health too, there is a history of why numbers became the preeminent mode of measuring disease and of making disease comparable across borders. While health statistics had been gathered for centuries, the movement to standardize epidemiology accelerated particularly in the interwar period under the League of Nations Health Office (LNHO). The doctors at the LNHO believed in collecting and communicating standardized statistics, not stories. The LNHO created the first international epidemiological intelligence system that by the late 1920s, encompassed two-thirds of the world’s population.2For more on this history, see Heidi J. S. Tworek, “Communicable Disease: Information, Health, and Globalization in the Interwar Period,” American Historical Review 124, no. 3 (2019): 813–42. The organization did so because its leader, Ludwik Rajchman, believed that the LNHO could justify its existence by creating comparable statistics around disease and by making the League the central, neutral conduit of health information.
But that system was also a disciplining of how to represent disease. The LNHO demanded comparable statistics from the 74 nations, empires, and territories submitting data. The boxes at the League’s archives in Geneva contain many different representations of disease, ranging from tables to maps. Over the 1920s and 1930s, the archive reveals League officials pushing for standardized collection of data about particular diseases. While this seemed to make diseases comparable, it also excluded other modes of discussing disease or rendered other forms of suffering invisible. To take one quick example, the League’s system focused on diseases like plague and smallpox. These were, in many ways, priorities for empires that wished to control the spread of disease from colonies back to Europe. They were not necessarily the diseases that mattered most to people living in India or sub-Saharan Africa. Rendering diseases statistical highlighted what mattered most to the most powerful within the League of Nations. The statistical mode also counted solely by cases rather than considering how political, economic, and social conditions could exacerbate disease. This focus continued into the World Health Organization.“Flawed statistics have been wielded by skeptics to claim that Covid is not that bad.”
Covid-19 has made clear once again the promise and limits to statistics, whether in collection, standardization, presentation, politicization, or perception. Flawed statistics have been wielded by skeptics to claim that Covid is not that bad. They have also served to desensitize, to make the pandemic about comparing cases in a macabre league table rather than about mourning and honoring those who have passed away. In places like the Netherlands, which are not allowed to collect statistics on ethnic backgrounds, statistical modes of collection have obscured the hugely differential impact of Covid-19 on racialized populations. In other places, like the United States, statistics helped to show how the pandemic disproportionately affected Black, Latinx, and Native American populations, but did not lead the Trump administration or many states to introduce policies to address those problems. Statistics showed that 73 percent of Covid cases in the Peel region of Ontario occurred in visible minorities, although they comprised 63 percent of the population there. In April 2021, 20 percent of all Covid-19 cases in Ontario happened in Peel, yet the region only received 7.5 percent of vaccines. Knowing the statistical disparities had not inspired Ontario’s provincial government to address them. Some statistics seemed to matter more than others, replicating long-standing inequalities or even an inability to understand and address the differential impact of Covid.
Beyond the authenticity of numbers, communications around the current pandemic remind us that authenticity also resides in the people communicating too. Statistics have seemed inauthentic to certain groups if presented by particular people or in particular ways. While epidemiologists in the interwar period generally presented depersonalized statistics as a mode of authenticity, now public health guidelines are often judged on the authenticity of the officials presenting them.
In this regard, I spent summer 2020 working with a team to understand how nine jurisdictions (Germany, Canada, Senegal, South Korea, New Zealand, Taiwan, Norway, Sweden, Denmark) and two provinces (British Columbia and Ontario) have communicated around Covid-19.3Heidi Tworek, Ian Beacock, and Eseohe Ojo, “Democratic Health Communications during Covid-19: A RAPID Response,” Centre for the Study of Democratic Institutions, UBC (September 2020). Amongst other findings, we point to the importance of values, emotions, and stories alongside scientific facts. We also show the culturally situated ways of conveying values and emotions that have frequently resulted in much greater compliance with public health guidelines.“Rather than using military metaphors or mockery, some countries have explained their pandemic responsibilities in terms of solidarity, kindness, and even love.”
Rather than using military metaphors or mockery, some countries have explained their pandemic responsibilities in terms of solidarity, kindness, and even love. In New Zealand, citizens were implored to “be kind” with one another. The informality and empathy of Prime Minister Jacinda Ardern’s communication style emphasized that she was part of the team, one citizen among many, working alongside others. Ardern won a landslide re-election victory in fall 2020. In Taiwan, physical distancing was framed as an act of civic love. “The deeper the love,” ran one key government slogan, “the greater the distance you keep.” The Health and Welfare Minister, Chen Shih-chung, has called for journalists and citizens alike to have empathy for other Taiwanese. “Have a heart!” Chen reminded the public regularly. A notable feature of Covid-19 communications in British Columbia was Dr. Bonnie Henry’s refusal to shame those not following the rules and her emphasis on humility. She repeatedly called for empathy, noting that “we don’t know everyone’s story… we are all working hard to stay safe.”
Counterintuitively, other officials have communicated values by not communicating. In South Korea, the CDC’s Director Dr. Jeong Eun-kyeong was only available during press briefings. She declined all media interview requests, explaining that she would rather spend her time working behind the scenes. Media reports claimed that she rarely slept and barely left her office. Jeong’s quiet modesty, humility, and dedication seem to have inspired trust and potentially greater compliance amongst Koreans, who seem to value her authentic dedication to her work.4See (in Korean), Kim Taehoon, “Foreign Press Commends Jeong Eun-kyeong, Who is ‘Humble’ and Doesn’t Use Any Social Media Services,” Segye Ilbo, April 5, 2020); and “WSJ: ‘The True Hero of the Coronavirus Crisis is Korea’s Jeong Eun-kyeong,” DongA, April 5, 2020.
The historical focus on statistics as the only authentic health data obscured other modes of communicating disease and other ways of understanding disease as a social phenomenon, not just an individual experience. At the same time, my work on Covid-19 communications around the world remind us that authenticity takes many forms. They need not be puerile disputes over statistics, but authenticity based on kindness and compassion.
Banner photo: Province of British Columbia/Flickr.