UCSF

Abstract: Importance: Consistent, evidence-based communication is critical to building trust and maintaining credibility of public health agencies. Objective: To identify any significant changes in the mainstream media’s presentation of public health advice for flu prevention before and after the COVID-19 pandemic. Design, Setting, and Participants: A systematic search in Factiva of top ten U.S. newspapers by circulation, using two search periods, 2018-2019 and 2021-2022. Articles with flu prevention advice were identified, abstracted for media outlet, reporter, date. Articles were coded for the specific advice provided. Main Measure(s): Number of recommendations for flu prevention, frequency of each recommendation; percent of recommendations aligned with CDC guidelines for each period. Changes in frequency of each recommendation. Differences determined using 2-proportion Z-tests, p-value 0.05 significance. Results: 128 articles with 244 recommendations for pre-COVID period; 122 articles with 296 recommendations post-COVID. 96.3% of recommendations in alignment with CDC guidelines pre-COVID. 63.9% of recommendations in alignment with CDC during post-COVID timeframe. Percentage of articles with advice to mask for flu increased by 1,494.8% (p=<0.00001). 14.5% decline in percentage of articles advising flu vaccine (p=0.002). 495.5% increase in percentage of articles recommending social distancing (p=0.001). 1,368.9% increase in percentage articles recommending increased ventilation (p=0.0004).Advice to cover cough/sneeze declined by 52.8% (p=0.041); advice to disinfect surfaces declined by 76.7% (p=0.038). Conclusions and Relevance: Expert advice on flu prevention as presented in top 10 U.S. newspapers changed significantly during the COVID-19 pandemic. The strategies discussed more frequently are not currently recommended by CDC. This is relevant information for public health leaders as they address ongoing issues of trust and credibility. Key Points: Question: Are there significant differences between the mainstream media’s presentation of expert advice for flu prevention before and after the COVID-19 pandemic? Findings: A systematic search of the top ten U.S. newspapers by circulation found that the percentage of total articles with advice to use a face mask for flu prevention increased by 1,494.8% from the pre-to post-COVID period, while the percentage of total articles advising a flu vaccine decreased by 14.5%. Other significant findings include an increase in advice to social distance (494.5%), an increase in advice to improve ventilation (1,368.9%), a decline in advice to cover your cough (58.2%) and a decline in advice to disinfect surfaces (76.7%). The strategies discussed more frequently are not currently recommended by Centers for Disease Control (CDC) for flu prevention. Meaning: Significant changes in public health advice on flu prevention, as presented by high-circulation U.S. newspapers, occurred during the COVID-19 pandemic, resulting in less consistency with CDC recommendations for flu prevention.