Sep. 2, 2009 -- As public health officials are bracing for and trying to avoid a possible outbreak of swine flu epidemic this fall, others are hoping their swine flu products and messages can spread virally.
While some new products, such as a stuffed swine flu virus, have commercial as well as their proclaimed educational purposes, other products have been created by a variety of people and agencies to spread messages about the virus.
"Reaching people where they actually get information that's persuasive to them is the way to go," said Doug Evans, director of health communications and marketing in the School of Public Health and Health Services at George Washington University, of the efforts to use new social media to reach people on swine flu.
"Clearly using things like podcasts, MP3 downloads, YouTube videos, things that are downloadable onto handheld devices, you've got a leg up," he said. "The question would then be, what exactly is the message, what is the strategy, what are you asking people to do?"
Unsurprisingly, messages have come from a variety of viewpoints.
On Tuesday, the U.S Department of Health and Human Services announced that it would use four public service announcements starring Sesame Street's Elmo, who encourages children to wash their hands, keep their hands away from their faces and cough and sneeze into their elbows.
At Public Health -- Seattle & King County, they have produced a comic book, "No Ordinary Flu," which discusses the 1918 epidemic and gives readers tips for flu season and a potential pandemic, including hand-washing and planning to work from home in the event of a major outbreak. The department plans another comic book next week on keeping kids and teens home with flu.
While no vaccine for swine flu has yet been approved, a music video has been released by a natural health site advocating against getting the shot.
"On these big issues, I feel like music is one more important medium through which a message can reach a wider audience," explained Mike Adams, who raps in the video and serves as editor in chief of NaturalNews.com, where the music video appeared. "On this issue, I feel like the American people are only getting one side of the story. They need to get the other side of the story, so I try to put that in the song."
While Adams typically writes articles, this is the third music video he has made, an effort he said often reaches a wider group of people.
"My experience with the previous songs is that it reached beyond the audience we typically reach with our articles," he said.
Adams said that public health officials have placed too much emphasis on hand-washing, rather than nutrition and exercise. He also said they have failed to publicize vaccination risks.
Researchers have raised a number of concerns about the potential problems of social media, particularly in light of the messages they can present.
Evans, for one, said he worries about the impact of an anti-vaccine message, and the potential damage it can cause in the current environment.
Years ago, he said, "Because vaccination had a stronger social norm, there was more public support for vaccination before the past few years where concerns were raised. [In] that changed social environment, I would say that messages saying 'don't get vaccinated' are more likely to be effective."
Robert I. Field, a professor of health management and policy at Drexel University School of Public Health, also expressed concerns.
"I would [say] that vaccines are one of the greatest lifesavers known to man," he said. "That doesn't mean we shouldn't be careful in how we develop and use them, because there are risks."
However, he said, swine flu presents a risk to millions of lives.
"To compromise such a powerful lifesaving tool, I believe, is unconscionable," said Field.
Of social media that opposes vaccines, Field said, "If you have enough of these, it could cause some number of people to decline the vaccine."
And while he supports some level of personal choice, that becomes less clear when dealing with an infectious disease like influenza.
"If someone makes the decision to risk their health or possibly their life, they should have the autonomy to make that decision," said Field. "The problem with the flu is that it spreads to rapidly…there are a lot of other people you may infect who have no control over the situation…you're presenting a threat to them. From that perspective, you are doing something socially irresponsible. If that decision costs someone their life, you could call it criminally irresponsible."
Commerce and The Flu
Commercial products, like stuffed swine flu virus toys, present a different situation.
One such soft toy is the latest in the line created by GIANTmicrobes, a company that produces stuffed animals designed to resemble microbes.
"I think in terms of products and commercialization, I don't see a tremendous amount of concern," said Field. "The problem would be the bounds of good taste."
Should swine flu result in a large number of deaths, "It would be unseemly, but that's an issue for the market to decide."
He noted that other viruses -- some that already have killed many people -- are available for sale in stuffed form.
"To me personally, the common cold, the flu, sore throat are inoffensive," said Field. "I think having the Black Death, Ebola, similar conditions, at least reaches the borderline."
Evans had concerns about the value of swine flu toys.
"If the intent is to educate…then I suppose they could potentially be effective," he said.
However, he noted, "I'm not aware of any research that's been done that shows the creation of toys like this has any demonstrated impact on people's health behaviors."
Calling them a "double-edged sword," he noted that many products like toys and video games can minimize potential risks to people.
"A lot of these things have the character of making it less real," said Evans. "Educational entertainment can bring home the reality, potentially, as opposed to public service announcements, which often aren't seen, are dry, and sometimes the message doesn't get through."
But the reality can be different.
"I think it could be an educational tool," said Evans, "but I think that often games like that don't end up being used that way. I think they could play that role, but often they don't."
The concerns of researchers notwithstanding, social media has spread to all. And some predict swine flu will bring a host of messages.
"I think you'll see more songs from other artists," said Adams. "I think you'll see people writing books about it. You'll see paintings, you'll see poetry. You'll see people taking the emotional charge of the issue and adapting it for various media over the next 12 months."