Dealing with COVID-19, the disease caused by the Coronavirus (SARS-CoV-2) raises many questions for librarians. Since being designated as essential disaster services, libraries have focused on the roles that we can serve during emergencies. Most of the attention, has gone to natural, weather, and human disasters as opposed to widespread disease outbreaks but the National Library of Medicine has a great Coronavirus resource page available to librarians as well.
The biggest role libraries can play in a national response to the emerging COVID-19 threat is as information specialists.
We do recommend that you complete the freely available National Library of Medicine online course In Case of Emergencies: Continuity of Operations (COOP) Planning. If you do, you will end up with a fully developed one-page preparation plan for your organization.
Information Literacy as a Nonpharmaceutical Intervention
The Centers for Disease Control (CDC) summary on COVID-19 is being updated constantly (get the website badge), and the National Library Of Medicine has this great page for resource tools for libraries. Of course, the overall message to citizens so far has remained the same. Don’t panic, and wash your hands.
It really is a pity that we wasted the efficacy of the “Keep Calm and…” posters because that would be a perfect image for libraries to post right now. With no current vaccine or approved medications, the best approach the CDC recommends at this time is a broad spectrum of what are called nonpharmaceutical interventions (NPIs). There are posters and other educational materials available on the CDC website.
NPIs for COVID-19 are quite similar to those for other viral diseases like the flu. On a personal level they include proper hand washing and maintaining social distancing. So when people talk about COVID-19 being similar to the flu, it is certainly true in terms of current best responses.
Comparisons between COVID-19 and the flu have gone beyond hand washing and entered the zone of conspiracy theories and misinformation. NewsGuard has compiled a list of sources that have advanced inaccurate information. For example, it has been proposed on some websites that the Coronavirus is a hoax, nothing more than the common cold or flu being elevated for political purposes. Other sides suggest cures or preventative measures that have no medical support or that misinterpret studies. These conspiracy theories need a NPI as well. One that libraries are uniquely poised to support.
Watch the Webinar on March 26th from Libraries 2.0. on pandemic preparedness.
Spreading Facts
One of the biggest roles that libraries can fill in the national response to COVID-19 is that of information literacy specialists. An underlying theme to much of the online discussion about COVID-19 as seen on sites like Reddit is that governments are incompetently responding to the outbreak. This leaves citizens unsure of where to turn and what news to trust. Libraries can help fill the void as trusted sources of information as well as a shield against misinformation. This role is highlighted in the ALA Pandemic Preparedness site alongside other NPIs.
Ironically, the spread of information and disinformation is quite similar to the spread of the virus being discussed in this situation. As noted in an article from Stanford from Oct, 2019, models for tracking the spread of disinformation were models using viral infection methodologies. As with diseases of the body, the mind can be inoculated against disinformation through early and repeated introduction of facts.
The World Health Organization (WHO) has complied a page of myth busting questions and answers that would be a great place to start for libraries looking to address disinformation. Each of the myths is debunked through a helpful graphic with a clear statement of facts.
One example of addressing information confusion is the question of masks. The CDC does not recommend the use of masks or respirators (aka N95 masks) for general use by the public as a preventative measure. Instead, the recommendation is for other NPIs including hand washing, avoiding touching the face, and social distancing (6 feet). A quick search on Google for Coronavirus masks returns numerous recent articles clearly stating that the general public does not need to be wearing masks. Searching about masks on Facebook or Reddit, however, is quite a bit more alarmist.
Ok, Doomer
Warning: This article is about to go down some Reddit rabbit holes. I went down them because fighting disinformation requires knowledge of the wrongness that is being discussed and shared. Despite my professional inoculation and comfort with compartmentalizing what I read, some of the content I encountered was still quite seductive in its portents of doom. Just imagine encountering what we are discussing here unprepared and with no ability to process and refute the disinformation.
Three prominent subreddits, communities on the user-moderated Reddit site, have emerged to address the global COVID-19 outbreak. There have been some attempts by Reddit and the moderators of the subreddits to address disinformation. In early February, the moderating teams of r/Coronavirus and r/China_Flu swapped to try and bring a more closely monitored information stream to r/Coronavirus (196k members, whoops…200k before I finished this article) as that name took over. r/China_Flu (82k members) has a more “off-hand moderating style” with “speculation allowed” and comments only loosely moderated. The related subreddits for r/China_Flu include r/collapse and r/preppers which pretty much sums up the tone of conversations. At the same time, r/COVID19 (32k members) has attempted to remain a more restrictive space with conversation focused only on scientific aspects of the outbreak.
Even on the less panic prone r/Coronavirus, the way that links are shared and posts are titled can lead to an overwhelming sense of doom after reading. Open venues like this are an extreme example of the confirmation bias that makes echo chambers such a damaging information phenomenon. Posts asking about where to buy masks or how much water should be stockpiled are viewed in isolation and not offset by the overwhelming mountain of information saying you don’t need to buy masks and that basic utilities won’t collapse.
Libraries have places to turn for help. RAND has a guide to fighting disinformation created as part of their Truth Decay project. Truth decay, RAND explains, is partially defined by “the increasing relative volume and resulting influence of opinion and personal experience over fact.” Sites like Reddit and Facebook provide windows into a personal experience that can be misinterpreted without the full context of the situation. If all you read are stories posted by people that are prepping for the collapse of society in the next few weeks, it can start to seem like things are bleak.
Even well-intentioned resources by trusted sources can have a negative impact on understanding. For example, the COVID-19 map by Johns Hopkins should be a trusted, neutral source of information. But the graphical style of the site can shade our interactions with the data. The confirmed cases are represented by red circles on a world map. Those circles are drawn using GIS with the size of the circle being used to represent the number of cases in a specific area. The default state upon loading the site, however, shows almost all of China and the Korean Peninsula covered in red. Is everyone in China a confirmed case of COVID-19 then? And really? Red on a blacked out map? While likely a useful interface theme for display in data centers, it is hardly inspiring for the general public.
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A More Nuanced Approach
What libraries can bring to the COVID-19 outbreak is a more nuanced and information aware approach. Be thoughtful about not only what you post or display, but also how you do so and the potential unintended messages conveyed by graphic design. Unlike the doom of the red on black from Johns Hopkins’ map, the WHO myth busting graphics are a more subtle and calming blue. For more on the hidden messaging of graphic design and the ethical presentation of information, Donna M. Wong’s The Wall Street Journal Guide to Information Graphics (W. W. Norton, 2013) remains a great resource.
The truth is that COVID-19 is a serious disease outbreak. Leaving aside technical and political considerations to naming this a pandemic, the general consensus as backed by the CDC seems to be that there will be significant community spread of the virus in the coming months. However, statements like that need to be taken in context and explained within the specific vocabulary of epidemiology.
Currently, the flu is widespread throughout the United States (except for Oregon and Hawaii). But what does that word, widespread, actually mean to an epidemiologist? The flu in New York is considered widespread because more than 31 of the 62 counties in the state are reporting more than 10 cases per 100,000 population. That means the flu is widespread when 0.01% of the population is infected. So when the CDC talks about COVID-19 being potentially widespread in the near future, they aren’t saying that we are all going to die. Or even that we are all going to get sick. To epidemiologists widespread has a specific and quite low threshold and this needs to be explained to the public.
Another source of misunderstanding around medical terminology can be seen in discussions about how the Coronavirus spreads. At issue is the word “airborne.” Current understanding of the Coronavirus is that it is spread through droplets that can be released through coughing/sneezing and then travel through the air. The droplets are “airborne” in that they travel through the air and then land on something or someone. It is not thought that the virus is “airborne” in the sense that it is spread about through air circulation. Yet the very word is confusing and leads to reactions like the panic buying of masks.
Libraries can help inform patrons about transmission risk. Current scientific understanding about the transmission of the Coronavirus that causes COVID-19 is available on the CDC website. This includes clear definitions of categories for high, medium, low, and no risk. Low risk, it must be stressed, includes “being in the same indoor environment (e.g., a classroom, a hospital waiting room) as a person with [COVID-19] for a prolonged period of time but not meeting the definition of close contact [within six feet].” Even people sitting next to a confirmed case of COVID-19 on a plane are only considered to be at medium risk. This is why the CDC is stressing NPIs like social distancing.
As always, Medline Plus from the National Library of Medicine is a great library resource for trusted medical information written in easy to understand language. The topic page for Coronavirus testing includes updates for COVID-19.
To make information more understandable, it may also help to consider graphical messaging. For example, the CDC has a whole series of posters on hand washing. Another great resource comes from Singaporean artist Weiman Kow who is publishing free comics about COVID-19 and NPIs at comicsforgood.com. Comics cover general information about the virus, as well as hand washing, and masks. Mask use is culturally different in Southeast Asia, but even these comics remind us that the use of masks by healthy individuals is not as effective as simply washing your hands.
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What Libraries Can Do:
- Plan now for when COVID-19 becomes a local issue: In the United States, response to public health emergencies is localized. Reach out to your county public health department to see if there is anything you can do to support their efforts.
- Gather information resources from trusted and accurate sources like Medline Plus that are easily understood by patrons. Resources like the CDC summary page for COVID-19 are great, but require a deeper level of understanding and are not written for the general public. The comic-style resources made available by Weiman Kow at comicsforgood.com can also be effective for sharing.
- Spread awareness of disinformation using neutral sources like NewsGuard that are gathering and debunking myths. Be very cautious of the risks of disinformation from open sources like Facebook or from single issue resources like subreddits that promote confirmation bias. Also be cautious on the graphic design messages being unintentionally transmitted.
- Help patrons understand the medical terminology being used. Widespread has a specific and surprisingly low threshold in terms of epidemiology. When a doctor at CDC uses the word, it may mean something different from what the news reports or what the reader understands.
- Coordinate with community public health resources on local implementation of NPIs. Proper hand washing is the best defense at this time and is a good idea at all times. The National Library Of Medicine Coronavirus preparedness page has great policy and practices recommendations.
Guest Author Christopher Harris, is the Director of the School Library System for the Genesee Valley Educational Partnership, an educational services agency supporting the libraries of 22 small, rural districts in Western NY. A participant in the first American Library Association Emerging Leaders program in 2007, Christopher was honored as a Library Journal Mover and Shaker in 2008. Since then he has been involved with the ALA Office of Information Technology Policy (OITP) and ALA ebook and digital content efforts. Dr. Harris received his EdD from St. John Fisher College in 2018 for dissertation research on helping teachers become more confident teaching computer science.
Returning to his earlier work as a member of the ALA/Verizon gaming initiative panel of experts on games in libraries, Christopher started Play Play Learn in 2014. The site provides educational resources and consulting services to connect games and learning in libraries, schools, and homes for students of all ages. In 2015, the first titles in Christopher's Teaching Through Games series were released by Rosen Publishing as professional books with lesson plans for using tabletop games in classroom and library instruction. The Playful Classroom, a series of books with artwork tied to games from HABA were released from Rosen Classroom in 2018.
An avid gamer and reader, Christopher lives with his wife, a K-12 school librarian, their daughter, and cats in Caledonia, NY.