Top Pandemic-themed Public Health Media Bites of 2021, Metaphor Edition

During the early days of the pandemic, we read news coverage about the virus obsessively. No story was too small. We also paid close attention to behind-the-scenes conversations happening on public health listservs, and an overwhelming number of threads pointed to the need for one thing: more robust infrastructure and funding. Without it, experts warned, the pandemic would rage on, and, even more troubling, may not be the only pandemic we experience in our lifetimes.

It was clear that communicating the need for public health infrastructure was critically important to prevention, now and in the future, but how could we convey such an abstract concept in a clear, compelling way?

Then, we saw it: a beautifully — and simply — stated metaphor. Matt McKillop, senior health policy researcher and analyst at Trust for America’s Health (TFAH), and Dara Alpert Lieberman, TFAH’s director of government relations, co-authored a report that made a compelling case for why we must proactively prepare for threats like COVID-19 by investing in our public health workforce and infrastructure. “Not doing so is akin to hiring firefighters and purchasing hoses and protective equipment amid a five-alarm fire,” they wrote.

We’re reminded of that metaphor every time we read a new article or blog about infrastructure. McKillop and Lieberman gave us a new lens to look through. They shaped not only our understanding of their article but our understanding of all future communication about the subject.

We love metaphors at BMSG. Metaphors, which are prevalent but often overlooked in everyday language, carry many functions and benefits: They allow us to make strong arguments about complex or abstract ideas without relying on jargon; they can help us illuminate social problems — and how to solve them; they can even help us bridge ideological gaps. Researchers have found that exposure to a single metaphor can result in substantial differences in opinions — differences that can help disparate groups, such as opposing political parties, come together and see issues from a similar perspective.

Metaphors, then, can lead people to logical conclusions that may be harder to reach in other ways. For example, according to a study published in PLOS One, participants who read language portraying crime as a virus “were more likely to propose treating the crime problem by investigating the root causes of the issue and instituting social reforms” than participants who read language that likened crime to a beast lurking around every corner. Those participants were more likely to propose punitive approaches to fighting crime, such as “hiring police officers and building jails — to catch and cage the criminals.”

When it comes to communicating about COVID, we’ve seen many outstanding metaphors in the news. Public health practitioners, advocates, and researchers have used analogies to explain everything from the need for vaccines to the importance of masks to the way vaccines work. Many of these metaphors have been so memorable that we’ve decided to dedicate this year’s annual media bites blog to the creative comparisons.

Of course, no communication, no matter how clever or compelling, is a substitute for equitable access to vaccines, housing, job safety, and other conditions that shape our health. Words cannot replace these supports — but they can reinforce them. Cognitive linguist George Lakoff has explained that metaphors play a key role in defining our daily realities. And we at BMSG have no doubt that they have been instrumental in shaping narratives about the pandemic. Here are some of our favorite metaphors from this past year’s news and social media, as well our own resources, grouped by topic. Please sit back, enjoy, and if you have seen other metaphors that you think should be on our radar (metaphor intended!), share your top picks with us at info@bmsg.org or @BMSG.

Using fire safety to convey the effectiveness of vaccines, important caveats about breakthrough infections, and more

One of the most common and effective metaphors we’ve seen characterizes the virus as a fire. If the virus is a fire, then it becomes easier for readers to imagine how public health tools like masks and vaccines compare to common elements of fire safety, from fire extinguishers to flame retardants. Fire safety metaphors can help us communicate the following:

How vaccines slow the spread of infection:

Vaccinated people are like wet logs, unvaccinated like dry kindling. COVID is the fire.

Can wet logs catch fire? Yes.

Can wet logs SPREAD fire once they catch flame? Sure.

But it’s MUCH harder to start a fire with wet logs, and nearly impossible when there’s no more kindling. pic.twitter.com/P5BXp1AtKM

— Dr. Michelle Au (@AuforGA) August 7, 2021

Why breakthrough infections are expected, “unextraordinary,” and have been “no cause for alarm”:

How public health measures have implications for entire communities, not just individuals:

Why freedom — and opening things up — requires caution and responsibility:

Why hostility toward public health guidelines is self-destructive:

Using auto safety and drunk driving to communicate about prevention, freedom, social responsibility, etc.

Automobile safety is another compelling comparison that can help audiences to understand:

Why prevention is critical:

How wearing masks increases our freedom:

How vaccines work — and why breakthroughs still speak to their effectiveness:

Why we need multiple layers of protection:

Driving metaphors are especially salient when combined with the dangers from drinking alcohol. In the following example, drunk driving helps show how the decision of whether to vaccinate has larger social consequences:

Using tobacco control to discuss interconnection

Although tobacco control took decades to gain widespread acceptance, anti-smoking efforts that were once controversial are now considered common sense. Now we can use tobacco control metaphors to demonstrate how our health outcomes are connected.

Using hunger to highlight health equity

Equity is an abstract concept for many people, but the sensation of hunger is universal, making the two an especially powerful combination. In referencing vaccine equity across the world versus boosters for the U.S., Heather McGhee stated:

I don’t know… anybody else feel like we shouldn’t be going back to the kitchen for seconds when so many at our table are still going hungry? https://t.co/FBzkwclPl1

— Heather McGhee (@hmcghee) August 18, 2021

Using money metaphors to make the case for infrastructure support

Public health infrastructure and prevention are hard concepts to connect with, in part because they don’t make the news if they are fully funded and working well. Money metaphors can bring the hidden infrastructure to light and help demonstrate the need for more funding:

The reporter of the same article drove home the point using some social math:

Using a common sandwich ingredient to explain the complex concept of risk mitigation

This Swiss cheese metaphor is sophisticated yet surprisingly simple. (It’s from last December but is so useful, we had to include it!)

Using training and preparation metaphors to demystify how vaccines function

When people say they “trust their immune system” and offer that as a rationale for not getting the vaccine, these metaphors that evoke training and instruction manuals can help:

If you’re vaccinated and exposed to Covid, your immune system shows up ready to fight and win. But if you’re unvaccinated and get infected, your immune system is forced to fight a dangerous opponent without proper training.

— Dr. Tom Frieden (@DrTomFrieden) September 27, 2021

If you’re vaccinated and exposed to Covid, your immune system shows up ready to fight and win. But if you’re unvaccinated and get infected, your immune system is forced to fight a dangerous opponent without proper training.

— Dr. Tom Frieden (@DrTomFrieden) September 27, 2021

For an extended training metaphor that explains why the vaccine is still effective even though it does not offer 100% protection, watch this video (second clip in the thread):

Talk to your doc, then go get yo shot 💉

Let’s #GetToImmunity, #VaccinateALL58, #CaliforniaForAll, #CDPHpartner @capublichealth pic.twitter.com/EGGFdzHQ4v

— Drew Comments (@sjs856) September 16, 2021

Although training metaphors can be highly effective, they can also backfire if they cross a line into war or combat comparisons that view viruses as “enemies” that can be “conquered through the technological subjugation of nature,” Alex de Waal, of Tufts, explained. Then people may falsely conclude that “if we have just the right weapons, then just as an individual can recover from an illness and be the same again, so too can a society,” de Waal said. “We didn’t have to pay attention to the pesky details of the social world, or see ourselves as part of a continuum that includes the other life-forms or the natural environment.”

Using candy to explain correlation vs causation

The Vaccine Adverse Events Reporting System, which was created to provide transparency and to quickly address any adverse events, is commonly cited by those who are vaccine hesitant. Although the system contains unverified data, the adverse events have led to confusion, with many people raising concerns about what the database means for vaccine efficacy. To help people understand why the data should not be taken as gospel, this simple reference to candy may be useful:

Using sports metaphors to show why COVID work must happen over the long haul

Too often, we see people inclined to celebrate victories and relax prevention practices, only to end up back in risky situations. COVID and our public health response continue to evolve. As such, it’s important to be cautious about using “finish line” metaphors. Suggesting that the pandemic may end soon and we are close to the finish line — and then moving that finish line — erodes trust in science and public health.

Instead, it’s helpful to recast metaphors in ways that effectively communicate the long game:

Using disability to illustrate the realities of chronic illness

People who have never experienced disability or chronic illness may have difficulty conceiving of life with long COVID. This description helps to break up the false dichotomy between the infected and the recovered, revealing a middle ground between two extremes.

At BMSG, we’d be happier than a flea on a dog if we were able to kick COVID to the curb tomorrow, but we know this is a marathon and not a sprint. We are grateful to be in the game with all of you and will continue to shine a spotlight on language that helps us all get to the light at the end of the tunnel.

But seriously, we are in a moment where the news media and the public are more focused on public health than perhaps at any point in most of our lives, and yet we know that there are many aspects of public health infrastructure, vaccines, and COVID that are hard to understand or that don’t get much news coverage. Metaphors can meet people where they are, break down complex topics, transform public health jargon into easy-to-understand ideas, and help us move forward together.

Originally published by Berkeley Media Studies Group