pH1N1 sustained large-scale news coverage over many months, a media focus commensurate with the seriousness with which major health organisations and governments approached the disease. Despite the uncertainty surrounding the virus, statements made about pH1N1 were generally non-alarmist and reassuring, in keeping with findings related to newspaper coverage. As with all studies focused on the content of news texts alone, a limitation of this study is that we are unable to draw any conclusions about the impact of coverage on audiences. In using statements as the unit of analysis we also acknowledge that conclusions cannot be drawn about individual news stories in context. However, we do find areas for consideration regarding the messages potentially taken away by news consumers.
The emerging pandemic saw reportage fuelled by the daily release by the WHO and Australian government of data on new infections and deaths[38, 39]. The volume, duration and much of the content of the coverage was such that the public could hardly avoid concluding that the disease was serious enough to warrant the prominent attention it was receiving. The initial sub-text was that pH1N1 might have been shaping to be "the big one": a pandemic that could threaten many lives. While Australia and the world saw relatively few deaths, the possibility that this might change underscored the enduring media attention and government vigilance. This, combined with the audience's experience of other prominent health campaigns in recent years, may have created audience expectations that reportage would include information of a less "banal" nature on important practical strategies for risk reduction.
Health officials openly acknowledged the uncertainty regarding how the pandemic might unfold, yet such statements were accompanied by authoritative reassurance that high-level preparedness existed if worst-case scenarios eventuated: 17% of the government's reassuring statements confirmed they had an effective plan, a stockpile of medication and the will to take action as necessary. Viewers were often reminded to seek further advice by visiting the government website, calling the information line or contacting a doctor.
But beyond advice that the public should remain alert and keep informed, and that the government was well prepared, few clear directives were given on what viewers should actually do themselves. Routine advice that mirrored advice for reducing contagion from common colds and 'flu was given regarding basic hygiene (e.g. hand-washing, covering mouth when coughing, etc) and containing the spread of infection (e.g. staying at home with 'flu-like symptoms, deferring non-essential travel, adhering to quarantine associated with school closures, etc.) - but overall this accounted for only 13% of all statements.
This low key and relatively infrequent advice may have imbued viewers with a sense that pH1N1 was nothing out of the ordinary and helped prevent undue alarm arising. Yet occasional news incidents which belied any sense of banal risk may have fomented some dissonance in viewers. While such items did not make up the bulk of the reportage, they risked creating alarm in viewers who may have only seen occasional news stories. Early in the reporting period, a cruise ship with infected passengers and crew was reported over several days, with undertones that it was a potential conduit for the virus to spread into different Australian cities. Items containing contradictory risk information sometimes were broadcast within the same news bulletin (e.g. a lead news item that the WHO had declared a pandemic, adjacent to a sports news story about a recently infected footballer who had been cleared to play; footballers together in a spa adjacent to a story about the cancellation of a national elite swimming event; Government ministers talking about increased airport measures, with vox populi of disembarking passengers saying they had experienced no border control screening etc.). These inconsistencies had the potential to undermine the government's assurances that everything was under control but they may also have encouraged viewers to seek out more information about the disease.
Other than the inconsistencies described - a product of different reactions and responses to the risk posed by pH1N1 in the community - we saw little to no evidence of editorial effort to sensationalise reportage by, for example, highlighting examples of community anxiety or the views of any "maverick" experts arguing that the assurances being given were irresponsible or, conversely, that the seriousness with which the threat was being taken and the public health measures put in place had been exaggerated. For the most part, reports were moderate or simply updating previous news.
It is also important to recognise the limitations of accusing the media of sensationalism or lack of balance in that it risks obscuring rather than clarifying the processes that influence media coverage. For example, as Kitiznger notes determining what constitutes alarming or reassuring statements or media coverage is no simple task and is very much dependent on the situation in question as to whether one believes people should be alarmed or reassured.
We recognise the time constraints facing television news journalists as well as the different expectations that viewers bring and the factors that shape their interpretations of risk. Notwithstanding these factors our study identifies opportunities where reporting of emerging diseases could be enhanced. While there were daily tallies of infection rates with commentary on how this related to changes in the pandemic alert level, there was little apparent effort to contextualise what the figures meant. Viewers might hear that pH1N1 had arrived in Australia, yet still have little understanding of their personal vulnerability or how the number of infections and deaths compared with those from other infectious diseases like seasonal 'flu or whooping cough, which was also affecting the community at the time . We suggest that constant updates to infection rates could be improved by providing commentary that either (a) would allow a viewer to reach conclusions about their own level of risk or (b) reiterated useful advice about reducing infection and contagion at home and in the community at large, especially given that in other countries viewers felt infection was inevitable and not easily preventable.
News coverage of pH1N1 as an uncertain and potentially serious risk raised serious challenges for risk communication. With both SARS and avian 'flu having recently attracted mass reportage yet not causing any deaths in Australia, potential "cry wolf"  legitimacy risks faced Australian health authorities. Concerns over the catastrophic potential of foreign-origin infections had proved unwarranted twice before, so further major public alerts with similar outcomes might engender a sense of either cynicism or complacency. On the other hand, authorities risked the charge that they had not done enough in the event that the disease caused many deaths. These competing concerns created a challenging communication context for health authorities and journalists alike.
It would have been unacceptable for the government to promote personal risk reduction practices like working from home, avoiding crowds and discretionary travel, and the wearing of facemasks if such measures were unwarranted by the risk assessments available. However, it may have been sensible to advise the community of what situation would need to occur before such measures would be recommended. Such advice may have gone some way to promoting greater community understanding of the phases of pandemic preparedness.
There was also the difficulty of communicating complex information within the narrow time constraints of television news, something further compounded by urging viewers to remain calm while simultaneously acknowledging that authorities did not have answers to several questions. Given that a vaccine was not available throughout this sustained period of uncertain risk communication and that mortality remained low, the potential for a 'cry wolf' affect may have been magnified.
Judging by the frequency of press releases across the sample period and the frequency with which the health authorities were available to the media, decisions were plainly taken that the public should be maximally informed, despite there being little different to say from day-to-day in terms of advisories. Almost-daily efforts to generate news coverage were framed by the media in terms of updates and developments, mainly focussed on case increases. For the news media's part, the commercial imperatives to produce compelling news items to attract large audiences for their advertisers may have been tempered by the government's concern to underline the potential seriousness of the disease and journalistic notions of socially responsible reportage. The frequency and volume of news coverage that pH1N1 attracted was, arguably, not reflective of its impact in the community, and understanding the implications of this is an area that warrants further investigation.