Communicating COVID-19 – Cosmos

It was overwhelming, say immunologist Dr Chris Puliuvea and virologist Dr Natalie Netzler.

TheNew Zealand Association of Scientists(NZAS) had called to say the pair had won New Zealands most coveted science communication prize, the 2023Cranwell Medal,for their community engagement during the COVID-19 pandemic.

It was such a privilege and an honour, Netzler says.

We all remember the dark days of the COVID-19 pandemic the fear and the lockdowns, the loneliness, and perhaps the losses of those we loved. The quiet cities. The variants and the vaccinations. Working from home, the toilet paper wars.

Those days are still raw, and of course, COVID-19 is still with us.

Puliuvea, who is Tongan, was then a PhD candidate at the University of Auckland. Netzler is Mori and Samoan and a senior lecturer also at the University of Auckland. Neither set out to win the prize, they were simply responding to the Mori and Pasifika communities need for unambiguous, factual information on the disease, and on the vaccinations under development. Pasifika communities are people of Pacific ethnic origin living in New Zealand.

By the end of June 2021, both researchershad been fielding COVID-related questions from family and friends in their Pasifika and Mori communities for months. Whats this new vaccine?, Why get vaccinated Is it safe?, What do we do?

New Zealands often-cursed tyranny of distance and government policy were working in the countrys favour by then,there were just 2741 cases,and31 people had succumbed to the disease. Globally, the picture was dire, withabout 180 million cases and almost 4 million deaths.TheUS Food and Drug Administrations approval of the first COVID-19 vaccine Pfizer BioNTech, on 23 August was then still almost two months away.

Then Puliuvea and Netzler received invitations to talk at theInaugural Pacific Peoples Fono(meeting), held In Auckland in June 2021. The conference, hosted by Mori and Pacific Island researchers from the Universities of Auckland and Otago, discussed research into issues affecting Pacific peoples.

Subjects ranged from antimicrobial resistance to drug development, traditional medicines, and COVID-19, with Netzler covering vaccines and PuIiuvea, the immune response. Researchers also focussed on correcting misinformation and disinformation, says Puliuvea. The hall was packed with a broad cross-section of Aucklands Mori and Pacific communities, including community organisations, nurses, midwives, clinicians and doctors.

Puliuvea and Netzler were flooded with questions. Netzler says that the response showed the communitys appetite for answers they were really struggling to find a touch-point that was relatable, where they could get the answers that they needed, she says.

Multiple invitations followed, and more talks were given, at community groups and organisations in Auckland, and online more than 60 events:videos, webinars, Tik Tok and Facebook Lives, reaching into Mori and Pasifika communities in New Zealand, Australia and throughout the Pacific, says Netzler.

The videos, on how vaccines work and getting vaccinated, were created because the pair couldnt keep up with demand, says Puliuvea. Many of the face-to-face and online events were set up by Youth Horizons (Kia Puwai) Pasifika Principal Advisor, Synthia Dash, with the first aimed at Kia Puwais Pasifika and Mori frontline staff, 90% of whom were averse to vaccination.

Dash knew that Netzler and Puliuvea had the necessary cultural competency and humility to sensitively frame the information without stepping on the cultural and religious beliefs holding staff back from vaccination. Proportions reversed after 6 months of work, with 90% taking the needle. What we wanted was to answer specific questions and make sure that people felt like it was a two-way dialogue, so they were empowered, says Netzler. At one of those meetings, she continues, a guy got up and said: Ive never seen a scientist that looks like us, before.

Science is full of jargon converting the language of COVID-19 into understandable English was, and is, a challenge in itself. Translation into meaningful Mori, Tongan, Samoan, Niuean and Tuvaluan, adds further complexity, particularly as there are often no equivalents for the terms needed.

The researchers presentations were translated into these languages through a range of organisations. A partnership with theMokoFoundation delivered the English-Mori translation, and Puliuvea did the Tongan translations. He would often Tonganise a word to make it flow within a sentence in that language. Antibody would become antipoti, lockdown would become lokatauni, so that the Tongan community could relate it to the English word when they came across it, he says. Immune system became sisitemi malui. Malui means to protect.

At one of those meetings, a guy got up and said: Ive never seen a scientist that looks like us, before.

Puliuvea and Netzler also made extensive use of analogies. One of Netzlers favourites involved going to war with the virus, and comparing the vaccination to a fire drill. Antibodies are the weapons, shed say, and the vaccine is like a fire drill, teaching your body how to fight off the virus before it brings the house down. Viruses, like fires, can get away on you, shed continue, and become uncontrollable. If youve had a vaccination, your immune response has been trained and can quickly quench a real infection before it brings the house down.

In addition, Puliuvea says Mori and Pasifika communities are showing a lot of interest in the publication of a dictionary of medical terms in their languages. We dont need to wait for a pandemic for this to happen, he adds. We need medical terms and their Mori and Pasifika translations, to improve communication between communities and local medical professionals.

Some lists do exist already April 2020 saw the release of a list ofMori terms for COVID.

Its not merely the need to understand concepts which drives these communities.

Data are hard to come by, but the New Zealand Medical Journalreportedthat Mori are 2.5 times, and Pasifika 1.8 times, more likely to die of a COVID-19 infection than European New Zealanders.

A variety of issues contribute, includingmultigenerational livingwhich tends to overcrowding because of the lack of suitable housing, andpoverty, which exacerbates access to health care.

We need medical terms and their Mori and Pasifika translations, to improve communication between communities and local medical professionals.

And there may be genetic reasons. The gene, LZTFL1, has been associated witha two-fold increase in respiratoryfailure in COVID patients. A variant of this gene causes shorter villi in the upper respiratory tract in some Southeast Asian populations, which means that the virus spreads more easily into the body, resulting in severe disease, says Puliuvea.

That gene is slightly different in Mori and Pacific people, and Puliuvea is currently exploring linkages with disease. If the variant is associated with severe illness, we can prioritise carriers for vaccination, he says. We detected more than 2000 unique genetic variants in Mori and Pasifika people, that were virtually absent in other populations. Some of these unique variants occurred in up to 30% of the people sampled, he adds.

Puliuvea and Netzler continue to drive health literacy and empower Mori and Pasifika communities. As Netzler said, Chris and I were really honoured with this medal, but there was such a group effort, involving a lot of partnering with a lot of people, including churches, charities, schools, and other organisations.

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Communicating COVID-19 - Cosmos