Crisis communication

This is a subject that has doctrinal work besides having many fields in which it can be applied: economy, politics, strategy, health, etc. In any of its possible developments, Coombs points out that three premises must be taken into account by those who manage a crisis: “(1) timing, being the first to report the crisis is beneficial to the organization; (2) victim focus, emphasizing the victim in public crisis messages, and (3) misinformation, the need to aggressively fight inaccurate information” (Coombs, 2014, p. 1).

To deal with crisis communication from a strategic point of view, there have been many approaches used in recent times, although we must refer to these communication theories:

- Benoit's Image Repair Theory

- Weiner's Attribution Theory, together with Coombs and Holladay's Situational Crisis Communication Theory (SCCT), and the

- Framing Theory, by McCombs and Shaw (Zurro et al., 2021, p. 4).

In the first case, Benoit (1995, p. 72) refers to the fact that the key element "is not whether the actor caused the damage, but whether the relevant audience believes the actor to be the source of the reprehensive act."

In the second case, Coombs refers to four types of crises in his work Situational Crisis Communication, based on the Attribution Theory, that is, "in a framework of external agents, users, affected and unaffected, tend to let themselves be guided by emotional guidelines when attributing responsibility for a situation or crisis” (García and Smolak-Lozano, 2013, p. 56).

And, in the third case, the framing theory is used in the field of crisis communication. As Rodelo (2021, p. 93) explains, relying on other authors, “research has demonstrated the effects of various frames on how people process information about public issues”.

Communication of the Omicron health crisis

Some of the meanings of the term crisis that may be useful in the case of Omicron can be found in the Dictionary of the Spanish Language: "profound change with important consequences in a process or a situation, or in the way in which they are appreciated" or "abrupt change in the course of a disease, either to improve or to worsen the patient" (Rae, 2022).

We can frame the health crisis caused by COVID-19 in the first, to the extent that the change caused had very relevant consequences. And in the second, we can do the same with the Omicron crisis, which brought about a sudden change in the course of the disease, in such a way that it became the most invasive wave of all known until then.

In the second case, it is also necessary to assess how the different audiences perceived the new reality after so many months of negative news about the health crisis. Hence the responsibility of the media when reporting on any aspect related to this situation. "In this age of socially mediated communication, audiences determine the relevance, interest, and credibility of the information they receive" (Utz, Schultz, & Glocka, 2013). It is true that, despite the messages received, many citizens did not show the same concern as in the initial months of the pandemic.

One fact that should be highlighted in a crisis communication of these characteristics is that of assuming a leadership role in exposing the messages to different audiences. In this case, the one that did it from the beginning was the WHO itself and thus, besides reminding the population of the benefits of applying social and public health measures, it encouraged countries to follow a series of instructions:

1.- Intensify surveillance and sequencing activities to better understand the variants of SARS-CoV-2 in circulation. 2.- Submit the complete genome sequences and related metadata to a publicly available database, such as GISAID. 3.- Notify the WHO of the cases or conglomerates of cases of infection by the variants of concern, through the mechanism of the International Health Regulations. 4.- If sufficient capacity is available, and in coordination with the international community, carry out field studies and laboratory analyses to better understand the effects of the worrying variants on the epidemiological characteristics of COVID-19, the severity of the symptoms they produce, the efficacy of social and public health measures, diagnostic methods, the immune response, neutralization by antibodies, and other pertinent issues. (WHO, 2021)

Omicron

Unlike in the case of COVID-19, the name of Omicron by the media was uniform. The reference to this variant was similar since the WHO reported its appearance. This Organization took care to explain its evolution: “the B.1.1.529 variant presents a large number of mutations, some of which are worrying. Initial evidence indicates that the risk of re-infection with this variant is greater than with other variants of concern” (WHO, 2021).

Regarding the main characteristics of this variant, it was noted that:

Compared with infected patients with either Alpha or Delta variants in our health care system, Omicron patients were significantly younger, had significantly increased vaccine breakthrough rates, and were significantly less likely to be hospitalized. Omicron patients required less intense respiratory support and had a shorter length of hospital stay, consistent with on average decreased disease severity. (Christensen et al., 2022, p. 642)

Source: own elaboration.

As can be seen in figure 1, in Spain, the search for the term 'Omicron', after a few days of interest, drops until the Christmas period approaches. In fact, from December 23^rd to January 5^th, the trend does not drop below 70, reaching the highest peak (100) on December 28^th. These data show the concern of the population about the high rate of contagion on those dates. Once Christmas is over, the decrease is gradual until reaching a trend of 17 in the last days analyzed in this work.

Variant

When genetic sequencing or analysis of a virus is carried out, based on samples taken in different regions of the world, "scientists identify certain characteristics by which these mutations can be grouped into variants" (Sánchez, 2021). This explains the meaning of the term 'variant', which is sometimes confused with 'strain' in the media. And this error occurs with all the variants that have appeared so far.

Source: Own elaboration

Figure 2 shows that the search for this term starts from a trend of 100 on the first day of analysis to later go down with some moments of a certain rebound. The novelty in the appearance of this variant attracted the attention of the media and their respective audiences.

The main rebound occurs in the first days of 2022 as a result of the Christmas period in which interest in the Omicron variant rose among Spaniards.

Face mask

It was the surgeon Mikulic who, in 1897, at the university hospital in Breslau, forced all his collaborators to put charcoal in their mouths during operations; These, when speaking, logically spread drops of saliva mixed with charcoal and when they splashed, they impregnated the patients' bodies and other places in the operating room with black. Hence, he launched the hypothesis of wearing face masks (Lozano, 2021, p. 158).

The face masks, in the pandemic that we analyze in this text, soon became an element of protection and limitation of the spread of the coronavirus infection. “We can differentiate various types of face masks (surgical, self-filtering, hygienic, etc.), each of them having a different consideration in terms of product type, regulatory requirements, and protection they offer us” (Márquez-Peiró, Carreño, Cases, & Muñoz, 2020).

The use of face masks was also the subject of political debate, hence Royal Decree-Law 30/2021, of December 23^rd, which adopted urgent prevention and containment measures to deal with the health crisis caused by COVID-19, indicated that one of the measures to control transmission was "the extension of the correct use of face masks by citizens" (Boe, 2021).

Source: Own elaboration.

According to what is indicated in Figure 3, the appearance of this term was constant, although not very relevant in its early days. With the publication of the aforementioned Royal Decree, searches increased, reaching trend 100 on December 23^rd.

As of that date, searches decreased again, achieving a very uniform trend, except for a few days that saw how the interest of the Spaniards picked up.

PCR

The acronym 'PCR' has become, during the COVID-19 pandemic and its successive variants, a name known and used by almost the entire global population.

The PCR test (Polymerase Chain Reaction) is a technique developed in the 80s, which

consists of specifically replicating the genetic material extracted from a patient until millions or billions of copies are obtained; that is until sufficient quantity is obtained to analyze it and so that the result of that analysis has a high degree of reliability. (Csic, 2020)

Source: Own elaboration.

The evolution of the search for this term is similar in the first and last days analyzed in this work, although in the second there is a greater decrease. However, they do reach very notable data on the dates close to Christmas. Between December 20^th and 28^th, the trend shoots up because they were days of family reunions, and in this period, the 23^rd stands out with a trend of 100.

Antigen

With the appearance of the Omicron variant, the use of antigen tests was activated among the population to find out if the person could be infected. According to the Spanish Agency for Medicines and Health Products (2022), antigen tests serve

to detect an active infection, since they identify the presence of virus proteins… A positive result means that the virus is present and there is probably an ongoing infection. It should be done within the first 7 days of infection when the viral load is at its highest.

It was shown to be an effective method, although the experts insisted that the way of carrying out this test should be adequate. Therefore, the moment of taking the sample and repeating the test was key (Izquierdo, 2021).

Source: Own elaboration.

Similar to what happened with 'PCR', the search for the word antigen was similar in the first and last days analyzed. The first abrupt rise was on December 15^th, although the 23^rd of that same month was when relevant data was reached (94). The maximum was achieved on December 31^st (100) given the interest of the population in knowing their situation before the New Year's Eve celebration. From this day, the curve gradually and steadily descended.

Cumulative incidence

The cumulative incidence reflects the expansion of a disease in a given time and population. With COVID-19, it has become "one of the markers that determined political decisions" (Rae, 2022). For its calculation, "the number of cases in a period is divided by the number of people who are free of the disease at the beginning of the period" (Instituto Carlos III, 2020). The sample chosen in the case of daily monitoring of COVID-19 is 100,000 inhabitants.

Furthermore, as has been verified in the declarations of the different Spanish health authorities, the period chosen was 14 days, while the cumulative incidence at 7 days advanced the trend.

Source: Own elaboration.

The expression 'cumulative incidence' was searched by the different audiences every day of the analyzed period. The constant references to these words made by the health authorities were echoed in the media. The highest peaks were on December 20^th and 27^th (with trends of 100 and 98, respectively), dates that coincided with the proximity of the Christmas celebrations.

Vaccine

One of the most controversial aspects of everything that COVD-19 has meant is related to the vaccine. And it has been for various reasons, although it should be noted the resistance of those who do not believe in its effectiveness, besides the difficulty in finding out which of those provided by the different laboratories is the one that offers the best results.

The WHO launched a Technical Advisory Group on the composition of vaccines against COVID-19 to study and assess the consequences of the appearance of variants of concern and their effects on the efficacy of vaccines (Rae, 2022).

The first studies showed signs of optimism and emphasized the need for a new dose of the vaccine. "Total antibody increase after the third dose of the vaccine in older people, strengthening immunity" (Rae, 2022).

However, some wonder if the population should be repeatedly vaccinated:

Journalism has to do something more than transmit live the number of cases, hospitalized and deceased, and, above all, something more than communicate what politicians want people to be told. Should we keep repeatedly vaccinating the population? In this, Omicron also represents a pandemic change. Its lower intrinsic virulence forces us to rethink the benefit/risk balance of booster vaccination in relatively young and correctly vaccinated healthy subjects (Simó, 2022, p. 1).

Source: Own elaboration.

Vaccine is one of the words that maintain a greater regularity as far as the search in Google Trends is concerned. The controversy surrounding its use justifies this situation. It never goes below a trend of 20 and it is in the days before Christmas Eve when it reflects higher figures. One fact that is verified in Figure 7 is that, as the days and weeks go by, the interest in searching for this term decreases.

Booster dose

The Spanish Ministry of Health considered the risk of dissemination of Omicron in Spain to be very high. Therefore, it indicated that: "due to the current epidemiological context and the expansion of the Omicron variant, it is recommended to continue increasing the percentages of vaccination coverage and the administration of booster doses in target populations" (Ministry of Health, 2021).

Hence, a booster dose began to be talked about as "an additional injection intended for the general population whose immunity tends to disappear between five and six months after complete vaccination" (Rae, 2022).

Although this booster dose, like the first doses, was the subject of controversy by those who were against vaccines, some studies demonstrated its effectiveness. For example, in the case of BNT162b2 (Pfizer BioNTech), several authors concluded that: “participants who received a booster at least 5 months after the second dose of BNT162b2 had 90% lower mortality due to Covid-19 than participants who did not receive a booster” (Arbel et al., 2021).

However, some scientists show their doubts:

The authorization of the FDA (Food and Drugs Administration) allows anyone over 50 years of age to receive a second booster dose. But experts note that the little research done so far only recommends the fourth injection for those over 65 or those with underlying conditions that put them at high risk. (Rae, 2022)

Source: Own elaboration.

Figure 8 shows saw teeth that have to do with the interest of the different audiences in the need, or not, of a third dose. The data on the vaccines and these doses are matched, to the extent that there is a direct relationship between the two.

Once again, we observe how at the end of 2021, interest in getting this dose grows, and the fact that it disappears as the population was getting it is also highlighted.

Immunity

One of the main concerns among the different audiences was to know to what extent the fact of being vaccinated could make them immune to the new Omicron variant. The first studies pointed to pessimism: “Omicron's success in southern Africa might be due largely to its capacity to infect people who recovered from COVID-19 caused by Delta and other variants, as well as those who've been vaccinated” (Callaway and Ledford, 2021, p. 198).

Other authors such as Orellana-Centeno and Guerrero (2022, p. 29) influenced this prognosis by stating that "through mutation and adaptation, viral variants can effectively evade host immunity, which leads to prolonged infection and the spread of the virus to other people”.

In any case, the passage of time will reveal some unknowns in this regard. "For this, it would be very important to follow the vaccinated and check if they suffer from COVID-19 infections and sequence them in their case" (Picazo, 2021:591).

Source: Own elaboration.

'Immunity' is another of the terms that, during the analyzed period, was searched for every day. Without a doubt, the possibility of receiving a third dose of the vaccine or obtaining self-diagnostic tests made the public interested in knowing to what extent they could be immune.

Influenza

This word "is well formed, just like the word derived from it, flu" (Rae, 2022). Also, the fact that it is used with quotes

It is not objectionable if you want to indicate the novelty of the words or their figurative meaning since it does not refer to turning COVID into the flu, but to carrying out sentinel surveillance of COVID similar to that done for the flu.

The idea of this term is to treat the situation as endemic. However, various organizations, such as the European Commission, are more cautious in their forecasts, although it is to be hoped that with the acceleration of vaccination a better scenario can be reached (Rae, 2022).

The debate has moved to the experts. While some consider that a situation will be reached in which the virus will be circulating and people at risk will have to be taken care of, accepting that the average person will be fine, others affirm that the pandemic cannot be ended by turning the virus into endemic in one country while the rest of the world grapples with the pandemic (Rae, 2022).

Source: Own elaboration.

During the analyzed period, the word 'influenza' had an impact on Google Trends on January 5^th, 2022 for the first time. Until then it was not sought by the audiences. A few days later, it was tracked again achieving a 100 trend on the 12^th of the same month. Since then, the search process for this term has been very irregular.