Constructing the coming plague: a discourse analysis of the British Columbia Pandemic Influenza Preparedness Plan

This study explores how pandemic flu is constructed as a threat to public health in the British Columbia Pandemic Influenza Preparedness Plan such that planning for it makes common sense. Despite a history of critical research on constructions of disease, social sciences literature on pandemics is primarily practical. This study takes a critical approach using discourse analysis, which focuses on how meaning is created and shared through language use. The analysis shows how rhetorical and linguistic strategies--including active language and statistics; limited adjectives, adverbs and metaphors; recalling the past as a key to the future; reference to expert knowledge; and conferring moral responsibility onto the public to feel at risk--construct a pandemic flu as inevitable, significant and manageable. It seems to follow that such a potentially catastrophic outbreak demands considerable attention and resources. The construction makes commonsense because it is based on a familiar narrative: risk avoidance and pursuit of optimal health are fundamental responsibilities of citizens, who are enabled in these efforts by expert knowledge and the progressive discoveries of medical science. However, discourse analysis challenges common sense, revealing potential implications of social constructions. In this case, implications stem from two tensions in the plan's discourse. First, a theme of partnership and empowerment is evident, but it conflicts with a co-existing theme of authority and control. Second, although the public is addressed as an audience of the plan and exhorted to be active participants, ultimately our role is to wash our hands, receive timely information from experts, and generally "be involved." The implication is lack of clarity on who is responsible for what when difficult decisions need to be made and actions need to be taken around a pandemic. Ultimately, the analysis reveals that language need not be dramatic to wield power. It also demonstrates that disease, despite its "biomedical reality," is socially constructed, often such that the interest and values at play are obscured. The British Columbia Pandemic Influenza Preparedness Plan is not just an attempt to protect the public from an outbreak, but a reiteration of a worldview that should be challenged from time to time.