Risk Communication about COVID-19 in India: Corpus-Assisted Discourse Analysis of Mainstream News Reports about India’s Wave I and Wave II Outbreaks

Abstract

This study employed critical rhetorical analysis and corpus-assisted discourse analysis in analyzing the news coverage of India’s transition from Wave I to Wave II Focusing on news coverage from the Times of India, we examined how COVID-19 was constructed in the public and technical spheres and how India’s COVID-19 risk communication was shaped by unique geopolitical, cultural, infrastructural, and material factors. Our analysis highlights the tendency to datify COVID as statistics and case numbers, which both dehumanizes the patients and caretakers while erasing human suffering. It also reveals the critical roles played by the geopolitical, socioeconomic, infrastructural, and material conditions in shaping the national and regional capacities to respond to such far-reaching crises. Last but not least, affect and trust play prominent roles in the public coping with emerging pandemics given the uncertainties on all fronts, and thus should be centrally highlighted and addressed in public policies.

In January 2020, India reported its first COVID-19 case before introducing policies of nationwide closures and lockdowns in the country. With new mobility regulations introduced in March 2020, India witnessed not only economic distress, but also exacerbated the socio-political inequalities. This was especially evident in the migrant laborers’ struggles to return to their hometowns given the limited availability of transportation options because of the lockdown. Over the year 2020, the Ministry of Health and Family Welfare (MoHFW n.d.)—the health administration department of the government of India—recorded several detections of COVID-19, fatalities, and changes in regulations as well as relief measures introduced by the government. In June 2020, the country slowly opened up with different iterations of “unlock”, which allowed specific public places to gradually open up for services. During the unlock process, positive COVID-19 cases and records of the deaths still took place. In the meantime, between December 2020 and January 2021, India declared the successful development of its own COVID-19 vaccine.

Despite the introduction of the vaccination program in India, the country saw a transition from Wave I to Wave II. In April 2021, India recorded 360,960 COVID-19 infections in a single day, making it the worst wave of COVID-19 worldwide. The surge of COVID cases overwhelmed the health infrastructure of the country and resulted in shortages of testing kits, hospital beds, oxygen supplies, and medical staff (Thiagarajan 2021, p. 1). Many socio-political, economic, and cultural factors contributed to this transition from Wave I to Wave II. Media coverage of the Indian outbreak revealed the existence of these socio-cultural factors that shaped the COVID-19 narrative and the development of the outbreak. International media coverage of the Indian outbreak focused on the policy responses of the government, the surge in the number of cases, and the records of fatalities due to COVID-19. While these international news reports sought to uncover the conditions of the outbreak in India, they were doing so from “sensationalist” (Islam 2021) and analytical perspectives following “Western attitudes rather than human problems” (Gurmendi 2020)—almost as if they were gazing over the outbreak—without attempting to put the pandemic in perspective with the underlying socio-political factors (Aaina 2022).

In this study, we paid attention to the COVID-19 outbreak in India and focused on risk communication strategies in the public and technical spheres. We conducted a corpus-assisted discourse analysis of COVID-19 narratives in the Times of India, the most widely circulated English newspaper in India, between 6 July 2020 and 6 July 2021. It examines how COVID-19 risk communication was shaped by the local geopolitical, cultural, and material factors, how COVID-19 was constructed in the public and technical spheres (Goodnight 1982, 2012), and what led to the transition between the first and second COVID-19 waves in India. In the remainder of this paper, we highlight several important factors that contributed to the rise of Wave II in the technical and public spheres.

1. Literature Review

1.1. Material Rhetoric

Much has been written about the material nature of writing, and by extension, journalistic writing. In her framework of rhetorical ecology, Jenny Edbauer (2005, p. 8) urged scholars to examine persuasive activities in a “wider sphere of active, historical, and lived processes”, which can help reveal the “mutuality of material practice, embodied experience, and discursive representation”. Rickert (2013, p. 106) foregrounded such connectivity in his ambient rhetoric, arguing

Connection is already given as possibility by the world itself, with world being a composite of meaning and matter. The salience of our discursive entreaties is already prepared in advance by the complexity of ambient relation and interaction [among] language, person, and environment.

Putting “place, language, and body into coadaptive, vital, and buoyant interaction” (Rickert 2013, p. 197), the ambient rhetoric provides researchers with a useful tool to examine how, in emerging pandemics, the body is produced and disciplined through a material-discursive entanglement of both social experiences and techno-scientific and political practices.

In her study of cancer care deliberation, Teston (2017) examined the collaborations of human, nonhuman, and computational actors to visualize, assess, synthesize, and compute contingent and indeterminable evidence in her attempt to open up biomedical, backstage black boxes. Using material feminist approaches to highlight the relational nature of both health and care, Teston (2017, p. 174) advocates for “an ethic of care that treats as sacred the fragile ecological flux we always already share with a host of human and nonhuman agents.” According to Alaimo (2008, p. 261), this material feminist approach invites us to “reimagine human corporeality, and materiality itself … as something that always bears the trace of history, social position, region, and the uneven distribution of risk” (as cited in Teston 2017, p. 179).

Examining the material exigencies surrounding vaccine rhetoric, Heidi Lawrence (2020) explored “the ways in which material operations of key objects in controversy constrain rhetoric and possibly produce discord” (p. 155). Using what she calls “the material rhetoric approach”, she argued that “perceptions of risks and benefits, safety and harm, and the very nature of health” can be conceived as “a series of material enactments of the body” (p. 156). Her approach opens up a new space for rhetoricians to employ new “nuanced methods of research, engagement, and intervention [while] broadly acknowledging the multiplicities of realities that are created by medical interventions” (p. 156).

Global pandemics are centrally featured by their materiality, namely, the material and biomedical actants that coalesce as central factors in the maintenance of population health (Latour 2005). Enmeshed within a network of “information, technology, and materiality” (St. Pierre 2015, p. 341), nonhuman actants such as tests and vaccines hold transformative capabilities both as objects intervening with the body and through their ascribed meanings (Latour 2013).

1.2. Spheres of Argumentation

Goodnight (1982, 2012) introduced the framework of three spheres of argument in public deliberation, namely, technical, public, and personal, which all function to “organize grounds of authority” and “serve as sites of controversy” (p. 260). In the technical sphere, experts use “limited rules of evidence, presentation, and judgment” to achieve communication goals (Goodnight 1982, pp. 219–20). In the public sphere, representative spokespersons employ “common language, values, and reasoning” to settle “disagreements transcending private and technical disputes,” which are matters of interest to ‘the entire community” (Goodnight 1982, p. 220). The personal sphere, in contrast, is featured by “informal demands for evidence […] and language use” to make arguments.

To study how the socio-technical uncertainties are negotiated, Callon et al. (2011) introduced the hybrid forums as “an apparatus of elucidation” that mediates the division that separates specialists and laypersons, or experts and the public. Walsh and Walker (2016) called attention to “hybrid genres, forums, and communities that […blur and] reshape the boundaries of personal, technical, and public discourse.” For them, the hybrid forums allow for the “hybridization of arguments, genres, and communities” by combining or violating standards of argument from different spheres (p. 72). In world risk contexts, hybrid forums represent sites that assemble a heterogeneous group of concerned stakeholders to explore political options for the reformation of technical, personal, and public boundaries.

As Goodnight (1982, 2012) and others have pointed out, boundaries between the spheres emerge through rhetorical and political power struggles by actors who have interests in rearticulating what may have been previously considered as “technical” or “personal” as matters of public concern or vice versa. The assignment of argumentation to one sphere or another is not a neutral process, but a practice of widening or narrowing an argument to serve political ends (Zarefsky 2012).

1.3. Risk Communication, Crisis Communication, and Datafication

Risk communication plays a prominent role in shaping how individuals and communities respond to emerging pandemics such as COVID-19. Paul Slovic (1999) claims that “defining risk is an exercise in power”, for “whoever controls the definition of risk controls the rational solution to the problem at hand …” (p. 689). In World Risk Society, Beck defined risk society as one that focuses on the uneven distribution of risks. He argued that as side effects of scientific and technological innovations, industrial technical–scientific projects produce omnipresent mega-dangers or unintended consequences, which are not attributable, accountable, insurable, or manageable due to manufactured uncertainties and organized irresponsibility (Beck 1999, 2006). He identified three possible reactions to risks: “denial, apathy and transformation” (Beck 2006, p. 331).

For Leiss and Powell (2004), effective risk communication practices bridge expert risk assessment with public risk perceptions by providing information about the risks. Ding (2014, 2018, 2020) examined how, in emerging epidemics, the public perceptions of the risks introduced are shaped not only by technical and media discourses, but also by grassroots risk communication efforts carried out by medical care workers, patients, and affected communities to leverage individual knowledge of and experiences related to the health risks.

For disciplines such as economics, statistics, and engineering, risk is associated with the unpredictability of outcomes, which can be objectively and quantitatively assessed (Weber and Johnson 2009; Sandman 1993). The field of psychology, in contrast, acknowledges risks as a subjective, culture- and experience-driven experience, often associated with negative emotions such as fear and vulnerability (Slovic et al. 2004; Weber et al. 2002; Figner and Weber 2011). These two divergent disciplinary approaches to framing risks are defined by Beck (1995) as “natural objectivism” and “cultural relativism” (p. 162). While the former emphasizes expert rationality and dominates institutional risk-assessment practices, the latter sees risks as a social reality shaped by institutional discourses, cultural beliefs, and individual perceptions (Beck 1999). “Cultural relativism”, or subjective experience of an individual with a risk, is also relatively dependent on the material conditions that induce fear, panic, or other negative emotions. For instance, the surge in the number of COVID-19 cases in India during Wave II resulted in the lack of material and biomedical resources, which highlights the subjective struggles (including fear, uncertainty, and anxiety) that the COVID-19 patients, their families, and the medical staff faced. Therefore, an immediate connection exists between material factors that shape the risks and individual experiences associated with and caused by such risks.

Risk communication differs from crisis communication, since risk involves the potential threat of harm while crisis is “a disruption to organizational strategy” (Coombs and Holladay 2023, p. xxvii). Risk communication focuses on future threats or unpredictable negative outcomes caused by uncertainties, which are often associated with new technologies or man-made disasters (Beck 1999). In comparison, situated in management and public relations, crisis communication is concerned with both threats posed by unexpected crises that have already taken place and with attributed responsibility and organizational reputations (Coombs and Holladay 2002; Coombs 2007; Ma and Zhan 2016). These two fields also share similarities since, in crisis communication, organizations can be victimized by unexpected crises, create unintentional crises due to accidents, or knowingly put people at risk by creating preventable crises due to organizational misdeeds (Coombs and Holladay 2002). Negative emotions often accompany both risk communication and crisis communication, which include but are not limited to fear, uncertainty, anxiety, and concerns in the former and anger and schadenfreude in the latter (Coombs 2007). Given our focus on the emerging pandemic of COVID and the uncertainties surrounding the unknown health hazards and socioeconomic disruptions brought by COVID, our study is firmly situated in the field of risk communication. However, we briefly touch upon the Indian government’s crisis communication efforts and the media coverage of vaccine politics in Wave II. Some of the Times of India (TOI) reports mentioned vaccine exports to countries outside of India as well as vaccine hesitancy, thus leading to questions regarding the government’s (mis)management during the risk situation.

Risk communication approaches affiliated with “natural objectivism” seek to promote rational responses through top–down, expert-centered efforts, and to minimize the so-called “irrational” responses of fear, distrust, and despair from panicked citizens (Grabill and Simmons 1998). Many scholars have argued that “irrational” responses are “sometimes a more appropriate and reasonable response than logic” in coping with emerging risks (Katz and Miller 1996, p. 131; see also Fischer et al. 1991; Leiss and Powell 2004; Ding 2021).

Much attention has recently been paid to datafication to examine how technologies such as big data tools, methods, and applications are used to sort, classify, score, and rank people and organizations in all sectors (Galliers et al. 2015; Loebbecke and Picot 2015; Newell and Marabelli 2015). Digitalization and big data analytics have turned humans into walking “data generators” (McAfee and Brynjolfsson 2012), before converting such data into “actionable insights” (Kitchens et al. 2018, p. 541). Whether it is for prescription, prediction, manipulation, or coercion, datafication provides the ability for organizations to use data for influence, surveillance, and control, or to use Sunstein and Thaler (2009)’s term, “nudge” (Carolan 2018; Sætra 2019). Efforts in datafication are omnipresent in risk communication surrounding COVID-19, which turn patients, illnesses, symptoms, and deaths into measurable and objective data points. Often prominently featured in the public sphere and the technical sphere, such rhetorical moves can help divert public attention from human suffering and institutional accountability to trends, epicenters, and new discoveries, focusing on material actants at the cost of human sacrifice.

Datafication is closely connected to material rhetoric since it reveals “a new materiality of data wherein cheap memory, powerful processors, algorithms, and machine learning quantify our world and selves” (Pybus et al. 2015, p. 3). By examining the competing interpretations of health data in the public sphere and the technical sphere, we demonstrate how the mainstream media, government agencies, and doctors used material rhetoric to engage with the data and help shape the public perception of the risks associated with COVID, the benefits of quarantine and lockdown policies, and ways to discipline individual bodies to reduce harm. Our findings shed light on both the socio-technical assemblage that enabled the pandemic risk communication about COVID and the material-discursive entanglement of unevenly distributed risks, social experiences, techno-scientific insights, and public policies.

1.4. Journalism and News Media in India

In 1780, James Augustus Hicky published India’s first newspaper, which was said to be a critique of the British administration under the governor, Warren Hastings. Given its anti-colonial nature, the newspaper was only in circulation for two years, but it inspired the publication of other Indian newspapers. After 1857, Indian newspapers were split into two categories: nationalist and Anglo-Indian. While the discourses in nationalist newspapers were critical of colonial rule, those in Anglo-Indian newspapers propagated colonial rule (Pathak 2021). The very nature of early newspapers in India is indicative of the underlying political context that shaped the voice of these newspapers. Although the Indian Constitution provides freedom of speech to the press, media critics have voiced their concerns about governmental influence on print and electronic media outlets (Bhurtel 2020; Kamdar 2020). An overview of India’s media infrastructure provides us with insights into the prominence and role of newspapers.

Sonwalkar (2015, p. 618) highlighted how India’s democracy has historically been rooted in “[…] dialog, debate, and argument, which had been transformed by the growth of print journalism since the late eighteenth century”. Despite the widespread existence of newspapers, people had uneven access to them during the COVID-19 outbreak due to health concerns. Hesitant to receive newspapers in their print versions, subscribers and delivery people were afraid that the newspaper would carry the virus. As a result, the print media went through a circulation disruption (Ninan 2021) that caused commotion among people because “[…] Indian readers trust the information coming from the newspapers” and “the credibility of print media in the country is still highly regarded”, despite the growth in web-based media sources (Jadhav 2020, p. 124).

In the Indian context, an overview of the media landscape is representative of the prominence and role of print media, specifically newspapers. The Times of India, or TOI, is the most circulated Indian-English newspaper in India, and third-most circulated Indian daily (preceded by newspapers published in Hindi language). Based on its historical presence, readership, and circulation data as well as the highest number of COVID-19 news publications between 6 July 2020 and 6 July 2021, the TOI offered an extensive and relevant dataset that would help address our research agenda. The fact that this newspaper is written in Indian-English adds a cultural nuance that would further help understand the transition from Wave I to Wave II and how that was communicated to the public.

2. Method

This study employed critical rhetorical analysis and corpus-assisted discourse analysis to analyze the news coverage of India’s transition from Wave I to Wave II. We examined the perspectives from the epicenter, India, where the Delta variant spread quickly, using LexisNexis to collect news reports on COVID in India.

While searching for news reports in Nexis Uni, we used the two keywords COVID and INDIA with the date range of 6 July 2020 to 6 July 2021. Hoping to conduct close reading and detailed cultural analysis, we chose to focus on the newspaper with the largest number of reports, which ended up being the Times of India—100 articles analyzed.

After collecting the data, we performed data cleansing to remove any unrelated content such as the byline, copyright, subject, and industry to ensure that only the titles, publication dates, and original reports were retained in the cleansed corpus. Then, we saved the corpus as a .txt file in preparation for computational analysis.

We performed computer-assisted discourse analysis using AntCon 3.5.8, a corpus analysis tool released by Lawrence Anthony (2019) in Tokyo, Japan for concordancing and computational text analysis, using the tools of clusters, concordances, and collocates. The Cluster Tool helps identify common expressions in a corpus by showing clusters based on the search condition, in our case, individual high-frequency words. The Collocates Tool shows the collocates of a search term, which makes it possible to investigate non-sequential patterns in language.

We first reviewed the word list by copying and pasting the entire list of over 5000 words in an Excel spreadsheet, grouping together words morphologically derived from the same stem (i.e., act, acted, acting, and action), and identifying important concepts and topics for additional analysis. This preliminary analysis highlighted the technical sphere and public sphere as the two most relevant spheres of argumentation in our corpus. Then, we created two word lists for the technical sphere and public sphere, respectively, focusing on the top 10–15 high-frequency keywords related to each sphere before compiling their individual clusters and collocates using an Excel spreadsheet.

We then started a close reading to categorize clusters and collocates. To add qualitative insights to these quantitative results, we used the Concordance Tool to view how individual words as well as their clusters and collocates were used in contexts, often returning to the original reports to view the entire paragraphs and sometimes, the entire reports. Rhetorically significant passages were manually collected to perform more in-depth critical reading, which helped us move beyond frequencies, collocates, and clusters to identify the socio-economic, cultural, infrastructural, and geopolitical factors at work during the two waves in India.

3. Results

Based on our critical rhetorical and corpus-assisted discourse analysis, we observed several material factors that led to the transition to Wave II in India. These material exigencies included stakeholders from both the technical and public spheres of argumentation (Goodnight 1982) to achieve specific communication goals during the pandemic. To organize our results, we decided to use spheres of argumentation in documenting our findings while also highlighting the hybridization of different spheres.

Several important factors that contributed to the rise of Wave II were identified in the technical sphere including vaccine exports and vaccine hesitancy, confusing lockdown and open up policies, health inequity, and inadequate public health infrastructure such as access to oxygen, testing, or hospital treatments. In the public sphere, several factors were covered in depth including the overall public health situation in India, addressing mental health, myth-busting as well as the local socio-economic and cultural conditions (i.e., profession-focused coverage, multigenerational/joint families, and religious beliefs and values) and political conditions (i.e., government’s approaches and measures to containing the spread of COVID-19).

4. Technical Sphere

4.1. Datafication of the Human Bodies Affected by COVID

4.1.1. COVID and COVID Patients

As the most frequently used collocation for COVID, patient/patients appeared 136 times in the corpus, focusing on symptoms (60), death (24), infrastructure (32), case numbers (16), supplies (6), and social factors or impacts (6). Numerous new symptoms were recorded, which, as emerging technical evidence, suggested COVID’s impacts on a wide variety of human organs. The list was long and puzzling to both the experts and reporters, which included blood clotting, Bell’s palsy, burning of eyes, blurred vision, acute loss of vision, psychological issues such as anxiety and depression, gastrointestinal complications such as vomiting, diarrhea, intestinal clots and gangrene, abdomen pain, neurological and cardiovascular ailments such as stroke, elevated blood sugar levels, low oxygen saturation levels, or hypoxia. Questions were raised about the causal relationship between COVID and infertility, myocarditis, and neurosis. Frequently mentioned infrastructure included hospitals, beds, oxygen, blood banks, and COVID care centers. Social factors were also included in the coverage such as concerns about disclosing patient names that violated patient privacy, the lack of comprehensive studies of long-COVID patients, and the need to encourage COVID patients to donate their blood after 28 days of recovery to help alleviate the “voluntary donor crunch” (Kanwar 2020).

Our analysis of the concordance for COVID patients revealed the datafication tendency of using patients as the site of medical study to compile the ever-increasing list of possible symptoms, co-morbidities, and post-recovery complications while trying to address uncertainties surrounding the long-term health impacts posed by COVID. The few exceptions are the references to social factors and concerns faced by COVID patients, which put a human touch to the suffering experienced by the patients and their families.

Such datafication efforts became much more obvious in our analysis of the next few collocates: cases (88), deaths (56), infection (42), wave (26), vaccine (32), complications (post-COVID, 18), and tests (18). The references to COVID cases (88) were rather datified, focusing on numbers (20), trends (rising, stable, surge, spurt, decline, or falling, 36), locations (21), and time (5). Similarly, the collocates for “COVID and” focused on patients (14), complications (12), symptoms (8), and policies (2).

4.1.2. Deaths

Death was mentioned 234 times in the corpus, focusing on information such as causes of death (66), numbers and locations (72), and confirmed COVID-related deaths (42). While death has mostly been datified as trends and patterns, our qualitative analysis identified several reports that focused on strong emotional responses to the massive deaths caused by COVID. The corpus contained several in-depth reports about the critique and concerns related to the panic and disruption caused by COVID deaths, which highlights the human suffering and losses surrounding death (22).

Multiple concerns were raised in one article published in July 2021 by Farheen Hussain about the post-traumatic stress disorder (PTSD) caused by Wave II in India. India was reported to undergo “a psychosocial crisis”, with many citizens suffering from PTSD due to loss, grief, and fear of death as well as a shortage in hospital beds and oxygen supplies. This dire situation led to a call for “innovative methods [to] spark hope and policy shifts”. The absence of rituals, most importantly, funerals, due to the COVID death protocol made it difficult for people who lost family members to process grief. Medical care workers suffered from mental health problems due to the additional burden of conveying the deaths to families after working around the clock to combat the pandemic. COVID-related deaths led to unprecedented grief and trauma, with “people in their 20s and 30s [losing] both parents, families [losing] multiple members and entire families [hospitalized] in ICUs” (Hussain 2021).

Reports also describe the confusion and despair caused by the large number of deaths, overwhelmed COVID-designated funeral centers, COVID-protocol cremations, and unclear operating procedures for funerals. When dying without being officially certified as a COVID-related death, COVID victims were handed over to relatives and taken home to perform death rituals. Furthermore, when the cause of death was not mentioned as COVID, the protocol mandated for the cremation of bodies of COVID victims was not followed. The body was handed over to the relatives, which was then taken to their houses for funeral rites where several people participated.

Claiming “the whole system had collapsed”, one cremation center reported an increase in cremations from 7 to 10 a day to “50 COVID-protocol bodies [with over] 100 ongoing cremations” in late April 2021 (Singh 2021). This exponential growth was caused by both the rising number of patients in Wave II and the large number of COVID victims dying at home during quarantine. Such deaths were not tracked or certified by overwhelmed local hospitals, which not only increased the risk of infection at funeral centers, but also put the burden of reporting and trafficking on the relatives of those victims.

4.1.3. Affect

While denial and apathy featured in the Indian government’s early responses to COVID, negative emotional responses from the public were recorded extensively in the corpus, with mental (84), concern (58), anxiety (32), fear (31), and grief (28) most frequently mentioned. Mental issues were recorded extensively, focusing on mental illness (30), mental health (28), mental confusion (8), mental fatigue (8), mental hospital (4), mental breakdown (2), and the lack of mental care (2) and mental focus (2). The corpus identified many factors that caused concerns in the public including, but not limited to family clusters, increasing cases, resurgence of cases, long-COVID, complications, comorbidities, overcrowding at vaccination centers, deaths, waste disposals, waste segregation, grief and fear, and a constant dip in testing. These concerns were technical, infrastructural, material, socio-economic, and emotional. Anxiety appeared quite frequently in the corpus, with the collocates of and (24, depression 8, insomnia 2, stress 12, panic attack 2); are (reference to mental health problems, 6), fear (6), and tiredness (4). Fear was recorded 31 times, focusing on the fear of COVID, infection and reinfection, uncertainty, fraudsters, and not finding beds, oxygen, and timely treatment. Large-scale grief was also recorded frequently, with collocates of loss (12), fear (8), death (4), and trauma (4).

These references to emotional responses highlight the essential roles that affect plays when people cope with emerging health risks. One report called for the need to address “large-scale grief, fear, and mental health problems […] on a policy and social level” and to frame COVID as a marathon, not “a 200-m dash” in existing public health messaging (Hussain 2021).

4.1.4. Bodies Entangled with Biomedical Actants in Techno-Scientific Practices

Our analysis of the technical sphere identified how COVID patients were subjected to the materialistic enactment of powerful biotechnologies (i.e., ventilation machines, oxygen tanks, testing, diagnostic tools) for various co-complications, medications, and so on. They were also disciplined by public health measures––quarantines, shutdowns, and contact tracing, with the goal of treating unexpected complications and comorbidities, containing the outbreak, and reducing cross-infection. As a result, the sick bodies were entangled in and disciplined by techno-scientific and political forces. These material-discursive elements created evolving social construction and thus public perceptions of risks and health. Our analysis of the deaths suggest a datafied focus on patients who died from COVID and thus the failed biomedical intervention to treat COVID as an emerging pandemic. In contrast, our analysis of clusters related to the sick body revealed a much more extensive coverage of the material conditions surrounding the critical needs to treat sick patients and to provide timely medical intervention such as oxygen supply and blood transfusion as well as the human consequences of failing to meet such urgent needs. What follows is our analysis of the clusters and concordances related to blood, oxygen, and treatments, three material elements severely impacted by Wave II.

4.1.5. Brain and Heart as the Main Organ Battlefield

A lot of confusion was observed in the early stage of COVID when the evidence showed that the brain (162) and heart (117) were the two top organs heavily impacted by COVID. Such an emerging understanding quickly transformed the medical understanding of COVID from a straightforward respiratory disease to a puzzling pandemic that creates whole-body damage.

With a total of 117 references to the heart, the corpus discusses in great depth the observation of heart diseases (49) in patients; heart complications such as heart damage, heart ache, clots, and unusually high heart rate (>150); infiltration, inflammation, or damage of the heart muscles (12); impacts on the heart and (12) other systems such as the brain, liver, lung, pancreas, kidney, and mind, namely, depression; heart attacks (8); heart failure (6).

The brain was mentioned 162 times, focusing on brain health/function (39), brain fog (38), brain cells/tissues (8), and brain stroke (6). Stroke, as a closely related concept, appeared 52 times in the corpus, focusing on patients (10), heart (8), disease (8), and brain (8). It was identified as one of the complications that can take place as an initial manifestation or later manifestation of COVID. Neurologist was mentioned 24 times, often cited as experts who provided information about the COVID-brain connections as well as the diagnosis of and treatments for COVID patients suffering from brain issues. Such biomedical data points worked together to present COVID as a multi-organ disease rather than a straightforward respiratory one.

4.1.6. Blood

The material shortage of blood is reflected in the references to blood banks (6) and the need for more blood donation (12) to enable blood transfusion for COVID patients. Much attention has been paid as to how COVID influenced blood in all aspects: blood clotting (20) started to appear due to thickening blood in both COVID patients and post-COVID patients causing heart complications, thyroid derangement, gangrene in limbs, and sometimes amputation. Blood vessel/s (16) were impacted, which resulted in blockage, swelling, or inflammation. Blood supply (14) was blocked or cut-off, which led to stroke symptoms in COVID patients. Uncontrolled, high, or elevated blood sugar (12) became a common problem and high blood pressure (6) started to emerge. Meanwhile, the corpus contained ten references to the need to monitor the blood oxygen saturation levels, which could drop to 92/95% without any complaints of discomfort from the patients and thus lead to hypoxia.

While many complications appeared in the so-called “post-recovery serious cases”, the TOI also reported on how even asymptomatic patients or patients with mild symptoms could have post-COVID problems.

4.1.7. Oxygen

As a high-demand material, oxygen was constructed as both a problem to be overcome and a commodity in need, with 76 and 34 references, respectively. Oxygen saturation (24) needed to be monitored and checked regularly to make sure it stayed above 95%. Shortage in oxygen supplies (22) was reported all over the country, which led to dropping oxygen levels (10) in patients, the lack of oxygen support (12), oxygen beds (4), or oxygen for ventilators (2) in hospitals. This shortage also resulted in questions regarding oxygen accountability (4)

As a commodity, oxygen is connected to medical facilities, treatments, and supplies such as oxygen enrichment units (10), oxygen cylinders (8), and oxygen therapy (6), which helps increase the oxygen concentration (4).

4.1.8. Virus

Virus was used mostly in factual description, with the following collocates: caused (damages such as stroke and hemorrhage, 12), spread (stem/control virus spread, 12), in (organ locations, 10), directly (affected organs, 10), particles (in droplets, nose and threats, 4), and medical care workers (4). While much emphasis was put on the spread and health impacts of coronavirus, medical care workers were presented as the defense between patients and COVID from prevention to treatment. The corpus also revealed the existence of fake products that catered to people’s desire to protect them from COVID through the references of the so-called “virus shut out cards” (8). The product was a Japanese-made lanyard with chlorine dioxide, which was falsely advertised as being able to kill “99.9% virus and bacteria in the air” (Tewari 2020).

4.1.9. Testing and Treatment

Testing was covered extensively in the corpus, focusing on tested positive (58), tested negative (22), tested for (14), testing in (8), and test capacity (6). These collocates were largely informational and provide insights into the testing locations, results, and trends. The corpus contained several personal narratives about the patients’ experiences with severe COVID symptoms and long-COVID, with one patient claiming to have sudden shivers, vomiting, and splitting headaches after 21 days of testing negative (My COVID Story 2020).

As a locus of biomedical actants, treatment (56) received extensive attention in the corpus, focusing on treatments for emerging complications and post-COVID issues (22), issues of having access to facilities (16), changing treatment protocols due to new discoveries (10), and cases (2). Our analysis of the coverage of treatment revealed the evolving nature of COVID-related knowledge, which led to changing treatment protocols in response to the latest scientific understanding of the pandemic. For instance, one report divided the progression of COVID into two periods, with the first week being the infection period and the second and third weeks being inflammatory weeks (Ali 2020). It also provided a list of body proteins and enzymes found in tests for COVID patients. Based on the levels of elevation, these biomarkers can indicate the quick progression of COVID and the need for immediate treatment, and were thus included in the revised treatment protocols issued in December 2020.

Several concerns about treatments (6) were recorded, which indicates the human consequences caused by delayed treatments such as thrombolysis or clot removal for COVID patients due to delays in screening or their fear of seeking treatments during the pandemic. Questions were also raised about unnecessary charges for patients holding Ayushman cards, a health insurance scheme introduced by the Government of India in 2018 to provide free medical care for economically vulnerable people (Jha 2021). Such issues revealed the difficulty for low-income individuals to gain access to timely treatments during COVID outbreaks, which clearly suggests the material consequences of socio-economic status on access to treatments and health outcomes.

5. Public Sphere

5.1. People-Focused Keywords

The COVID-19 narratives in the TOI used multiple keywords that specifically focused on people, referring to them as patient(s) (254), case(s) (239), people (155), and the public (42). The most frequent collocation of patient(s) focused on the relationships that patients had with other factors pertaining to health and treatment (52), patient conditions and numbers (172), and patient experience (7). In general, the results for patient(s) yielded health-related data including infection and recovery rates, and hospitalization data. However, even though the narratives were datafied, they were still humanized in some ways. For instance, identifiers such as the names of the patients and hospitals where they sought treatment were included in the news reports. Attention was also paid to the patients’ emotional experience after recovering from COVID-19. For instance, one news report mentioned how mental health conditions such as anxiety, depression, and insomnia were common among patients who recovered from COVID-19, which highlights the impacts of affect in these narratives (Timesofindia.com 2020).

Case(s) was mentioned 239 times in the corpus, focusing mostly on the trends in COVID-19 infection and death rates. The collocates for case(s) revealed a focus on keeping a tally on the active cases (19), reported cases (25), new and emerging cases (fresh, rise, rising, surge, 48), the overall COVID-19 conditions in the country (worst, unusual, 8), and fatalities (8). The narratives about the cases were highly datafied, mostly highlighting the post-recovery symptoms that the patients faced. For instance, one report said, “Fresh novel coronavirus infections are declining, but the post-COVID-19 complications have become a major cause of worry for doctors. Several such cases are being reported daily.” (Chauhan 2020).

People (155) and public (42) were used in the context of the overall public health situation of the country during COVID. The cluster and collocates for public emphasize India’s infrastructural concerns (health, service, transport, 18). Those for people, in contrast, described the affect and emotions felt by the populations including feelings of hesitation, stress, fear, coping, and apprehension (8). For instance, one report highlighted how patients felt post-recovery: “He [doctor] emphasized that coronavirus causes neurological involvement, as several patients experienced distress post-COVID recovery.” (Timesofindia.com 2020).

In the public sphere, people-focused keywords also consisted of references to professionals such as expert(s) (43), official(s) (39), worker(s) (30) as well as families (58). The cluster and collocate results for expert(s) positioned them as credible sources of information that can be relied on in this relatively new pandemic situation (experts said/say, opined, point, recommend, caution, feel, report, treat, 19). Collocates of official(s) yielded results that were more action- and regulation-oriented (officials said/say, implement, assert, maintain, preview, add, brief, 45): “Health officials said that the prevention protocols must be followed in letter and spirit to keep trouble away.” (Timesofindia.com 2021).

Worker(s) appeared 30 times in the corpus and was in reference to the types of workers (migrant, healthcare, public, health, frontline, 49), their health situation in relation to COVID-19 as well as their vaccination status.

5.2. Geopolitics-Focused Keywords

The TOI narratives also covered some geopolitical aspects that shaped the COVID-19 situation in India. This included keywords such as state (138), government (86), India/Indian (113), lockdown(s) (40), and minister (30). We framed this as geopolitical because the idea of states and governments is both deeply tied with the political landscape of India and situated within specific geographical contexts.

The most frequent collocate of state(s) emphasized the role of government (19), state-specific approaches to managing the pandemic (6), and the number of cases in a given geographical location (18). Certain references to states were made in terms of accountability (i.e., who should be held responsible for the growing number of cases and the dearth of medical resources). One example on the oxygen supply in hospitals wrote, “Sardesai held the officer responsible for the delay and deficit of oxygen leading to deaths in hospitals” (Directionless Leadership 2021).

India/Indian appeared 113 times in the corpus, and the collocation results mainly pertained to research institutions (institute, science, serum, 14) and the television industry in India (producers, cinema, films, broadcasters, council, 21). This was an interesting insight because it shows the role that the television industry plays in India. A news report also highlighted the impacts of lockdown on the television industry: “The new diktat of no shootings during the weekend is going to hit producers of all platforms in a big way. JD Majethia of the Indian Film and Television Producers Council said, ‘TV units shoot at least two episodes in three days.’” (Dubey 2021).

Another prominent keyword in our corpus analysis was government. The collocation results showed that government frequently appeared with state (19). The cluster also revealed the emphasis of government infrastructures (hospitals, medical, offices, 13) and government approaches/guidelines (protocols, support, claims, 8).

Lockdown appeared 40 times in the corpus. A brief overview of the COVID timeline in India shows how the lockdown measures in India were constantly modified and applied to different parts of the country; hence, lockdown was certainly an important factor in analyzing the transition from Wave I to Wave II in India. The collocation results for lockdown framed it as a constantly evolving process that had clear socioeconomic impacts (complete, another, happened, during, enter, introduced, 24). For instance, Sengupta (2021) cited actress Geet Roy: “I think the current solution is a lockdown for a short span. If we go for a lockdown for 15 days, the chain will be broken and we might be able to curb the rapid rage. I know it will lead us to a huge financial crisis but I don’t think we have any other choice currently.”

Finally, in the geopolitical keywords category, ministers was used 30 times. There was an obvious interconnection among the keywords state, government, and minister as all three fell under the political prospect of COVID narratives. The most frequent collocates were the names (Narendra Modi, Uddhav Thackeray, Sawant, Pramod, 22) and affiliations of various ministers around the country (health minister, union minister, chief minister, prime minister, 24). These narratives focused on the actions taken by the ministers in response to COVID-19. One report covered how Chief Minister Pramod Sawant called the rising cases of COVID-19 as “a cause for concern”, urged people “to stay on alert and take necessary precautions”, while disclosing the plan to stop lockdown measures (Rising COVID Cases 2021a).

5.3. Health Infrastructure Keywords

In the public sphere, we observed the central roles played by hospital(s) (150), doctor(s) (79), and vaccine(s) (121) in how the pandemic emerged in India from Wave I to Wave II. While the technical sphere highlighted the inclusion of very specific medical information, the public sphere focused on the actions taken by doctors, the condition of the health infrastructure as well as affect and emotions during the outbreak.

Hospital(s) appeared 150 times in the corpus, and the most common collocation results were in relation to location-specific information (district, Goa, south, 20). These instances underlined the shortage of medical resources, the emergence of cases in various age groups, and other health-related symptoms that were prominently seen in COVID-19 patients. For instance, one news report described the strained health infrastructure during Wave II: “While the state may send out trains to fetch oxygen from Odisha and put up beds for treatment, there aren’t enough doctors, nurses or paramedical staff across all hospitals” (COVID-19: Five Pandemic Problems 2021). There was also a modest focus on the limited transportation and mobility (3) of certain socio-economic populations that could not afford a personal vehicle and relied on public transport for their daily commute. In addition, government approaches to manage the situation were also covered in the news reports; some reports addressed the shortage of medical resources at the state-level, and some highlighted the imposition of lockdown restrictions in certain sectors such as the television industry to reduce the spread.

Another significant keyword that appeared under health infrastructure was doctor(s). The most frequent collocates of doctor(s) were nurses and patients (17). This was anticipated as doctors, nurses, and patients are all part of the health infrastructure ecosystem. References to doctors were action-oriented and focused on what they were doing to treat COVID-19. Myth-busting was highlighted as efforts made by doctors to curb misinformation and provide correct information to the public. Myth-busting was also at the core of vaccination narratives in the TOI. Several examples were of doctors providing clarification regarding COVID-19 treatment and vaccines.

The collocate results of vaccine(s) and vaccination yielded interesting insights that informed on how existing and emerging pandemics and vaccines can lead to feelings of uncertainty in a relatively new situation. Collocates of vaccines can be further divided into myth-busting and care (41), research and development of vaccines (23), and vaccine administration data. Some reports also focused on fake news via social media as factors that contribute to misinformation among the public. For instance, Deshpande (2021) wrote:

Misconceptions and fake news have already started spreading about vaccine for all 18+ citizens. Apart from regular WhatsApp forwards holding vaccine responsible for impotency, DNA change, and cardiac arrest, the latest and most circulated one is about the vaccination for women during their menstrual cycle. Experts have debunked all these theories.

The major reasons for vaccine hesitancy were the fear of developing infertility, uncertainty as to whether the vaccine was safe while menstruating, and concerns regarding consuming alcohol after being vaccinated. In addition, people were also worried that the vaccine might cause COVID-19.

News reports also highlighted the overlap between doctors and ministers and how they collaboratively played a prominent role in myth-busting. For instance, there were narratives of doctors demystifying misinformation regarding the vaccine, but two days ahead of the launch of a nationwide vaccination drive, the Union Health Minister Harsh Vardhan took to Twitter to bust some myths regarding the vaccines and urged people not to pay heed to rumors or misinformation regarding the vaccines from unverified sources (Can COVID Vaccine 2021).

6. Discussion

6.1. Datafied Material Rhetoric in Hybrid Spheres

Material conditions of the COVID-19 pandemic in India pertain to both the shortages of nonhuman, biomedical actants (i.e., medical resources such as testing kits, blood, oxygen) and to the reimagination of the human body with new determinants of health and well-being. Intertwined with the reality of the pandemic, these material conditions reveal that risk is unevenly distributed and has clear socio-political, economic, and cultural implications. As risk communication efforts involve stakeholders from both the technical and public spheres, the interconnecting and competing discourses help create a hybrid space for both argumentation and materiality.

Technical spheres and public spheres function to serve different purposes, with the former focusing on top–down communication from experts and authorities to inform and educate the public with scientific judgment and the latter functioning to solve private and technical disputes by leveraging common values and reasoning. The technical sphere functioned as a hybrid sphere, or as termed by Callon et al. (2011), hybrid forum, where medical care workers referred to patient experiences and narratives that pointed to new comorbidities, complications, and emerging evidence of the existence of post-recovery symptoms that were later collectively called long-COVID. Concerned stakeholders such as clinicians, biomedical researchers, public health officers, and patients and their families all contributed to the ongoing efforts of understanding how the coronavirus impacted human bodies, families, communities, and India as a country by sharing different types of evidence and arguments, be they emotional, financial, infrastructural, or technical.

Our analysis showed many instances of hybrid arguments that crossed the boundaries between experts and the public and connected specialists and laypeople with shared uncertainties and concerns. These hybrid arguments relied heavily on datafication efforts to mediate socio-technical uncertainties surrounding COVID, namely, to convert new and available data into the description of local outbreaks and case updates for epidemic surveillance, the influence of public perception, and the control of community responses. Meanwhile, material conditions and embodied human experiences are all heavily emphasized in hybrid arguments circulating in the technical and public spheres, which not only serve as data points to be converted into data analytics insights, but more importantly, reveal the material enactments of the body through the impacts of history, socio-economic status, class, caste, region, and education and profession.

The hybridity of the technical and public spheres is also reflected in how narratives of myth-busting are framed and the various stakeholders involved. While the technical sphere emphasizes information coming from experts regarding infection, treatment, and vaccines as official, the public sphere focuses on values such as trust and belief in the official communication as an integral factor to curb the fears and myths associated with the virus and vaccine. For instance, a news report cites a housewife, Sheela Thakare, as saying that there was no “hesitation in taking the second dose” and that she “believe[s]” in Indian doctors and scientists (Rising COVID Cases 2021b). Sheela also said that she would be taking her second dose four weeks after the first one was administered. This example is a clear indication of how information transmitted in the technical sphere overlaps with the public sphere—the fact that Sheela had no vaccine hesitancy, believed in Indian experts, and had knowledge of the vaccination process reveals how public outreach and education efforts made by experts can lead to public trust in the official recommendations and policies. The hybridism of the technical aspects was proven in the stakeholders involved in this example (i.e., experts, Indian doctors, scientists, journalists, and the general public). This creates a hybrid sphere of argumentation wherein the technical aspects of vaccines are not only drawn from expert knowledge, but also from public hesitancy about vaccines, thus shaping the overall vaccine narrative.

6.2. Affect as an Essential Response to Risks of Emerging Pandemics despite Datafication

Human suffering tends to be erased and simplified into data points due to the datafication and thus dehumanization of patients as case numbers, trends, and epicenters. The TOI did provide some traces of human experiences and large-scale suffering by discussing the concerns and negative emotional responses such as anxiety, fear, and grief in response to rising cases, infection, deaths, and long-COVID. Our analysis clearly showed how affect was an integral part of the risk coping mechanisms rather than so-called “irrational” responses. Emerging pandemics such as COVID are shot through with de-localization, uncertainties, uninsurability, incalculabilty, and the unknowns, which fully illustrate Beck’s (1999, 2006) theoretical framework of manufactured uncertainties in the world risk society. As a result of these “globalized manufactured risks and uncertainties” (Beck 2006, p. 5), experts struggle on a daily basis to make sense of the epidemiology, pathology, clinical demonstrations, and containment and treatments for new pandemics through datafication efforts. Thanks to the constantly evolving nature of our understanding of emerging pandemics, rational responses are transient, if not non-existent.

With patients and families devastated and medical care workers overworked, overwhelmed, and suffering from mental health problems, it is not surprising how individual responses featured negative emotions such as fear, anxiety, frustration, and panic. The affect ramifications of emerging pandemics should be addressed at a policy and societal level, and not swept under the rug as something to be digested by affected individuals. In the public sphere, references to individuals who tested positive for COVID-19 were dehumanized into “cases” of COVID-19. Such a framing of people as data points to keep track of the health conditions of populations can serve to overshadow the socioeconomic and cultural aspects of health inequity, differential access, and other social constructs at play.

6.3. Unique Materiality and Socio-Economic Conditions in India

Our analysis clearly shows how the materiality of COVID was uniquely shaped by the history, religion, and culture as well as socio-economic and infrastructural conditions of individual countries. Human bodies are interconnected with biomedical actants that are used to measure, diagnose, contain, alleviate, and treat COVID, the comorbidities, and its widespread mental health impacts.

In the case of India, religion and politics worked together to usher in Wave II through political and festival gatherings before the mass migration of migrant workers brought the virus from big cities to remote, under-resourced towns and villages. For example, the Kumbh Mela, which happens once every twelve years, took place during the transition between Waves I and II. Kumbh Mela is a 100-day long festival, however, because of the pandemic, the festivities were limited to 30 days in April 2021. The authorities assured the public that that if people followed the measures of social distancing and mask-wearing, the religious festival could be celebrated, and cross-infection could be contained. However, the Kumbh Mela ended up being a spreader event because the crowds did not follow preventative measures.

Unique socio-economic factors also helped shape how COVID unfolded in India. An important factor that was at most hinted at in the corpus is the multigenerational/joint family structure, living conditions of marginalized populations, and family-centered care in the country. Due to differential socio-economic conditions, many families lack the monetary resources needed to live separately as a nuclear family. The idea of care and protection is at the core of living in multigenerational families, especially with aging parents who have underlying health conditions. Given the joint-family structure, it is more likely that if one person in the household tests positive, the rest eventually will. This, in turn, has a direct impact on the number of individuals who are infected by COVID-19, and the subsequent fatality rate during the second wave.

A related factor is the challenging living conditions in less developed parts of the country. For example, the slums in the city of Mumbai have numerous people dwelling in the same community/vicinity. These slums have poor living conditions with only basic access to resources such as food, water, and sanitation, and could be a breeding ground for the virus, thus leading to more positivity rates in infections. An awareness of the socio-economic fabric of India is integral to fully understand the transition to Wave II.

7. Limitations and Future Directions

Our analysis highlights the hybridity of the technical and public spheres, positions affect as a significant part of risk communication, and showcases the unique materiality and socio-economic conditions in India. Our study uncovered the TOI’s narratives of the Indian outbreak and revealed the existence of various socio-cultural factors that shaped the narrative and the development of the outbreak, but it also had some limitations. First, the TOI is one of the many newspapers distributed in India, with over 100,000 registered newspapers and periodicals (Basuroy 2022), meaning that these COVID-19 narratives are only a slice of what was happening in India between Waves I and II. Second, India has a rich linguistic fabric with about 121 languages spoken in various parts of the country (More than 19,500 2018), thus there are local and regional narratives that are not covered in this English publication, the TOI. Third, the TOI left out direct political connotations in their narratives, which served to conceal the role of government in the spread of the virus and the transition to Wave II.

That being said, there are many future directions that this kind of study can take. First of all, a considerable number of references have been made on social media, fake news, rumors, and misinformation in the public and technical spheres of the pandemic. It would be insightful to understand the role of social media during COVID-19 and the ways in which misinformation was circulated and/or regulated. This study is also well-positioned to bring in a semblance of health crises and government response by countering the element of fake news, misinformation, and myths. For instance, this study highlights the myth-busting narratives that were published in the TOI to regulate misinformation and the circulation of fake news regarding testing and vaccines. In post-pandemic rhetoric, such a study can help frame strategies for effective risk communication that focuses on the common questions and concerns expressed by the public, and promptly addresses misinformation and myths that may lead to negative subjective risk experiences. In addition, a valuable next step could be to compare the framing of the pandemic on an international vs. national, or national vs. regional scale to diversify the narratives and better understand how socio-cultural contexts shape risk situations. Finally, collecting accounts of the Western gaze and sensationalization of the pandemic in India can also help us uncover some colonial continuities in the media and in communication.