How an outbreak became a pandemic: an authoritative chronology December 2019 – March 31 2020 by Michelle Hopgood

Overview
The objective of this project was to communicate a complex, authoritative, and interactive public-facing chronology of the evolution of the COVID-19 pandemic, that showed the spread of SARS-CoV-2 and actions taken locally, nationally and globally. The chronology would form a key basis of evidence presented by an international panel of experts, as part of their highly-anticipated report in May 2021. It would need to be 100% accurate and evidence-based; contain real-time and retrospective information, legible and compelling to a range of audiences, including global health policy specialists, academics, and mainstream journalists.

Background: In November 2020, The Independent Panel for Pandemic Preparedness and Response (the Panel) began to compile an authoritative chronology of the events linked to the emergence of and response to SARS-CoV-2 and the COVID-19 disease. The Panel set out to examine the facts (science and COVID-19 cases); the resulting alerts by the World Health Organization (WHO) as well as other international and government bodies; and, individual countries’ responses to the COVID-19 threat. For the Panel, the chronology intended to form the basis for further questioning as well as research and analysis into why and how SARS-CoV-2 evolved from a localized outbreak, to a global pandemic.

In order to achieve this objective and before producing the interactive public-facing chronology, the Panel required an internal chronology document for research purposes. Later, this internal chronology became a key piece of supplementary material for The Lancet journal article “How an outbreak became a pandemic: a chronological analysis of crucial junctures and international obligations in the early months of the COVID-19 pandemic” (For reference, https://ars.els-cdn.com/content/image/1-s2.0-S0140673621018973-mmc1.pdf). The development of the internal chronology formed the foundation for the overall approach to information collection and design methodology. Both chronologies needed to be linear and easy to navigate across four themes: international actions, country actions, real-time facts, and retrospective facts. Within each theme, data points included a subcategory, headline, caption, and source. Also, some data points were highlighted as key events and/or WHO actions with date ranges and/or timestamps.

Additional considerations for the interactive public-facing chronology included easy navigation on mobile and desktop, incorporation of a real-time COVID-19 case count for different global regions, and multimedia stories related to key events and frontline workers of the pandemic.

Strategy/Methodology
One of the most important aspects of this project was understanding the intention of the chronology and the information that needed to be featured. Through many meetings and consultations I worked closely with the client to determine the best approach for information collection, organization, and communication. I was able to help them create a detailed and logical taxonomy and structure to help streamline the categorization and data input process.

As part of the exploration phase for both the internal and interactive public-facing chronologies, I drafted a skeleton spreadsheet with sample information to guide the client through their data collection and input processes. The skeleton spreadsheet would form the foundational structure of the data collection and input as well as the organization, design, and execution. We chose Microsoft Excel as our data input tool because it allowed the international research team to work in collaboration with the communications team on a live document while maintaining accuracy and consistency of information.

The design process involved researching existing timelines and iterating organizational solutions for the chronology. While many visual timelines exist, those with similar parameters and needs were difficult to find because most showcase one dimension of data rather than multiple dimensions and anomalies. I took inspiration from these timelines and consulted with other information designers about my proposed solutions to ensure that they were logical and understandable. Following these consultations I iterated further and presented rough prototypes to the client to gauge their reactions and thoughts about these proposed directions. Client collaboration was essential in this project as I could not afford to lose time by pursuing a direction that was not desired. The final direction used an information structure that supported the required hierarchy of themes and data points.

An on-going challenge with both chronologies' development was flexibility within the structure because data collection and design implementation were happening simultaneously. Time constraints made it impossible to postpone design until data collection was complete.

The groundwork for the internal chronology laid the foundation for the interactive public-facing chronology which followed a similar research and design framework. I collaborated closely with Helios Design Labs so that we could move as quickly and efficiently as possible once the all chronology data, case count data, and designs were finalized. From a user experience perspective and after researching a variety of techniques, we decided on a scrollytelling interaction to showcase all data. I designed two layouts based on mobile and desktop interfaces and consulted with the development team to ensure what I proposed would be possible. From design to development, the execution of the interactive public-facing chronology happened in approximately three weeks.

Solution and Design Details
A skeleton spreadsheet formed the basis of data input for the interactive public-facing chronology. The spreadsheet’s construction facilitated information collection, organization, and communication by creating a solid hierarchical structure that informed all design processes. By focusing on the organizational structure we were able to think through all content required for the Panel members to analyze, question, and research pandemic events within a logical and linear structure. The final chronology included the following base elements:

Date line: Providing time-based context and orienting the user it creates a visual anchor. The date is built into the scrolling function which changes as you move from one day to the next. For easy reference it is positioned at the top of the screen, below the themes. Users can also jump through time by clicking on any circle on the vertical timeline.

Themes: Colour and a fixed horizontal position anchor each theme in the desktop version. The data was organized to create an intuitive understanding of evidence followed by events followed by leadership responses. We collapsed retrospective evidence, combining it with real-time evidence and positioned evidence-based data on the left followed by international and country actions.

Data points: All data contained the same base structure of subcategory, headline, caption, and source with possible additional elements, including:
Key event
WHO action
Date range and/or time stamp
Publication date
Cases per million

The interactive public-facing chronology also included: a stacked bar chart of case counts, a vertical navigation tool, and breakout key events and human-interest stories.

The chronology’s design and information considerations, structures, and visual language reduced the Panel members’ cognitive load so that they were able to easily navigate the data, ask poignant questions, understand how and why the COVID-19 pandemic happened, and make thorough recommendations.

Results/Impact
Both versions of the chronology stand as the most authoritative recounting of the early months of the COVID-19 pandemic to date; and include the minute-by-minute and hour-by-hour actions taken in the earliest days. The chronology is an internationally respected contribution to the understanding of how SARS-CoV2 evolved from a localized outbreak into a global pandemic.

One of the greatest positive results of the chronology is its publication in the most prestigious health journal, The Lancet, as part of a paper published in November 2021. The Lancet rejects most papers submitted, and every article accepted goes through a rigorous peer-reviewed process. Publication by The Lancet stature indicates the quality and importance of the chronology; and puts it on record as an enduring contribution to COVID-19 literature.

The development of the background paper chronology enabled The Independent Panel for Pandemic Preparedness and Response to create actionable recommendations received by all levels of government and global leadership. When referencing the events of the COVID-19 emergence the chronology is often cited by global leadership officials.

In an article by The Washington Post’s Emily Rauhala she states: “One of the panel’s most notable contributions is … in background materials: an hour-by-hour, day-by-day reconstruction of what happened in Wuhan, China, from December 2019 to January 2020. Through interviews with officials, a review of WHO documents and a close read of relevant reporting and research, we are reminded, for instance, that Chinese labs started sequencing the new virus before the WHO was even aware that an outbreak was underway. We see clearly and painfully how potentially lifesaving information emerged on social media and through Chinese-language press reports rather than through official channels designed to identify precisely this kind of threat.”

The acceptance of the chronology by the academic community, press, and global leaders shows the effectiveness of its communication and information design. We were fortunate to have the support of the Panel Co-Chairs, former heads of State The Right Honorable Helen Clark and Her Excellency Ellen Sirleaf as well as other Panel members who provided us with clear guidance and a platform to disseminate the chronology. We hope that in years to come the chronologies will be used as teaching tools for generations to come.