China’s Instagram war on COVID-19: picturing healthcare workers and governance in Xinhua’s photographs

Abstract

China came under intense international scrutiny after it was accused of suppressing information, silencing its doctors, and destroying laboratory evidence that led to the spread of COVID-19. To understand how China attempted to rebuild its reputation, this article examines the visual frames and semiotic devices used to depict Chinese frontline workers and the country’s health governance across 289 photographs posted by China’s state-owned Xinhua News Agency on Instagram. Healthcare workers appeared as soldiers working tirelessly on the COVID-19 battlefield, while also revealing their human emotions and vulnerabilities at times. Further, the efforts of the frontline workers were perpetually showcased as guided by the Chinese leaders who were omnipresent either physically or through Communist symbols. Xinhua’s photographs thus presented the Chinese leadership as the architect in establishing a competent health sector that overcame the pandemic – a paradigm for the world to follow. The study discusses the implications for the state’s portrayal of global health governance during crises.

Introduction

In December 2019, Chinese ophthalmologist Li Wenliang posted on social media about a virus that was spreading quickly. Instead of heeding his warning, the Chinese government accused him of spreading false information (McDonell, 2020). After Li’s death from the same virus, Chinese social media users expressed anger towards the government and questioned its handling of the healthcare sector (Wu, 2020). As the virus spread worldwide, the international community further accused China of engineering and leaking the virus from a laboratory (Markson, 2020). These incidents heralded a ‘political disaster’ for China and arguably uncovered the ‘worst aspects of China’s command and control system of governance under Xi Jinping’ (McDonell, 2020: para. 21).

Studies that examined China’s media response during health crises demonstrate the use of emotional narratives that glorify individual sacrifices and praise China’s healthcare governance efforts (Xie and Zhou, 2021). They also celebrate China’s success in overcoming crises (Jacob, 2020), using combat jargon (Chatti, 2021), and evoking feelings of national unity (Zhang, 2022). During China’s initial handling of the COVID-19 crisis, its state-controlled media produced daily news reports, documentaries, TV series, and films that glorified frontline workers and their efforts (Jacob, 2020; Molter and Diresta, 2020; Xie and Zhou, 2021). Yet, this existing body of literature on Chinese media has focused more on texts. To address this research gap, this study examines photographs to address the research question: How did China visually and semiotically frame its healthcare sector in the early stages of the COVID-19 pandemic?

Visuals can play a key role in conveying counter-narratives, dismissing accusations, and sending warnings to adversaries. Moreover, public attention to crisis portrayals heightens with the incorporation of visuals laden with emotions and creative designs (Verma, 2022). Building on the nascent work on China’s visual coverage of COVID-19 (e.g. see El Damanhoury and Garud-Paktar, 2021; Hellmann and Oppermann, 2022; Schneider, 2021), this study aims to examine how the country’s mouthpiece, Xinhua News Agency, portrayed Chinese health governance through Instagram photographs targeting an international, English-speaking audience. Social media platforms such as Instagram allow governments to surpass the gateways of traditional media and swiftly respond with value-added messages that can build a positive narrative about the crisis (Reynolds and Quinn, 2008). Further, the platform’s interactivity brings in immediate audience feedback, thereby allowing state media to post preferred images that address conflicting information, while maintaining a continuous flow of positive stories about crisis management in their countries vis-à-vis other states.

The study focuses particularly on China to understand how authoritarian states, especially those that finance and control their media systems and exert substantial restrictions over the projected narratives globally, picture their medical sector and frontline workers during health crises (Xin, 2018). Using visual framing and semiotic analyses of the COVID-19 pandemic photographs in China’s state-owned media, the study reveals how Xinhua appropriated war metaphors and ‘politics of emotion’ (Zhang, 2022: 241) in its depiction of only Chinese doctors, nurses, medical cleaners, pathologists, paramedics, ambulance drivers, and healthcare administrators to international audiences.

China’s communist media system

A Communist press system, as in China, encompasses state-controlled media that serve as mouthpieces for the state (Seibert et al., 1956). Together, the Chinese media work to generate, especially during crises, the ‘China stories’ that praise the state (Jacob, 2020), undermine Western attacks, and even at times mislead the audiences (Molter and DiResta, 2020). Xinhua News Agency is one of the most prominent Chinese outlets, which has attracted millions of followers on social media and gained access to international audiences, while adhering to the objectives of the Chinese Communist Party (CCP) (Cheng et al., 2016; El Damanhoury and Garud-Paktar, 2021). By engaging with global audiences through a social and, more importantly, a visual medium such as Instagram, Xinhua can appear less political and more effectively project China’s achievements and visual performances (Ekman and Widholm, 2017).

Over the past decade, the CCP has gained substantial influence over global news flow by means of ownership of sophisticated technological infrastructure and the launch of disinformation campaigns on social media (Freedom House, 2022). Especially, during the pandemic, the CCP imposed restrictions to keep journalists away from Wuhan and used its social media to provide its own spin on health narratives. Such actions make it imperative to understand China’s portrayal of its health sector at this critical juncture to leverage its health governance positioning on the global stage (Chatti, 2021; Jacob, 2020; Xu and Tang, 2021).

China’s coverage of health crises

A health crisis, such as a pandemic that results in many fatalities, is detrimental to the political standing and reputation of those in power (Coombs, 2007). Given its mammoth size and economic standing, China is under the continuous scrutiny of international media. To control and respond to this attention, many independent and state-owned media in China formed a global network that fed international media with preferred narratives when China was at the epicenter of the H1N1 and SARS viruses (Xu and Tang, 2021)

Recent studies, examining mostly texts, show that China’s COVID-19 coverage was expectedly positive and celebrated its triumph over the virus early on (Gui, 2021; Xie and Zhou, 2021). Xinhua, for example, published a white paper admiring the victorious efforts as well as praising President Xi’s leadership and work to unite citizens (Xinhua.net, 2020; Yang and Chen, 2021). The Chinese media also resorted to strong war frames and mostly used words such as fighting, warfront, soldiers, battle, frontline, and victory in its coverage (Gui, 2021; Yang, 2021). Through mediated health narratives, China conveyed that health workers and citizens should put the nation above themselves and serve as soldiers to fight the pandemic (Gui, 2021). These studies, however, stopped short of investigating the framing of China’s health governance on visual social media platforms like Instagram.

Theoretical framework: visual framing and semiotics

Framing is a recurring theoretical lens in the study of news coverage. The psychological roots of framing date back to Sherif (1967) and Kahneman and Tversky’s (1979) work that examines varying demonstrations of identical ‘decision-making scenarios . . . [and their influence on] people’s choices and their evaluations of the various options presented to them’ (Scheufele and Tewksbury, 2007: 11). Using this approach, studies often employ equivalent frames, such as gain vs loss or peace vs war (Fahmy and Eakin, 2014; Fahmy and Neumann, 2012). For example, Cho and Boster (2008) point to the persuasive advantage of using loss frames in anti-drug ads among adolescents. On the other hand, Goffman’s (1974, 1979) research lays the foundation for the sociological school of framing that moves beyond equivalent frames toward a ‘territory where the selection of one set of facts or arguments over another can be deemed a frame’ (Cacciatore et al., 2016: 10). In other words, inductive, context-specific frames emerge from the text in ways that can define a problem, interpret its cause, present a moral evaluation, and/or recommend a treatment (Entman, 1993). This study applies the sociological approach to framing to the photographs of the Chinese health sector that Xinhua put out.

Photographs and their captions play a key role in news framing. With hundreds of millions of digital photographs taken every year, the 21st century has brought, in the words of WJT Mitchell (1994), a pictorial turn that marks sight as the dominant sense, makes the audience more picture-minded, and transforms the world into visuals for public perception (Finnegan, 2015; Verma, 2022). Photography further serves as a less intrusive medium in conveying arguments, verifying claims, presenting ideologies, and defining cultures (Barthes, 1981; Birdsell and Groarke, 1996). Yet, the surrounding texts are critical in describing the depicted scenes and contextualizing the overarching stories (Green and Dill, 2013; Tankard, 2001). Collectively, the photographs and their captions generate inductive visual frames that can perform Entman’s (1993) four functions of problem definition, causal interpretation, moral evaluation, and treatment recommendation.

Visual framing, however, is a multi-layered approach to understanding photojournalism. Rodriguez and Dimitrova (2011) highlight four visual framing levels: denotative, semiotic, connotative, and ideological. At the denotative level, texts and captions present the very basic description of the depicted scene. At the semiotic level, visual grammar and pictorial stylistic conventions, such as shot sizes, eye contact, facial expressions, and camera angles, can influence viewers’ perceptions by tacitly suggesting meanings of the photographs and the characters appearing in them. The connotative level involves the displayed signs, symbols, and metaphors to uncover the preferred reading and interpretation of the visual frame. Finally, the ideological level transpires, based on the denotative, semiotic, and connotative tiers of visual framing. This fourth level connects the descriptive, stylistic, and symbolic aspects to often present a coherent, overarching narrative and voice that reinforce the communicator’s ideological underpinnings. This study adopts Rodriguez and Dimitrova’s (2011) framework in the analysis of Xinhua’s photographic coverage during the pandemic.

Methodology

To better understand how the official state-run Xinhua portrayed the Chinese healthcare sector in Instagram photographs, the study examined all COVID-19 related posts on the news agency’s official page over a two-month period following the announcement of the first coronavirus-related death in China on 11 January 2020. In doing so, the study gauges the immediate official media response patterns from China as it visually communicated with over one million Instagram followers. Between 11 January and 10 March 2020, Xinhua disseminated a total of 289 photographs focusing on the pandemic, with an average of almost five per day, displaying mostly China’s healthcare system and its personnel. After manually scraping the photographs, each image constituted the unit of analysis, while the Instagram captions provided needed text to contextualize the depicted scenes.

The study, which is part of a larger project exploring the depiction of COVID-19 across international broadcasters’ visual coverage, employed a mixed-methods approach. First, the two authors conducted a quantitative content analysis of each of the 289 images, examining the human character types and scene locations. After analyzing a small testing sample of the larger dataset, the authors developed a coding sheet and carried out a pilot study resulting in .96 intercoder agreement based on Cohen’s Kappa. Upon finalizing the instrument, each coder examined half of the dataset, achieving an intercoder reliability of .95 agreement based on Cohen’s Kappa. The coding examined the frequency with which a range of character types were depicted–frontline workers (0 = No, 1 = Yes), health leaders (0 = No, 1 = Yes), political leaders (0 = No, 1 = Yes), religious authorities (0 = No, 1 = Yes), law enforcement (0 = No, 1 = Yes), and patients (0 = No, 1 = Yes) – and the location where each photograph was shot as identified in the captions. All variables achieved over .90 agreement except for one falling between .70 and .80, which is considered an acceptable level (Neuendorf, 2002). For intercoder reliability levels across the variables in this study, see Table 1.

Table 1.

Intercoder reliability for coding variables in content analysis.

Variable	Per cent agreement	Cohen’s kappa
Frontline workers	90.45	.75
Health leaders	100	1
Political leaders	100	1
Religious authorities	100	1
Law enforcement	100	1
Patients	100	1
Location	97.48	.94

Second, the authors conducted a framing analysis of the photographs. A Straussian approach to grounded theory, which involves an open coding of text to discover emergent categories (Grbich, 2007), served as the first step to inductively generate frequent visual themes across healthcare photographs. The analysis accounted for the English-language photo captions as framing devices that clarify the visual scene, point viewers to key characters, and communicate overarching messages (Birdsell and Groarke, 1996; Green and Dill, 2013; Parry, 2010). Together, the photographs and text formulated four key visual frames: Fighting the Battle, Human Warriors, Victorious China, and Wise Leadership.

Additionally, the authors incorporated a qualitative semiotic analysis to account for key recurrent signs, including ideological cues and sociopolitical symbols, that can have a ‘corresponding signified of connotation sufficiently constant to allow incorporation in a cultural lexicon of “effects”’ (Barthes, 1978: 3). The study further examined a number of semiotic devices that have comprised a grammar of visual design: proxemics, gaze, facial expressions, and camera angles (Kress and Van Leeuwen, 2020).

Findings

Xinhua’s visual coverage of the pandemic primarily promoted China’s healthcare system as robust and a prototype for the world to follow. Frontline workers served as the most recurring character type across Xinhua’s COVID-19 photographs, appearing in all but two images that focused on mainland China’s provision of medical supplies to Hong Kong. COVID patients appeared in one out of every five photographs, followed by politicians, while health leaders, religious authorities, and law enforcement were almost nonexistent across the depicted scenes (see Figure 1). Unsurprisingly, mainland China emerged as the predominant location of the photographs (94%), thus depicting the country as the key line of defense against the virus to a global audience. Hong Kong and Tibet were also the backdrops of several photographs to showcase a unified front against the virus in China, including its autonomous regions (see Figure 2).

Figure 1.

Character types in Xinhua’s COVID photographs.

Figure 2.

Locations of Xinhua’s COVID photographs.

The qualitative analysis further dissects Xinhua’s photographs. The 289 images projected four key visual frames: Fighting the Battle (n =128); Human Warrior (n = 95); Victorious China (n = 50); and Wise Leadership (n = 22), which will be discussed through key examples to highlight the overarching trends and patterns. As the findings below will show, the somewhat lacking display of politicians in the scenes was offset by the Communist Party’s semiotic omnipresence as a symbol. Playing to the war’s visual rhetoric, the depictions of frontline health workers (rather than their leaders) on the ground sacrificing their lives to fight the virus and treat patients projected an emotionally charged image of soldiers carrying out the commands of a wise leadership against an invisible enemy.

Fighting the battle

‘Fighting the Battle’ emerged as the most prominent theme, accounting for 40 per cent (n =128) of the total COVID-19 related photographs. A depiction of frontline workers carrying out their responsibilities amidst the possibility of getting infected was prominent in this theme. The photos displayed medical staff wearing protective kits while attending to infected patients, frontline workers disinfecting medical facilities, markets, and train stations, essential workers delivering packages with food items, and medical staff working on producing a vaccine. Almost all of those images were in mainland China and its autonomous regions. While 11 photographs showed frontline workers fighting the virus elsewhere, the predominance of Chinese workers in the scenes emphasized the prowess of the country’s healthcare sector in the face of the pandemic compared to the rest of the world.

In a series of photographs, such as the one in Figure 3, frontline workers are shown working on an assembly line to dispose of medical waste. They appear with masks, gloves, wearing full protective kits that are soiled due to continuous work, while no other human being can be seen in the streets behind them. The scene, as well as the workers’ uniforms and demeanor, project an image of a chemical warfare that is fought by courageous, dedicated individuals. The workers appear weary, yet they carefully carry on with their tasks: one packs the medical waste in bags, the other puts it in big trash bins, a third disinfects the trash bins, and a fourth worker uploads the bins to a truck in a harmonious manner. The photo caption states that there is an urgent need for Wuhan to dispose of its medical waste to control the spread of the virus and that the essential workers are ‘shouldering the dangerous task of medical waste disposal’, thus anchoring the scene as part of a chemical warfare. Through this theme, Xinhua highlights the workers’ heroism, unbreakable momentum, and commitment to their duties.

Figure 3.

An Instagram post on 5 March 2020 shows a healthcare worker, wearing protective gear, busy cleaning, disinfecting, and disposing of medical waste. Source: Xinhua.

In terms of visual semiotics, Xinhua employed dynamic action to create more engaging scenes. The workers were always displayed in the acts of cleaning, disinfecting, operating on patients, and so on. Dynamic visuals prompt increased ‘attention levels, heightened recall, and intensified evaluation’ because they allow viewers to complete the captured action in their imagination (Candan et al., 2015; Winkler et al., 2021). This can trigger the viewer’s stored memory and reinforce message recognition, encoding, and recall (Winkler et al., 2021).

Further, Xinhua frequently used wide camera shots with low camera angles, no eye contact, and serious facial expressions in the portrayals of frontline staff, who were captured working while surrounded by heavy-duty disposal machinery, loading trucks overflowing with thousands of food packages, sanitizing the streets while it snows heavily, and rushing patients to makeshift facilities. These wide shots give the viewer a panoramic view: a sense of the workspace and a perspective of the challenging war-like working conditions (Caple, 2013), coupled with the avoidance of eye contact, indicative of the frontline workers’ unwavering commitment to fighting the virus without being distracted. Moreover, the low camera angles looking up at the frontline workers make them appear in a dominant position in comparison to the viewer (Kress and Van Leeuwen, 2020). Such a technique suggests the superiority and power of the frontline workers, here in terms of the significance of their work and sacrifices (Jewitt and Oyama, 2008; Kress and van Leeuwen, 2020).

The visual semiotics further liken frontline workers to soldiers. Health personnel often appeared as trained combatants following deployment orders and advancing synchronously on the battlefield in groups, like military units, focused on getting the work done without ever being distracted or engaging in conversations (Van Leeuwen, 2001). Like soldiers, the medical staff also rush their wounded (the patients in the COVID-19 context) to the emergency rooms, while others work on developing high-end equipment to combat the enemy by means of vaccines and virus detection kits. For instance, Figure 4 shows Chinese medical staff covered in protective gear from head to toe, marching equidistant from each other as if returning from combat, except that the photographed individuals use their gloved hands and fully covered bodies as weapons in this fight against the virus. The juxtaposition between the workers’ clean uniforms – along with their togetherness – and the caption pointing to increasing COVID local transmissions in other countries further suggests the prowess of China’s health sector and its personnel. In other words, the Fighting the Battle theme tapped into the war metaphor, which is both motivational and attention-grabbing (Chatti, 2021), to project the selfless efforts and dutifulness of the medical staff in the field as millions of citizens had to stay home.

Figure 4.

An Instagram post on 9 March 2020 shows healthcare workers, wearing protective gear, walking together in a group. Source: Xinhua.

Two more strategies in the Fighting the Battle visuals were the presence of Chinese citizens from diverse backgrounds (as identified in captions), including those from Tibet to signify the concept of a unified China, and the CCP’s flag. Since its first use in 1949, the country’s red banner with the four yellow stars revolving around a bigger one at the top left has symbolized Chinese unity (Xu, 2021). The CCP’s red flag is very similar to the national emblem except for a yellow hammer and sickle replacing the stars, which together present the party as the vanguard for the workers’ and farmers’ interests (Spierings, 2021). The red flag has also become a recognizable branding tool and ‘an important ambassador, telling the world the story of China as a country longing for unity, harmony and stability’ (Xu, 2021: 483). The CCP flag accompanied the healthcare workers while they disinfected public places, set up hospital beds, and worked late at night in their offices. For instance, Figure 5 shows two healthcare workers, who are wearing protective gears, involved in a deep discussion with each other late at night with the CCP flag behind them. The caption suggests that their efforts have brought down infections as the makeshift hospitals are now closing. The flag’s presence identifies the workers’ united efforts and strength in fighting against the virus while also emphasizing the symbolic presence of Communist leaders to guide the workers’ efforts. Xinhua’s use of the red emblem thus alludes to the role of the CCP in the success of frontline workers in their fight against a deadly pandemic.

Figure 5.

An Instagram post on 9 March 2020 shows healthcare workers, wearing protective gear, working late at night with the CCP flag behind them. Source: Xinhua.

Human warrior

The Human Warrior theme, which made up almost one-third of Xinhua’s COVID-19 photographs, revealed the humane side of frontline workers. The images, which were exclusively shot in mainland China, normalized the vulnerability and exhaustion of the health personnel. The 95 photographs displayed medical workers bidding farewell to their loved ones, going beyond their job responsibilities to comfort patients, resting at makeshift hospitals, and posing for the camera in their traditional clothes. One image, for example, shows a patient on a ventilator lying on the bed outdoors and a doctor to his right pointing to the sun going down on the horizon (see Figure 6). The caption anchors the emotional feel of the scene with the words, ‘this is perhaps one of the most memorable and inspiring moments amid the coronavirus epidemic’ (Junchao, 2020). In short, the theme highlighted that behind China’s competent health sector are humans who laugh, cry, and can feel downhearted.

Figure 6.

An Instagram post on 5 March 2020 shows a patient in bed with a healthcare worker pointing towards the sun. Source: Xinhua.

The visual semiotics here prompt identification with the frontline workers. Xinhua frequently used close-up shots, direct eye contact, and clear facial/body expressions in the portrayals of health workers. The viewer can see the medical staff at an intimate distance with red eyes, swollen hands, and marks on their faces from wearing the protective gear for hours. The images also convey the workers’ exhaustion to the onlooker, seeing them lean on each other’s shoulders, sitting on the floor, and looking downward while witnessing the sadness of their family members as they wave goodbye. One of the images bringing all three semiotic tactics together was an extreme close-up shot of a female health worker’s face full of marks from the gear she had worn for hours (see Figure 7). She has a peaceful smile that expresses her strong will and determination, reinforced by the words, ‘marks for heroes’ in the caption (Xiang, 2020). Hence, the pictorial conventions in Xinhua’s Human Warrior images attempt to stimulate a connection with the frontline workers and suggest their familiarity, credibility, and strength (Jewitt and Oyama, 2008). Although projections of soldiers’ strength and power are typical in war photography (Cookman, 2009; El Damanhoury, 2022), Xinhua’s use of healthcare workers as symbolic warriors facilitated the emotional depiction of their vulnerabilities at a time of tremendous public support for doctors and nurses.

Figure 7.

An Instagram post on 12 February 2020 shows a female healthcare worker with red marks on her face. The caption says: ‘Marks for heroes’. Source: Xinhua.

Xinhua further emphasized family as a key symbol in the Human Warrior photographs. Nationalistic symbols were almost always absent in the displays of exhausted, vulnerable frontline workers, thus reserving such emblems only for demonstrations of strength. Children were recurrent in the Human Warrior photographs either as patients or as sons and daughters of the health staff. As patients, children received a level of emotional care that is beyond what would be expected, especially during a global health emergency. For example, the photographs showed medical staff feeding kids, playing with them, holding them up to watch TV, and turning their own uniforms into canvases for children to paint on (see Figure 8). As sons and daughters, on the other hand, the children appeared sad and were weeping as they hugged their parents before they joined the efforts to contain the virus. Yet, Xinhua painted an image of those kids as willing to support their parents as evidenced by captions like, ‘[Dad], cure patients as many as you can’ coming from the mouth of a 7-year-old girl (Duan, 2020). The visual juxtaposition between frontline workers leaving their own kids and spouses to treat young and old patients in need of help presented the Chinese society as one big family. The emphasis on childhood not only underscores the critical familial role of Chinese health workers in society, but also facilitates the spread of the message to a global audience, given the exclusion of children from politics as well as the innocence and future they connote (Burman, 1994; Wells, 2007). In sum, Xinhua’s display of sacrifices and emphasis on family constituted ‘emotion work’, as Xie and Zhou (2021: 3) describe it, that can not only garner support, but also ease the transformation of an international health crisis into a national victory.

Figure 8.

An Instagram post on 23 February 2020 shows a child painting on the back of a healthcare worker in Wuhan. Source: Xinhua.

Victorious china

The Victorious China theme was another prevalent response in Xinhua’s photographic campaign, accounting for 17 per cent of the images, which conveyed a message that only China was swift in mitigating the impact of COVID-19. The 50 photographs were all shot in China, showing frontline workers and patients celebrating recovery and the closing of makeshift hospitals that reportedly were no longer needed. Take, for example, an image that Xinhua posted on 9 March, showing over a dozen masked frontline workers in red uniforms cheering and dancing outside the Wuhan International Conference and Exhibition Center. The text emphasizes the closure of a temporary hospital housed inside that center for over a month as the reason for celebration after health workers had succeeded in treating all their patients (see Figure 9). The theme served as a culmination of the two previous visual frames by underscoring workers in a competent health sector who sacrificed their lives to overcome the pandemic in China as other countries were still struggling to contain the virus.

Figure 9.

An Instagram post on 9 March 2020 shows red-uniformed frontline workers dancing and making the V-sign while holding the Chinese Communist Party flag in their hands. Source: Xinhua.

In many Victorious China images, the use of direct eye contact, positive expressions and, at times, low camera angles constituted a unique semiotic treatment. Viewers can often look straight into the eyes of medical staff as they pushed a jubilant old woman in her wheelchair, posed for a photo with recovering patients, and celebrated their success. Viewers can further see health personnel’s smiles and feel their positive energy as they interact with patients or look up to them standing tall on the streets providing emergency health care to a pregnant woman. Sometimes, such semiotic strategies all appeared in tandem. A photograph on 28 February, for example, shows 13 young men and women in matching red jackets, and with face masks on as they all give viewers a thumbs up. The caption describes them as a medical team heading to a southern Chinese province to combat the virus, but it also provides a written assurance of their success: ‘We can do it!’ (Hua, 2020). Most team members look directly at the camera, beaming with positivity as evident in their hand gestures (i.e. thumbs up) and/or smiling eyes. By using a low camera angle, the photograph virtually positions the viewer below the team as they look up to happy young men and women who seem eager to join the health efforts. The visual grammar used by Xinhua’s photojournalists can thus establish an imaginary connection with a global audience by having Chinese health personnel look directly at the camera (i.e. the audience in the viewing experience) and/or smile at the onlooker, while also suggesting their credibility, and elevating frontline workers literally and metaphorically in the scene through picturing them from below to appear grandiose and in command (Forgas and East, 2008; Kress and Van Leeuwen, 2020). In doing so, the depicted frontline workers’ celebrations can perceptually translate into a victory for China’s entire health sector at such a critical time.

Multiple symbols further promoted a preferred reading of the victory scenes. First, the Chinese medical staff and patients often clenched their fists and raised them in the air in celebration of recovery and hospital closures. Take, for example, a photograph posted on 2 February that shows a female patient clenching the fist of her right hand while holding a flower bouquet in her left hand as she gleefully stands in front of a hospital surrounded by four healthcare workers also clenching their fists in celebration of her recovery, as well as of the discharge of hundreds of other COVID patients as per the caption (see Figure 10). This hand gesture has typically connoted unity and resistance from as far back as the early 20th century to the Arab Spring uprisings (Cushing, 2006), yet it is particularly deep-rooted in the history of communism. The clenched fist represented the disenchanted workers’ readiness to fight injustices before the Industrial Workers of the World organization – a labor union that dates back to 1905 – altered it into a symbol of solidarity with all workers, thus internationalizing its use in protests (Korff and Peterson, 1992). The German Communist Party also used it as an emblem of its paramilitary organization, the Roter Frontkämpferbund, with the slogan, ‘protecting the friend, fighting off the enemy’ to signal solidarity amongst workers in the face of the right-wing nationalists and the Nazi movement (DBPedia, nd). Over the following decades, the clenched fist became an iconic symbol that appeared in the visual rhetoric of numerous social movements, ranging from the Black Panthers and the Occupy Wall Street protests in the US to the anti-Milosevic demonstrations in Serbia. Xinhua used the symbol to present the health workers and patients as a unified front against the virus.

Figure 10.

An Instagram post on 10 February 2020 shows a female patient clenching her fist while holding a flower bouquet, surrounded by four healthcare workers also clenching their fists. Source: Xinhua.

The victory hand was another symbol that only Chinese frontline workers signaled in the photographs. Appearing together, the health staff created a ‘V’ shape as they all posed confidently to suggest their imminent triumph. The V-sign was the rallying symbol for the Allies in WWII after a Belgian lawyer in 1941 had described it as a sign of victory and the BBC had encouraged its use during the war (Morris et al., 1979). Then UK Prime Minister Winston Churchill used the V-sign, thus popularizing it as a symbol of defiance across Europe. Complementing the originally Communist symbol of the clenched fist, Xinhua portrayed frontline workers making the once Western, now global V-sign to assure its international audience that China is defeating the virus. Simultaneously, the flags of China and its Communist Party appeared interchangeably as backdrops in the makeshift hospitals, on the outside walls as crowds danced and celebrated, and in the hands of cheering health personnel. Invoking the red banner along with the clenched fists and V-signs in the scenes further reinforced state-led nationalism as the catalyst for unity and victory.

Wise leadership

The Wise Leadership theme, accounting for the smallest percentage of photographs (n = 22, 7.6%), depicted Chinese administrators as responsible leaders possessing effective managerial skills. Photographs in this category depicted President Xi and CCP leaders inspecting hospitals and medical facilities to ensure the enforcement of COVID-19’s health and safety regulations. Even in the three photographs where a health leader appeared, it was because of his affiliation with the CCP. Xi, in particular, was portrayed as a present boss who invested his time in visiting patients, medics, police officers, military personnel, and volunteers who had been fighting the virus. Xi appeared ‘at work’ in 15 images either involved in deep conversations with healthcare professionals, communicating about the new safety policies, surveying scientific laboratories for updates on a vaccine, or at conferences with his own party members. When visuals showed other CCP leaders carrying out similar duties, his presence still echoed through his photographs in the background of these visuals or through the captions that stated Xi was directing the recovery efforts despite being physically absent. A series of photos, including the one in Figure 11 published on 7 January 2020, show the general secretary of the CCP Premier Li Keqiang touring the country to monitor the COVID-19 situation. Li appears surrounded by medical professionals as they all clench their fists in unison, while the captions read that Li has been entrusted with duties by Xi and is directing the efforts to prevent the outbreak of the virus. Thus, the wise leadership theme emphasized the omnipresence of Xi and that, in his absence, the CCP leaders were his eyes and hands in the field. The theme reiterates that the Chinese leadership is proficiently handling the crisis, has a structured system of managing power, and that the people have faith in Xi’s decisions.

Figure 11.

An Instagram post on 27 January 2020 shows the general secretary of Premier Li Keqiang talking to medical staff and doctors in Wuhan. Source: Xinhua.

Like workers in the Fighting the Battle theme, the Chinese leaders were shown as being involved in dynamic actions: pointing, waving, and lecturing the medical and military personnel, who on the contrary, were mostly static – standing in an attentive position (see Figures 11 and 12). The photographs project an image of Chinese leadership as proactive, responsible, and making synergistic decisions in the larger interest of the nation. The Chinese leaders were surrounded by people, suggesting compliance with and approval of their leaders’ decision-making process. Given that Xi’s leadership has faced severe criticism both nationally and internationally due to increasing censorship, surveillance, and ideological indoctrination, along with the crackdown on journalists and activists, depictions of the public’s approval at a time of health tragedy served as an opportunity for Xi and the CCP to gain national support.

Figure 12.

An Instagram post on 10 March 2020 shows President Xi Jinping talking to patients and doctors via digital conferencing. Source: Xinhua.

In the same vein as the Victorious China theme, the visuals here depict CCP leaders greeting and addressing medical staff and frontline workers with a clenched fist and/or other gestures, such as waving their hands and pointing towards them. Such portrayals, especially in the presence of the citizenry, connote the Chinese leaders’ contribution to the efforts on the ground through endless guidance. More importantly, these visuals implied the Chinese leaders’ omnipresence either physically or through Communist symbols, thereby playing their role of continuously reviving the feelings of unity and nationalism against an invisible enemy.

Discussion

This study employed visual framing and semiotics to examine Xinhua’s COVID-19 coverage on Instagram to better understand how China handled the pandemic and attempted to reinstate trust in its healthcare system in the digital sphere. Xinhua’s photographs constituted four main themes: Fighting the Battle, Human Warrior, Victorious China, and Wise Leadership. Photographs outside China and its autonomous regions were very rare and were limited only to the showcase of healthcare personnel doing their work (i.e. Fighting the Battle). Meanwhile, the photographs in China encompassed the four visual frames, which worked together to present a synergistic narrative about committed, brave healthcare workers who sacrifice their lives and time with their families to serve the bigger Chinese family in a time of crisis. China’s leadership – whether appearing physically in the field or symbolically through national and Communist symbols – appeared only in scenes of strength and defiance, thus emerging as the wise mastermind behind the country’s very early claim of victory against COVID-19, which aligns with Xi’s stated mission of offering ‘Chinese wisdom’ to the world to solve the problems of mankind (Xi, 2017: 9).

The study accounted for semiotic and ideological cues that analyzed a covert cultural lexicon in tandem with the photographs’ denotative and connotative meanings. At the denotative level, healthcare workers were the main protagonists (compared to political, health, security, and religious leaders) in advancing China’s story about developing a healthcare management system – depicted mostly as impregnable. Showcasing frontline workers as the soldiers on the battlefield yielded a compelling picture of Chinese people instead of only featuring the leadership. Meanwhile, Xinhua’s relative exclusion of other parts of the world from its COVID scenes, while referring to their struggles in captions, visually presented China as the world’s main line of defense against the pandemic and a success story for others to follow.

The visual semiotics and grammar further promoted preferred readings of China’s response to the health crisis. The wide camera angles showed frontline workers working cohesively and tirelessly like cogs in the wheel of China’s health sector to protect citizens – thus ‘Fighting the Battle’ against the global pandemic, the dominant theme in this study. Furthermore, as the camera shots got closer, the facial/body expressions of the workers became clearer, and their identities and personalities became prominent. The pictorial conventions emphasized the frontline workers’ humanitarian side – the second prominent theme ‘Human Warrior’ – by expressing grief and sadness over their separation from their loved ones, reminiscing about the happiness of their pre-COVID times, and taking a break due to exhaustion. Yet this weariness did not prevent them from performing acts beyond their duties to prioritize the larger Chinese family, especially embracing the vulnerable COVID patients, thereby leading to China’s self-proclaimed early victory over the pandemic under the auspices of Xi and his CCP.

Together, Xinhua’s denotative and semiotic tiers of visual framing resulted in a carefully choreographed message equating China’s COVID-19 response to warfare at the connotative level. Frontline workers emerged as ground troops with their covered bodies, protective gear, gloves, and masks serving as weapons in the fight against the virus. Chinese makeshift hospitals and empty streets appeared as battlegrounds of chemical warfare. Meanwhile, Xi and CCP leaders were the commanders not only strategically planning for war, but also joining, commending, and motivating their troops on the ground despite the risks involved. By portraying the health response as defensive warfare, China’s state media attempted to transform the pandemic into a test of the country’s patriotic resolve, thus ignoring any criticisms of the government and its handling of COVID-19.

Xinhua’s COVID-19 photographs further emphasized an ideological layer of meaning, presenting communism as a recipe for success. The photo editors strategically employed symbolism with references to historical events and communist flags to signal ideas of nationalism and unity in fighting the pandemic. The cues, such as the frontline workers clenching fists and raising them in the air to celebrate their victory, tapped into similar visual rhetoric used with the Arab Spring uprisings (Cushing, 2006) and the Occupy Wall Street Movement, as well as the Black Panther and the Industrial Workers of the World organization (Korff and Peterson, 1992). Unlike these social movements, however, communism, as visually communicated by Xinhua, not only alleviated anti-government sentiments, but also brought together the ground troops (i.e. frontline workers), the commanders (i.e. CCP leadership), and civilians in unison – regardless of whether they are mainland Chinese, Tibetans, residents of Hong Kong, or Uighurs – as they battle and defeat the pandemic with aplomb. Hence, Xinhua’s photographs told the story of a powerful Communist China and its longing for unity, harmony, and stability (Xu, 2021).

Conclusion

This study demonstrates two strategic visual approaches by authoritarian states as they compete over visual evidence and public approval on the global stage. First, states like China are extending war metaphors to social media visuals in order to maximize the effectiveness and reach of their global messaging campaigns. The use of war metaphors in times of health crises and epidemics is not new in and of itself (Chatti, 2021). The CCP’s ‘Patriotic Health Campaign’ and ‘Four Pests Campaign’ in the 1950s and 60s, for example, were loaded with themes of war and struggle (Schneider, 2021). The Chinese government more recently used words such as ‘war’, ‘victory’, ‘soldiers’, and ‘frontline’ in framing health crises (Gui, 2021; Yang, 2021). Yet, nowadays, some state-run media can further use more visual social media platforms, such as Instagram and TikTok, to hypervisualize ‘war-like efforts’ by governments in response to health crises in attempts to grab attention, garner respect, and evade criticisms. In addition, such platforms allow authoritarian states to build synergy between visual war frames, text, and the overarching political rhetoric as they internationalize their appeal to a wider audience.

Second, the visual expressions of vulnerability, in tandem with metaphorical military framing, provide authoritarian states with unique opportunities in the digital sphere. With the rhetorical and argumentative advantages of battlefield visual narratives and the transformation of frontline workers into symbolic troops and warriors, state media can preserve the aura of powerful, undefeatable leadership and military (Cookman, 2009), while projecting hyper-emotionalized scenes to prompt intimacy and connection with viewers (Chouliaraki, 2013). In the case of China’s visual coverage of COVID-19, for example, the scenes of weeping family members hugging their loved ones as they head to the field, exhausted healthcare workers leaning on each other, and medical personnel going above and beyond in treating patients and children like family echoed the CCP’s emotional mobilization messaging strategy (Xie and Zhou, 2021). The appropriation of the hyperemotional visual strategy can thus help bolster political mobilization and state ideology as well as glorify state policies and responses (Dai, 2018; Perry, 2002).

Xinhua’s visual framing of COVID-19 has wider implications for the portrayal of global health governance during crises. More and more, state-controlled outlets are using social media visuals to generate heroes that can tacitly push official narratives about being the vanguard in fighting enemies of the state and to glorify the country’s health governance strategies. These visuals can bolster the ‘seeing is believing’ effect that is more engaging than just words, hence allowing state-sponsored narratives to seek the fading attention of the digital audiences in a less intrusive and more effective manner. Moreover, the perceived informality that Instagram and TikTok bring to government communications opens up spaces for highlighting personal stories, evoking empathy, and generating positive perceptions. Take, for example, the displays of Chinese health workers’ heroism, competence, and sacrifices in Xinhua at a time when Asians were experiencing hate crimes in other parts of the world during the pandemic, coupled with the portrayal of political figures as powerful global leaders to restore faith and trust.

However, political entities are increasingly using social media visuals not just as a crisis management tool, but rather as a means to alter truth and spread false information. Chinese state media’s initial coverage of COVID-19 communicated victory against the virus as far back as March 2020. Almost three years later, the government said over 80 per cent of the population contracted the virus, while maintaining a much lower death toll than scientific projections. With authoritarian states increasingly using their social media mouthpieces to export nationalistic discourses and take advantage of health crises at the global stage, the need for digital media literacy becomes more pressing for schools, colleges, and beyond.

Several pathways can be explored to advance our findings. First, future studies can examine the ideological, connotative, and denotative meanings in the visual representations in the advanced stages of the pandemic as we limit our focus only to the early stages. Second, apart from Xinhua, China also sponsors CCTV, CGTN, and The People’s Daily which target different demographics at various levels, which new studies can investigate. Third, studies can also expand to state-supported media, such as USA’s Voice of America, Turkey’s TRT, Russia’s RT, Iran’s Press TV, and Germany’s DW, to compare the coverage emanating from different media systems. Finally, the media effects of photojournalistic decisions can be experimentally investigated to gauge attitudes towards healthcare professionals to explore new theoretical pathways to visual studies.

Biographical notes

NISHA GARUD-PATKAR is an Assistant Professor in the Department of Journalism and Mass Communication at San Jose State University in California, USA. Her research focuses on visual communication, international communication and diplomacy, and new media and online journalism. She has published several peer-reviewed articles in Digital Journalism, International Journal of Communication, Journal of Magazine Media, and Place Branding and Public Diplomacy.

Address: San José State University, 1 Washington Square, San Jose, CA 95112-3613, USA. [ email: nisha.garud@sjsu.edu]

KAREEM EL DAMANHOURY is an Assistant Professor in the University of Denver’s Media, Film & Journalism Studies Department, and a faculty affiliate in the Center for Middle East Studies. He is the author of Photographic Warfare: ISIS, Egypt and the Online Battle over Sinai (University of Georgia Press, 2022) and co-author with Carol K Winkler of Proto-State Media Systems: The Digital Rise of Al-Qaeda and ISIS (Oxford University Press, 2022). His research focuses on visual communication, international/intercultural communication, and media and conflict. [ email: kareem.eldamanhoury@du.edu]