Category: Risk communication
Is Covid 19 different from the influenza flu?
Even after a year, some are grappling with the same old question: Is Covid 19 different from the seasonal flu?
How do we communicate the risk convincingly to this target audience? Obviously, we need to compare number of deaths due to Covid 19 with the number of deaths due to the seasonal flu. The Centre for Risk and Evidence Communication in the University of Cambridge has done exactly that.
Look at the following graph;
It compares the number of COVID 19 deaths with the deaths from influenza flu and several other common causes. As we can clearly see that the number of Covid deaths sharply increases with age when compared to the deaths from influenza flu. It convincingly debunks the claim that Covid 19 is not different from influenza.
A face mask is not a substitute for physical distancing
A face mask over your mouth AND nose is not a substitute for physical distancing;
stay at least 6 feet apart from those who don’t live with you.
Messageframing.com
#WearAMask over youth mouth AND nose in addition to staying at least 6 feet apart from people who don’t live with you and washing your hands often.
Cover your mouth AND the nose: Massage framing
The CDC has re-framed the face mask message: Cover your mouth AND the nose. This message emphasizes the importance of covering the nose by adding the word, “AND” in-between the mouth and nose.
Why should we wear a face mask?
In my earlier post, I wrote about how and when we should wear a face mask and its two varieties: fabric and medical or surgical masks. This post refers to the most crucial question: Why should we wear a face mask?
I will begin with the World Health Organization’s reasoning. Following is their response to the question with their exact verbatim:
Masks reduce potential exposure risk from an infected person whether they have symptoms or not.
World Health Organisation
This is the primary reason; no one knows, if someone gets the virus in the first few days because it takes 4-5 days to develop symptoms. But, they still can infect others.
There is another reason to wear a mask;
People who wear face masks protect themselves from getting infected.
world health organization
The second reason is that masks can protect someone who is not yet infected with the virus.
However, according to the World Health Organization, masks should be used as part of a comprehensive “do it all” approach; it includes physical distancing, avoiding crowded, closed, and close-contact settings, improving ventilation, cleaning hands, covering sneezes and coughs, and more.
Now, I will cite the exact verbatim of the US CDC for the same question.
Masks are primarily intended to reduce the emission of virus-laden droplets (“source control”).
Masks also help reduce inhalation of virus-laden droplets by the wearer (“filtration for personal protection”).
US CDC
The US CDC further says;
- Wearing face masks by all is necessary because those infected but unaware that they are infected due to the absence of symptoms account for 50 percent of virus transmissions.
When and how to wear a face mask
Even almost a year after the covid19 pandemic, reminding ourselves when and how to wear a face mask continues to become a life-saving activity.
Wearing a face mask alone is inadequate to combat this pandemic.
However, wearing a face mask is essential to combat this pandemic. This post reminds us of the basic rules of when and how to wear a face mask as recommended by the World Health Organization.
How to wear a medical or surgical mask
- Wash hands before touching the mask
- cover nose, mouth, and chin (my emphasis: at all times; it cannot be below the nose! not an easy task)
- Wash hands after taking off the mask
What type of a mask?
Medical or surgical masks, if you are,
- over 60
- have a medical condition
- feeling unwell
- looking after an ill family member
Who should wear medical or surgical mask, when and where?
Otherwise, you can wear a fabric mask.
How to wear a fabric mask
What type of fabric?
When and how children should wear a mask
Avoid traps in risk communication
As an individual who closely follows pandemic communication, I have been observing some communication “traps” that the communicators fall into. During my research on this, I found excellent advice from the US CDC website with regard to this topic. I am sharing relevant pieces from that post here.
This post details out dos and don’ts when we communicate events related to an outbreak.
| Dos | Do not s |
| define technical terms in plain language | Use language that even a small section cannot understand |
| Ask whether you have made the information clear. | Do not assume that everything is clear. |
| use examples or analogues to explain a complex topic | Do not assume they understand everything. |
| Focus on facts at hand | Do not speculate |
| Promise only what you can deliver | Do not make promises you cannot deliver |
| Take responsibility of your share of the problem; use empathy | Do not blame or shame others |
Physical distancing is not social distancing
Image source:https://pbs.twimg.com/media/EWCfY8-UwAAdsv_?format=jpg&name=small
What we need exactly is to stop spreading the COVID 19 virus; that is it. We do it by staying away from each other physically and adhering to washing hands each time when we touch anything or any surface outside the home and avoid touching face each time after touching anything or any surface outside the home.
Certainly, not social distancing; in fact, we should combat social isolation. I am not the only one talking about it. Although a bit late, WHO emphasized its position about it at one of their media conferences, held on March 20, 2020; this is what, the WHO epidemiologist Maria Van Kerhove said;
We’re changing to say physical distance and that’s on purpose because we want people to still remain connected.
More than a month later, we can see the most countries are still using the term, “social distancing” instead of “physical distancing”.
“No health without mental health”: This became a major theme popularized by the UN and of course, the WHO sometime back. Although we talk about it, we hardly observe its due prominence in mass media and at any other agency communique mandated for mental health promotion, particularly with increased reporting of domestic violence as collateral damage of this pandemic.
Interestingly I found two posters developed by a small, still very young country highlighting the importance of social connection while maintaining physical distancing. The country is Timor-Leste.
Here it is:
Why is this paradigm shift necessary?
Rebecca Gale outlined several valid reasons in her post in the Washington Post based on an interview with Daniel Aldrich, a professor of political science and public policy at Northeastern University in Boston, Massachusetts. The key points he pointed out are as follows;
- Those with stronger social ties are more capable to weather the storm.
- The communities who rebuild and adapt their lives to the “new normal” are the ones who are with strong social networks.
- The people and communities who had difficulties coming back to their new normal lives were the ones with weak social ties and lack mutual trust and cohesion.
Words matter in COVID 19 communication
Words matter in Communicating COVID 19 pandemic. It is not easy. Unknowingly, we contribute to social stigma with our words and phrases. UN agencies have been addressing this problem during the past two decades with regard to previous outbreaks and pandemics through their country counterparts.
Still, the problem exists and is widespread.
Find out the words and phrases that we need to use and avoid while communicating COVID 19.
Words matter in COVID 19 communication; it matters a lot.
Raise awareness among your circles, particularly opinion leaders, decision-makers, program managers, social media, and other influencers including media reporters, and their editors.
| Talk about | Do not talk about |
| COVID -19 | Wuhan virus/ Chinese virus |
| People who have COVID -19 | COVID – 19 cases |
| People who are being treated for COVID -19 | |
| People who died after contracting COVID -19 | COVID – 19 victims |
| People “acquiring” or “contracting” COVID-19 | People “transmitting COVID-19” / People “infecting” others/ “spreading the virus to others” |
| Talk positively, effectiveness of the measures taken | Do not use hyperbolic language designed to raise fear like, “plague”, “apocalypse”. |
| Do not emphasize or dwell on negatives, messages of threat |
prepared based on information available in the WHO/UNICEF guide document: https://www.unicef.org/media/65931/file/Social%20stigma%20associated%20with%20the%20coronavirus%20disease%202019%20(COVID-19).pdf
WHO short guide on how to communicate COVID 19
This is not a new one. It was released on Feb. 24, 2020. And, it is the responsibility of the WHO people to communicate and train relevant country representatives.
The key points in this very short document are as follows;
1. Do talk about “people who have COVID 19”
(Do not talk about “COVID 19 cases” or “COVID 19 victims”)
2. Do talk about “people who may have or (presumptive) COVID 19
(Do not talk about “COVID 19 suspects” or “suspected cases”)
3. Do talk about people acquiring or contracting COVID 19
(Do not talk about “transmitting COVID-19” “infecting others” or “spreading the virus” as it implies intentional transmission and assigns blame.
Using criminalizing or dehumanizing terminology creates the impression that those with the disease have somehow done something wrong or are less human than the rest of us, feeding stigma, undermining empathy, and potentially fuelling wider reluctance to seek treatment or attend the screening, testing, and quarantine.
4. Do not use hyperbolic language such as “plague” and “apocalypse”; do not scare people using words, “killer virus”, “very dangerous” etc.
5. Do not use messages of threat
6. Engage social influencers such as religious leaders; train them.
7. Implement “hero” campaigns for front-line workers to save them from being stigmatized.
8. Do not use words such as spreaders (super) or do not try to identify the “patient zero”.
You can read the document through this link.
How to frame messages in an epidemic – I
“Tell the truth; be transparent“
source: the US CDC CERC (CRISIS + EMERGENCY RISK COMMUNICATION WALLET CARD: https://emergency.cdc.gov/cerc/resources/pdf/cerc_wallet-card_english.pdf
The world is now grappling with another global epidemic: the coronavirus, COVID-19.
The risk communication is very critical during epidemics. Its importance is apparent now more than ever.
Providing factually correct messages is necessary but not adequate; the messages need to be framed in ways relevant to the intended audience and persuasive enough to change into the recommended behaviors.
Based on recent past experience with the SARS and Ebola virus types, the World Health Organization (WHO), US CDC, European Union, and almost all countries have developed comprehensive evidence-based guidelines, manuals, training modules, etc.
This post summarizes the relevant sections of these documents while citing those references where relevant.
Steps in framing messages in an epidemic
The US CDC recommends to include the following components when formulating messages with regard to the epidemic irrespective of its mode of delivery, either orally, in writing, or in any other media.
Begin with empathy
- Acknowledge the target audience’s concerns by saying/writing.
- Either write or say something similar to this: “we are aware that you are anxious and worried and we care and working to understand their perspective more”.
- In fact, we need to include contact methods to demonstrate to them that we really care and should promote asking questions.
Identify and explain the threat
- Mention “what is causing the threat, who is at risk, and what causes someone to be at risk”;
- “What to do to prevent the harm and to get help if needed”;
- “Acknowledge uncertainties”;
- “Do not over-reassure or over-promise”
Explain what is currently known and unknown
- Provide exact details and timelines
- Admit what is unknown at the moment saying, “we do not have sufficient information yet and we will inform you as soon as we obtain those details without holding back.
- Explain what is being done to minimize harm
Explain what actions are being taken and why as well as the actions that are not being taken and why
- Explain the agencies involved, their roles and responsibilities
- Share dilemmas, be open with making decisions on imperfect and incomplete information
- Explain possible undesired consequences, if anticipated
- Let the media know the assumptions and the possibility of changing recommendations in the future based on new information
Crisis + Emergency Risk Communication (CERC) Wallet Card
The US CDC CERC had produced an extremely useful wallet card that, I believe every professional responsible should carry. Anyone can access to it through this link:https://emergency.cdc.gov/cerc/resources/pdf/cerc_wallet-card_english.pdf
