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Electronic Journal of General Medicine
2020, 17(4), em203
https://www.ejgm.co.uk/ Letter to the Editor OPEN ACCESS
Perceived Risk of COVID-19 Pandemic: The Role of Public Worry and
Mohsen Khosravi 1*
1 Department of Psychiatry and Clinical Psychology, Baharan Psychiatric Hospital, Zahedan, Sistan and Baluchistan, IRAN
*Corresponding Author: email@example.com
Citation: Khosravi M. Perceived Risk of COVID-19 Pandemic: The Role of Public Worry and Trust. Electron J Gen Med. 2020;17(4):em203.
Received: 23 Mar. 2020
Accepted: 26 Mar. 2020
In late December 2019, an outbreak of the novel
coronavirus disease (COVID-19) was started in Wuhan, China,
and quickly reached the other countries of the world (1). In
comparison with the other members of coronaviruses family
such as SARS-CoV and MERS-CoV, COVID-19 appears to have a
lower fatality rate (virulence). However, the high transmission
rate of this virus, as well as the lack of vaccines and certain
pharmaceutical treatments for COVID-19 have posed serious
challenges to the control of the disease spread (1-3). To tackle
such problems, it is necessary to implement non-medical
measures such as the promotion of personal protection
practices (e.g. use of face masks and following personal
hygiene), imposing travel restrictions, and maintaining social
distance from possibly infected cases. To achieve the
successful implementation of such measures recommend by
public health authorities, the willingness of the public plays an
important and decisive role. However, it is still a health
problem to encourage the public to unconditionally follow
these recommended preventive actions. People’s risk
perception of pandemic is one of the factors contributing to an
increase in public participation in adopting preventive
measures (4-6). According to the Protection Motivation Theory
(PMT), the intention of the general public to adopt protective
measures is significantly influenced by high levels of perceived
risk. The theory posits that public perception of the severity
and vulnerability to a certain health threat determines their
risk perception about a disease (7). Therefore, during a new
pandemic, getting information from various sources, such as
public health professionals, the government, and the media,
can increase people’s awareness about the risk, and
consequently, their adoption of preventive measures (4).
However, several factors might affect the subjects' perception
of their actual risk for disease. This discussion aims to
investigate the role of public worry and trust in the perceived
risk of the COVID-19 pandemic.
The worry over getting a disease can influence the
perceived risk of a pandemic. It is an affective emotional
response to a threat, which can predict protective behaviors
independent of the risk severity. In other words, worrying is a
predictor for the individual’s behaviors when facing a threat.
Various factors, including socio-demographic characteristics,
social context, and individual values can affect worry about a
pandemic (8,9). Based on recent studies, being older, female,
more educated, and non-white are associated with a higher
chance of adopting the protective behaviors (10). Note that the
worry over a threat doesn’t occur in a vacuum; rather under a
circumstance where individuals might be quickly influenced by
the emotional reactions of others. This reveals a strong
correlation between perceiving the anxieties of family and
friends, and personal concern (8). In any stage of a pandemic,
practitioners must be aware of the rumors going around and
the potential risk of “emotional contagion” among populations
(8,11). Also, the social context may affect the experienced
levels of worry. For instance, the low-income class is more
concerned with issues such as the equal and fair distribution of
health services. Thus, during a pandemic, such class may
experience emotional responses to health risks, more risk
perceptions, increased negative emotions expressions such as
anger or fear, and huge challenges to the risk reduction (9).
Another factor affecting public worry includes conservation
values such as security, conformity, and tradition. Individuals
who emphasize conservation values would carefully put
preventive measures into practice. Whereas people with the
opposite values (e.g. high self-direction, stimulation, and
hedonism based on Schwartz’s model) pay less attention to the
desirable behavior (8).
One more factor that contributes to shaping an accurate
risk perception of disease is trust. According to the Trust and
Confidence Model, trust plays an important part in managing a
threat by affecting the public’s judgments about the risks and
the related benefits. It can indirectly impact the adoption of the
recommended measures. Trust is believed as the main core of
hearing, interpreting, and responding to public health
messages. This has resulted in a growing dependency of the
effective risk and crisis communication on the method of
receiving information and the level of trust in the government
during the pandemic period. Therefore, governments must
provide complete information about the pandemic to maintain
2 / 2 Khosravi / ELECTRON J GEN MED, 2020;17(4):em203
public trust, even when the information is very limited.
Governments must never downplay the reality of risk and
vulnerabilities to reduce public fears and worries. Besides,
contradictory information maintains by the government can be
associated with reduced public trust. Recent studies found that
in a pandemic, governments must consider that healthcare
workers and municipal health services are among the most
trusted information sources during the process of providing
information. The media has the lowest trust position in such an
Since major coronavirus outbreaks often occur in waves,
surviving the first wave may be accompanied by a misleading
sense of immunity. Moreover, worrying about the infection
may change rapidly during the course of a disease. For
instance, due to people’s concern about a specific behavior
(e.g. vaccination), they may be encouraged to examine that
behavior. However, this behavioral action would reduce the
levels of worry in later stages. Such a case, therefore, “can lead
to apparently conflicting worry–behavior correlations” (8).
The results show that public initial emotional concerns and
trust can play an essential role in improving the perceived risk
of a pandemic and increasing public participation in adopting
preventive measures. Therefore, practitioners can utilize and
develop these models of responding to a pandemic when
facing newly emergent threats.
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