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Risk communication is a key factor able to affect the response of the population to an emergency and to promote correct actions and behaviors. The advent of a crisis on a global scale, as the 2020 pandemic of COVID-19, exposed some of the weakness of healthcare and political institutions worldwide, which failed to provide a proper and coordinated communication plan. With no effective preparedness and readiness procedures in place, the communication models used were arbitrary and distressed by the attempts of the many, some moved by good will, others merely by personal interest. In such a cacophony of often unsolicited opinions, any contingency plan and any procedure aimed to prevent the spread of the virus seemed to fail, often because the general public was simply unable to understand what was going on and why some measures were needed.
The scientific community’s response to COVID-19 has resulted in a large volume of research moving through the publication pipeline at extraordinary speed, with a median time from receipt to acceptance of 6 days for journal articles. Although the nature of this emergency warrants accelerated publishing, measures are required to safeguard the integrity of scientific evidence.
A number of important principles in effective risk communication established in the late 20th century can provide important scientific insight into patient response to the risks posed by coronavirus disease 2019 (COVID-19). Early risk communication scholars found acceptability of risk was shaped by 2 key components: hazard and outrage. The number of people who are exposed, infected, and fall ill can be considered the hazard. How the public and patients and respond to messages regarding risk mitigation relates to outrage. Social and cultural factors, immediacy, uncertainty, familiarity, personal control, scientific uncertainty, and trust in institutions and media all shape perception and response to risk mesaging. Outrage factors influence the ever-changing public understanding of COVID-19 risk. In concert, hazard and outrage along with cultural and economic context shape adherence to, and overall acceptance of, personal mitigation strategies including wearing facemasks and social distancing among the general public. The spread of misinformation on social media also provides both challenges and opportunities for clinicians. Social media offers an opportunity for experts to quickly convey true information about hazards, but offers others the opportunity to counter this with the spread of misinformation and exacerbate outrage. We propose strategies for infectious diseases clinicians to apply risk communication principles and frameworks to improve patient care and public message development in response to COVID-19.
Integrating risk communication and community engagement into the national public health emergency response is crucial. Considering the difficulties and challenges faced by China in the prevention and control of coronavirus disease (COVID‐19) and based on interim guidelines from the World Health Organization, this article makes several recommendations addressing the outbreak in China. These include improvements in the internal governmental risk communication systems, enhancing the coordination between internal and partner governmental emergency management, and promoting public communication in response to societal concerns. Regarding these recommendations, we emphasize community engagement in joint prevention and control, confronting uncertainty and countering rumors effectively, and strengthening international cooperation and evidence‐based decision making for prevention and control measures.
The aim of this paper is to analyse cultural differences in attitudes towards perceived risk, during public health emergencies. In order for risk communication to be effective and to properly address people's expectations and fears, political, social and economic factors should be taken into consideration. Moreover, since we consider cultural backgrounds to highly influence communication strategies, the main research questions of this paper are: to what extent cultural dimensions, such as high and low uncertainty avoidance or power distance, are visible in risk communication, and how the message is conveyed in cases of public health emergencies. The focus is on the discourse of state representatives or public institutions, such as ministries of health, in the context of the recent COVID-19 outbreak.
The World Health Organization has declared the rapid spread of COVID-19 around the world a global public health emergency. It is well-known that the spread of the disease is influenced by people's willingness to adopt preventative public health behaviors, which are often associated with public risk perception. In this study, we present the first assessment of public risk perception of COVID-19 around the world using national samples (total N = 6,991) in ten countries across Europe, America, and Asia. We find that although levels of concern are relatively high, they are highest in the UK compared to all other sampled countries. Pooled across countries, personal experience with the virus, indi-vidualistic and prosocial values, hearing about the virus from friends and family, trust in government, science, and medical professionals, personal knowledge of government strategy, and personal and collective efficacy were all significant predictors of risk perception. Although there was substantial variability across cultures, individualistic worldviews, personal experience, prosocial values, and social amplification through friends and family in particular were found to be significant determinants in more than half of the countries examined. Risk perception correlated significantly with reported adoption of preventative health behaviors in all ten countries. Implications for effective risk communication are discussed.
The ongoing COVID-19 pandemic is shaking the foundations of public health governance
all over the world. Researchers are challenged by informing and supporting authorities on acquired
knowledge and practical implications. This Editorial applies established theories of risk perception
research to COVID-19 pandemic, and reflects on the role of risk perceptions in these unprecedented
times, and specifically in the framework of the International Journal of Environmental Research and Public
Health Special Issue “Research about risk perception in the Environmental Health domain”.
This perspective is written to give a rapid response to discuss the role of media in risk communication in the first three months of the COVID-19 pandemic. We analyze two sets of media data, China’s social media and global news event, and draw a few initial observations in relation to the impacts of China’s information control policy, global risk governance, and the role of WHO.
The emergence of the 2019 novel coronavirus has led to more than a pandemic—indeed, COVID-19 is spawning myriad other concerns as it rapidly marches around the globe. One of these concerns is a surge of misinformation, which we argue should be viewed as a risk in its own right, and to which insights from decades of risk communication research must be applied. Further, when the subject of misinformation is itself a risk, as in the case of COVID-19, we argue for the utility of viewing the problem as a multi-layered risk communication problem. In such circumstances, misinformation functions as a meta-risk that interacts with and complicates publics’ perceptions of the original risk. Therefore, as the COVID-19 “misinfodemic” intensifies, risk communication research should inform the efforts of key risk communicators. To this end, we discuss the implications of risk research for efforts to fact-check COVID-19 misinformation and offer practical recommendations.
Our society is built on a complex web of interdependencies whose effects become manifest during extraordinary events such as the COVID-19 pandemic, with shocks in one system propagating to the others to an exceptional extent. We analyzed more than 100 millions Twitter messages posted worldwide in 64 languages during the epidemic emergency due to SARS-CoV-2 and classified the reliability of news diffused. We found that waves of unreliable and low-quality information anticipate the epidemic ones, exposing entire countries to irrational social behavior and serious threats for public health. When the epidemics hit the same area, reliable information is quickly inoculated, like antibodies, and the system shifts focus towards certified informational sources. Contrary to mainstream beliefs, we show that human response to falsehood exhibits early-warning signals that might be mitigated with adequate communication strategies.
Risk communication is critical to emergency management. The objective of this paper is to illustrate the effective process and attention points of risk communication reflecting on the COVID-19 (2019-nCoV) outbreak in Wuhan, China. We provide the timeline of risk communication progress in Wuhan and use a message-centered approach to identify problems that it entailed. It was found that the delayed decision making of the local government officials and the limited information disclosure should be mainly responsible for the ineffective risk communication. The principles for effective risk communication concerning Wuhan's outbreak management were also discussed. The whole communication process is suggested to integrate the accessibility and openness of risk information, the timing and frequency of communication, and the strategies dealing with uncertainties. Based on these principles and lessons from Wuhan's case, this paper employed a simplified Government-Expert-Public risk communication model to illustrate a collaborative network for effective risk communication.
An emerging outbreak of COVID-19 has been detected in at least 26 countries worldwide. Given this pandemic situation, robust risk communication is urgently needed particularly in affected countries. Therefore, this study explored the potential use of Google Trends (GT) to monitor public restlessness toward COVID-19 epidemic infection in Taiwan.
We retrieved GT data for the specific locations of Taiwan nationwide and subregions using defined search terms related to coronavirus, handwashing, and face masks.
Searches related to COVID-19 and face masks in Taiwan increased rapidly, following the announcements of Taiwan’ first imported case and reached its peak as local cases were reported. However, searches for handwashing were gradually increased in period of face masks shortage. Moreover, high to moderate correlations between Google relative search volume (RSV) and COVID-19 cases were found in Taipei (lag-3), New Taipei (lag-2), Taoyuan (lag-2), Tainan (lag-1), Taichung (lag0), and Kaohsiung (lag0).
In response to the ongoing outbreak, our results demonstrated that GT could potentially define the proper timing and location for practicing appropriate risk communication strategies to the affected population.
Background: Community responses are important for outbreak management during the early phase when non-pharmaceutical interventions are the major preventive options. Therefore, this study aims to examine the psychological and behavioral responses of the community during the early phase of the COVID-19 epidemic in Hong Kong.
Method: A cross-sectional online survey was launched within 36 hours after confirmed COVID-19 cases were first reported. Councilors of all 452 district council constituency areas were approached for survey dissemination. Respondent demographics, anxiety level, risk perception, sources to retrieve COVID-19 information, actual adoption and perceived efficacy of precautionary measures were collected.
Result: Analysis from 1715 complete responses indicated high perceived susceptibility (89%) and high perceived severity (97%). Most respondents were worried about COVID-19 (97%), and had their daily routines disrupted (slightly/greatly: 98%). The anxiety level, measured by the Hospital Anxiety and Depression Scale, was borderline abnormal (9.01). Nearly all respondents were alert to the disease progression (99.5%). The most trusted information sources were doctors (84%), followed by broadcast (57%) and newspaper (54%), but they were not common information sources (doctor: 5%; broadcast: 34%; newspaper: 40%). Only 16% respondents found official websites reliable. Enhanced personal hygiene practices and travel avoidance to China were frequently adopted (>77%) and considered effective (>90%). The adoption of social-distancing measures was lower (39%-88%), and their drivers for greater adoption include: being female (adjusted odds ratio [aOR]:1.27), living in the New Territories (aOR:1.32-1.55), perceived as having good understanding of COVID-19 (aOR:1.84) and being more anxious (aOR:1.07).
Discussion: Risk perception towards COVID-19 in the community was high. Most respondents are alert to the disease progression, and adopt self-protective measures. This study contributes by examining the psycho-behavioral responses of hosts, in addition to the largely studied mechanistic aspects, during the early phase of the current COVID-19 epidemic. The timely psychological and behavioral assessment of the community is useful to inform subsequent interventions and risk communication strategies as the epidemic progresses.
Although there has been consistent evidence indicating that school closures have only limited efficacy in reducing community transmission of coronavirus disease 2019 (COVID-19), the question of whether children should be kept home from school has attracted extensive and often divisive public debate in Australia. In this article we analyse the factors that drove high levels of concern among parents, teachers and the public and led to both demands for school closures in late March 2020, and to many parents' reluctance to return their children to school in May 2020. We discuss how the use of well-established principles of risk communication might have reduced much of this community concern. Then we set out a range of practical suggestions for communication practices that build trust and hence diminish concerns in relation to managing schools over the long term of the COVID-19 pandemic.
Lifestyle is a cornerstone of cardiovascular prevention and the process of risk communication constitutes an important step to obtain favorable changes in daily habits. Nevertheless, there is no definite consensus on how health operators should provide information on cardiovascular risk, and several models have been proposed in different settings. The current COVID-19 pandemic - with related communication strategies to reduce the spread of the disease and morbidity - may offer an interesting opportunity to reconsider communication in cardiovascular prevention: even though cardiovascular conditions are not communicable diseases, both COVID-19 and cardiac illnesses force a huge segment of the population to major lifestyle changes. This narrative commentary describes similarities between these conditions, mainly focusing on modalities of risk communication, strategies to counteract fake news, actions to enhance the expertise of health operators, and finally on new skills that could derive as a lesson from COVID-19.
The purpose of this study was to describe population knowledge and beliefs about COVID-19 and current social media coverage to address a gap in what is known about risk communication during health crises. A survey with 27 questions was developed. Twenty-three percent ( N = 1,136) of respondents started the survey. Less than half of the students reported a high health literacy level (43%, n = 365/855). When asked where students have heard about COVID-19, the majority reported the Internet and social media. Students reported a basic level of COVID-19 knowledge, but few students (18%, n = 173/966) correctly identified all three signs and/or symptoms of COVID-19. Results highlight the need for an increased public health presence on social media and the urgent need to remain diligent in educating community members about COVID-19 myths.
Coronavirus disease (COVID-19), an infection of the zoonotic coronavirus, is presenting a healthcare challenge around the globe. This study aims to assess the levels of disease knowledge and risk perception among pharmacists. We also recognize predictors of risk perception and perceived media roles. Methods This is a questionnaire-base cross-sectional study. The questionnaire was developed on a web-based platform and invitations were sent to pharmacists nationwide to participate in the study using social media applications. Results A total of 486 pharmacists participated in this study, where females were dominant (78.6%, n = 382). Most (40.4%, n = 198) pharmacists scored 4 out of 5 in basic disease knowledge, and more than half were able to recognize common methods of spread. Risk was highly perceived among participants, and was predicted by gender, living area, and having children (p < 0,05). Frequency of watching the media and sources of information also influenced both risk perception and perceived media roles. Conclusion Disease awareness among pharmacists, as well as risk perception must be considered for effective risk communication planning. The role of media in shaping perceptions should also be carefully studied to encourage compliance with government containment measures and engagement in preventive behaviors.
John Ioannidis writes about the harm caused by misinformation about COVID‐19.1 We draw from communication research to offer best practices for reducing misinformation, disseminating accurate health information, and promoting prevention and control recommendations. We recommend three strategies that medical, public health, and scientific professionals working with government officials, clinicians, media commentators, and in other contexts around the world can use to improve communication about outbreaks.
The manuscript highlights available data on gap in public awareness about recent clinical and scientific facts about COVID-19, insufficient community knowledge about symptoms and preventive measures during COVID-19 and previous MERS-CoV epidemic, and lack of monitoring the community perception and adherence to preventive measures. We also summarize literature evidence about reluctance to change social behavior and disregard recommendations for social distancing among persons who percept to having low risk of infection or complications, and briefly describe destructive psychological response and misleading communications.Our analysis could be translated into important policy changes in two directions:(1)to communicate recent scientific discoveries about COVID-19 pathophysiology to better prepare public opinion to longer period of extraordinary measures;(2)to implement sociological feedback on knowledge, attitudes and practices among general public and some vulnerable social groups.
Risk communication is crucial in response to any hazard to human health. Sharing
information can help triggering necessary actions that can eventually lead to the solution of
a problem or to a reduction of its negative effects, improving the outcome. Some basic rules
must be followed, though, in order to create an effective communication, avoiding those
mistakes that undermine the trust that people rely on risk assessors and decision-makers.
Air pollution is a peculiar problem in risk communication as its effects are blurred although
partially known also by the public. Most of them appear later in life and not always the cause-
effect relationship is clear. For this reason, air pollution remains a major challenge in risk
communication and health education.