Published:  12:00 AM, 23 April 2020

How to communicate the coronavirus risk?

How to communicate the coronavirus risk?

Frank Dobson, the former Secretary of State for Health in UK mentioned to John Kreb, the day he joined as a Head of the Food Standard Agency in 1999 that "I can't understand why you would want this job. People tell me it is a poisoned chalice, but I have looked carefully and I can't see the chalice anywhere, only the poison."

This quote tells us about the perception of risk and the risk itself. One can see risk everywhere but other can separate risk from non-risk scenario. Kreb steered the Food Standard Agency through a turbulent five years as an expert, when Britain was affected by the human form of mad cow disease.

He maintains that "Scientific knowledge is distinct from other kinds of expert knowledge in being both cumulative and open to test.

It should and will continue to be central in underpinning policy. The challenge in an age of hyper-democracy is to blend expert advice (with all the limitations of uncertainty) into participatory decision-making." How to do this should be a part of risk communication strategy.

When there is a risk, there must be something that is unknown or has an unknown outcome. Therefore, knowledge about risk is knowledge about lack of knowledge.  From epistemological point of view, this combination of knowledge and lack of it make the issues of risk complicated.

This view echoed, what Leo Tolstoy wrote in his novel War and Peace, "all we can know is that we know nothing. And that is the sum total of human wisdom."

One of the problems of risk communication is the scientific disagreement about the problem in hand. This disagreement can arise from various reasons such as disagree about values and access to different sets of information.

This is always the case in science, but through social media, now it becomes more public than it used to be. In case of coronavirus death rate is one of the issue.

The estimates of COVID-19 death rate in different countries vary from as low as 1 in 1000 to as high as 1 in 30. That is because the risk depends on age, sex, health and the access to medical care. It is important to know the infection fatality rate instead of knowing the case fatality rate.

In UK, we do not know yet the infection fatality rate, because this can only be revealed if we do an antibody testing and know who has been infected in the past and then died or otherwise. Currently in UK reported number of death cases out of confirmed cases of COVID-19 is in fact tell us about the case fatality rate.

Another important issue is 'herd immunity'. Initially it was considered as a target, then it has been considered as a consequences and a by-product of the UK government policies such as suppression by social distancing.

A very recent research carried out in the University of British Colombia suggests that there is a cell protein known as Angiotensin converting enzyme 2 (ACE 2) which may explain the severity of COVID-19. The research suggests that variation in how much of this protein people have may help explain why some are more likely to die from COVID-19.

Individuals with lung disorder, smokers, coronary heart disease and diabetics are more likely to die than other people if they contract coronavirus, because those individual seems to produce more ACE2 in their cell.

The coronavirus attaches to this receptor protein and take longer time to clear from the body. If we use drug to rectify this problem, then what other side affect it will create from interfering with the protein?

Clearly there is an uncertainty attached to this research finding. Kreb mentioned that "Life may have been simpler in the past when the authority of the expert was automatically respected. The zeitgeist is now much more questioning. So it is harder for people to know what to do in a time of many conflicting voices."

In order to communicate the uncertainty and disagreement among the scientific communities, people need to know how to deal with information, what to do when different kinds of evidence are quoted, examine where and how evidence comes from, and not to react with shock and horror when there are disagreements.

Kreb suggests that "If you knew whom you could trust, or whether you could trust anyone, that would help. Creating trust between experts and the public is not that different, in my view, from creating trust in any other kind of relationship."

 Trustworthiness is very important in communicating coronavirus risk. A Kantian philosopher named Onora Sylvia O'Neill, in the Reith lecture in 2002, mentioned that there is a need for 'intelligent transparency'. This involves making sure that information is accessible, comprehensible and useable.

These can be achieved through repeating information again and again and checking that the people have got right impression about the information disseminated. In order to make the information useable government has got to listen and answer the question and concern of the people. However, most critical thing is that the information has to be assessable.

Very recently UK government has published the scientific findings in relation to the decision about lockdown. This could be different for different countries because of socioeconomic, cultural and behavioural factors. So, country like Bangladesh can publish her own finding in relation to any impact of lockdown.

John Barry, in his book, The Great Influenza, mentioned that "you don't manage the truth, you tell the truth". But to tell the truth is not purely a science, it is also an art. One has to be open and transparent and communicate consistently referring trusted sources. Also one has to say what they know and what they don't know and the level of uncertainty attached to it.

What a country is planning to do and why such plan, also should be spelled out clearly. It is also important to mention -what people can do and how they should act. Finally, the crucial thing to be realised is that what said today can be changed tomorrow if we learn more about the behaviour of the coronavirus. These rules are pertinent for the communication of coronavirus risk.

The writer is a UK based academic, environmentalist, columnist and author

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