Risk Communications -Lessons from a desktop comparative study of the COVID 19 Risk Communication Response.
Short profile of a few of the cases reviewed, resources, and references at the end of this draft.
Key Findings
· The Covid 19 Pandemic response was unpreceded. (It was a novel Corona Virus- Covid 19). The nature of the outbreak including the need for evidence-based coordinated risk communications i.e. global and novel disease took many governments off guard. In general, across the countries studied, governments were not well prepared for the Pandemic. While some governments had response plans in place for national public health emergencies, the nature of the disease required a specific and global response. The global effort of the response needed was not unlike the response needed for Small Pox or a World War.
· The cases studied illustrate that the Covid 19 “Pandemic” crisis highlighted the importance of planning and leadership and the damaging effects of confused communications. To be effective, the risk communication systems must involve high levels of the government, and generally, plans for Pandemic response should have been prepositioned with planning and action supported by the national emergency agencies.
· The cases illustrate, that where risk communication has been most successful (garnering trust and action by the stakeholders and public) support WHO recommendations for timely decisive government leadership for evidence-informed, risk-based escalation and de-escalation decisions and communications combining rigorous case detection, isolation, contact tracing, and quarantine measures with population education and engagement.
· While the response to the Covid 19 crisis is about Epidemiology –The work to control disease outbreaks - is also about Epistemology – “How we know what we know”. Expertise for Risk Communications planning and response is needed from both disciplines to do effective planning efforts during early emergency response.
· In terms of knowledge and data - Covid 19 Specific Risk Assessment needed unique integrated data, knowledge, sharing of good tools and methods.
· While the pandemic is global, the responses including risk communications are local. The results will come in the community and communities need guidance and coordination for messaging and data collection and knowledge sharing.
Key Lesson 1 – Countries expressing successful containment strategies had quickly established Coordination Mechanisms including Risk communications at the top of government at the COVID 19 Emergency Onset (even before the Pandemic was called by the WHO).
· Many governments in East Asia and the West established national committees and other coordination mechanisms using a whole-of-government approach.
· China, the State Council established a Joint Prevention and Control Mechanism.
· Taiwan, the first response task force consisting of experts in infectious diseases, public health, and laboratory sciences, etc., was established by the end of the first week of January, BY the Central Epidemic Command Center (CECC),
· The Japanese government soon followed, with the Prime Minister creating a task force to prevent the further spread of COVID-19 on January 30, 2020.
Key Lesson 2 -Response Strategies were needing informed Covid 19 Risk Communications and Community Engagement across the Proactive Response, Recovery, and Preparedness cycle to be effective.
· Effective risk communications are inherently linked to disaster management and planning. This effort must predefine leadership (Canada established planning strategies for emergency response after 9/11) for communication in advance of events and have established coordination for communication at the subnational and national levels.
Key Lesson 3 -Multi-level Communication & Risk Management Specific Planning is needed at the international, national, and subnational levels.
? The COVID 19 was a global disease outbreak and risk management and planning for communications needed specific strategies for managing communications including at the international, national and sub-national levels.
? Phasing the response including developing the risk communication messages was central to preparedness about key management areas of action based on risk assessment for containment.
? South Korea, for example, as a good practice, announced several policies ( 5 step process) to improve its Pandemic response system based on the Covid 19 experience including a large emphasis on the needs for and types of information i.e. epidemiology type subjects as well as other for daily life needed for decision making and communications. The case has shown that such stringent implementation ensured compliance and restored faith in the measures, policies, and actions the government took on behalf of society.
Key Lesson 4 -Risk Communication to be effective needs Public leadership & Consistent Messaging Based on Science
? The cases studied show that political leadership at the highest level is needed with consistent messaging based on credible science are needed.
? Countries with risk communications where the leaders (national, regional, and local) gained the public trust had greater response results than those with chaotic risk communications.
? Effective communication is about who is the messenger for the risk communications to build public trust and garner buy-in i.e. and for hard response measures such as lockdown and masks for the public good.
? High political leadership is needed also to establish situation rooms and intersectoral work agreement mechanisms.
? Some experiences show how communication can be either effective (South Korea) or confused if the leaders as messengers are not science-based.
Key Lesson 5: Integrated Risk Assessment is the foundation of Covid 19 Communication Strategies. Multidisciplinary, Stakeholder, and Sector Risk Assessment informs Communication strategies is the basis for Communication / Collaboration applying science data use for risk monitoring, setting and lifting of public health measures.
? Lessons had emerged to support the idea of global standards for Covid 19 Pandemic communications, knowledge sharing, and data collection methodologies.
? Covid Risk communications to be effective must be based on risk assessment across many topics and sectors/stakeholders.
? Risk Assessment for Covid 19 policy and decision making also involves mapping the rules of the political game, convening the inter-sectoral and multidisciplinary science, data and information gathering, and protocols for monitoring.
? The Covid Pandemic has taught us core lessons about the need for consistent and technically coordinated data is integrated for policy and messaging must be covering across topics about the disease: -virological surveillance, immunology, vaccine development, and also governance, social, health, and economic policy (business, schools, and health) topics.
? Thus recognition that this is a cross-disciplinary exercise for decision making and action regarding health and pandemic mitigation type outcomes.
? What data is collected and how it is analyzed and presented should influence the decision-making. The cases show that the standards for information gathering and management have not been uniform globally.
Key Lesson 6: Emerging Data Tools proved to be useful but were uneven. The experience of COVID communication tools raised questions on what data is collected, what agreements are prepositioned or put in place, and how are data interoperability achieved in systems for sharing and analysis.
? The tools and tactics used for data collecting were contentions including the use of AI for monitoring the disease and people movement surveillance.
· The national ideals regarding freedoms and surveillance vs public good interests were contention but the experience has shown that where there was trust in government people were not an adversary to the idea of data collection and surveillance.
? Standards for Covid risk communication tools and information management /sharing are still evolving.
· Some countries have gone higher-tech than others i.e. Taiwan used effectively AI, communication, and linked data analysis tools.
· Japan provides a case of jumpstarting integration of key elements of the Pandemic to notions of building back better, equity, and sustainable development.
? A series of commonly used Covid Risk Communication Tools emerged with lessons that include:
· The use of digital tools and apps for information sharing
· Artificial intelligence AI for monitoring and contact tracing,
· Unique information management systems with common targets and indicators for integrating data analysis and inputting data including for greater equality in response and targeting public measures.
? Common targets and indicators are emerging for data tractors and information management systems including data on the most vulnerable and excluded/marginalized.
· Joint sector policy analysis is the final part of the integrated data collection and analysis.
· Response need systems for undertaking rapid assessments i.e. outbreak control
· The IM system need prepositioned data sharing agreements and standards for indicators and target setting.
Key Lesson 7 - While COVID 19 is a global disease outbreak the responses are local. Requirements for Risk Communication at the Community are essential for COVID 19 results.
? Engaging closely with the community is essential for COVID 19 expected outcomes.
? Establishing community-level data collection, rapid communication channels, and trust are essential to expected outcomes.
? For instance in the case of vaccines – to deal with vaccine hesitancy.
? Some community engagement strategies expressed across the cases include:
? Local champions
? Vaccine plans
? Community Alerts and Message boards
? Recruiting local champions and leadership for information sharing by phone and text alerts.
? Using the local app for contract tracing
Key Lesson - Early engagement of the Media is essential for effective risk communications and credible information dissemination for results.
? The media is a key ally in the management of disinformation and dissemination of credible Covid 19 information. A common problem for credible communication as part of the COVID 19 response has been the spread of misinformation on social media.
? Infodemic phenomenon.
? Vaccine hesitancy
? Dispelling Social Media Rumors
Risk Communication Development Strategies
? Risk communication systems Involvement of highest levels of government
? Existence of RC plans prior to COVID-19 pandemic
? Procedures on timely release of information RC operational team Budgetary issues
? Internal and partner coordination Identification of relevant partners
? Communication capacity of partners
? Existence and use of Standard Operating Procedures (SOPs) Public communication spokespersons
? Identification of key media Identification of channels of communication
? Role of health professionals in RC Community engagement
? Understanding of concerns, attitudes, and beliefs of key audiences Identification of target audiences and gathering of information about their knowledge and behaviors
? Engagement through social media, radio, and other appropriate means
? Identification of community influencers
? Special information needs for people who are disabled or illiterate Establishment of hotlines to respond to concerns
? Addressing uncertainty and perceptions and managing misinformation
? System for responding to misinformation
? System for gauging public perceptions and rumors and misinformation
? Preparation of guidance for health professionals, community leaders, local government staff, and other key groups on how to respond to misinformation
? Capacity building Training activities in various areas of RC System for assessing and responding to training needs
New Zealand
? Embarked on an early Covid 19 specific intervention.
? Based its action even with a lack of concrete evidence of the effectiveness of non-pharmaceutical interventions against COVID-19. Used early evidence in Asia, including China, Singapore, and South Korea, which has shown results for COVID-19 control using combinations of movement restrictions, physical distancing, hygiene practices, and intensive case and contact detection and management. Where the WHO-China Mission recommended decisive government leadership to rapidly enhance surveillance and apply risk-based non-pharmaceutical interventions with effective population engagement. However, it was unclear how well this could be implemented in societies with little experience of successfully containing a novel respiratory virus.
? The New Zealand experience was about the speed of early Covid and decisive action and coordinated communicating in the face of uncertainty.
South Korea
? Took swift action even before WHO declared Pandemic – had prior similar experience with Sars and Mers. Implemented a Control tower mechanism The Case studied also illustrated that while democratic capitalist countries have discounted the importance of the role of government intervention, the case argued that the need for a coordinated disaster response plan that can only be performed with effective and efficient mechanisms enabled by an empowered national government.
? South Korea announced a number of policies and took five steps to improve its system based on the COVID 19 response including a large emphasis on the needs for and type of information i.e. epidemiology type subjects as well as other for daily life needed for decision making and communications
Canada
? Took Swift Federal government actions after the WHO declared Pandemic Health led, Province network of Health Focal Points.
China
? Response was characterized by Early Coordinated and National Control Intervention –focus on non-pharmaceutical interventions -Pooled testing in place before the pandemic. Risk-based lifting of restrictions.
? According to the Chinese Center for Disease Control and Prevention, China’s strategy was built on active case finding and case management with identification and quarantine of close contacts, as well as the risk-based lifting of restrictions. Chinese authorities aim to test each suspected case and all close contacts of those infected. After three COVID-19 cases were identified in October 2020, in Qingdao, a pooled testing approach coordinated by the government with the cooperation of residents enabled 10·9 million people—almost the entire population of the city—to be tested within 5 days. Although few COVID-19 cases have been reported, people are generally adhering to non-pharmaceutical interventions, such as avoiding large gatherings. After the government urged people to abandon travel plans, and with local governments imposing strict quarantine measures, there was a 70% drop in the number of passenger trips across the country in the 2 weeks leading up to the Chinese Lunar New Year this year, compared with the same period in 2019. China’s public health measures, as well as the public’s compliance, largely owing to high trust in the government, have contributed to the effective response. Elements of China’s approach, such as those that involve monitoring citizens’ whereabouts, might not be countenanced in many western countries. However, China’s domestic successes in controlling COVID-19 stand in contrast with outcomes elsewhere, and other countries should learn what public health lessons they can.
USA
? USA – Delayed Federal Covid 19 response- not prepared for the WHO call on a global Pandemic.
? Did not have a strong Pandemic response strategy in place. The responsible agency was weakened after the prior administration left office.
? Additionally, continued chaos by leadership in messaging - states generally had control over response but lacked guidance.
? Variety of Covid Trackers- Indicators are a case in point See COVID data tracking: Best dashboards and other tools parsing cases, hospitalizations, and more | ZDNet
Mongolia
? Response included centralized the early coordination -GASI, NEMA, Heath Ministry, information technically supported WHO sit reps, cooperated with UNICEF, WHO OCHA data trackers
Japan
? Had health emergency planning in place. It moved quickly with an integrated response plan building on the opportunity for transformation to sustainable development. Focus on equality and inclusive response.
Russia
? Compared to elsewhere in Europe and Asia, the impact of Covid-19 in Russia was delayed.
? The situation has turned very serious with the number of confirmed cases exploding from just 495 on March 24 to 10,131 as of April 9.
? Moscow, as Russia’s most populous city and economic center, accounted for the vast majority of cases. The number of new daily cases had been growing exponentially.
Others - Blog on the 10 global best and worst COVID 19 responses – See blog. The Countries Who've Handled COVID-19 the Best and Worst | MoveHub.
References and Resources
? COVID-19 Pandemic Response in Japan: What Is behind the Initial Flattening of the Curve? Ai Tashiro 1 and Rajib Shaw 2,* 1 Graduate School of Environmental Studies, Tohoku University, 468-1 Aoba, Aramaki, Aoba-ku, Sendai, Miyagi 980-0845, Japan; [email protected] 2 Graduate School of Media and Governance, Faculty of Policy Management, Keio University, 5322 Endo, Fujisawa-hi, Kanagawa 252-0882, Japan * Correspondence: [email protected] Received: 15 May 2020; Accepted: 27 June 2020; Published: 28 June 2020
? UNDP/UNDRO. UNDP/UNDRO: Disaster Management Manual; United Nations Development Programme: Geneva, Switzerland, 1991
? The Japan Study https://www.sciencedirect.com/science/journal/22124209
? COVID-19 in New Zealand and the impact of the national response: a descriptive epidemiological study Sarah Jefferies, Nigel French, Charlotte Gilkison,Giles Graham, Virginia Hope, Jonathan Marshall, Caroline McElnay, Andrea McNeill, Petra Muellner, Shevaun Paine, Namrata Prasad, Julia Scott, Jillian Sherwood, Liang Yang, Patricia Priest Lancet Public Health 2020; 5: e612–23 Published Online October 13, 2020 https://doi.org/10.1016/ S2468-2667(20)30225-5
? Applications of Google Search Trends for risk communication in infectious disease management: A case study of the COVID-19 outbreak in Taiwan Atina Husnayaina,b , Anis Fuadb , Emily Chia-Yu Sua,c,d, * aGraduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan bDepartment of Biostatistics, Epidemiology, and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia c Clinical Big Data Research Center, Taipei Medical University Hospital, Taipei, Taiwan d Research Center for Artificial Intelligence in Medicine, Taipei Medical University, Taipei, TaiwanArticle history: Received 21 February 2020 Received in revised form 6 March 2020 Accepted 6 March 2020
? Gilmore B, Ndejjo R, Tchetchia A, et al. Community engagement for COVID-19 prevention and control: a rapid evidence synthesis. BMJ Global Health 2020;5:e003188. doi:10.1136/ bmjgh-2020-003188
? Quarantelli, E.L. Community crises: An exploratory comparison of the characteristics and consequences of disasters and riots. J. Contingencies Crisis Manag. 1993, 1, 67–78
? Articles www.thelancet.com/public-health Vol 5 November 2020 e614
? National Disaster Management System: COVID-19 Case in Korea Junic Kim * and Kelly Ashihara School of Business, Konkuk University, 120 Neungdong-ro, Seoul 05029, Korea; [email protected] * Correspondence: [email protected]; Tel.: +82-2-450-3484 Received: 14 August 2020; Accepted: 8 September 2020; Published: 14 September 2020International Journal of Environmental Research and Public Health (ISSN 1660-4601; CODEN: IJERGQ; ISSN 1661-7827 for printed edition) is an interdisciplinary, peer-reviewed, open access journal published semimonthly online by MDPI. Int. J. Environ. Res. Public Health 2020, 17, 6691 7 of 18
? https://www.sciencedirect.com/science/journal/24146447 Early stage risk communication and community engagement (RCCE) strategies and measures against the coronavirus disease 2019 (COVID-19) pandemic crisis Ernest Tamboa,b,? , Ingrid C. Djuikoue a,b , Gildas K. Tazemdaa,b , Michael F. Fotsing b , Xiao-Nong Zhouc a Higher Institute of Health Sciences, University of the Mountains, P.O. Box 208 Bagangté, Cameroon b Prevention and Control, NGO, Cameroon c National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; WHO Collaborating Centre for Tropical Diseases, Shanghai 200025, China. Article history: Received 30 March 2020 Accepted 11 February 2021 Available online 14 February 2021. RETRIEVED FROM WEB MAY 2021 https://www.keaipublishing.com/en/journals/global-health-journal/
Links to comparative work
? Southeast Asia Covid-19 Tracker | Center for Strategic and International Studies (csis.org)
? COVID-19 Resource Centre (thelancet.com)
? Assessing Risk Factors for Severe COVID-19 Illness | CDC
? The Countries Who've Handled COVID-19 the Best and Worst | MoveHub.
? -https://www.canada.ca ? bases-support-units ? covid19-info
? Here is a discussion about which platforms to uses one physician encourages TIK TOK
? ? https://www.cbc.ca/news/health/coronavirus-canada-communications-social-media-1.5761917
? Here is how the Canadian federal government organizes data
? https://www.canada.ca/en/public-health/services/diseases/coronavirus-disease-covid-19.html
? New face mask guidelines: Dr. Sanjay Gupta says the CDC 'made a critical error' – CNN
? Eric Clapton slams vaccine 'propaganda' after experiencing 'disastrous' side effects (msn.com)
MD, MPH, Public Health and Immunization Troubleshooting
2 年Stephanie Hodge great work, and very timely - it seems pandemic will soon give us a chance to apply some of practical lessons learnt you provided...lots of good thoughts for designing better approach...this time. ??