Monday, February 24, 2020

Time to Get Real about COVID-19 Risk Communication

Risk communication is one of my research and teaching areas.

I noticed recently that two well-established risk scholars have published an editorial arguing for the critical importance of risk communication NOW around COVID-19:
Jody Lanard and Peter M. Sandman (2020, Past Time to Tell the Public: “It Will Probably Go Pandemic, and We Should All Prepare Now”

People are far more likely to panic under conditions of uncertainty, particularly when they feel information is being hidden.

Effective risk communication reduces uncertainty and offers pro-active strategies individuals can take to help reduce their personal and community risks.

Below find the latest information on COVID-19 from the Chinese Center for Disease Control and Prevention.  Although this report is only a snapshot, it includes important information about risk for severe symptoms.

It is important to contextualize the risk reported below in the context of its production, including the risk context of disease burden in China (impacted by smoking/pollution/etc), and the still-limited nature of our unfolding understandings:
Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. Published online February 24, 2020. doi:10.1001/jama.2020.2648

Most case patients were 30 to 79 years of age (87%), 1% were aged 9 years or younger, 1% were aged 10 to 19 years, and 3% were age 80 years or older. Most cases were diagnosed in Hubei Province (75%) and most reported Wuhan-related exposures (86%; ie, Wuhan resident or visitor or close contact with Wuhan resident or visitor). Most cases were classified as mild (81%; ie, nonpneumonia and mild pneumonia). However, 14% were severe (ie, dyspnea, respiratory frequency ≥30/min, blood oxygen saturation ≤93%, partial pressure of arterial oxygen to fraction of inspired oxygen ratio <300 and="" infiltrates="" lung="" or="">50% within 24 to 48 hours), and 5% were critical (ie, respiratory failure, septic shock, and/or multiple organ dysfunction or failure)

Although we don't know that the Chinese statistics will replicate elsewhere, we do know that some percentage of people who fall ill with this virus (everywhere it circulates) are going to need hospitalization.

Although modern medicine can reduce mortality, our hospitals are ill-prepared for a sudden surge across the nation of very sick patients needing ventilators.

Time is now to get real with scenario planning and risk mitigation strategies.

Time is now to formulate and disseminate risk communication - virus needs to be addressed by trusted authorities and the public instructed in what they can do specifically to help prevent its circulations.

Public should also be instructed in conditions under which appropriate to to visit emergency rooms, urgent cares, and family doctors, in descending order of urgency.


  1. China is facing a dilemma. Stay home and go broke, or go back to work and increase the spread of the virus. Back in December the Japanese "cult" where the virus recently broke out was in Wohan holding meeting and services; then they found out that in November a new virus started going around. November! They left and went home.I suspect the CCP is terrified that the Chinese people will find out that the virus escaped from the level 4 bio lab. Reports that the epidemic is slowing have to do with inducing people to return to work.

    According to Dr Francis Boyle the virus originated at the U of N Carolina. A chimera with "gain of function". Like China Iran is also being opaque. Perhaps the virus has mutated.

    Not much testing in the USA but then the tests are only about 50% accurate. If the epidemiologists are correct during the coming year about 15 million Americans will need ICU care.

    Save your containers as containers are mostly made in China.

  2. And what of the 300 other passengers on the airliner that brought back the cruise ship people?

    Sure they had plastic up.....but duh....there is only one airconditioning system!!!!!

    CDC fears ‘community outbreak’ in Sonoma County after discovering first US case of “unknown origin”

    Saudi Arabia suspends pilgrimages to Holy Sites

    Hawaiian Airlines suspends service to South Korea

    Brazil’s neighbors take steps to keep virus out


  3. Positive RT-PCR Test Results in Patients Recovered From COVID-19

    Lan Lan, MD1; Dan Xu, MD1; Guangming Ye, MD2; et al Chen Xia, MS3; Shaokang Wang, MS3; Yirong Li, MD, PhD2; Haibo Xu, MD, PhD1
    Author Affiliations Article Information
    JAMA. Published online February 27, 2020. doi:10.1001/jama.2020.2783


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