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MINI REVIEW
Year : 2021 | Volume
: 10
| Issue : 3 | Page : 227-230
Risk communication in COVID-19 pandemic: A note for health-care workers
Abdel-Hady El-Gilany, Nesrine Saad Farrag
Department of Community Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Correspondence Address:
Dr. Nesrine Saad Farrag
22 Dr. Nagy Abdel-Razik Street, Gamaa District, Mansoura
Egypt
Source of Support: None, Conflict of Interest: None
CheckDOI: 10.4103/ijhas.ijhas_1_21
The concept of risk communication (RC) in the era of COVID-19 pandemic needs to be highlighted. Basic definitions, steps, principles, cycles, benefits, barriers, and harms of RC were briefly outlined. This brief review is intended to be a quick guide for health-care workers and risk communicators. It will be useful for busy health-care workers in providing information and counseling regarding COVID-19.
Keywords: COVID-19, health-care workers, risk communication
Communication plays a significant role in health promotion, disease prevention, and quality of life.[1] Risk communication (RC) is an essential component of the response to any infectious disease epidemics including COVID-19.[2] The COVID-19 pandemic is a public health disaster with negative health, economic, and social effects at both the national and international levels.[3] The pandemic overburden the already fragile health systems of the developing countries. Effective communication of risk is the responsibility of public health specialists and epidemiologists. RC is important to mitigate the mass panics and misinformation about COVID-19 among the public and even among health-care workers themselves. Timely and accurate information about COVID-19 is critical to minimize the social disruption and economic effects of this emerging infection. RC improves public awareness of health threats to be able to make an informed decision about protecting themselves and preventing the spread of infection.[4]
The community members have the right to be informed about issues of COVID-19. This affects their lives and allows them to make informed decisions to protect themselves, their families, and the community in general. It is important to communicate with the public about COVID-19 (the known, unknown, what to be done, actions taken) on continuous basis.[5] A community can be prepared through accurate updated information.[6] For a lethal disease like COVID-19 with no vaccine or a curable treatment, the principal preventive measure is information aiming at behavioral changes. Management of public health emergencies such as COVID-19 pandemic always includes a communication component to inform people about nature of the disease, its spread, protective measures, symptoms, and medical treatment.[7]
The rationale for this review is to provide risk communicators with basic knowledge and principle to prove adequate communication that overcome the rapidly spreading misinformation by nonexperts in the field of epidemiology and disaster management as in the situation COVID-19 pandemic.
Risk is defined as the probability of an adverse event.[8] A related term is risk perception which means how individuals think and feel about the risks they face. It is an important determinant of protective behavior and should be based on facts, feelings, and fears. It should be managed with transparency, trust, early response, listening, and planning.[8],[9],[10] Understanding risk perceptions of the community is a prerequisite of RC.[11] Perceived trust in information, empathy, support, competence, and services provided lead people to make informed choices and comply with healthy practices[2],[12],[13]Communication is the activity of information transfer. It includes a sender, a message, and a recipient. It occurs across vast time and space distances[3]RC refers to the interactive and dynamic exchange of real-time information, advice, and opinions between experts and people facing threats to their health or social well-being. RC should be an integral component of COVID-19 mitigation activities and empowering decision-making as COVID-19 has been subjected to high levels of media attention and public concerns.[12],[14],[15] Steps of Risk CommunicationThe steps of risk communication include:[16],[17],[18]
Assessment of existing capacity. Gather information about peoples' knowledge, attitudes, and behaviors related to prevention and control of COVID-19; communication channels; languages, influencers; religions; health services; and epidemiological situationsDevelop a coordination mechanism with the public, influencers, academics, charity organizations, and local authoritiesPrepare a national-level policy of emergency communication plan for announcement and release of information before, during, and after the outbreak. Define and prioritize the objectivesImplement the endorsed plan with regular supervision and monitoring. Take corrective activities as required. Address and track rumor and misinformation and respond with evidence-based knowledgeCapacity building through training including simulation and exercise to ensure readinessCommunication evaluation to identify strengths and weakness during and after the epidemic. Communication Life CycleRC should be a continuous process with five phases' cycle. Each phase identifies the information to be delivered during that phase. In the precrisis phase, Healthcare workers should be prepared, foster alliances, develop consensus recommendations and test message. The next is the initial phase during which acknowledging of the event, informing the public, and establishing a communication committee . The third phase is the maintenance and consolidation of effective and acceptable activities and empowers risk/benefit decision-making. The fourth phase is the resolution which educates the public to improve the response in a similar crisis, enforces the positive actions and encourages the public to provide resources, and finally, evaluates the plan performance and takes action to improve the plan.[19],[20]
Principles of Effective Risk Communication in COVID-19 PandemicA scientifically based action plan is essential to provide accurate and timely information in clear local language through reliable channels. This helps populations to make decisions and adopt positive practices to protect themselves and their communities from COVID-19. The principles of effective RC in COVID-19 pandemic can be summarized as follows:[2],[3],[7],[16,[21],[22],[23],[24],[25],[26],[27],[28],[29][30],[31],[32]
Establish a multidisciplinary team including an epidemiologist, mass media specialist, social worker, religious personnel, policymaker, local authority, resources supply, communications, legal, health, nongovernmental and charity organizations, and more. Assign a coordinator for all activities and intersectorial co-operation. Include marginalized and vulnerable people in RC and community engagement. Ensure political commitment, advocacy, and governanceInitial capacity assessment, risk analysis, and mapping vulnerable population. In early stages of a pandemic (before detecting cases in a country), focus on increasing awareness about protective behavior and risk reduction. In later stage (confirmed cases in a country), support and encourage people to take the correct preventive measures without creating panic in the community. Initial capacity assessment and risk analysis are importantEmpower people in the community to be able to act for their self-protection. It is important to allocate adequate financial and time resourcesWrite feasible culturally adapted action plan. Develop a protocol for continuous monitoring of information. The RCs evaluation priorities are clear communications objectives; monitoring system; and integration into preparedness plan. Set minimum quality indicators and standards to evaluate communicationEnhance a trustable dialogue between experts, officials, nongovernmental organizations, and the public in general. Listen to the public and accept that they want zero risks and consider their concerns, expectations, and needs. Use the appropriate channels and all proper means of communication to reach people. This requires expertise and competency. Use small groups (rather than large groups) and mass media for information transmissionFollow the six Fs' rules (Fast, Factual, First Frank, Fair, and Friendly) during communication through the mass media. Be clear, open, transparent, and honest about both the known and the unknown. RC is an ongoing activity, not a single event. Use the local simple and clear language rather than purely scientific and epidemiological terms. Think of values and ethos: Understand empathy and support. Tailor information to special groups and train local people to disseminate it. Be proactive and available to minimize the effects of the crisis. Look for opportunity, positivity, and take actionPay attention for cultural, religious, and ethical sensitivities. Include those who are at high risk, for example, minorities, marginalized, women, girls, and the poor. Avoid technical terms and balance between lack of information and information overload. The message should be socially acceptable and culturally sensitiveStrengths, weaknesses, opportunities, and threat analysis of the situation. Benefits of Risk Communication in PandemicsRC is crucial in COVID-19 pandemic and its benefits include:[3],[23],[24]
Improve individual and collective policy-making. It encourages stakeholders' engagement and community involvementMake a fully informed public and increase coordination and trust among experts and public. Provides people with the necessary information about how to manage risk as it encourages informed decision-making, maintains trust, and protective behaviorMinimize social and economic disruption as it builds trust to prepare for, respond to, and recover from pandemic threatsIncrease national preparedness and response for the pandemicTrain personnel on prevention and control activities and identify areas of program weaknessProvide knowledge on risks and management; reduce anxiety, and built trust and cooperation. Barriers of Risk CommunicationMany barriers of RC were reported in the literature including:[3],[33],[34]
Difficulty to prioritize a risk: COVID-19 can be categorized as a risk with a high probability of occurrence but lower losses rather than a lower of occurrence with higher lossesOrganization may lack the capacity to identify all risks or different types of risk debatesDifficulty in allocating human and funding resourcesFailure to reach the intended communities or people at most risk due to internal traditional culture and habitsMany uncertainties in risk and its managementFailure of multi-sectorial collaboration reduces the effectiveness of RCDifferent risk perception of individual and groups which results in miscommunicationVarying levels of credibility and trust in the source of information, especially with changing nature of informationTechnical difficulty reduces the quality of communication. Harms of Risk CommunicationPoor communication increases risk and creates panics, phobia, and stigma in the target population. Panic about COVID-19 has harmful consequences both to societal cohesion and outbreak control. Panic-buying food and other products creates a false sense of shortage; panic-buying medical commodities, for example, masks, drives up their price and reduces their availability for those who are sick and health-care workers (those who actually need them); panic can result in the stigmatization of particular ethnic groups; and panic effect on local economies makes responding to the outbreak more difficult. The WHO warns against stigmatizing anyone with the virus as this may contribute to more spread of the virus.[9],[23]
ConclusionRC is an important health-promoting measure, especially in the emerging COVID-19 pandemic. Epidemiologists and health-care providers should be aware about steps, principles, benefits, barriers, and harms of RC.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
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