Recovery, Renewal, Resilience

The complexity of COVID-19 has meant that the risks have often been difficult to predict and understand, thus creating uncertainty and a challenge for those responsible for public risk communications. "When scientific uncertainty appears in public settings, it could reduce the perceived authority of science" (Zehr, p.11). Effective communication of uncertainty is essential, to ensure that individuals and communities are well-informed, are better able to make decisions about their well-being and respond to/mitigate the impacts of risk. Consider:

• Create a visualization of risk, to generate a deeper and more relevant understanding of the facts and insights often concealed in abstract data, e.g.; 'The risk characterisation theatre', a visualisation approach using a seating chart (like those used when booking seats in a theatre) which "visually displays risk by obscuring a share of seats that correspond to the risk" (see example below)
• This approach generates a visual of the likelihood of the risk, and enables a visual communication of rare risks that are often challenging to represent and communicate effectively
• This approach also enables an individual to relate a risk with a level and within a context that they can naturally associate to. By not stating exact figures, this approach tackles the "big issue" of uncertainty in risk
• Other examples of visualizations of risk include; displaying the impact of "long COVID" as places in a bus, e.g. "a figure such as 22% of patients discharged from hospital after COVID-19 reporting hair loss could be depicted as 11 individuals on a bus full of 50 people who have left hospital after receiving care for the virus". This is a scenario that anyone familiar with a bus can easily imagine. The data becomes immediately less abstract.

You can view a visualization of this concept in the last page of this article here..

Reference: Rifkin, E. and Bouwer, E. (2007) The Illusion of Certainty: Health Benefits and Risks. Boston, MA: Springer US.

While the vaccine programme may be in its early stage in many countries, thought is required on how to access people who are not on any social services list or registered in any location. This includes homeless people, illegal immigrants, stateless people and refugees who are not in the 'system'. Excluding such people from the programme risks the virus continuing to affect them, and then spreading into other parts of society. Consider:

• Take a national perspective on how to involve people who are marginalised from mainstream public services in the vaccine programme
• Establish who is responsible for vaccinating unregistered people
• Decide whether all vaccination centres are open to vaccinating unregistered people
• How partners that have strong community links can disseminate the vaccine message to unregistered people
• Assess the consequences of unregistered people not being vaccinated
• When the first vaccination of an unregistered person should take place and a target time frame in which to vaccinate all unregistered people
• Identify challenges for the vaccination programme in vaccinating unregistered people
• Recognise that un-registered people may be fearful or hesitant to come forward to receive the vaccine:
  • Consider a moratorium/amnesty on those who regard themselves to be illegally resident in the country to receive the vaccine
  • Work with partners and external organisations who have links to un-registered people to communicate that they can register to receive the vaccine without fear of immigration enforcement activities

Vaccines must be a global public good, which contribute to the equitable protection and promotion of human well-being among all people. At national level, a clear aim for vaccine programmes is essential, e.g. reduce immediate risk to life, in order to inform the identification of priority groups. As sufficient vaccine supply for whole populations will not be immediately available, WHO have provided a Prioritization Roadmap and a Values Framework, to assist with the prioritization of target groups. The WHO guidelines and framework advise to:

• Identify groups that will achieve the vaccine programme aim where there is an immediate risk to life, e.g. Stage 1 Priority Group - Care home residents, staff and volunteers working in care homes; Stage 2 Priority - Frontline health workers and those of 80 years of age and over. Priority groups should be listed and detailed to cover the whole population that is to be vaccinated
• Clearly define groups within priority phases, e.g. workers who are at very high risk of becoming infected and transmitting COVID-19 because they work in, for example, frontline health care, COVID-19 treatment centres, COVID-19 testing laboratories, or have direct contact with COVID-19 infected patients
• Avoid classifying groups as 'essential workers' as a qualifier
• Make priority groups explicit, straightforward, concise and publicly available
• Assess the prioritisation of those who are in high population density settings, e.g. refugees/detention camps, prisons; or who are not recorded in existing systems, e.g. un-registered persons
• Recognise vaccination as a global issue to begin conversations that identify how we will achieve the aim of reducing immediate risk to life globally, through international collaboration

During COVID-19 decision makers have grappled with containing outbreaks and how to reopen or reclose business and services based on infection numbers and other measures. Research in Canada has shown that accounting for geography, epidemiology, and travel patterns, localized county approaches to lockdown result in fewer days of service and business closure, and impacts fewer people compared to entire province closures. The research suggests, when implementing a local lockdown, to consider:

• The trigger conditions that require a local lockdown to be enforced and ensure they are agreed with central government but can be enacted upon by local government
• Coordinating with neighbouring counties or metropolitan areas, including the criteria for when and how local lockdowns should be implemented and when a neighbouring region should also lockdown
• Gathering local lockdown lessons that can provide useful insights into compliance of measures, and implementing learning to help avoid ineffective strategies
• Decentralizing control over when a local lockdown should be enforced to ensure local decision makers can enact closures promptly

To ensure that statements and information given to the public are consistent, while recognising some regional differences in content. Consider a communication strategy that clearly lays out:

• What will be said
• To whom will it be said
• Who will say it

Consider what existing relationships the news outlets have with organisations and the public and how the media can become a welcomed partner in communications strategies.

Reference: Emergency Planner, Canada