By Clio Heslop, Partnerships and Impact Manager

The current COVID-19 pandemic is forcing leaders of Governments, businesses and charities across the world to take incredibly difficult decisions. For each of these decisions, they must deal with a large volume of information, including the statistical evidence of the virus' impacts, plus broader behavioural factors which influence the changes being proposed.

In these situations, they need to be confident about what information to prioritise, which opinion to trust, and that the decision they take is the correct one. In the case of COVID-19, new information is emerging every day, and leaders must respond accordingly.  

'Risk' is a word used in daily discussion across all levels of society, but it is an especially important concept for understanding and communicating with people in times of uncertainty. The perceived risk to livelihood, health and wellbeing determines how far people change their behaviour, for example, how much food to buy, or whether they choose to observe social distancing recommendations. With COVID-19 we're not just talking about health risk. There are financial, environmental, social, and cultural implications for how we react to the crisis.   

Alongside our annual Huxley Summit, the British Science Association (BSA) have been bringing together scientists, business leaders and policymakers to discuss public perception of risk, and how organisations could adapt their processes to better use the concept of risk in policy.  

Our first report published in 2018 in partnership with Diageo, identified three challenges which are especially relevant now:  

• There are varying levels of understanding of what risk is and how it applies to decisions, especially in industry and government. In academia, where there is a higher level of knowledge of the evidence base, there is limited knowledge of its application. Gaps in knowledge often carry through in messages communicated to the public - this then lends itself to limited understanding and trust within the wider population 
• Evidence and risks are often communicated to simultaneously inform the public and persuade them to change behaviour. To be effective, there needs to be a distinction between the two types of messages, rather than trying to do both and subsequently being unclear about the purpose is. 
• Processes such as setting up risk registers are commonly used for supporting decisions, however their prescriptive nature can reduce an organisation’s ability to be responsive. If an unpredictable scenario occurs, organisations may be left with limited options for how to proceed. 

A key recommendation from this report was that leaders should set up external support mechanisms comprising of public, industry, and expert groups, who can inform and support a quick response. The ideal scenario would be to build and maintain these relationships when there is no threat. External supporters advisors should understand the time pressure and needs of decision-makers; and support them to ensure they have complete and consistent information, and access to skills  to inform their approach.  

We also talked about the impact of language on the way the risk is perceived, especially in rapid response situations, similar to the current COVID-19 crisis:  

• Communication must be balanced and should not be apologetic about issuing rebuttals when the information is wrong.  
• Instructions and guidance should use images or infographics instead of (or in addition to) graphs, have statistical clarity and be consistent.
• Provide a denominator and a reference point which people have an intuitive understanding of. For example 1/1000 is easier for people to picture than 0.1%.
• Try to present comparable options and don’t use relative percentages or odd ratios. For example: 4/1000 instead of 1/250.
• Responses need to chime with public values, and tell compelling stories with the evidence, so that the debate is not between statistics and emotions or individual case studies. Include real terms and real-life examples where possible and compare the risk factor in question to other everyday life risks. 
• Make the parameters clear, especially the timescale of the risk and the impact it will have. Uncertainties can be included in communications — provided the messages are confident in their uncertainty, public trust is not lost.  

We asked BSA Chief Executive Katherine Mathieson for her thoughts on risk communication and COVID-19: "We at the BSA think most of the Government and NHS infographic guidance has been accessible and actionable. The Chief Medical officer and Chief Scientific Advisor have used clear language and made good use of charts and graphs. Increasingly, the government are also showing where they are consulting expert groups to inform their approach. 

"Another good example of communication is the government suggestion to sing Happy Birthday as a way to time how long you wash your hands. While some in the Twittersphere may have ridiculed this, can you think of another song/poem that everyone in the country knows, regardless of their age, their native language, their literacy, or their culture?"

In our follow-up report published in 2019, also supported by Diageo, we discussed how risk communication should create broader, more democratic discussion around complex societal challenges. For public health and clinical settings such as the current pandemic, risk communication needs to enable people to make decisions, rather than just better understand decisions institutions have made for them. Therefore, future models for risk communication could start to move away from a top-down model where evidence is dictated to the public by scientists and professional leaders, towards models which better equip the public to join the conversation and contextualise the situation.  

Katherine reflects: "It has been great to see people engaging and responding to concepts, like exponential increases, herd immunity, and community testing, which they may not have been familiar with previously.

"The scientific community can learn lessons from this – we don't always need to 'dumb down'. Many people are very capable of understanding complex information when it is useful and relevant to them and their lives."   

Given the speed of development of the COVID-19 pandemic, there has been limited public engagement activity so far. We are starting to see initiatives like the symptoms tracker app and governments announcing new support packages after consultation with specific groups such as self-employed individuals and voluntary sector organisations. However, there are communities who have good reason to mistrust authorities, or who are not being reached through mainstream communication channels, and therefore could be more likely to believe misinformation through closed networks like WhatsApp. 

Evidence suggests we will feel the wider effects of COVID-19 for a long time, and in the months to come we at the BSA hope to see a much more inclusive approach to communicating how the virus is affecting people and communities. Leaders should move on from simply emphasising transparency, communication, and description as key concepts; and explore how to promote open discussion a societal level, allowing us all to have a greater role in understanding and shaping the difficult decisions they take.