>>> Click here to jump to the video!

Is the coronavirus going to kill us all and lead to the zombie apocalypse?

I don't know. It depends on who you ask, but people are pretty concerned about it.

Other people aren't concerned at all.

People are funny, they're scared of some things that present no risk or hazard to them at all and then they're not scared of things that really are a danger to them.

This disconnection between people's feelings of fear and the real objective threat is something poses is a real challenge for communication.

Today, I'm going to talk about how we communicate about risk.

This video was made in February 2020. The world situation has changed but the fundamental principles of risk communication are the same.

 

Risk Communication

As many of you know, my full-time job is to be a Professor of Health Communication at Northwestern University, where I also direct the Center for Communication and Health. So it's with both a personal and a professional interest that I've been closely following the news about the 2019-2020 coronavirus, which is infecting tens of thousands of people in China and killing hundreds of people in China, and now spreading to the rest of the world. The 2019 novel coronavirus is the technical name that people use for what people are calling the Wuhan virus or the Wuhan flu, or just the coronavirus.

I've been fascinated to read all the different ways that people communicate about the risk or lack of risk posed by the coronavirus. As a student of health communication, this is a real-world example of how we communicate with the public about a potentially serious threat to our health. If there's some interest, I may make another video about the coronavirus itself.

But this particular post is not about whether or not you should be afraid about the coronavirus. That would be a very different blog, and I'm not a medical doctor. I am someone who is science literate and who has been reading and following the news, though. So I might be able to explain to people in terms that they can understand what risk I think that coronavirus presents.

Instead of talking about the virus in particular, I want to talk about risk communication in general, and to give you a basic framework for thinking about how we talk about risk. The framework I'm going to describe today was developed by Dr. Peter Sandman, a well-known risk communication expert whose work I've been reading a lot in connection with the coronavirus and how to communicate about pandemic diseases.

You can read more of what Dr. Sandman writes at his website, psandman.com. But I'm going to introduce the most basic idea from his way of thinking about risk communication.

 

Hazard vs. Outrage

The first observation that Dr. Sandman makes is that there are two components to risk, what he calls hazard and outrage.

Hazard is what we might think of as the real objective threat. That is, how dangerous is something really scientifically, objectively? How much of a threat is it to human health? How much harm could the thing do you? That's the hazard, the real objective threat according to science.

The other half of the risk equation is what he calls outrage. This is how upset or frightened does it make us? Hazard is the objective part – how much could it hurt us? Outrage is the emotional part – how scared or upset are people about the thought of this risk?

Fascinatingly, from the point of view of human nature these two dimensions, hazard and outrage or the objective and the subjective parts of risk perception are barely correlated at all. If you want to predict how scared people are going to be, you might think that if people were rational then objectively the biggest threats would be the things that scare people the most, but that's not how it is at all.

Sandman says that the correlation between perceptions of hazard and perceptions of outrage are only about 0.2, meaning that they only share about 4% of their variants. That means people are scared about things that don't present any real threat to them, and people are not scared about things that present a real great threat to them.

We see this all over the place. For example, someone might be afraid of electromagnetic radiation coming from the power lines behind their house. They might be very, very upset and frightened by that, even though there's very little objective risk associated with living near a power line.

People might be very, very afraid of microplastic beads in the water or in their food or BPA additives in their plastic water bottles, and yet they smoke cigarettes and aren't upset about the threat that the cigarettes pose to them.

There are so many examples. People are very frightened by air travel, even though air travel is objectively much safer than car travel, but people aren't very afraid of car travel.

Over and over again, we see that people are not frightened by things that present large objective threats to them, but they are frightened by things that present very little objective threat to them. Now, occasionally people are scared of things that present a real threat to them, and maybe that's the coronavirus case.

 

Dr. Sandman’s Risk Model – Analysis

Let's take this framework that Sandman gives us and think a little bit more carefully about it. There are four possibilities if we think of a two-by-two table of high and low hazard, and high and low outrage.

1. PRECAUTION ADVOCACY - high hazard, low outrage

This is where whatever entity we're talking about presents a real objective threat to human health, but people aren't worried about it.

For me, a classic example of this in health communication is tanning beds. People still use tanning beds. If you go to a tanning store and interview people about tanning beds, they're not really afraid of them. There's no public outrage about tanning beds and yet there's very, very strong scientific evidence that tanning beds are very bad for your health. There’s significant evidence that tanning beds lead to the development of skin cancer, which is often deadly.

Here you have an objectively high hazard and low outrage. The goal of health communication in this case is what Sandman calls precaution advocacy, which means we should be advocating for people to take precautions.

In the case of tanning beds, any health communication message should be designed to scare people a little bit so they will take adequate precautions. In this case, so they'll stop using tanning beds.

That's our first case. High hazard, low outrage. The goal is precaution advocacy. We're basically trying to tell people, "Watch out, take some precautions. You're not worried enough about a real threat."

 2. OUTRAGE MANAGEMENT - low hazard, high outrage

This is the opposite example to the first one. Here we have something that scientifically and objectively doesn't present a very significant threat, but that people are very, very worried about.

An example here might be vaccines. People are very, very frightened that vaccines might be harmful. The objective evidence is that vaccines are not that harmful, but people are very, very scared of vaccines, at least some people are.

Other examples might include things like electromagnetic radiation from our cell phones. So sometimes people are very scared that the electromagnetic radiation will give us brain cancer or something like that.

Another example of low hazard, high outrage might be concerns about certain kinds of foods and their association with heart disease, like consumption of eggs or red meat. Now, you might not want to eat eggs or red meat for your own personal reasons, but the evidence that they're harmful to your health is very minimal.

There might be some small association between eating red meat and bad health outcomes or eating eggs and bad health outcomes, but they're tiny compared to things like exercise or smoking or alcohol consumption, or something like that, where the effects are huge and detrimental and people aren't that upset.

In these situations of low hazard, high outrage, the essence of the message is “calm down”. This doesn't mean we should actually tell people to calm down because that's just insulting. But the effect that you should be going for is to try to reduce people's outrage and to get them to understand that they have maybe overestimated the actual threat. This is what Sandman calls outrage management.

3. Low hazard, low outrage

This third category is when you don't have to communicate about it all, that's everything's fine. There's no health communication challenge there so there's nothing to talk about.

4. CRISIS COMMUNICATION - high hazard, high outrage

This is a situation where people are very frightened and the scientific objective threat to human health is real. So this is where I think coronavirus communication falls.

People are very concerned about the coronavirus all around the world. It's as of this writing, there are 78.3 million or more official cases and about 1.72 million deaths. The disease has spread rampantly, affecting nearly every single country, so there's a lot of concern.

In fact, coronavirus is a real threat to human health. How large a threat is uncertain, but there's no question with the number of deaths, hospitalizations, and now serious long-term post-infection consequences. So it's a real threat. It's not made up.

The challenge as Sandman describes it in a high hazard, high outrage circumstance like this is what he calls crisis communication. The essence of crisis communication is we'll get through this together.

The dangers in crisis communication is that health communicators are afraid of scaring people. They're frightened that people are going to panic. They're frightened that they're going to scare stakeholders or constituents or voters that they don't want to scare, and that people might over-prepare or panic, and they don't want to be responsible for that. So they're afraid of talking seriously about people's fears and acknowledging the reality of fear, and maybe the legitimacy of people's fears.

Related to this fear is that health communicators, public servants, politicians, others are often tempted to over-reassure people. They think it's their job to reassure mass audiences to get them to just relax and say, “it's not a threat”. You’ll see some of this in the communication about the coronavirus.

Around February of 2020, people said it's no worse than the flu and that the flu kills many more people in the United States than the coronavirus has killed. That's true, but we were at the very beginning of this epidemic (at the time this video was made – you can see how this aged). The flu in the United States kills tens of thousands of people, the coronavirus in the United States hadn't killed anyone yet. Though, it had killed hundreds of people in China (Feb 2020). Clearly, this statement no longer holds up.

 

Summary

As you hear people talking about the coronavirus and other health threats in the future, ask yourself, which quadrant does this situation fall into? Is it high hazard, low outrage,  or low hazard, high outrage, or high hazard, high outrage?

Are they doing the right thing? Are they trying to calm us down? Are they trying to tell us to watch out and take precautions? Or are they trying to tell us that we'll get through this together?

I think there's no perfect answer. That even in something like the coronavirus situation, some audiences might not perceive any threat. Maybe for those people we need to tell them to watch out and take precautions.

Other audiences might be really, really panicked and afraid to leave their homes or afraid to interact with people who are Chinese. There were also all these stories in the media of people who won't eat Chinese food because they're afraid of the coronavirus. Maybe with those people, we need to help them calm down.

Then in the middle, there might be people who are perceived high hazard and high outrage, and we need to talk about solidarity with them. They need to take some precautions, but we need to emphasize this message that we'll get through it together.

I found this basic framework for thinking about risk communication in terms of hazard and outrage and the different goals when you see different levels of hazard and outrage to be really helpful. I hope you do too.

Everybody, stay safe out there. Be afraid of the things you should be afraid of. Try not to be afraid of the things you shouldn't be afraid of and try to figure out the difference.