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 Table of Contents  
COMMENTARY
Year : 2020  |  Volume : 9  |  Issue : 5  |  Page : 107-110

Effective risk communication – An essential strategy in combating covid19 pandemic – Report from Tamil Nadu, a South Indian state


Department of Community Medicine, SRM Medical College and Research Centre, Chengalpattu, Tamil Nadu, India

Date of Submission04-May-2020
Date of Decision05-May-2020
Date of Acceptance11-May-2020
Date of Web Publication04-Jun-2020

Correspondence Address:
Dr. Balaji Ramraj
Department of Community Medicine, SRM Medical College and Research Centre, Kattankulathur, Chengalpattu - 603 203, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_91_20

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  Abstract 


Risk communication is one of the eight core principles of pandemic preparedness by International health regulations, which is essential to prepare for, respond to and recover from serious public health hazards like emerging infectious diseases. Covid-19 being a novel disease, generates intense fear, misinformation, and rumors confusing both authorities and the population, thereby creating the necessity for prompt information. The communicator, when imparting or exchanging information, should be clear about the message, target audience, conveying medium, and the effect it will produce. Effective communication can minimize the spread of disease, limit the impact, and ultimately save lives. Risk communication is not a last-minute additive to publicize decisions. It should be an integral part of preparedness planning for effective risk management and has to be translated into action. The risk communication strategies should be analyzed as the situation evolves, reviewed and changed if needed, as different populations and affected groups may require different strategies.

Keywords: COVID19, pandemic management, risk communication


How to cite this article:
Marimuthu A, Venkateswaran PP, Ramraj B. Effective risk communication – An essential strategy in combating covid19 pandemic – Report from Tamil Nadu, a South Indian state. Int J Health Allied Sci 2020;9, Suppl S1:107-10

How to cite this URL:
Marimuthu A, Venkateswaran PP, Ramraj B. Effective risk communication – An essential strategy in combating covid19 pandemic – Report from Tamil Nadu, a South Indian state. Int J Health Allied Sci [serial online] 2020 [cited 2020 Jul 2];9, Suppl S1:107-10. Available from: http://www.ijhas.in/text.asp?2020/9/5/107/285976




  Introduction Top


COVID-19, a disease caused by a novel strain of corona virus (SARS-CoV-2), was declared a pandemic by the World health organization. The Government of India made a prompt response initiating the pandemic preparedness. Risk communication is one of the eight core principles of pandemic preparedness. It acts as a means for communicating the threat through appropriate information and tailored messages to encourage informed decision making and positive behavioral change in the population. It is a prerequisite for effective risk assessment and risk management that helps to mitigate those risks well before an emergency.[1],[2]

Outbreaks cause fear, confusion, and create a necessity for prompt information. The goal of risk communication is not just to disseminate information but also to raise awareness, encourage protective behavior, and to promote acceptance of risks and management measures. Internal and external communications are the two facets of risk communication. Internal communication is between authorities and internal stakeholders to develop a common understanding of their tasks and responsibilities. External communication is often employed by partners, private sectors, and public.[3],[4],[5] Advocacy, media relation, and stakeholders relation are also essential for successful risk communication and for curbing fake news.

Trust on authorities, early, transparent, and complete information of risk is mandatory for any public communication.[1],[5],[6] Risk communication should not be a last-minute additive to publicize decisions. It should be an integral part of preparedness planning for effective risk management and has to be translated into action, and thereby it can minimize the spread of disease, limit the impact and ultimately save lives.


  Selecting the Best Risk Communication Strategy Top


There is a difference between how experts and the public perceive the risk. Technical people estimate risk based on the characteristics of the hazard, whether small or big, imminent or can evolve in future, levels of exposure, vulnerability of population versus their capacity to withstand the threat and resources available. Whereas the public are more concerned with the unfamiliarity of the hazard, fatalities, financial loss, inappropriate risk communication, and lack of trust.[4],[7] The success of risk communication lies in choosing the optimum strategy based on the hazard and perceptions of the affected or at-risk population [Table 1].
Table 1: Selecting the best risk communication strategy

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  Risk Communication Approaches by Tamil Nadu Government at Various Phases Top


The authors verified for the authenticity of the data from various sources like government's health website notifications, official daily bulletins, press releases, expert opinions, debates, traditional media such as newspapers, television and radio, social media such as Facebook, twitter, digital blogs, YouTube, and WhatsApp.


  Planning Phase Top


Stakeholder relation

  • The director of public health and preventive medicine issued official circulars to district surveillance officers and district collectors to alert them on Covid-19 and to initiate syndromic surveillance in the community
  • Administrative authorities at various levels were instructed to conduct awareness programs with a focus on preventive measures, cleaning practices, and home quarantine guidelines
  • Meetings were organized with government and private doctors to orient them on the containment plan for Covid-19 and to raise the level of awareness and knowledge among health-care workers
  • Guidelines on identification, management, specimen collection, and notification of cases were communicated appropriately with stakeholders from time to time. Proper training on personal protective equipment was given to all health-care workers
  • In the view of pandemic preparedness and response to Covid-19, surveillance was strengthened in all international airports and at check posts and railway stations in the districts bordering the neighboring states.



  Mitigation Phase Top


Proactive communication

  • Display of proper signal and (IEC) Information, education and communication materials. Distribution of IEC pamphlets at check posts and railway stations
  • Health minister and district collectors of various districts addressed the media, stating the preventive measures for active case surveillance.



  Response Phase Top


Internal communication

  • Tamil Nadu declared Covid-19 as a notifiable disease in the state
  • Standard operating procedures were circulated and duly updated among health professional on par with the Indian Council of Medical Research (ICMR) guidelines
  • Following the rise in positive cases, the authorities announced an increase in testing laboratories and the procurement of more testing kits.


Public information

  • The public health measures regarding the number of persons screened, quarantined, admitted with symptoms, dead, number of samples collected, tested positive, and availability of isolation ward and ventilators were released on the Tamil Nadu government website for health
  • Notification for the general public was given to keep them informed about the preparedness and action, advocating them to follow the cough etiquette, frequent handwashing with soap and water, and ensuring physical distancing.


Media communication

  • Regular press releases from the Chief Minister kept journalists constantly informed about the situation and the preventive measure taken to control the disease at various levels
  • Interviews and panel discussion with experts in television to clear myths and to understand disease transmission and prevention
  • Noted and popular personalities were made to talk on television about Covid-19 stressing the importance of preventive measures
  • Twitter was used as a platform to disseminate emergency updates instantly to reach the public and to respond to people's concerns and woes.


Health promotion and health education

  • The discharged patients narrating the experiences of their isolation period were shared in the media to allay the havoc and fear among public
  • IEC materials and hoardings were displayed in hospitals to educate the public visiting them
  • Health advisory posters, audios, and videos were released both in traditional and social media
  • Washbasins with running water and soap were installed at places where people gather in large numbers.


Social mobilisation and community engagement

  • The Government assured the supply of essential commodities through media messages to avoid panic
  • Health-workers, along with police personnel, made public announcements in residential areas using a microphone, stressing the importance of staying indoors and following physical distancing
  • Health nurses were deployed for issuing pamphlets house to house on hand hygiene and cough etiquette
  • Awareness program on handwashing and use of sanitizers along with the distribution of soaps and masks were carried out by representatives from departments of education, agriculture, and media
  • Street plays, corona helmet, beautiful paintings on road intersections, puppets to stress the need for wearing masks were used to create public awareness.


Dynamic listening and feedback

  • Exclusive website stopcorona.tn.gov.in was initiated to share information, create awareness and to receive public feedback for improvement
  • Separate 24 × 7 landline and mobile numbers were announced to address the needs of Senior citizens, migrant workers, pregnant women and differently abled in urban and rural areas. Experts well versed in sign language addressed those calls of hearing and speech impaired via WhatsApp video call
  • The Chief Minister of Tamil Nadu launched interactive voice response system for Covid-19, where advice was given based on their reply to questions.


Rumour management

  • Health minister clarified the rumors and misinformation and also warned rumor mongers on social media.


This study critically analyzed the risk communication modes and strategies adopted by Tamil Nadu, to infer its effectiveness and the need to strengthen it in future [Figure 1]. The state employed multiple modes such as official notifications, traditional media, and social media to communicate the risk. They started off with stakeholder relationships in the planning phase and continued with outrage management and crisis communication after reporting of cases. The media communication and public information approaches were appropriate, but credible and sustainable communication is needed, considering the evolving nature of the situation. The integrated approaches and community engagement began late during the response phase. The messages spreading awareness and targeting behavioral change were more focused as the cases surged over time. More focus on proactive risk communication at earlier phases would have helped people adopt healthy behaviors and prevented spread.[5],[8] Multi messaging and debates in the media often confused the public on actions and recommendations than giving them clarity. Although the rumors and misinformation were dispelled by the experts, addressing uncertainty and providing newer facts in a constantly evolving situation might shift people's trust in reliable sources.
Figure 1: Risk communication strategy applied versus recommendation. Planning phase: Initial step of preparedness to mitigate the effect of occurrence of the disease. Mitigation phase: Anticipated actions are taken up while the disease has not yet occurred. Response phase: When the disease is occurring; Recovery phase: Post incident period[4]

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  Conclusion Top


Covid-19 is a novel disease generated intense fear, misinformation, and rumors confusing both authorities and the population. Media monitoring to understand the community behavior and monitoring at the grass-root level for understanding demographics, literacy levels, languages spoken, and to uncover cultural, political, and communication barriers is essential to identify the reasons for rejection of recommended interventions.[9],[10] The paradigm must shift from telling people what to do, to hear those affected. The risk communication strategies should be analyzed as the situation evolves, reviewed and changed if needed, as different populations and affected groups may require different strategies.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Outbreak Communication Planning Guide. World Health Organization. Geneva: WHO publishers; 2008.p1-19.   Back to cited text no. 1
    
2.
Communicating Risk in Public Health Emergencies. World Health Organization. Geneva: WHO publishers; 2017.p1-79.   Back to cited text no. 2
    
3.
Gamhewage G. An Introduction to Risk Communication. World Health Organization. Geneva:WHO publishers; 2014.p.1-6.  Back to cited text no. 3
    
4.
National Risk Communication Plan. 1st ed. National Centre for Disease Control, Epidemiology Division Directorate General of Health Services Ministry of Health and Family Welfare, Government of India; 2016.  Back to cited text no. 4
    
5.
Zhang L, Li H, Chen K. Effective risk communication for public health emergency: Reflection on the COVID-19 (2019-nCoV) Outbreak in Wuhan, China. Healthcare 2020;8:1-13.  Back to cited text no. 5
    
6.
US EPA. [Internet] Risk Communication. 2020. Available from: https://www.epa.gov/risk/risk-communication. [Last cited 2020 Apr 28].  Back to cited text no. 6
    
7.
Lohiniva AL, Sane J, Sibenberg K, Puumalainen T, Salminen M. Understanding coronavirus disease (COVID-19) risk perceptions among the public to enhance risk communication efforts: A practical approach for outbreaks, Finland, February 2020. Euro Surveill 2020;25.  Back to cited text no. 7
    
8.
Lohiniva AL, Sane J, Sibenberg K, Puumalainen T, Salminen M. Understanding coronavirus disease (COVID-19) risk perceptions among the public to enhance risk communication efforts. Euro Surveill 2020;25(13):1-4.  Back to cited text no. 8
    
9.
World health organization [internet]. Weekly epidemiological record. 2016. Available from: https://www.who.int/wer/2016/wer9107/en. [Last cited 2020 Apr 18].  Back to cited text no. 9
    
10.
Abrams E, Greenhawt M. Risk communication during COVID-19. Journal of Allergy and Clinical Immunology 2020;96:1-4.  Back to cited text no. 10
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1]



 

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Abstract
Introduction
Selecting the Be...
Risk Communicati...
Planning Phase
Mitigation Phase
Response Phase
Conclusion
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