Communicating risk: An inherently risky activity

The World Health Organization (WHO) has received a lot of criticism over the years and particularly since the start of the coronavirus pandemic. The recent announcement of an independent evaluation of this international organization’s response to the COVID-19 pandemic and the end of its relationship with the United States demonstrates the scale of the problem. This news comes as no surprise to a team of researchers at the Université de Sherbrooke (UdeS) and University of Ottawa (UOttawa) who have been working on a similar project for some time now.

What actions did the WHO take during the first month of the crisis from December 31 (when the first cases were reported to the WHO) to January 31, 2020 (when it declared COVID-19 a public health emergency of international concern)? What did it communicate and how did it communicate it? Communicating Risk/Risky Communication is an initial exploratory report on the WHO’s communications and actions at the start of the crisis. It was produced by a research team that included professors Gabriel Blouin-Genest (UdeS), Éric Champagne (UOttawa), Nathalie Burlone (UOttawa), and Mélissa Généreux (UdeS), as well as research professionals Natalia Torres Orozco (UdeS) and Anna Bogic (UOttawa). Other reports analyzing other periods will be issued in the future.

We can already say that the WHO does not have a very clear communications strategy, if it has one at all. The WHO did not follow existing information communication procedures and did not use the channel identified in international treaties to disseminate information. This resulted in multiple messages, which did not help countries clearly identify problems and possible solutions.

Gabriel Blouin-Genest, Professor of Applied Politics, UdeS

The WHO used a number of media and communication tools but did not appear to focus on official channels, which sowed uncertainty among international authorities and the public. This research report shows that the WHO mainly used social media to communicate a large amount of information, including to announce the first cases.

“The WHO probably wanted to reach as many people as possible (governments, hospital managers, health workers and the general public) through multiple channels, but this only increased confusion,” explained Professor Blouin-Genest. “Anyone following the official WHO channels could get, on the same day, a multi-page report on how the virus was evolving in China, a few messages on Twitter about the health standards to deploy, and a global risk assessment with interactive maps.”

The effectiveness of these many messages has been questioned by a number of public health bodies, including those in Canada. Many governments were also developing their own communication strategies that did not necessarily cast doubt on the WHO strategy but that added to the clamour of recommendations and the mixed bag of other communication tools that the WHO developed.

So who exactly is the WHO for?

“The value of the WHO’s contribution varies for each country. Canada has a good health care system and public health agencies that people trust. Other countries don’t have this luxury and only have the WHO as a reliable source of information during the pandemic.”

Professor Blouin-Genest pointed to the Ebola crisis as an example, as people did not know how the disease was transmitted. To address this problem, the WHO did a great deal of awareness work over text chains and social media platforms.

The contradiction of this international organization is that it has no democratic basis, yet it wants to have a relationship of proximity with individuals.

As shown by this population survey conducted by the UdeS research team, information and communications provided by bodies that are close to citizens (e.g., local or provincial governments) seem to have smaller psychosocial impacts. In this light, the WHO does not appear to be a source of information or communication that reduces stress, anxiety or misinformation; in fact, quite the opposite appears to be true. Proximity and the strategy used can play a role here.

Problems assessing risk

What about the risk level assessed by the WHO, and what does this risk actually represent? The report concluded that the WHO lacked accuracy and nuance on these points when it came to COVID-19, as the risk was not the same for every country. From the outset of the crisis, the organization did not report the correct risk level of the virus, which may have caused major problems for many countries.

“At the start of the health emergency, the WHO did not communicate the correct global risk level for 3 consecutive days. This type of failure can have very serious consequences, as many countries and health organizations around the world use these reports to guide their health decisions, such as border closures. As a result, public health agencies based their decisions on poor risk assessments.”

Errors are expected in a virtually unprecedented situation, but according to this professor of applied politics, the WHO must be transparent and be able to explain its mistakes, otherwise its relevance may come into question.

We don’t want to unduly criticize the WHO. Instead, we want this body to reflect on its communication strategies. How can they channel the flow of information and prioritize messages? How can they clearly communicate risk? How will the information be received and used? The WHO must be ready to manage the next crisis.

A sense of déjà vu

This is not the world’s first health emergency and it is not the first time the organization has been criticized. Can the WHO learn from its mistakes?

“The problem is that not much thought was given to its communications strategy. The WHO often finds itself caught between sounding the alarm and offering reassurance without lying about what is actually going on. It over-evaluated the risk for the H1N1 pandemic, which resulted in billions of dollars in unnecessary government spending. In the case of Ebola, it did not declare a health emergency quickly enough. This creates an eternal back and forth between too much and not enough caution,” explained Professor Blouin-Genest.

The research team is clear, however, that the WHO must be part of the solution. Despite the many criticisms levied against this body, the group believes that the WHO’s role is essential.

“We would like a collective reflection process to develop common tools to manage future pandemics and answer questions such as how we can communicate in an over-connected world and what kind of health communication we should have.”

The team would therefore like to conduct interviews with the WHO to confirm the hypotheses raised by the study. According to the researchers, future reports can be used to identify problems and validate with the WHO why it took certain actions.

About the research project
A multidisciplinary team from the UdeS is conducting an international comparative analysis of the influence of communication strategies and media discourse on the psychological and behavioural response of populations to COVID-19.

The UdeS team includes Prof. Gabriel Blouin-Genest, Prof. Marie-Ève Carignan, Prof. Marc D. David, Prof. Mélissa Généreux, and Prof. Mathieu Roy, with contributions from international researchers in six countries so far in the fields of strategic communications, epidemiology, information and journalism, medicine, politics, psychology, public health, and more.

The project’s main goal is to analyze people’s perceptions and interpretations of public health messages (from the WHO and governments) and other sources of information (from the media and other sources) as well as the psychosocial impacts of the COVID-19 crisis on individuals.