Alessandro Guido

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Maria Grazia Modena

Maria Soledad

Maria Teresa Savo

Marina Marini

Matteo Cevenini

Maurizio Cipolla

Mauro Bonomini

Michela Dimilta

Ombretta Para

Roberto Volpe

Simona Linarello

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See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/340233931Risk communication at the time of Coronavirus: are we washing our hand ofCOVID-19?Preprint · March 2020DOI: 10.13140/RG.2.2.36000.53766CITATIONS0READS85842 authors, including:Some of the authors of this publication are also working on these related projects:Chemical Fingerprint of plant-derived materials and biological activities evaluation View projectSpecial Issue "25th Anniversary of Molecules—Recent Advances in Natural Products-2020" View projectFabio CapelloSIT - Italian Society of Telemedicine117 PUBLICATIONS   161 CITATIONS   SEE PROFILEMaurizio BattinoUniversità Politecnica delle Marche507 PUBLICATIONS   28,953 CITATIONS   SEE PROFILEMarco BertolottiUniversità degli Studi di Modena e Reggio Emilia169 PUBLICATIONS   3,362 CITATIONS   SEE PROFILEDomenico BrittiUniversità degli Studi "Magna Græcia" di Catanzaro, Catanzaro, Italy213 PUBLICATIONS   5,860 CITATIONS   SEE PROFILEAll content following this page was uploaded by Fabio Capello on 27 March 2020.The user has requested enhancement of the downloaded file.Risk communication at the time of Coronavirus: are we washing our hand of COVID-19? Dr Fabio CAPELLO, MD, MSc1, Prof. Antonio V. GADDI, MD, PhD2, and  Dr Laura BARALDINI, MD3, Prof. Maurizio BATTINO, MD, PhD4, Prof. Marco BERTOLOTTI, MD5, Dr Mauro BONOMINI, MD6,, Daniele BOVO7, Prof. Domenico BRITTI, DVM, PhD8, Dr Lorenzo CARUSO, MD9, Gaetano CASTIGLIONE10, Dr Gavino CASU, MD, FESC11, Dr Matteo CEVENINI, MD12, Prof. Arrigo F.G. CICERO, MD, PhD13, Dr Maurizio CIPOLLA, MD14, Dr Gabriele CIPRIANI, PhD15, Dr Francesco DENTALI, MD16, Dr Michela DIMILTA, PharmD 17, Dr Clara FAGIOLI, FT18, Dr Maria Soledad FERREIRO COTORRUELO, MD19, Dr Paola GADDI, MD, MSc20, Morena GADDONI21, Ing. Patrizio GAGLIARDI, BE22, Dr Francesca GIAMPIERI, PhD23, Dr Simona LINARELLO, MD24, Dr Alessandro Guido CAVALIERI MANASSE, MBA25, Prof. Marina MARINI, PhD26, Dr Laura MISTRETTA, MSc27, Dr Maria Grazia MODENA, MD, PhD28, Dr Andrea E. NAIMOLI, BIT29, Prof. Giorgio NOERA, MD, PhD30, Dr Ombretta PARA, MD31, Dr Giuseppe PILI, MD32, Dr Giovanni RINALDI, PhD33, Dr Antonio SABATINI, BE34, Dr Marco SANTINI, BScEcon 35, Maria Teresa SAVO36, Dr Flavio TANGIANU, MD37, Prof. Giovanni USSIA, MD38, Prof. Francesco VISIOLI, PhD39, Dr Tommaso Diego VOCI, MD40, Dr Roberto VOLPE, MD, PhD41.  1 Director Centro Studi SIT, Italian Society of Telemedicine and Digital Health, Bologna, Italy 2 President SIT Emilia Romagna Region, Italian Society of Telemedicine and Digital Health, Bologna, Italy 3Poliambulatori S. Lazzaro, Bologna, Italy; 4Università Politecnica delle Marche, Ancona, Italy, University of Vigo, Vigo, Spain and Jiangsu University Zhengjang, China; 5Internal Medicine, Dept of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia, italy; 6Fondazione Verani-Lucca,Italy; 7Amministrazione Gruppo Caravelli Labs, Bologna, Italy; 8Dip. Scienze della Salute, Università Magna Graecia di Catanzaro, Italy; 9Medicina per la complessità assistenziale 1 AOU Careggi, Firenze, Italy; 10CM S.r.l. – Italiana Pastifici, Italy;  11Cardiology San Francesco Hospital, European Society of Cardiology ATS-Sardegna, Italy; 12 Urology resident, Department of Specialistic, Experimental and Diagnostic Medicine, Urology, Alma Mater Studiorum-University of Bologna, Italy; 13Medical and Surgical Sciences Dept, Alma Mater Studiorum Università di Bologna, Bologna, Italy; 14 President SIT Calabria Region, Italian Society of Telemedicine and Digital Health, Catanzaro, Italy; 15European Court of Auditors, Luxembourg; 16Dipartimento di Medicina e Chirurgia, Università dell'Insubria Varese, Italy; 17Azienda Freia Farmaceutici S.r.l. Milan, Italy; 18Azienda Ospedaliera Ospedale Riuniti di Ancona, Ancona, Italy; 19Physiotherapy Area of Emilia Romagna Region Division of Digital SIT, Bologna, Italy ; 20 Scientific Director European Project ICARE, AUSL Bologna, Italy; 21Casa di Cura Giardino S. Lucia, Massa Lombarda, Ravenna, Italy; 22SIPRA ENGINEERING S.r.l., CEO-IT commission of association of Engineers of Bologna, senior Member, Italy; 23University of Vigo, Vigo, Spain; 24 AUSL Bologna,Italy; 25 BScEcon, ATI Srl, Milano, Italy; 26 School of Medicine, University of Bologna, Italy; 27CM S.r.l. -Italiana Pastifici, Italy; 28UNIVERSITY of Modena e Reggio Emilia-Policlinico di Modena, Italy; 29University of Trento, Italy; 30Health Ricerca e Sviluppo, SrL, Spin off Università di Bologna, Massa Lombarda, Ravenna, Italy; 31Medicina per la complessità assistenziale 1 AOU Careggi, Firenze, Italy; 32Child and adolescent neurology and psychiatry, ASL1 Imperiese, Sanremo, Italy; 33Italian Society of Digital Health and Telemedicine, Bologna, Italy; 34Dedalus Italia, Firenze, Italy; 35 Collectibus Srl, Milano, Italy; 36Università degli studi di Firenze, Firenze, Italy; 37Dipartimento di Medicina e Chirurgia, Insubria University, Varese, Italy; 38Surgeon Consultant NHS, United Kingdom; 39Department of Molecular Medicine, University of Padova, Italy; 40Associazione Interregionale Cardiologi e Specialisti Medici Ambulatoriali (ACSA), Torino, Italy; 41Unità Prevenzione e Protezione, Consiglio Nazionale delle Ricerche (CNR), Roma, Italy.    As the tide of Covid-19 flood the world, health authorities are implementing a number of measures that have deeply changed the way people live. However, there is no shared consensus on how to communicate to the public what is happening, and why these extreme interventions are needed. Instead, people received in the latest weeks contrasting messages from the different actors involved in the fight against Coronavirus. Nevertheless, risk communication represents a key factor and is part of the response to any emergency or to the rise of any hazard affecting human health (1).  In Italy, as of the 27th of March 2020, the first country in the world for number of deaths ascribed to Covid-19, public health authorities have implemented drastic measures to reduce the spread of the virus. At the same time, different voices are sending uncontrolled and contrasting messages to the population. This is consistent with what is happening worldwide: whilst some official voices trivialized the nature of the disease, labelling this epidemic as “a little bit like the flu”(2), other presented a catastrophic scenario, with SARS-CoV-2 dubbed as “public enemy number one” (3). Besides, it appears that there is no shared consensus also among the experts on how to share knowledge, or the lack of it, with the people. With no common restraint tactics and no risk communication plans in place, hand-washing seems to be one of the sole measures everyone agreed upon. Yet, is washing hand – a solution Semmelweis suggested 150 years ago (4) – our best answer to the infection? Is therefore the public perception of what is happening distorted? Who are the professionals intitled to speak to the people? Are the voices of the experts and of the politicians so relevant that they can bypass a properly designed strategy of risk communication? Above all, is there such a strategy in place, both at local and at international level? Moreover, what an expert is remain controversial: a virologist, may not be competent in epidemiology, public health, risk and crisis management, scientific communication and above all risk communication. This same reasoning applies to other professionals involved in the management of this outbreak. In addition, epidemiologists, virologists and especially institutions are deaf to the voice of those who fight on the front lines as emergency doctors, general practitioners or clinicians, pretending that the decision-making process in the battle against the virus is their exclusive prerogative. Yet, different, unsolicited opinions are striking the media, offering a chaotic overview to the public, and risking to undermine the effects of the public health measures on the one hand, and to create uncontrollable panic on the other.  As we asserted in a previous publication (5), risk communication remains a key part in the fight against environmental health. We have the duty to explain clearly what is happening, what the possible scenarios are, and why some measures, however unpopular, are needed. Risk communication is not a solo, of course. On the contrary, it should be a choir of coordinated, trustworthy voices. Finally, the good practice in the management of mass critical events and catastrophe medicine highlights the need of strategies for emergency preparedness (6). A plan should always be in place and when an emergency is foreseen should be made available to the population as soon as possible. Different strategies should be ready graded according to a scale where all the possible scenario, from mild to catastrophic, are considered. The effectiveness of the implemented model should be verified in a continuous feedback process. Moreover, the message should be delivered using suitable technical solutions taking into account the different targets, the safety and confidentiality of the contents, the forwarding speed, the ease of use, and senders’ reliability. Data sharing should be appropriate, and there must be a worldwide consensus on definitions and on what the numbers presented to the public – like the number of deaths for Covid-19 or that of confirmed cases – represent. This delicate phase of information also has ethical and legal implications and directly affects people’s right to know and to act consequently for their own and the collectivity’s sake. We therefore call for the urgent creation of an International Crisis Management Unit aimed to implement a global, coordinated, top-to-bottom risk communication plan, coherent with what measures have been taken and will be taken in the future.   1. WHO. Risk Communication 2017 [Available from: http://www.who.int/risk-communication/en/. 2. Remarks by President Trump, Vice President Pence, and Members of the Coronavirus Task Force in Press Conference [press release]. Washington: www.whitehouse.gov, 27 February 2020. 3. Coronavirus press  conference 11 February, 2020 [press release]. Geneve: www.who.int, 11 February 2020. 4. Best M, Neuhauser D. Ignaz Semmelweis and the birth of infection control. Qual Saf Health Care. 2004;13(3):233-4. 5. Capello F. Basic Principles of Risk Communication in Air Pollution.  Clinical handbook of air pollution-related diseases: Springer; 2018. p. 637-42. 6. Gostin LO, Hanfling D. National preparedness for a catastrophic emergency: crisis standards of care. JAMA. 2009;302(21):2365-6.  View publication stats

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Risk communication at the time of Coronavirus: are we washing our hand of COVID-19?

Risk communication at the time of Coronavirus: are we washing our hand of COVID-19?

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