Sabrina Macpherson: In praise of good COVID communications experiences
Ontario's latest modelling is much improved. And, alas, my kid's school handled the outbreak there well, too.
By: Sabrina Macpherson
On Friday the Ontario Science Table (OST) released a report with a new range of predictive modelling. I held my breath and clicked, and found myself pleasantly surprised by what I saw.Â
This slide in particular is glorious. A simple chart, showing a reasonable predicted range of roughly 200-700 cases by the end of next month. At a glance that range makes perfect sense to anyone who's been following the day-to-day trends over the last month. Based on recent trends in case counts, activity, and the success thus far of Ontario's high vaccination rates, these numbers make sense.
What's more, the surrounding language is very clear. The chart title: "Ontario's case counts are expected to remain stable, even with more social contacts, if we keep public health measures."
It's a single sentence that contains everything you need to know. It's so good that the first place I saw the title of that chart was when it was almost exactly replicated in the headline of the Toronto Star's coverage of the OST report. And those "public health measures," wondering what those are? It's right there next to the chart this time! They're called out as masking, vaccine certificates, good ventilation, and symptom screening. It’s fantastically simple messaging: "Keep doing these specific things, and the cases won't explode even if you change this other behaviour."
This is how you craft a good message, making complex data modeling consumable by people who don't necessarily care about the data modeling part. Pare it down to the minimum viable data and speak to behaviour with a clear answer to someone asking "what does this mean for my life?" Well done, OST. Nice work!
I find myself comparing this with the other COVID-19-related risk communication experience I had last week. On Wednesday morning, I got a text from a mom-friend saying she'd heard that my son's teacher's class was sent home to isolate due to a COVID case, and wanted to check in and see how my son is doing.
Wait, what? I hadn't heard anything from the school, neither had my husband. I immediately checked the voicemails I had collected during my work meetings — nothing. I checked my email — nothing. When I asked how she found out, she told me that a friend's sister's kid is in that teacher's class, and that's how she knew. But, she thought that I would have heard from the school first. So we both assumed she had got the teacher wrong.Â
Cool, OK, back to my normal day.
About an hour and a half later, I'm at a restaurant for lunch. I rarely go out even in normal times, except when my parents visit. It's been two years since I sat and ate a meal out with them, and we'd planned for them to come up and do just that together. I was very excited to have a lunch with them. At a restaurant! With fancy food! And adult conversation! It felt very normal and very strange all at once.Â
As my husband and I were waiting for them to arrive, we got a phone call from my son's school. It was an automated message, saying there had been a positive case in his class, and we had to pick him up right away.Â
We subsequently got three emails over the afternoon: one with detailed information from Public Health on what to do next; a general email from the school to the whole population about a class with a single case; and another one specific to our class with some relatively rough messaging around "your kids will have to shift to online for a few weeks, your teacher will provide more details tomorrow in a personal phone call."
So first, I have a whole new perspective on information chains that start at my friend's friend's sister's kid. Normally I would simply scoff, but this time? No prizes for accuracy, but it absolutely won the day in terms of message speed. (This is exactly how bad info spreads like wildfire, but that's another conversation.)
The automated message I understand, for exactly the same reason: you need speed. In a situation where you have to call a bunch of parents and say the same thing over and over, you don't want to get bogged down with 30 different versions of parental worry that have just been shot full of adrenaline — that shit is scary. (And, at least in the case of me and my husband, also somewhat swear-y.) What you need is to give parents the minimal information needed (pick up your child now), with a promise of more practical info after that step is completed.
At the time the gap between that mom-text and the robocall frustrated me. But when I thought through the process involved, it made a certain amount of sense. Our last name starts with M, after all, and if you're running a machine through the list alphabetically then that's exactly how that would happen.
Overall, it was handled as well as it could be. Schools have practice at calling parents to say "something is wrong," and they've obviously worked with Public Health to have a series of useful steps for urgent COVID matters. Ways to communicate immediate action, ways to share clear follow-up information.Â
There is a communication nuance between "risk assessment" and "a risk has actualized." The former requires that you give people information that they can use to make personal, varied choices over a medium-to-long term. The latter requires that you share exactly what they need to know in order to act in a specific way as soon as possible. Both require that the message is reduced to exactly what people need to know to make good decisions. To continue the analogy from my last article at The Line, it’s the difference between how a financial advisor might talk to you about the general risks of an investment, versus how they talk to you when the market is crashing and you need to know what to do next.
In the end, our family all tested negative. There are minimal cases in the rest of the class, because masks and good ventilation work well even against the Delta beast. I'm hoping that the kids who caught COVID get well soon, that their families are all OK, and that we all get through a couple weeks of online learning with relative ease. While I'm really, really tired of living through historic times, I find I'm extremely grateful for risk communication done right. It's a small mercy in an otherwise impossibly frustrating time.
Sabrina Macpherson is a product manager in the financial services industry. She lives in Ontario with her family.
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This had to happen at some point: an acceptable level of dying must be chosen. Where Ontario notes that a continued 500 cases/day is an outcome from re-opening but with the current vaccinations and behaviours, both the tone of the model presentation and this journalism indicates that 500/day, indefinitely, is acceptable.
Population-proportionate, that would be about 170/day for BC, and I suspect that wouldn't be unpopular here, either, nor 1300/day for all-Canada. Because Delta's worse, and because most "cases" are unvaccinated, the death rate is still about 1%, so that's 13 dead/day for Canada, about 4700/year. We are clearly also choosing those deaths as "acceptable".
It's all pretty acceptable to we vaccinated, of course: the unvaccinated are risking our lives, too, by keeping it circulating and giving us that very small chance we'll be a "bad" breakthrough case. But the case-load is suppressed enough that's just not a big risk in our lives. Just a few dozen of those 4700 dead will be vaccinated, not elderly or previously sick; total flukes, like a car accident.
The real risk will all be borne by about 10% of the population that aren't vaccinated, and aren't little kids. One suspects that vaccination rates will exceed 95% after a year or two of it, and cases will finally peter out.
You stated that there is a nuance between "risk assessment" and "risk actualized" - My comment is to add an observation: School boards could really help parents and teachers assess the amount of risk they face by activating a mandatory test regime. Instead, with parents not required or enabled to test their children who are showing symptoms (not only that, but most parents don't have the time or convenient transportation to take their kids to a testing centre which is likely across town) the only requirement in our school board is to keep them home for a few days. So everyone is left in the dark. How can you assess risk when there is no mandatory testing?