Sabrina MacPherson: More information, not less, will help ease people out of COVID fear
If you want your audience to move away from fear, you can't shout at them to stop panicking.
By: Sabrina MacPherson
Sometimes I marvel at Doug Ford's ability to make everyone angry. He leads by checking polls, acts two weeks later than he should, and flip-flops faster than our federal government telling truckers what the border vaccine policy is today. It's not just him, either, his whole cabinet is known for their "whoops, we meant the opposite!" method. I've tried to accept that their lack of cohesive strategy is always going to frustrate me.
That said, one of Ford's recent moves really got me thinking. Ontario is longer reporting COVID-19 cases in schools, and public-health units are no longer sharing with potentially affected families that they were exposed. I've written about my family's COVID scare last fall, and how the messages from public health were key to our sense of calm and sanity at the time. It made a real difference to know about the cases in our school generally and about our son's exposures specifically.
Why is that? We were scared and uncertain, and the fear that stems from uncertainty is solved by more information, not less. Good communicators know when to provide more or less information based on who they are trying to reach and what the desired outcomes are. If you want your audience to move away from fear, you can't shout at them to stop panicking. You have to give them good info and let them find the path to calm decisions with it.
Like most Ontario parents we sent our son back to school last week, and like all those other parents we're feeling a lot of conflicting emotions. We're nervous: Omicron is everywhere, Ontario’s testing and tracing system swiftly collapsed under the crush of cases, there are many stories about kids in hospitals. It feels daunting sending our son to a crowded school in this context. We're also happy: he's with his friends and teachers, and the return of his excited stories at the dinner table tells us that he's spending his days where he belongs. And we're hopeful: we're fully boosted, he's vaccinated, and his school's overall vaccination rate is stellar for both staff and eligible students. He is as safe as we can make him and our community has done its part, too. We are grateful to see him getting the joys of school and friends back in his life.
There remains one cloud of worry, and it's related to that information gap. Without that data, parents are missing the ability to analyze trends, which is a key element of their risk-assessment toolkit.
Our family has kept an eye on spread numbers in the communities we live and work in more than the provincial ones, because those matter most for our day-to-day. Our region is relatively calm, but many families here have at least one income that relies on a commute south, where cases and hospitalizations are much higher. My husband is one of those, and also an essential worker whose workplace has remained open the entire pandemic. Because of that layer of risk, we've taken the approach of limiting our family's exposure as much as possible when numbers spike really high, so that we can stay safe — and also to help protect our school community, in hopes that it will remain open longer. We use the trend data we have to help us make reasonable decisions that keep our family and our community safe.
Many commentators have called for a change at this point in the pandemic: "we're nearing the end, so move away from panic-based messaging and tactics." Broadly I agree with this, in part because fear is not sustainable and tactics counting on a fear-driven response will not work forever. And because we eventually do have to embrace that our window for eradication of this virus has all but closed, and it's likely that from now on we live with "COVID season" like we do flu season. Book your flu shot and your COVID shot in the fall, practice good hygiene, and carry on. We're not quite there yet, but we're close, and we do have to start shifting the messaging to something that can help people and communities make the necessary mental shifts in their approach.
That said, you have to manage this change thoughtfully. Moving from fear to calm and certitude requires giving people more useful data, not less, to help calm them during the return to more normal activities.
In the absence of provincial numbers, some school boards have come up with a neat solution. They are reporting on daily absences of both students and staff, the percentage of deviation from the average absences from the period of September to December of 2021, daily change rates, and the five-day trends. This won't give you exactly the same information as you had before, but it does let you look at trends of school absences in relation to community spread, and infer if things are getting better or worse.
The data nerd in me really loves this: it's a solution that creates a trend line, which is something that people can use. The parent in me feels calmed, knowing that the community is looking out for the community, providing a tool that helps people make more informed risk assessments.
I believe that the transition to the end-game of our pandemic communications is important, but you can't let a hurried approach ruin your mid-game. That goes for the Ford team's obvious focus on the upcoming election, too. Don't let the prize of another term make you forget that Ontario Conservative fortunes are made and broken in suburbs, the ones that ring Toronto, which are currently filled with parents who are both angry and anxious. If you give them good data and communications that they can use to keep their families safe and happy, they will remember those feelings. Increasing their uncertainty will only leave them looking for a target, a place to put all that fear and worry and frustration, and for many that place will be the incumbent, by way of the ballot box.
To paraphrase Maya Angelou's well-known quote: Ford will have to hope that people will forget the majority of what he did and said, but he — and all the provincial leaders, for that matter — would do well to think about what people will remember feeling by the time June rolls around. Those feelings are what will matter for them in the end.
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I do agree with the general theme, but I find this article is tailored to the biases and personality of its author, and for similar people.
COVID-19 itself has never worried me too much, especially for my kids. I read both the official Government of Canada information as well as the state of knowledge in the journals. For example, I read the approval process and details for all of the vaccines. Take, for example, the Pfizer-BioNTech Comirnaty: https://covid-vaccine.canada.ca/info/regulatory-decision-summary-detail.html?linkID=RDS00856
It was comforting to see that they were honest about the lack of knowledge in long-term safety, noting, "An important limitation of the data is the lack of information on the long-term safety and effectiveness of the vaccine. The identified limitations are managed through labelling and the Risk Management Plan RMP)." The RMP is also described in monitoring feedback and updating the product monographs. This is an excellent risk management plan because both the labelling and monographs diversify risk via one-on-one informed decision-making between patient and doctor. And, the monographs are informative. The Comirnaty monograph was last updated Nov 19 here: https://covid-vaccine.canada.ca/info/pdf/pfizer-biontech-covid-19-vaccine-pm1-en.pdf
Notably, Section 7 lists risks and is quite honest. It says, "It is unknown whether COMIRNATY has an impact on fertility." and "The safety and efficacy of COMIRNATY in pregnant women have not yet been established. It is unknown whether COMIRNATY is excreted in human milk. A risk to the newborns/infants cannot be excluded. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for immunization against COVID-19."
This may not sound comforting to some, but to me it means the scientific process works and is being honest. As a scientist who works with scientists working on this stuff, I'm aware there is a lot we don't know. Transmission is a big one too, but once again, the national scientific process works. The GoC brain trust for COVID-19 recommendations is the National Advisory Council on Immunization (NACI), who put out an Advisory Council Statement on Oct 22, 2021: https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/recommendations-use-covid-19-vaccines.html
On infection and transmission it states, "There is currently limited evidence on the duration of protection and on the efficacy of these vaccines in reducing transmission of SARS-CoV-2, although studies are ongoing. Evidence of protection against asymptomatic SARS-CoV-2 infection is emerging for the mRNA and Janssen vaccines." And, in the section "Efficacy and effectiveness against asymptomatic infection and transmission" it states that "the current data is insufficient to draw conclusions" and AstroZeneca "has not demonstrated efficacy against confirmed SARS-CoV-2 asymptomatic infection".
All true. We didn't know, and still don't know exactly the effectiveness of the vaccines at reducing asymptomatic infection, transmission, and the relative importance of exposure risk. For example, a remote-working unvaccinated person is probably much safer to be around than an in-person worker who has been to restaurants and the gym recently, largely because remote workers have limited exposure risk, and being unvaccinated means they can't go where the virus spreads, which is restaurants, gyms, bars, and other enclosed spaces with other people, especially strangers.
And, it is also useful to know that the WHO recommends against getting booster shots except for those in high risk cases: https://www.who.int/news/item/22-12-2021-interim-statement-on-booster-doses-for-covid-19-vaccination---update-22-december-2021
And, NACI similarly separates strong "should be offered" and discretionary "may be offered" regarding boosters, meaning from 18 to 50 you can get one, but not getting one is also just fine, and are only really needed for >50 particularly in higher risk circumstances: https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/guidance-booster-covid-19-vaccine-doses.html
Similar with children under 12, the WHO (above booster link) says, "WHO is currently not recommending the general vaccination of children and adolescents ..." with details here: https://www.who.int/news/item/24-11-2021-interim-statement-on-covid-19-vaccination-for-children-and-adolescents. And, from GoC data, 0-19 year olds are approximately 13 times more likely to be killed in a car accident than from COVID-19. In fact, anybody younger than 45 is more likely to die in a car accident from that data.
It is similar with myocarditis, where adolescents may have a 10-fold increase in risk from vaccination over not being vaccinated and risking COVID-19 instead (https://www.acpjournals.org/doi/10.7326/M21-3700) because, as is also calming to me, after 2 years only 7% of the Canadian public have gotten COVID-19, which works out to about 0.07% of the public with COVID-19 any given week, and since it is potentially contagious for up to a week, that means only 0.07% (about 1 in 1500) average that any person you meet might have it, or you need to be in a room with 1500 people to likely have 1 that is currently contagious, on average.
So, my kids will be fine, vaccinated or not, mixing or not. They may or may not be better off vaccinated, but either way the risks are quite low. I'll likely be quite fine, being 50, vaccinated but not yet boosted (but monitoring the data). My parents are at risk, but they are vaccinated and boosted, as recommended.
What isn't calming to me though, is when the politicians, and often press, do and say the exact opposite of the scientific process and/or ramp up fear by providing too much inaccurate information, or pull out one or two studies and claim that's what science says. (Simple studies are often very limited and contradict. It takes time, data, and many studies to extract signal from the noise.)
While NACI and the literature explicitly say we don't know about vaccine effectiveness on asymptomatic infection and transmission through the fall of 2021 and still now, the PM was out creating and spreading hatred of the unvaccinated, saying "those people" are a threat to our children. Quebec is looking to tax them. People are spreading hate and oppression, without any scientific basis from NACI, WHO, or other bodies of review. People will sit in a restaurant with 50 vaccinated strangers, but worry about being around a single unvaccinated person who isn't even allowed in a restaurant. That makes no sense whatsoever. A Quebec judge rescinded a father's visitation rights with his daughter because he's unvaccinated, but she's allowed around hundreds of vaccinated people? What kind of risk calculation was involved there? The federal employee mandates are based on the notion that a remote unvaccinated person cannot be accommodated and is a risk to others if forced to come to work ad hoc. There's no basis in science for that claim, and quite the opposite. This is pure fear-based hatred, not science, and is very worrisome coming from the people that are supposed to be level-headed.
Meanwhile, it's not clear that vaccinating children is a good idea and the WHO recommends against it, and NACI says it is ok not to vax them. And, per the WHO, we'd be at less risk if we send all of those doses to countries that are well undervaxxed rather than giving our rich selves third doses and to our kids who probably don't need them and it probably doesn't do much to slow spread.
It seems what comforts some people is simplistic thinking -- vax = good, therefore more vax = more good, and give me and my family more vax to keep us safe, and threaten our neighbours to vaccinate to keep us safe. It all sounds so very unscientific, greedy, and selfish to me. These "please keep me safe" people are very discomforting, especially when their fears are pandered to by politicians and press.
What would comfort me more is if politicians and the press spent more time trying to inform people about the actual science, that risks from COVID are quite low, quite negligible for young people, and that it is ok to be around unvaccinated people. At worst, one unvaccinated person might as risky to be around as a couple of vaccinated people, and a remote working unvaxxed person is likely much safer to be around. And, that it is ok for your kid to be unvaccinated, and for you to not get a booster.
And, for government to destroy the very risk diversification plan of the Health Canada science by removing the informed consent and instead creating coerced consent and "against their will" coercive tactics. That creates higher risk situations, not less risk. Because, there are a lot of things we don't know yet. That is how science works. Politics and the press don't work that way though, which is the source cause of much of our anxiety, unfortunately.
“One of the painful things about our time is that those who feel certainty are stupid, and those with any imagination and understanding are filled with doubt and indecision.”
- Bertrand Russell
The problem with your article is that it ignores the most important data: Covid risk to healthy kids compared to other risks they face. That data is simple and clear: your child is safe (defined as vastly lower risk than the myriad other risks that you simply don't worry about) from Covid and always was. If the government had been open about that from day 1, parents would not now be frightened. Unfortunately, they lied and misled, so if they come clean about that now and are believed, parents will be furious. No government wants that.