Risk Perceptions – Coronavirus A Case Study

In this post, we’ll explore risk perceptions and how our opinions may not match the actual risk.

Updated: April 10, 2020 

In previous posts, we’ve explored risk and decision making around risks, but how do our perceptions and influences around risk impact our decision making? 

What is risk perception?

People do not make decisions based solely on empirical data. Decision making is influenced by a variety of factors that include an individual’s expertise, personal experiences, and more. When it comes to evaluating risks or situations that could pose harm to ourselves or a loved one, we make decisions based on several factors.

Three broad factors include:

  • the degree to which a risk is understood.
  • the degree to which it evokes a feeling of dread.
  • the number of people exposed to the risk.

While these factors break down further into at least 14 sub-factors we can see how emotions impact the way we understand risk and react to threats.

Let’s look at the coronavirus.

COVID-19 is caused by the SARS-CoV-2 virus that has infected millions globally causing serious illnesses leading to death and severe economic repercussions as populations work to mitigate the disease’s spread.

COVID-19 invokes dread and fear because it’s a new and emerging risk and currently there is no known cure beyond controlling symptoms. Researchers are working on developing a cure and a vaccine, but that takes time.

Additionally, with strict social distancing in place media and entertainment options focus heavily on the COVID-19 outbreak which increases knowledge around the disease and can also increase public anxieties. People's feelings of dread, anxiety, helplessness, and fear related to COVID-19 increase our perception of risk. 

Let’s look at the seasonal flu.

Influenza (flu) season begins around October 1 and can go until the end of May. The U.S. Center for Disease Control and Prevention (CDC) estimates that influenza has resulted in between 9 million – 45 million illnesses, between 140,000 – 810,000 hospitalizations and between 12,000 – 61,000 deaths annually since 2010 in USA. 

While scientists work to create a vaccine to prevent COVID-19, researchers in the USA have developed and distributed the flu vaccine to help prevent and lessen the impact of the seasonal flu. However, many Americans choose not to get vaccinated.

Let’s look at the flu vaccine.

Season flu vaccines can be highly effective; in fact, in 2017-2018, the vaccines prevented an estimated 6.2 million influenza illnesses and 5,700 influenza-associated deaths. However, for a variety of reasons, people choose not to get the seasonal flu vaccine or any vaccines at all.

People make this choice even though the evidence shows there is no increased risk of death associated with getting the vaccine at the population level (1, 2) and the vaccines are proven effective at lessening or preventing illnesses, such as the seasonal flu, that can lead to hospitalization and death.

What does it all mean?

If you look at the numbers, it’s clear to see that the seasonal flu is a significant health burden that kills tens of thousands of individuals. Yet, the flu isn’t taken as seriously as COVID-19 for many reasons

  • COVID-19 is a novel disease unrelated to influenza so hospitals are dealing with the baseline level of ill individuals stricken with a familiar illness like the flu in addition to the wave of individuals infected with novel coronavirus; thus, limiting hospitals' abilities to treat critically ill patients. 
  • The novel coronavirus has a longer incubation period than influenza leading to increased contagiousness. 
  • At present, it's thought that COVID-19 has a higher mortality rate than the seasonal flu.

If we look at the broad factors influencing our risk perception, it makes sense that we would react with a stronger emotion to the COVID-19 outbreak than the flu outbreak. However, we’ve never reacted as intensely as a population in modern memory even though the flu mortality range since 2012 has been between 23,000 and 61,000 with most years being in the mid-30,000 range; why?

If we look at the flu perceptions, we are very familiar with the flu. It happens yearly, we have a vaccine to help prevent severe flu cases, our hospitals have capacity to treat critically ill patients suffering from the flu, and we are familiar with best practices to avoid getting the flu.

Such familiarity can skew our perceptions of the actual risk, especially when the risk doesn’t receive wide-spread publicity.

We know that the measures we’ve taken as a society and as individuals to combat COVID-19 such as strict social distancing, using CDC recommended cloth face masks, and increasing hygiene best practices such as hand washing and home disinfection would also decrease the spread of the flu.

Due to our current lack of knowledge around the novel coronavirus, it makes sense to take extreme actions as a society and as individuals to help limit the spread. However, after society gets COVID-19 under control, we shouldn’t stop implementing best practices like social distancing when ill, wearing face masks when ill, getting recommended vaccines, and practicing excellent hygiene because the flu and other communicable illnesses are also a significant health burden to society.

We all have biases and perceptions and we need to look closely at the facts and make decisions and take actions that we know will have a positive impact on our health and the health of our community.

NOTE: The first version of this risk perception article published on February 3, 2020, used the data, infection rates, and known contagiousness for the SARS-CoV-2 (formally 2019-nCoV) infection. Our analysis took into consideration only the known information at that time.

Since then, SARS-CoV-2 has become a pandemic deeply impacting the global community. We have updated this post (April 10, 2020) to reflect the current state-of-the-science and to acknowledge that our perspective and actions need to change in response to new and fuller data.


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