risk management of COVID-19

1. COVID-19
RISK MANAGEMENT AND
RISK COMMUNICATION- What
we know and what we don’t
know
Part I
COVID-19 RISK COMM1/TENGKU HANIDZA 1
Prepared by:
Tengku Hanidza Tengku Ismail, PhD.

2. The corona virus has no sense of
morality: It just spreads its selfish
genes, along its misery and chaos, as
fast as it can.
(Richard Wolffe, The Guardian March 25, 2020)
COVID-19 RISK COMM1/TENGKU HANIDZA 2

3. This lecture is going to describe risks on COVID-19 (Risk
Assessment) and talk about them (Risk communication).
This lecture is prepared while following the insurgence of
Covid-19.
Risk is everywhere
Risk in unavoidable
Risk has different degree of severity/seriousness
Risk has uncertainties (the more expert disagree, the
more uncertain we are)
COVID-19 RISK COMM1/TENGKU HANIDZA 3

4. Risk framework
for infectious diseases Identify risk
Risk
assessment
Risk
response
Screening and Treatment
Contact tracing
Social distancing
Restricted traveling
Travel ban
Curfew/Partial lockdown/Containment zones
Country lockdown
+ Social &
Psychological
Risk assessment
Technical RA
COVID-19 RISK COMM1/TENGKU HANIDZA 4

5. Agent names:
• Novel corona virus
• COVID-19 (Corona Virus Disease-19)
• SARS-COV-2
(Severe Acute Respiratory Syndrome
Corona Virus 2, formerly known as
HCoV-19)
COVID-19 RISK COMM1/TENGKU HANIDZA 5
AFP PHOTO /US FDA
Disease Profile

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The origin, transmission
and clinical therapies on
coronavirus disease 2019
(COVID-19) outbreak – an
update on the status. Guo,
Y., et al. Military Med
Res 7, 11 (2020).
https://doi.org/10.1186/s40779
-020-00240-0

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The current estimates of the
basic reproductive number
R0 are between
2 and 3, in settings from
China and during the early
stage of an outbreak on a
cruise ship.
Infectivity

10. The reproduction number (R0) is the average number of people
infected from a person with an infection.
R0 =D*O*T*S
where :
D = duration (number of days someone is infectious)
O = opportunities for transmission (number of person-person
greetings / day)
T = probability of transmission
S = susceptibility (proportion of population susceptible)
COVID-19 RISK COMM1/TENGKU HANIDZA 10

11. • The team found that the median daily
reproduction number of the virus
dropped from 2.35 down to 1.05
within the week following the
introduction of strict travel restrictions
in Wuhan on January 23rd.
• Identification of patients with the
illness, followed by careful isolation,
can be a strong strategy against
transmission.
COVID-19 RISK COMM1/TENGKU HANIDZA 11
Early dynamics of transmission and
control of COVID-19: a mathematical
modelling study.
Adam J Kucharski, et al.
Model structure: The population is divided into the following
four classes: susceptible, exposed (and not yet symptomatic),
infectious (and symptomatic), and removed (ie, isolated,
recovered, or otherwise non-infectious). A fraction of exposed
individuals subsequently travel and are eventually detected in
their destination country.

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Fatality

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COVID-19 : A Visual Data Science Analysis and Review
TIBCO Spotfire®
By: Colin Gray
Published: 7:28pm Mar 18, 2020

15. Is COVID-19 a pandemic?
COVID-19 RISK COMM1/TENGKU HANIDZA 15
The World Health Organization
upgraded the status of COVID-
19 from epidemic to pandemic
on March 11, 2020.
In the last pandemic, the H1N1
influenza virus killed more than
18,000 people in more than 214
countries and territories (WHO)

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20. COVID-19 : A Visual Data Science Analysis and Review
TIBCO Spotfire®
By: Colin Gray
Published: 7:28pm Mar 18, 2020
COVID-19 RISK COMM1/TENGKU HANIDZA 20
South Korea has been widely praised for its management of the outbreak
and spread of COVID-19. The success is due the country’s heavy use of
surveillance technology (CCTV) and the tracking of bank card and mobile
phone usage, to identify who to test.

21. Global Community response (or lack of) to COVID-19
COVID-19 RISK COMM1/TENGKU HANIDZA 21

22. Packed UK concerts amid rising Covid-19 cases, for three nights
(March 13)
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The band, however, has defended
its action, saying the UK
government’s position was that
there was no need to ban large
public gatherings at the moment.

23. Spring Break Florida- US students partying despite COVID
pandemic (March 19)
COVID-19 RISK COMM1/TENGKU HANIDZA 23
“If I get corona, I get corona.
At the end of the day, I’m not going to
let it stop me from partying”
“It’s really messing up my spring break.
What is there to do here other than go to
bars or the beach? And they’re closing
all of it,”
“This virus ain’t that serious.
There’s more serious things out there like
hunger and poverty and we need to
address that.”
“I just turned 21 this year so I’m here to party. (We’re)
just trying get drunk before everything closes.”“We’re just living in the moment.”

24. Australians at Bondi Beach ignoring social distancing measures
(March 22, 2020)
COVID-19 RISK COMM1/TENGKU HANIDZA 24
“If people need to, they can practice social distancing on
the beach.”
"I think it's excessive,
we're Australians,
we go to the beach"
the "whole ordeal" was
an overreaction

25. Refer to these readings for the following slides
1. Responding to Community Outrage: Strategies for Effective Risk
Communication by Peter M. Sandman, Ph.D.
2. Risk and Crisis Communication For Disasters Manila, Philippines,
February 12-15, 2007. Jody Lanard M.D.
COVID-19 RISK COMM1/TENGKU HANIDZA 25

26. Covid-19 Public (or lack of) Outrage?
COVID-19 RISK COMM1/TENGKU HANIDZA 26

27. Fear Button ON
: Panic buying
COVID-19 RISK COMM1/TENGKU HANIDZA 27

28. COVID-19: Is panic buying pointless and puts others at risk?
COVID-19 RISK COMM1/TENGKU HANIDZA 28
According to Paul Marsden, (consumer psychologist at the
University of the Arts London),— where we buy to manage our
emotional state (“retail therapy”)
“It’s about ‘taking back control’ in a world where you feel out of
control,” he said.
Stocking up on supplies is a valid response. It indicates
people are not helplessly reacting to an outside
circumstance but instead are thinking forward and
planning for a possible situation.
Part of this response is due to the urge for self-reliance, it may
also be a herd behavior, is one driven by imitating what
others do –

29. COVID: Real vs. Fake news
Causing fear and panic
COVID-19 RISK COMM1/TENGKU HANIDZA 29
Who do
you
TRUST?

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31. Who do you trust?…
Government? Politicians? Expert? Scientists?
Social
media?
Media?
Friends &
Families?
COVID-19 RISK COMM1/TENGKU HANIDZA 31

32. • Trump claims public health warnings on covid-19 are a conspiracy
against him
• An associate professor at the London School of Hygiene and Tropical
Medicine (LSHTM), said that there was no clear evidence that
commuters travelling on the underground were at greater risk.
• Experts have criticised an unpublished modelling study released to
the media on Tuesday 24 March that suggested that half the UK
population might already have been infected with covid-19.
COVID-19 RISK COMM1/TENGKU HANIDZA 32

33. COVID-19 situation in Malaysia
COVID-19 RISK COMM1/TENGKU HANIDZA 33

34. COVID-19 TIMELINE MALAYSIA
CLUSTER
1 Jan 25:
Tourist
and locals
CLUSTER 2 Feb
27 : Overseas
meeting
CLUSTER
3 Mar 6:
Religious
gathering
SPORADIC
case: First
case on
March 11
CLUSTER 4: ?
TO BE SEEN?
WHO declared as
a pandemic
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Movement
Control Order
Mar 18- Apr 14

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https://www.worldometers.info/coronavirus/country/malaysia/
Ijtimak
Feb 27- Mar 3First
case
Feb 2
Case 26
Feb 21

37. CLUSTER 1
COVID-19 RISK COMM1/TENGKU HANIDZA 37

38. CLUSTER 2
On March 3 (Tuesday), seven
cases were reported and they
were all linked to Patient 26, a
senior officer at Khazanah
Nasional Bhd and UDA
Holdings Bhd who is now
being quarantined at Hospital
Sungai Buloh.
COVID-19 RISK COMM1/TENGKU HANIDZA 38

39. CLUSTER 3
COVID-19 RISK COMM1/TENGKU HANIDZA 39

40. Sporadic (March 12, 2020 )
• The infected person did not have travel history to the
affected countries or contact with infected persons
• The first case was detected after the MOH conducted
surveillance on 600 samples taken from people with
influenza-like illness (ILI) and severe acute respiratory
infection (SARI)
COVID-19 RISK COMM1/TENGKU HANIDZA 40

41. COVID 19 Super spreaders
certain individuals with atypical pneumonia, now recognized as cases of SARS, who have been implicated in spreading the
disease to numerous other individuals (WHO).
COVID-19 RISK COMM1/TENGKU HANIDZA 41

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COVID 19 Super spreaders Malaysia

43. End of First CMO: A 14-
day Movement Control
Order (March 18 – 31)
Death rate: 1.41%
WHO risk assessment:
Global level VERY HIGH
COVID-19 RISK COMM1/TENGKU HANIDZA 43

44. Covid-19
Risk
Management
COVID-19 RISK COMM1/TENGKU HANIDZA 44

45. Covid-19 Risk Management
• Personal hygiene
• Screening
• Isolation of cases
• Contact tracings
• Aggressive interventions
COVID-19 RISK COMM1/TENGKU HANIDZA 45

46. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. van Doremalen et al. 2020.
The New England Journal of Medicine. DOI: 10.1056/NEJMc2004973.
• Survive in droplets for up to 3 hours after being coughed out into the air.
• Fine droplets between 1-5 micrometres in size – about 30 times smaller
than the width of a human hair – can remain airborne for several hours in
still air.
• cardboard – up to 24 hours
• plastic and stainless-steel surfaces- up to 2-3 days
• coronaviruses can be inactivated within a minute by disinfecting surfaces
with 62-71% alcohol, or 0.5% hydrogen peroxide bleach or household
bleach containing 0.1% sodium hypochlorite.
For List of Disinfectants for Use Against SARS-CoV-2
Go to https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-
against-sars-cov-2 COVID-19 RISK COMM1/TENGKU HANIDZA 46

47. Isolation of cases and contacts tracings: How effective?
COVID-19 RISK COMM1/TENGKU HANIDZA 47
Hellewell et al. 2020. Feasibility of controlling COVID-19 outbreaks by isolation of cases and
contacts. The Lancet Global Health

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49. What is social distancing?
Social distancing is a public health practice
that aims to prevent sick people from
coming in close contact with healthy
people in order to reduce opportunities for
disease transmission. It can include large-
scale measures like canceling group
events or closing public spaces, as well as
individual decisions such as avoiding
crowds.
COVID-19 RISK COMM1/TENGKU HANIDZA 49

50. International departure terminal at JFK
Airport New York : USA 2m (6 feet)
away
WHO: 1m (3 feet) away
COVID-19 RISK COMM1/TENGKU HANIDZA 50

51. With COVID-19, the goal of social
distancing is to slow down the outbreak
in order to reduce the chance of
infection among high-risk populations
and to reduce the burden on health
care systems and workers. Experts
describe this as "flattening the curve,"
which generally refers to the potential
success of social distancing
measures to prevent surges in
Illness that could overwhelm health
care systems.
COVID-19 RISK COMM1/TENGKU HANIDZA 51

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54. Lockdown
countries: China
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56. Border restrictions/Travel bans
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57. Curfew
COVID-19 RISK COMM1/TENGKU HANIDZA 57

58. Movement Control Order
(Partial lockdown)
March 16, 2020
KUALA LUMPUR: A 14-day
Movement Control Order
from March 18 - 31
nationwide. The Movement
Control Order is imposed
under the Prevention and
Control of Infectious
Diseases Act 1988 and well
as the Police Act 1967,
which cover a range of
activities.
COVID-19 RISK COMM1/TENGKU HANIDZA 58

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60. Risks of ‘aggressive interventions’: People not taking seriously:
‘Malaysian balik kampung’ (photo from The Star Mar 18, 2020)
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Only 60% comply
on Day 1 of COM
(MOH)
95% comply on
Day 8 of COM
(MOH)
Additional 2 weeks
of COM extension

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Nationwide
disinfection exercise
begins on March 30
within areas categorised as Covid-19 red zones

63. How to communicate risk?
COVID-19 RISK COMM1/TENGKU HANIDZA 63

64. “The public often misperceives the
hazard. The experts often misperceive
the outrage. But the overarching
problem is that the public cares too little
about the hazard, and the experts care
too little about the outrage.” (Peter
Sandman)
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65. Paradigms of Risk Communication
COVID-19 RISK COMM1/TENGKU HANIDZA 65
Are we ‘informed
citizen’?
Where are we at
with COVID-19?
We need to scare
the public!
We need to
calm the public

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67. Risk perception studies:
Psychometric approach– cognitive map
Risk communication guidelines widely
used in public health are based on the
psychometric paradigm of risk, which
focuses on risk perception at the level
of individuals.
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69. COVID-19 :
A BLESSING IN DISGUISE?
COVID-19 RISK COMM1/TENGKU HANIDZA 69

70. NASA images show ‘significant decreases’ in air pollution
over China amid coronavirus economic slowdown
COVID-19 RISK COMM1/TENGKU HANIDZA 70
NASA’s Earth Observatory pollution satellites show “significant decreases” in air pollution over China
since the coronavirus outbreak began.
Courtesy of NASA.

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72. https://balkangreenenergynews.com/
air-pollution-sharply-falls-worldwide-on-covid-19-lockdowns/
COVID-19 RISK COMM1/TENGKU HANIDZA 72
Clearing the air: N02 emissions down amid coronavirus outbreak
A hole in the ozone layer is in
recovery.
A decline in CO2 emissions
(World Meteorological Organization)

73. Coronavirus lockdown eases pollution, Venice canal runs clear
COVID-19 RISK COMM1/TENGKU HANIDZA 73
A view shows clearer waters by a gondola in a
Venice canal on March 17, 2020 as a result of
the stoppage of motorboat traffic, following
the country’s lockdown within the new
coronavirus crisis. Andrea Pattaro | Getty
Images
Clear water is seen in Venice’s canals due to
less tourists, motorboats and pollution, as
the spread of the coronavirus disease
(COVID-19) continues, in Venice, Italy, March
18, 2020.
Manuel Silvestri | Reuters

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75. .
COVID-19 RISK COMM1/TENGKU HANIDZA 75
Does lifting of restriction runs the risk
of new infections?
we’ll see…….

76. China to lift lockdown on Wuhan, ground
zero of coronavirus pandemic on April 8,
2020
People in Hubei, except for Wuhan, will be
allowed to leave the province if they have a
green QR code on their mobile phones.
COVID-19 RISK COMM1/TENGKU HANIDZA 76
Green = healthy, orange = suspected or in quarantine,
and red =you confirmed COVID-19 patient.

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Do we know who patient zero is in
the Covid-19 coronavirus outbreak
that started in China?
NO
A shrimp peddler at the Huanan
Seafood Wholesale Market has
been identified as possibly “patient
zero.” She developed the cold
symptom on Dec 10.
The first person to be diagnosed with Covid-19, was
on 1 December 2019 (a lot of earlier) and that person had
"no contact" with the Huanan Seafood Wholesale Market.
Can singling out one person as causing an outbreak do more harm
than good?

79. End of Part 1
COVID-19 RISK COMM1/TENGKU HANIDZA 79
It's not a matter
of “IF" but
“WHEN" the
new
coronavirus,
SARS-CoV-2,
will spread
globally