Re: Use of “normal” risk to improve understanding of dangers of covid-19
Dear Editor
Awareness of normal-risk is not normal.
Epidemiological rates and disease risks often do not resonate well with the general public.[1] [2]. This is primarily due to the fact that human beings are more attuned to anecdotes rather than hard data. The “Jade Goody effect” on cervical cancer screening amply demonstrates the power of anecdotes. [3]. So “excess normal-risk information” is unlikely to have a significant effect on public awareness.
Individuals are more likely to seek health information about personal vulnerability, not population level generic risks. Clinicians on the front line would prefer an easy-to-use risk stratification score that can inform clinical judgement. [4]. As such “normal-risk“ terminology is neither useful nor relevant for individuals and clinicians.
Finally, awareness of normal-risk is not normal. Normal public do not go around their daily life thinking of their mortality risk every day of the week. Death occurs to others. Even cancer patients with incurable disease use hope and optimism as coping mechanisms.[5]. As such, educating the public about extra mortality risk over and above “normal-risk” would be a tall order.
References
1 Spiegelhalter D. Use of “normal” risk to improve understanding of dangers of covid-19. BMJ 2020;370. doi:10.1136/bmj.m3259
2 Hollands GJ, French DP, Griffin SJ, et al. The impact of communicating genetic risks of disease on risk-reducing health behaviour: systematic review with meta-analysis. BMJ 2016;352:i1102. doi:10.1136/bmj.i1102
3 Bowring J, Walker P. The “Jade Goody effect”: what now for cervical cancer prevention? BMJ Sexual & Reproductive Health 2010;36:51–4. doi:10.1783/147118910791069420
4 Knight SR, Ho A, Pius R, et al. Risk stratification of patients admitted to hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: development and validation of the 4C Mortality Score. BMJ 2020;370. doi:10.1136/bmj.m3339
5 The A-M, Hak T, Koëter G, et al. Collusion in doctor-patient communication about imminent death: an ethnographic study. BMJ 2000;321:1376–81. doi:10.1136/bmj.321.7273.1376
Rapid Response:
Re: Use of “normal” risk to improve understanding of dangers of covid-19
Dear Editor
Awareness of normal-risk is not normal.
Epidemiological rates and disease risks often do not resonate well with the general public.[1] [2]. This is primarily due to the fact that human beings are more attuned to anecdotes rather than hard data. The “Jade Goody effect” on cervical cancer screening amply demonstrates the power of anecdotes. [3]. So “excess normal-risk information” is unlikely to have a significant effect on public awareness.
Individuals are more likely to seek health information about personal vulnerability, not population level generic risks. Clinicians on the front line would prefer an easy-to-use risk stratification score that can inform clinical judgement. [4]. As such “normal-risk“ terminology is neither useful nor relevant for individuals and clinicians.
Finally, awareness of normal-risk is not normal. Normal public do not go around their daily life thinking of their mortality risk every day of the week. Death occurs to others. Even cancer patients with incurable disease use hope and optimism as coping mechanisms.[5]. As such, educating the public about extra mortality risk over and above “normal-risk” would be a tall order.
References
1 Spiegelhalter D. Use of “normal” risk to improve understanding of dangers of covid-19. BMJ 2020;370. doi:10.1136/bmj.m3259
2 Hollands GJ, French DP, Griffin SJ, et al. The impact of communicating genetic risks of disease on risk-reducing health behaviour: systematic review with meta-analysis. BMJ 2016;352:i1102. doi:10.1136/bmj.i1102
3 Bowring J, Walker P. The “Jade Goody effect”: what now for cervical cancer prevention? BMJ Sexual & Reproductive Health 2010;36:51–4. doi:10.1783/147118910791069420
4 Knight SR, Ho A, Pius R, et al. Risk stratification of patients admitted to hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: development and validation of the 4C Mortality Score. BMJ 2020;370. doi:10.1136/bmj.m3339
5 The A-M, Hak T, Koëter G, et al. Collusion in doctor-patient communication about imminent death: an ethnographic study. BMJ 2000;321:1376–81. doi:10.1136/bmj.321.7273.1376
Competing interests: No competing interests