Posted: February 10, 2020
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Article SummaryIn 2003, Jody Lanard and I wrote an article about “SARS Communication: What Singapore Is Doing Right” (see here: http://www.psandman.com/articles/sars-3.htm) for Singapore’s dominant English-language newspaper, the Straits Times. So of course we have been following Singapore’s handling of another coronavirus (this one spreading from Wuhan, China) with great interest. Once again, in our judgment, Singapore is doing a wonderful risk communication job – not perfect, but amazingly close, a role model for any country – or any city – willing to treat its public with respectful candor instead of condescending over-reassurance. So when Bloomberg News reporter Jason Gale emailed us on February 9, 2020, asking for our assessment of a spectacular speech by Singapore’s prime minister, we jumped at the chance to respond. The resulting short article in Bloomberg Quint made no use of our response. We hope others will make some use of Singapore’s spectacular example.

A Coronavirus Risk Communication
Role Model in Singapore

What a wonderful heartening and bracing speech. PM Lee is adultifying his citizens, while many leaders all over the world are infantilizing and patronizing their own.

(In addition, Singapore’s daily coronavirus updates should serve as a gold standard for the entire planet. No place else is providing the crystal-clear descriptions of cases and relevant epi details. Singapore’s coronavirus transparency is unique.)

We have too many compliments for PM Lee’s speech to list all of them, but here are a couple:

In telling his people about the first community transmission cases, PM Lee’s speech illustrates what most sets Singapore way above other countries so far in this epidemic: warning people that containment efforts will change to mitigation and coping efforts, and what that may look like. It will help pre-load some of the justifiable anxiety this will cause, so people will be more ready to cope when it happens. They will have already gone through phase one of their “Oh my God” reaction, the “adjustment reaction” that can’t be avoided and shouldn’t be postponed.

Here are the two fabulous paragraphs, where he tells people what to expect (term of art: “anticipatory guidance”): link is to a PDF file

If the numbers keep growing, at some point we will have to reconsider our strategy. If the virus is widespread, it is futile to try to trace every contact. If we still hospitalise and isolate every suspect case, our hospitals will be overwhelmed. At that point, provided that the fatality rate stays low like flu, we should shift our approach. Encourage those who only have mild symptoms to see their family GP, and rest at home instead of going to the hospital, and let hospitals and healthcare workers focus on the most vulnerable patients – the elderly, young children, and those with medical complications.

We are not at that point yet. It may or may not happen, but we are thinking ahead and anticipating the next few steps. And I am sharing these possibilities with you, so that we are all mentally prepared for what may come.

Again, this is respectful and bracing – and vastly different from much of the communication around the world, the drumbeat of “the risk is low at this point.”

PM Lee is recruiting his citizens’ involvement and validating their strength and resolve, rather than trying to tell them to butt out and not worry.

He shares their worry, and guides their worry, when he talks about the first apparent community cases:

These worried us, because it showed that the virus is probably already circulating in our own population.

“Worry” is exactly the right word. All too often when officials finally get around to acknowledging that they share their public’s worry, they dumb down the word to “concern” – or, worse yet, the phrase nobody uses naturally, “This is concerning.”

Often when the situation worsens, many officials just say “We’re not surprised that…” or “As we have been expecting…”, and then they also say “We understand that many people are concerned or worried.” But PM Lee’s statement is about all of us worrying together, not a separation of “us versus you people out there.”

And then, after sharing the worry, he goes on to tell people what new steps the government is taking, and the new steps all Singaporeans should take.

Singapore officials used to ask us to tell them our criticisms as well as our compliments! So here are two criticisms of this speech, just so they know we are analyzing them carefully, and not just cheerleading about how good they are!

number 1

PM Lee sounds unduly and prematurely over-reassuring and overconfident about the mortality rate outside of Hubei being “so far only 0.2 percent.” Even with the words “so far,” it is premature for him to sound so confident that “the new virus is much closer to influenza than SARS.” Lord knows, we all hope that is true. And there are some signs. But when people hear that it’s “much closer to influenza than SARS,” in the backs of many minds is the question, “Then why are things so horrendous in Wuhan?”

The comparison with flu is also misleading for those citizens who underestimate the seriousness of flu. “Like flu” can sound to those people like “nothing to worry about” – as if a bad flu season didn’t mean a lot of illness and all too many deaths, and sometimes considerable disruption.

number 2

Announcing the increase in the risk level to orange, PM Lee reminds people that Singapore also did that in 2009, for H1N1 swine flu. Then he adds:

So there is no need to panic. We are not locking down the city or confining everybody to stay at home.

We always hate the “no need to panic” mantra. When is there a need to panic? The real answer is never. But saying this almost signals that “if we lock down the city or confine everybody to stay at home,” there will be a need to panic!

This statement is one of what we call the “three degrees of panic” statements:

  • There’s no need to panic….
  • There’s no need to panic yet….
  • There’s no need to panic yet because….

The message that Singapore is not locking itself down as many cities in China have been locked down is a message worth conveying. It’s very easy to convey the same message without implying that your hearty resilient worried anxious attentive patriotic strong citizens are panicking or likely to panic.

The most incorrect diagnosis and the most insulting diagnosis during every outbreak is the diagnosis of panic. The misperception that people are likely to panic often exacerbates official tendencies to over-reassure, or to withhold information, or even to delay implementing scary-sounding precautions.

Obviously, PM Lee and Singapore are not guilty of delayed reporting or over-reassurance about the current situation. Our only quibbles are that he sounds over-confident that coronavirus will be like flu, and that he used the no-need-to-panic mantra.

Copyright © 2020 by Jody Lanard and Peter M. Sandman

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