Risk communication is critical to emergency management. Following the message-centered approach or risk communication, the whole communication process for public health emergency is suggested to integrate the accessibility and openness of risk information, the timing and frequency of communication, and the strategies dealing with uncertainties. Based on these principles a simplified Government–Expert–Public risk communication model can illustrate a collaborative network for effective risk communication.
Accessibility and openness enhance the public’s perception that they are fully informed about risk and that they are partners in sharing the risk. Risk communication must consist of an interactive process where all parties are given access to multiple messages representing all relevant views. Identifying the points of convergence serves as a means for making sense of these interacting arguments, which leads to forming a consensus on the uncertain issue. Risk communication strategies require information sharing and establishing networks of working relationships among individuals, groups, and agencies. Establishing these relationships necessitates the accessibility and openness of information, which is the premise of collective action.
Risk communication should begin as soon as a risk has been identified and should continue as new information becomes available . For an unknown disease, communication should avoid using certain conclusions or expressions when clinical and epidemiological investigations are ongoing. Once an updated investigation is available, the information ought to be disclosed immediately. Any delay will likely lead to unexpected consequences. The shocking nature of risk can sometimes paralyze an organization, and even a holistic governance network. Therefore, inadequate preparedness, such as the shortage of goods, loose management in communities, and disordered collaboration amongst agencies. Effective risk communicators should make immediate contact with the public about risk and maintain regular information to the public concerning risk levels and tendency throughout an incident.
Risk communication often contains uncertainty information associated with technologies, behaviors, medical procedures, etc. To be effective, such messages need to incorporate ideas, images, and logic that will promote comprehension among the lay public. Due to the knowledge gap, experts and laypeople tend to perceive risks in different ways and tend to use different terms to discuss them. Communicating uncertainty effectively requires assessing the different levels of perception among different audiences, and utilizing an evidence-based approach to convey uncertainty. In risk communication, particularly in public health, using equivocal expressions is most effective when they avoid overly certain predictions. However, equivocal expressions are subjective, because of the heterogeneity of different people’s understandings. Thus, evidence-based communication aims to translate the verbal probability, such as “possible”, “probably”, and “maybe”, into numerical probability, which can convey the degree of uncertainty in an unambiguous way. Risk communication is not only designed to deliver the knowledge, but also to change the public’s attitude in order to make the public accept the general arrangement of outbreak management.
In this model, the three components of communicative interaction are government–public, government–expert, and expert–public. The government is the core decision maker in the risk governance process, and all of the government’s behaviors will have a profound impact on the effectiveness of governance.
For government–public communication, which is a typical external communication, the government’s responsibility is to convey adequate and accurate information to the public, which means that information disclosure is accessible and open. Government officials are often frustrated by what they perceive to be inaccurate public perceptions of risk and unrealistic demands by the public for risk reduction. In addition, this communication results in a response from the receiver, which can then be evaluated against the desired response. The public’s feedback enables the government to adjust its emphasis of information delivery and provide information in relation to the public’s own interests and values—communication can be most effective when it reflects an understanding of what the public wants to know. The existing literature indicates that a challenge identified in implementing openness in risk communication is that it is difficult to decide what to present and what not to present. For instance, complete transparency causes possibly unjustified fear among members of the public. As we mentioned above, the initial intention behind the Wuhan government concealing information was based on the consideration of maintaining social stability. Therefore, transparent risk communication is just as necessary, but is simultaneously difficult to achieve in practice due to many complex decision situations. Information disclosure is a technical measure that needs to balance different factors such as public risk tolerance and possible subsequent outcomes.
Government–expert communication is a primary element of risk assessment and decision making, which can be seen as internal communication. Risk is related to professional knowledge and technology. The very essence of responsible and rational action is to make viable and morally justified decisions in the face of uncertainty based on a range of expert judgments and assessments. At the stage of risk assessment, the consensus of experts’ judgments about the risk will ensure to assign an accurate probability for each possible consequence, to initiate each action, and to establish the rational decision as that which minimizes the negative outcomes and maximizes the expected benefits. Governments ought to empower experts to work on comprehensive and detailed research on the uncertainty of a risk issue rather than restrict experts’ voices out of other considerations, including politics or self-interest. The academic community should fully focus on the scientific analysis of the risk and sharing findings, data, and materials. In modern society, risk is an interdisciplinary issue. For public health risk, specialists in life and social sciences, biomedicine, and public health must seek better answers from multiple disciplines. Consensus on evidence-based analysis is the foundation of decision making. Uncertainty due to disagreement (experts, opinions, language) must be analyzed and disclosed, which aims to avoid misleading by ambiguous and diverse information.
Expert–public communication is dedicated to bridging the gap between expert and public views on public health issues through strategic communication. It represents external communication. A great challenge of risk communication is not only to convey knowledge, but also to find ways to convey comprehensive information that reflects uncertainty and empowers the public to make fact-based decisions about health. The public always fails to understand the complex professional knowledge about the risk, so experts’ responsibility is to translate the professional knowledge into simple and explicit content which can be easily understood. In Wuhan’s case, a doctor named Zhang Wenhong said frankly, “You are unable to understand what I am saying definitely, because we read different books. You know every word in my sentence, but you do not know what I mean”. Then, Dr. Zhang used quite straightforward language to explain how Shanghai is coping with the outbreak by integrating resources. His explanation received the public’s praise and support. The public need to express their appeals of uncovering uncertainty to experts when they encounter their unknown knowledge about the risk rather than seeking some unproven information or even rumors.
Risk communication responsibility should be a balance between being neither too centralized nor too decentralized. Different actors must fulfill their responsibility according to their roles and keep the communication network running. Accordingly, this model underscores the importance of partnerships in risk communication. Within the communication network, the government should and must play a leading role in communicating risk, and the proposed model offers a guideline to achieve this goal. Based on Wuhan’s case, the government will continue to face challenges as uncertain and unexpected outcomes occur. Therefore, the government must collaborate with other actors to share information in a timely and effective manner, which enables every actor to adopt preparedness in advance for tackling any unexpected incident in the future.