“Higher – Lower” and Covid-19

Author: Manu Steens

In this article I will tell you my own opinion. It is by no means the intention to present dealing with the pandemic as a simple matter. But there are some simple principles that strike me.

In the past, “higher-lower” was a game on television. Never before had I thought that these two words could be so important in assessing the need for action in a pandemic.

Currently, the federal government makes use of the services of specialists: virologists, biostatisticians , epidemiologists, etc. They can be used at any time to draw up difficult mathematical models to estimate the pandemic and to distil difficult indicators of the evolution from them.

How could it have been assumed with higher-lower at the beginning of September how it would evolve at the end of September and the weeks after ? (The next few months remain to be seen, but our experience with the first wave tells us that this wave is not over yet, and it is going to be difficult.)

Using three qualitative, easy to understand indicators as follows:

  1. What was the situation with the number of infections in Belgium at the beginning of September with regard to the number of infections at the very beginning of the first wave? Higher! Much higher ! And what about the number of super spreaders? Also much higher in September.
  2. What was the spread of the disease in the country with regard to the early onset of the first wave in early 2020? Also much higher.
  3. How did people behave in relieving the measures in terms of elation and carelessness? – higher ! And that is normal. If you doubt that, you should see a bunch of cows roaming about after a long winter, and then released into the pasture. People who have been a long time in lock-down have the same desire to be free again. And that behavior became part of the new normal. Goodbye caution. Goodbye discipline.

Is the result surprising, then, that there will be a more severe wave after September, which can whip higher than the first wave?

And that’s not even the question I want to talk about. What I want to talk about are lessons for the near future.

Is it inconceivable that there will be another wave after this? And what should we do about it?

We will not be able to do much about the first two indicators. As for the first, we are not even going to know if all the sick have been healed, and that no one is a carrier anymore. As for the second, mutatis mutandis: we cannot say much about the spread if we are not 100% sure who is still a carrier and who is not.

That is why it is important to do something with the third indicator. This is currently done by reducing the transmissibility of the virus as much as possible. In this way they try to prevent the spread in order not to overload the hospital system, if possible until there is a vaccine, and preferably forever.

But that requires discipline, both during the approach to reverse the new wave and the period afterwards to prevent another wave. So the discipline must be higher ! And that regardless of the precise measures in a ministerial order, or in the protocols, or in the local measures.

The search for exceptions, loopholes, back doors,… to do their thing must therefore be lower !

Opportunity statements and identification and COVID-19

Author: Manu Steens

Anyone who takes himself seriously concerning risk management knows that the definition of risk according to ISO roughly amounts to a cause that gives rise to an uncertainty in the achievement of objectives. That uncertainty can have a de facto positive effect, so that the objectives are achieved and more, or have a negative effect, namely that the objectives are not achieved or worse.

A risk can then be written as a risk statement, which consists of a cause, the actual risk and the ultimate effect. This suffices as a one-to-one cause-to-effect statement to follow our reasoning, although real risk statements can give rise to many-to-one, one-to-many, or many-to-many statements.

Having a negative effect is due to threats, having a positive effect is due to opportunities.

Since a risk, despite the ISO definition, is linked by most people to threats rather than opportunities, we need to use metalanguage to focus.

Metalanguage in these are ‘templates’ in which risk statements, including opportunity statements, can be included.

This one is based on the principle of a risk statement:

  • “As a result of , may occur, which may lead to .”

And for opportunities based on SWOT, this becomes:

If we apply this to the European situation regarding Covid-19, we get, for example, statements like:

  • Through a policy culture that allows for a firm response, we can limit a new flare-up of the virus, which gives the development of a suitable virus vaccine more time and thus more chance of success.
  • If we can limit the number of human contacts at work, on public transport and in public spaces and to the extent of the realistically possible also in private life and at all kinds of events, we may be able to reduce the virus sufficiently, which gives a chance to the world of making work of economic recovery.
  • If the global expansion of human activities is intelligently restrained , allowing the pandemic risk in the future to diminish, biodiversity can stabilize, the natural balance can restore, fewer people come into contact with wild animals that are no longer dislodged from their habitat so that new pathogens are no longer transferred, transmission can decrease internationally, citizens in the future will be more forgiving and tolerant of a mistake in policy.
  • If clear communication is used, the right experts are heard, and transparency is created about the relationship between cause and effect, the most decisive policies can be discussed in open forums, providing insight into necessary and perhaps sufficient reforms to support a sustainable recovery.
  • With this premise, there may possibly be brought forward new and better institutions, with improved basic infrastructure, better regulation of key economic sectors and investment in public services that create and protect human capital and render in the long term, not in the short term, which can shape the economy and the world of the future. For example, by opting for a low-carbon basic infrastructure as a result of an open debate without group-think or tunnel vision , which enables growth for new developments, but which can also provide an answer to climate challenges.
  • By organizing flexible technology in Europe, and building strategic stocks of raw materials, it is possible to switch quickly between conventional production and the production of necessary goods in a pandemic time (e.g. personal protective equipment), thus reducing Europe’s dependence on Asia, and which also makes it possible to test such a system in collaboration with regular customers (eg hospitals, rest homes,…).

Disinformation and Covid-19

Author: Manu Steens

A friend wrote me an email. He cited a number of websites and wrote:

” I must say, I believe less and less the prevailing views from the mainstream media … ”

By the mainstream media he meant, I understand, those media that let the authorities speak. He also provided a video message from ‘ the-iceberg ‘ and a Dutch version of it , as an alternative . These provide information that is contrary to the message of, yes, our governments.

In my view a case of misinformation.

But how do you recognize misinformation when people with a high IQ fall for it time and time again?

There are some basic rules that you can keep in mind when it comes to communication. Some should be used more in all communication, others should not:

  1. Simple words , not too much expert language.
  2. Support the spoken and / or written text with visual material.
  3. Use recognizable statements that could have been heard elsewhere ( familiarity )
  4. Use ” fluency ” : how easily something can be processed by the brain, eg text in an easy to read font .
  5. References to experts, but not to their work, which is difficult to trace.
  6. Use people’s gullibility to really get to know it all. (eg by an easy and associative name like ‘ the iceberg ‘: people become curious about what lies beneath the surface).
  7. Using figures without framing it, or material and images that are even irrelevant.
  8. Repetition of the desired statement.
  9. Use a good speaking rhythm to make it interesting. (The infotainment effect)

The video messages can be seen on:

https://the-iceberg.net/  (English)

https://www.youtube.com/watch?v=xrri7-uvuqI&feature=em-uploademail (Dutch version)

When I analyze the Dutch version, I have the following reservations:

They remain very vague in terms of “the independent scientists”: I don’t know any myself. Each of the experts is paid by an interested party. So I don’t think there are any of them “independent”. Every top research is either sponsored by a government (often via universities) or by a (in this case mostly pharmaceutical) company.

So far the independence of the scientists they claim to cite. On the English website there is a whole list of names with impressive titles . No reference whatsoever to their relevant work on which they claim to be relying.

Furthermore, statistics are shown of the number of deaths per 1 000 000 inhabitants. This is not scientific, because every country counts differently. Besides, the correlation with lock -down, which they claim to show that would be zero, cannot be demonstrated that way.

The number of corona deaths counted according to WHO is for Belgium 10x that of the flu deaths counted according to WHO standards. A factor of 10: that is an order of magnitude larger, and it is not over yet. So it is not comparable to a ‘simple flu’ . That was one of the first misconceptions that was common in Europe, and of which no one knows where it originated.

The medication which “has been proven to work” according to the video, has been shown not to work. Yet this is maintained, as if someone has to get rid of a large stock. The fact that this has the chance to further become its own self-fulfilling prophecy is due to the fact that for a long time it was incorrectly predicted to be the solution. After all, repetition makes it recognizable.

This video scores very high in terms of infotainment content, but it is the wrong info. And in addition, in infotainment in general, they often make fun of science. For example, it is incorrectly claimed in the video that the lockdown would have been imposed only after the flattened peak, which they say is a “normal seasonal epidemic event”.

 

Support for provincial measures during Covid-19 – a case

Author: Manu Steens

Corona times are special times. Nobody can deny that now, except for possible total deniers. And in English they say: “Desperate times call for desperate measures ” (Said to be words of Hippocrates). When this is said, it means that actions that seem extreme may (under normal circumstances) be appropriate in times of adversity and calamity.

The real problem is in the word “may”. After all, even in times of calamity, support is needed. And how do we measure support? I previously wrote about a tool that I created to make a visual assessment of the support for actions by governments, namely at the GDPR and at Brexit .

See also: http://www.emannuel.eu/en/artikels/risicomanagement-strikt-genomen-succesfactoren-van-gedragenheid/

However, these were only two cases, so now I am trying out the (now adapted) tool on the measures for the population of the province of Antwerp . Actually it is wrong from the beginning what I am doing, because for a balanced answer I would have to conduct a survey among a relevant number of citizens . But I avoid this error by stating that this is my opinion, a personal assessment of the situation. Based on indicators that I created based on other cases. That presumption goes as follows:

Legitimacy: The province of Antwerp makes use of the legislation and works together with jurists from various government agencies. The legitimacy of a number of actions is disputed, but the complaints do not currently seem to be of the heavy caliber and appear to be rebuttable. Score: +

Cohesion of the target group by proximity of the issue to the target group: The actions are strongly felt by the population. People ask themselves whether that ban on fun shopping really should be, because shopping should still be fun … In the street scene, I hear various sighs. But most seem to think negative when someone has no intention of wearing his on the bus, but there is no one reprimanded by fellow citizens. When does the wrong thing, it remains a matter for law enforcement. Score: o

Effectiveness : With the latest results viewed day by day, it seems to be going in the right direction in Antwerp hospitals. The fact that the measures are largely the same throughout the province also seems to prevent population shifts. As well as preventing the potential infections that go with it. Score: a cautious + subject to the trend continuing.

Targeting: There are of course entirely – deniers even the existence of covid-19 deny yourself. There are also machos who do not take the advice of the elbow strike seriously, and who absolutely want to shake hands. It turns out that quite a lot of Bart De Wever’s also eat in the restaurants and taverns. However, the majority of the population takes the measures seriously. Measures such as testing and tracing will be fine-tuned further. But is there more to be explored than enforcing the rules, or are there also alternative options? Score: o.

Efficiency: The PCC Antwerp (Provincial Crisis Center) runs on very flexible people, and the population has also shown itself to be largely flexible. For example, there was an emotional urge among citizens to want to wear a mask, despite original dissuasion. Now a mask is required all over the province, and citizens have agreed. Score: +

Perseverance: The PCC Antwerp team ‘goes for it’. The members contribute topics themselves and give their opinion freely. This criterion is more difficult to assess for citizens. But with the slightest weakening of the measures, a whole lot of freedom was taken. As a result, by wanting to be too social as one of the factors, it could be that this flare-up was increased. Score: –

Leadership: People should look up to experts. And there are indeed many (types of) experts involved. Not only masters in their field, but top people from universities. Some of them have been burned in the eyes of a number of the civilians, but the same citizens seem to be looking for whom they do want to trust as experts. Furthermore, the governor himself is being looked at: we have to wait and see how she will come out of this battle. Score: ++

Internalized: There are things that have been shown to work in the past. However, is the citizen motivated to comply with the measures, or are loopholes to be found quickly in the new measures ? That is still unclear at the moment. That is why I leave this score blank: blank.

Reputation: The question here is whether the citizens has a good or bad feeling in this situation in all its aspects and whether they are on an individual level involved. That also seems unclear to me at the moment. That is why I leave this score blank.

 

In summary , the score in the tool will look like this:

Conclusion: I feel that the situation is largely supported by the population of Antwerp, although much may depend on the results in the coming weeks. The situation should be reviewed anyway after the period of 4 weeks that has been set, or after serious interventions that would occur.

The need for civic engagement and clarity at Covid-19

Author: Manu Steens

Two articles on the website of the VRT appealed to me. They block the seriousness of the situation:

– Microbiologist Herman Goossens: “Insufficient Security Council measures, we are heading for disaster if we don’t act quickly”.

– Antwerp governor pleads: “Please limit your social contact to your family or choose two regular friends”.

The governor also said in the interview, “Be tougher on yourself than what’s allowed.”

This is not simple: it requires engagement and participation from the people.

Then, of course, the question arises: “What is engagement?”. And what are decisive factors at the government that demands engagement from the citizen?

According to John C. Besley (in Chapter22: ‘Public Engagement in Risk-Related Decision Making’ in ‘The SAGE Handbook of Risk Communication’), the fact that public engagement can involve a huge variety of activities is a stumbling block to transform available information into knowledge.

According to Creighton, public engagement is “the process by which public concerns, needs and values are incorporated into governmental and corporate decision making. It is two-way communication and interaction, with the overall goal of better decisions that are supported by the public”.

There may also be mechanisms whereby citizens have some degree of control over decisions. This then is a continuum that goes from agreeing with what the government wants up to becoming citizens who have a meaningful voice, and are recognized for this by the government.

An important parameter, according to the literature, to get participation is the confidence citizens have in the decision makers, as well as the more they know about the situation in which they have to participate. For the latter, a pervasive communication with press conferences and much more than that is a permanent necessity.

In our country at the moment, it seems that it is mainly the citizens agreement with what is decided that takes place. There are very few citizens initiatives. This seems to indicate that the citizens look to the government with the question “tell us”. But also with the question “save us, because we do not know the solution ourselves”. Decisions can therefore be tough, and as long as they are made authentically and offer the solution in the long term (if necessary), the citizen will continue to agree.

The solutions must also be clear.

This implementation of measures always requires clarity. How do you do this? Goal: defeat the virus. Operational measures are therefore necessary. How do you clearly describe the goals and actions operationally and why do you want to do that? In his book “Your Best Year Ever” Hyatt writes about a well-known method: SMARTER. How can we apply that to the actions we want to roll out?

SMARTER stands for Specific, Measurable, Actionable, Risky, Time-keyed, Exciting, Relevant.

The idea is that we first have to write down the goals. In this crisis, there is only one goal. To defeat the disease. But that in itself is not SMARTER.

This could be a proposal:

Specific: get the number of infections to zero to prevent a third wave. We do this by complying with the six golden measures and limiting our social contacts to our own family and otherwise to a maximum of two friends a week. The intention is to get the R-value back below “1”. However, all this is not specific enough. Therefore, to make things operational and specific, there are the MB and the FAQ. Unfortunately, in the past it has already been shown that these will always be incomplete, because one cannot summarize the lives of 11 million people on about 40 pages of paper. But the rules are there, both in the letter and in the spirit, and people are asked to take their own responsibility with common sense when their situation is not literally described.

Measurable: through testing and contact tracing, no new infections are detected. This is a criterion that clearly states when the downward tail of the new infections reaches zero. This is only possible if indeed we get the R-value under “1”. This is also measurable, through the numbers of for example hospitals that are passed on to the government. But measurable also means that the police must be able to check compliance. Such as leaving your details when visiting a cafe or restaurant. An example of what is very measurable here is a name tag.

Actionable: I translate this here as feasible and useful: it’s about what we do. Here the FAQs are useful again. The six golden rules are not difficult to follow. But the question was asked whether it would not be better to limit ourselves to much smaller bubbles. That in itself is not actionable: it is not useful, for example, to measure your social contacts. Better is “Find a maximum of 2 friends per week instead of 15”. This is useful because it is based on a useful verb: search. Not more generic, often unclear statements with verbs like “are” or “have”. So choice of verb is very important in communication.

Risky. Ugh. Normally it says something like “Reasonable”. But using the word Reasonable makes that we often do not challenge ourselves enough to set the bar at a high enough level. Reasonableness encourages you to make it easy with quickly achievable objectives. A bubble with 15 friends is easily achievable. It seems reasonable. But it’s not. It’s certainly not a challenge, but more than that, it’s a number where people stop counting. 15 seems infinite, so we’ll do whatever. And before you know it, you’ve got a lot more contacts than 15 and the infections are rising. Meeting just two good friends is much more challenging. You have to make choices, decide who you prefer and why. It’s more confrontational, the bar is much higher to realize it.

Time-keyed: the measure of the bubble is the clearest example here. Two friends, who are allowed to change per week. But it doesn’t always have to be time intervals. They can also be frequencies. This concept also divides the goals into “achievement goals” and “habit goals”. An example of an achievement goal is that you buy name tags to leave behind in a café that you visited to be available for testing and tracing. An example of a habit goal is that you always put on a mask when travelling by train. The goals should become a habit as much as possible. Then for many people it goes by itself.

Exciting: “What in God’s name is exciting about such goals and measures?” Actually, internal motivation is meant here. It is an important characteristic that people are intrinsically motivated to make them achieve their goals. Good health is an example of this. I assume that everyone loves themselves enough to find their own health important enough to be motivated. So contrary to what the word suggests, it is the feeling of concern that is important here. Worrying about your neighbor and yourself. Let that concern inspire you to take good care of yourself, your family, and your friends and neighbors.

Relevant: this is here with regard to the crisis situation (including other people) and also your personal health interests. This criteria is the bottom line. Effective goals and measures are relevant. It has everything to do with giving direction. This gives you the opportunity to check your gut feeling before committing to the measures. It is here that everything can go wrong if we are not careful. There are four criteria for measures you can check here: is the measure proportional, prudent, efficient, and effective? Note: what is “proportional” doesn’t necessarily have to be easy, it’s more in the sense of “necessary”. This criterion of relevance gives the necessary pressure in a crisis like this: the pressure can be social, financial, professional, … whatever. This helps to explain why challenging a crisis like this is no easy task. It is therefore essential not to oppose each other. Be stricter on yourself than what is asked for.

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