UK bride who suffered food poisoning on honeymoon now needs a feeding tube to eat

Adam Barnett and Katie Pearson report in the Mirror that a woman who fell ill with food poisoning on her honeymoon has developed a rare condition that “paralysed” her stomach so she can no longer digest food.

Jessica Heather, 30, from Wirral in Merseyside, who is studying design and innovation, might need a feeding tube for the rest of her life.

She caught the bug while on her honeymoon in Turkey with her new husband Wayne, 33, in July 2014.

The couple thought it was food poisoning.

She said: “I knew something was wrong when Wayne bounced back and I didn’t.

“I was seriously fatigued, forgetting people’s names and even how to talk.”

Ms Heather was hospitalised with severe stomach pains and bowel issues when she returned to the UKFinally last December she was diagnosed with Bechet’s Syndrome – a rare condition that results in the inflammation of blood vessels and tissue.

“It took six years until I was finally diagnosed”, she said.

“I still don’t know the cause, but doctors think it may have been something bacterial I picked up from my honeymoon.”

The Bechet’s Syndrome had attacked her stomach and left her with a gastroparesis – a condition that ‘paralyses’ the stomach and leaves it unable to digest food properly.

She said: “The condition had damaged a nerve connecting my brain and stomach so it couldn’t send signals properly.

“Food wasn’t being digested properly and just sitting in my stomach – causing me to be sick.”

Ms Heather is now unable to digest most fruits and vegetables and survives on a strict low-fibre diet.

Risk communication isn’t that hard

I don’t know why, but whenever me and my team gets cited once, twice, three times a day by another peer-reviewed publication, I get turned on.
Most of that stuff we wrote 20 years ago, but it still has relevance.
So here’s one that cited us and I wish they hadn’t.

Whoever wrote this abstract needs some communication training.
This report assesses peer‐reviewed and grey literature (WTF is grey literature?) on risk communication concepts and practices, as requested by the European Commission to support the implementation of a ‘General Plan for Risk Communication’, i.e. an integrated framework for EU food safety risk assessors and risk managers at Union and national level, as required by the revised EU General Food Law Regulation.
We conducted a scoping review of social research studies and official reports in relation to risk communication in the following areas: understanding and awareness of risk analysis roles and tasks, reducing misunderstanding of the different meaning of the terms ‘hazard’ and ‘risk’, tackling misinformation and disinformation, enhancing confidence in EU food safety, taking account of risk perceptions, key factors in trade‐offs about risks, audience segmentation and tools, channels and mechanisms for coordinated risk communications. We structured our findings as follows: i) definitions of key concepts, ii) audience analysis and information requirements, iii) risk profiling, models and mechanisms, iv) contributions to communication strategies.
We make several recommendations for consideration by the Commission, both in terms of actions to support the design and implementation of the general plan, and research needs that we consider crucial to further inform appropriate risk communication in the EU. EFSA carried out a targeted consultation of experts and a public consultation open to all interested parties including the general public, in preparing and finalising this report.

Technical assistance in the field of risk communication, April 29 2021
European Food Safety Authority
Laura Maxim, Mario Mazzocchi, Stephan Van den Broucke, Fabiana Zollo, Tobin Robinson, Claire Rogers, Domagoj Vrbos, Giorgia Zamariola, and Anthony Smith
doi: 10.2903/j.efsa.2021.6574
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083185/

From the duh files: Researchers say zero risk not possible in food safety

There is no such thing as zero risk when it comes to food safety, according to researchers.

Joe Whitworth of Food Safety News, writes researchers Marcel Zwietering, Alberto Garre, Martin Wiedmann and Robert Buchanan presented the study, published in Current Opinion in Food Science, at IAFP Europe.

They defined residual risk as what remains even after a fully compliant food safety system has been implemented. Every product has a residual risk but severity varies because it depends on a variety of factors such as the perspective or consequences.

Researchers gave the example of the risk of Salmonella in chocolate bars assuming contamination of one Salmonella enterica cell per 10,000 of 25,000 bars of 25-grams, and that the company produces 100,000 bars a day. Testing is limited to five samples per day, each sampling unit is a whole bar, and probability of a false negative or false positive is zero.

“The probability of detecting Salmonella in each sampling unit equals 0.01 percent, and the probability of detecting it in the product in a given day is 0.05 percent. In other words, we expect a single positive every 5.5 years. On the basis of this result, it could seem reasonable to conclude that the risk of salmonellosis is insignificant.

“However, a single cell of Salmonella enterica has a probability of causing illness that has been estimated to be 1 case per 400. Therefore, if we consider that 10 bars of the 100,000 daily production contain a single Salmonella enterica cell, the expected number of yearly cases of salmonellosis is 9.125, a value that is certainly not insignificant. Although sampling will rarely show a positive, there is clearly a residual risk.”

Bill Leiss and I wrote a book on this topic, Mad Cows and Mother’s Milk, published in 1997, explicitly stating there is no such thing as zero risk: it’s about maximizing the benefits and minimizing the risks in food safety stuff.

FDA speaks: E. coli O157 in leafy greens

Between August and December 2020, the U.S. Food and Drug Administration (FDA) and multiple state and federal partners were involved in an outbreak investigation related to E. coli O157:H7 illnesses and the consumption of leafy greens. The outbreak, which caused 40 reported domestic illnesses, was linked via whole genome sequencing (WGS) and geography to outbreaks traced back to the California growing region associated with the consumption of leafy greens in 2019 and 2018. FDA, alongside state and federal partners, investigated the outbreak to identify potential contributing factors that may have led to leafy green contamination with E. coli O157:H7. The E. coli O157:H7 outbreak strain was identified in a cattle feces composite sample taken alongside a road approximately 1.3 miles upslope from a produce farm with multiple fields tied to the outbreaks by the traceback investigations. In addition, several potential contributing factors to the 2020 leafy greens outbreak were identified.

Isolates within this cluster of illnesses are part of a reoccurring strain of concern and are associated with outbreaks that have occurred in leafy greens each fall since 2017. The two most recent outbreaks associated with this strain were an outbreak in 2018 (linked to romaine lettuce from the Santa Maria growing region of California) and an outbreak in 2019 (linked to romaine lettuce from the Salinas growing region of California). Clinical isolates from cases in this 2020 outbreak appear more closely related to those from the 2019 outbreak than the 2018 outbreak. In addition, several specific food and environmental isolates that appear to be highly related to this 2020 outbreak include a fecal-soil composite sample collected by FDA in February 2020 from the Salinas growing region and two leafy green samples collected in 2019 by state partners as a part of the 2019 investigation that traced back to the Salinas growing region.

As part of this investigation, tracebacks of leafy greens consumed by ten ill individuals from eleven points of service were conducted. Although that traceback investigation was based on a relatively small number of the total cases, it was based on those cases which presented the strongest evidence via purchase card information, invoices, bills of lading, and electronic data. The traceback investigation identified the Salinas growing region of California as a geographical region of interest.

In light of this most recent finding, combined with previous outbreak investigation findings in the region, FDA has identified key trends regarding the issues of a reoccurring strain, a reoccurring region, and reoccurring issues around adjacent and nearby land use of primary importance in understanding the contamination of leafy greens by E. coli O157:H7 that occurred in 2020 and previous years.

FDA also recognizes the interconnection between people, animals, plants, and their shared environment when it comes to public health outcomes. As such, we strongly encourage collaboration among various groups in the broader agricultural community (i.e. livestock owners; leafy greens growers, state and federal government agencies, and academia) to address this issue. With this collaboration, the agricultural community, alongside academic and government partners, can work to identify and implement measures to prevent contamination of leafy greens. FDA recommends that these parties participate in efforts to understand and address the challenge of successful coexistence of various types of agricultural industries to ensure food safety and protect consumers against foodborne illnesses.

Frank Yiannas, Deputy Commissioner for Food Policy and Response – Food and Drug Administration said in a release that as part of our ongoing efforts to combat foodborne illness, today the U.S. Food and Drug Administration published a report on the investigation into the Fall 2020 outbreak of Shiga Toxin-Producing E. coli (STEC) O157:H7 illnesses linked to the consumption of leafy greens grown in the California Central Coast. The report describes findings from the investigation, as well as trends that are key to understanding leafy green outbreaks that are linked to the California Central Coast growing region, specifically encompassing the Salinas Valley and Santa Maria growing areas every fall since 2017.

We released our preliminary findings earlier this year that noted this investigation found the outbreak strain in a sample of cattle feces collected on a roadside about a mile upslope from a produce farm. This finding drew our attention once again to the role that cattle grazing on agricultural lands near leafy greens fields could have on increasing the risk of produce contamination, where contamination could be spread by water, wind or other means. In fact, the findings of foodborne illness outbreak investigations since 2013 suggest that a likely contributing factor for contamination of leafy greens has been the proximity of cattle. Cattle have been repeatedly demonstrated to be a persistent source of pathogenic E. coli, including E. coli O157:H7.

Considering this, we recommend that all growers be aware of and consider adjacent land use practices, especially as it relates to the presence of livestock, and the interface between farmland, rangeland and other agricultural areas, and conduct appropriate risk assessments and implement risk mitigation strategies, where appropriate. Increasing awareness around adjacent land use is one of the specific goals of the Leafy Greens Action Plan we released last March, which we’re also announcing is being updated today to include new activities for 2021.

During our analysis of outbreaks that have occurred each fall since 2017, we have determined there are three key trends in the contamination of leafy greens by E. coli O157:H7 in recent years: a reoccurring strain, reoccurring region and reoccurring issues with activities on adjacent land. The 2020 E. coli O157:H7 outbreak associated with leafy greens represents the latest in a repeated series of outbreaks associated with leafy greens that originated in the Central Coast of California (encompassing Salinas Valley and Santa Maria) growing region (that’s me and Frank and the woman who wants to divorce me in our Kansas kitchen, 10 years ago)

In the investigation, the FDA recommends that growers of leafy greens in the California Central Coast Growing Region consider this reoccurring E. coli strain a reasonably foreseeable hazard, and specifically of concern in the South Monterey County area of the Salinas Valley. It is important to note that farms covered by the Food Safety Modernization Act (FSMA) Produce Safety Rule are required to implement science and risk-based preventive measures in the rule, which includes practices that prevent the introduction of known or reasonably foreseeable hazards into or onto produce.

The FDA also recommends that the agricultural community in the California Central Coast growing region work to identify where this reoccurring strain of pathogenic E. coli is persisting and the likely routes of leafy green contamination with STEC. Specifically, we have outlined specific recommendations in our investigation report for growers in the California Central Coast leafy greens region. Those recommendations include participation in the California Longitudinal Study and the California Agricultural Neighbors workgroup. When pathogens are identified through microbiological surveys, pre-harvest or post-harvest testing, we recommend growers implement industry-led root cause analyses to determine how the contamination likely occurred and then implement appropriate prevention and verification measures.

In response, Tim York wrote in The Packer that on April 16 the California LGMA Board took decisive action to endorse pre-harvest testing guidance. The guidance recommends pre-harvest testing specifically when leafy greens are being farmed in proximity to animal operations. 

It’s the intention of the board to include pre-harvest testing as part of the LGMA audit checklist so the government can verify that all LGMA members are in compliance. 

This is the first time an entire commodity group will be required to conduct pre-harvest testing.

This is a big deal, but a necessary response to the recent U.S. Food and Drug Administration report on outbreaks associated with lettuce in 2020.  The findings and regulatory language used by FDA in this report were nothing short of a warning shot that calls on our industry to do more to stop outbreaks. 

And so, we must do more.

Updating LGMA’s required food safety practices is an involved process that seeks input from scientists, food safety experts and the public. No other entity is capable of making such widespread change as quickly as we can.<

Some weeks ago, in the first piece I wrote for The Packer as CEO of the California LGMA, I stressed the need for collaboration with the retail and foodservice buying community, noting that we must lean on each other to make needed improvements together. And now, I am asking for your help.

Updating LGMA’s required food safety practices is an involved process that seeks input from scientists, food safety experts and the public. No other entity is capable of making such widespread change as quickly as we can.

Produce on-farm food safety

From planting to distribution, fresh produce can be contaminated by humans, water, animals, soil, equipment, and the environment. Produce growers play an essential role in managing and minimizing on-farm food safety risks. Because of an increase in public awareness about produce safety, farmer food safety education has become an important research and extension topic. This review article summarizes findings by researchers who have evaluated produce growers’ food safety knowledge and attitudes and the effectiveness of food safety educational programs for growers.

A search of on-line databases, journal archives, conference abstracts, and reference lists of relevant studies was conducted to locate peer-reviewed articles on produce growers’ food safety knowledge and behavioral changes. Study selection criteria included publications in English, publication between 2000 and 2019, and a focus on one of six topics: handling of agricultural water, soil amendments, domesticated animal and wildlife management, worker health and hygiene, food safety plans and record-keeping, and cleaning and sanitation. Forty-three published articles were included in the analysis. Handling of agricultural water and soil amendments were the two topics least understood by growers, whereas worker health and hygiene were the best understood. Food safety educational interventions were evaluated in 13 studies, and most studies used in-person workshops and self-reported pre- and postintervention knowledge assessments. Most reported increased knowledge, some reported improved attitudes and perceived behavioral control, and only four reported behavioral changes. Because of small sample sizes, many studies did not include a statistical analysis of the differences between pre- and postintervention survey results. This review article provides insights and guidance for the development of food safety education for produce growers.

Produce growers’ on-farm food safety education: A review

Journal of Food Protection

HAN CHEN ; AMANDA J. KINCHLA ; NICOLE RICHARD ; ANGELA SHAW ; YAOHUA FENG

https://doi.org/10.4315/JFP-20-320

https://meridian.allenpress.com/jfp/article/84/4/704/449180/Produce-Growers-On-Farm-Food-Safety-Education-A

Three die of salmonella poisoning linked to herbal remedy in Denmark

The BBC reports 19 people have been treated in hospital, according to Denmark’s SSI health agency. Those involved in the outbreak are aged between two and 92.

All those affected ate Husk brand psyllium husk capsules from batches recalled by manufacturer Orkla Care.

Authorities found traces of salmonella in the products at patients’ homes.

The herbal products are generally used as a laxative. Luise Müller of Denmark’s Statens Serum Institut said it was the first time the agency had found a herbal medicine to be the cause of a salmonella outbreak.

It is not clear which ingredient could have caused the poisoning.

Good governance for food safety management

If there’s one food, safety types will not eat, it’s raw sprouts. Alfalfa, mung bean, pea and clover, they tend to be the same microbiological shithole.

Costco and Walmart stopped selling them five years ago in the U.S.

It’s impossible to get a sandwich or salad in Australia without sprouts.

I’ve written chefs who should not be serving raw sprouts to immunocomprised people in hospitals.

They poo-pooed my concerns.

My South Australian colleague, Andrew Thomson, is the company director for Think ST Solutions, a food consultancy offering practical solutions to both management and staff in hospitals, aged-care facilities, restaurants, hotels and the food industry.

Thomson writes in his latest column for Hospital Health that it’s time for the health- and aged-care sectors to move beyond meeting minimum compliance requirements and strive for business excellence in food safety management systems.

Health- and aged-care organisations face challenges and high expectations from an array of stakeholders, regulatory and accreditation agencies, and consumers. The area of food safety is no exception. Despite this, many organisations are achieving minimum regulatory compliance and failing to recognise related risks until after a serious episode occurs.

It is essential that board directors of health- and aged-care organisations, or those about to take on these roles, understand their role and responsibilities. It is important to be aware of food laws and other regulatory requirements, and ensure that organisations abide by them.

As far back as 1997, Winsome McCaughey AO, the former chief executive of the Australia New Zealand Food Authority, outlined the broad policy framework for food regulatory reform in Australia. The reforms promoted a risk-based approach to food safety management, which is consistent with international guidelines on risk analysis. Central to this approach was the introduction of national food safety standards.

The national food regulator, Food Standards Australia New Zealand, has developed standards that require food safety programs to be implemented in high-risk sectors, such as those providing food services to vulnerable persons. Food businesses providing potentially hazardous food to vulnerable persons — including hospital patients, aged-care residents and children in childcare centres — are captured by these requirements, in addition to businesses that prepare and deliver meals to vulnerable people in the home.

Health- and aged-care organisations need to ensure that risks to food safety management within their business are properly identified, reported and controlled.

The key action points for boards of directors to embrace are:

Understand and accept their role and responsibility in food safety leadership.

Understand and accept, at an individual board member level, the accountability for the role.

Understand the organisation’s obligations under various (food) legislation.

Create clearly defined policies on accountabilities, risk and reporting.

Consider the food safety implications of board decisions.

Oversee management actions in food safety matters.
The board should also agree on how to incorporate food safety management into existing governance structures; how to set objectives and monitor performance of the business and food-related risks; and the appointment of a board member as its food safety ‘champion’ — a nominated food safety director who will take the lead on ensuring that the board’s food safety management responsibilities are properly discharged.

The governance of an organisation involves the establishment of a framework of values, processes and practices designed to regulate, monitor and provide effective reporting on organisational performance. Through this framework, boards and directors exercise their governing authority and make decisions to achieve the organisation’s purpose and goals. Directors ensure the organisation operates effectively and ethically, and complies with all laws and regulations.

Food safety governance is as important as any other aspect of governance. It is also a fundamental part of an organisation’s risk management strategy, which is a key responsibility of a board of directors. Both the board and its management team have a duty to exercise due diligence to ensure that the organisation complies with its food safety duties and obligations. Failure to effectively manage food safety risk has both human and business costs — this includes damaged reputations and potential prosecution.

It is important to distinguish between governance and management practices. Directors should focus on governance-related issues — determining the organisation’s purpose, developing an effective governance culture, holding management to account and ensuring effective performance and compliance. Directors work with management to develop strategy and business plans which are then implemented by management.

There is no ‘one size fits all’ solution for establishing effective governance for food safety management, as the structures and levels of engagement vary with the size and complexity of the organisations involved. There are a number of basic questions that a board of directors can ask itself to assist in creating the right business culture:

How does the board assure itself that the food safety management system has been fully implemented across the organisation?

How does the board assure itself that the organisation is demonstrating its commitment to food safety?

How does the board verify that the organisation’s food safety strategic and operational risks have been adequately identified and assessed, with appropriate mitigation strategies implemented?

What relevant information is the board receiving on food safety management? Is this reporting sufficient?

What processes are in place to inform board members of the results (and actions taken) from internal and external audits and comprehensive senior management reviews to ensure the food safety management system is fit for purpose?

How does the board satisfy itself that the organisation has food-handling employees and managers that are competent and adequately trained in their food safety responsibilities and accountabilities?

Does the organisation have sufficient resources (people, equipment, systems and budget) for managing its food safety management systems?

What approach does the board use to compare the performance of the food safety management system with comparable organisations? How does it monitor and rate its organisation’s performance?
In regards to competency and adequate food safety training, shrinking training budgets and providing employees with traditional training approaches to basic compliance training is one area for urgent change if an organisation is to flourish.

The decades-long and less desirable training practice used by many organisations relies on herding as many employees as possible to undertake (any form of) training and then show the regulator and/or accreditation assessors the training records. This approach fails on several fronts: it does not provide employees with the skills they urgently need for doing their job now and in the future; lacks the required processes when employees learn new skills and behaviours; and does not address developing the best employees for future roles. Questions relating to employee learning strategies, skills development, performance and systems improvement, and measuring training success are largely overlooked by senior leaders and the regulator.

RMIT Online and Deloitte Access Economics recently released Ready, set, upskill: Effective training for the jobs of tomorrow. This report provides fresh insights into post-COVID skill needs; how prepared Australians feel for a changing workplace; and where employers should invest in training to prepare for what’s ahead.

Modern approaches to learning in the workplace necessitate a model of continuous learning and supporting employee learning — it moves beyond designing and delivering one-off training programs.

A comprehensive table of sprout-related outbreaks can be found here.

Public health inspectors in Saudi Arabia

Background: Every year about 600 million –—almost 1 in 10 people in the world –—fall ill after eating unsafe food, and more than 400,000 people die. Public Health Inspectors (PHIs) perform important roles and have numerous responsibilities in efficiently protecting public health from foodborne illnesses (FBIs). Some of these roles and responsibilities include undertaking food safety assessments, enforcing local food safety legislation, and providing support to food establishments (i.e., restaurants) regarding the minimization of food safety risks. The processes of qualifying and training PHIs, and ensuring timely addressing of their professional needs are essential for the successful and safe development of the food industry in any country. At the same time, there is a significant knowledge gap in the food safety area in the Gulf Cooperation Council (GCC) countries, including Saudi Arabia, which is related to the lack of a detailed understanding of the major issues preventing, or interfering with, the implementation and improvement of a food safety inspection approach.

Purpose: There are two key approaches towards food safety inspection at the food establishments across the globe —the traditional approach and the risk-based (modern) approach. The traditional approach typically focuses on reactive measures towards problems once they have been identified. In contrast, the risk-based approach recommended for adoption by the Food and Agriculture Organization of the United Nations (FAO) has a more proactive character, whereby it attempts to identify and address food safety issues before they actually become a public threat. The transition of Saudi Arabia to the risk-based food safety approach raises important questions about the professional needs of the Saudi PHI workforce for and during such a transition. Therefore, guided by the Knowledge-to-Action (KTA) framework, the aim Page | v of this Thesis was to identify the knowledge and skills needs of the PHIs in Riyadh to conduct risk-based food inspections, including any barriers and factors that may influence the effectiveness of the inspection process.

Methods” This research was conducted in two phases using both qualitative (phase 1) and quantitative (phase 2) methods and utilising a sequential exploratory design. In the first phase, seven semi-structured interviews were conducted with four PHIs, two senior Environmental Health Mangers (EHMs) and the Coordinator of the Food Safety Diploma. The reason for the inclusion of the EHMs and the Coordinator in phase 1 was to obtain different perspectives. Then, the information gathered from these interviews and the knowledge and skills framework of the Food and Agriculture Organization (FAO), were used to inform the development of the survey in the second phase. A survey was deemed to be a best fit in the current study to capture a large cohort of PHIs’ perceptions. A total of 502 PHIs were invited to participate in phase 2 and 301 completed and submitted it, resulting in a 60% response rate. Findings Results revealed that the levels of formal qualification of PHIs in Riyadh are significantly lower than in other developed and developing countries. Female PHIs typically have lower levels of knowledge and skills compared to their male counterparts. In addition, according to the conducted qualitative (Phase 1) and quantitative (Phase 2) investigations, the majority of participants demonstrated only limited levels of understanding and knowledge about Hazard Analysis and Critical Control Points (HACCP) principles, food sampling techniques, food microbiology and the English language as a communication tool with restaurant staff.

Resuls: Leading towards the anticipated transition to risk-based food inspections in Saudi Arabia, special attention was focused on the professional needs of PHIs and issues that influence their performance, including on-going professional training. In particular, deficiencies in regular training and in the overall training arrangements to PHIs were also demonstrated by the current study. Additionally, lack of job satisfaction was another major finding of the study, with the highest levels of dissatisfaction being expressed with regard to motivation at the workplace, and the lack of support and security provided by the management. It was also found that a large proportion of PHIs in Riyadh regarded the existing food safety laws and regulations are generally inadequate and not sufficiently clear. These were the issues constituting the greatest perceived obstacles for the effective performance of PHIs and an effective transition toward the risk-based inspection approach in Riyadh. In addition, the obtained outcomes could also be generalised to other regions of Saudi Arabia and possibly, other GCC countries.

 

Investigating Riydah’s public health inspectors’ ability to conduct risk-based food inspection, and their professional needs, 2021

Queensland University of Technology

Sultan Abdullah Alsaleh

https://eprints.qut.edu.au/208321/1/Sultan%20Abdullah%20R_Alsaleh_Thesis.pdf

Huh? COVID-19 science and the uncertainty dance

My friend Tim Caufield, professor of law at the University of Alberta, the Research Director of its Health Law Institute, and current Canada Research Chair in Health Law and Policy, writes in an op-ed for the Globe and Mail that COVID public health policies have been with us for a year. So has uncertainty. We’ve all lived through twelve months of “huh”? And this has added to the public’s frustration, fatigue, and stress.

In the early weeks and months of the pandemic, there was uncertainty about masks and asymptomatic spread. There was uncertainty about if and when we’d get a vaccine. There was uncertainty about what type of public health policies worked best and were most needed. We have all had to tolerate a lot of ambiguity. And as the vaccines roll out, we are being asked to tolerate even more. (When will I get a vaccine? Which one will I get? And what about the variants?)

For public health communications to be effective, the public must have confidence in the message. And, unfortunately, for some, that confidence isn’t there. A recent study from the University of Calgary explored pandemic communication and found, not surprisingly, that “participants felt that public health messaging to date has been conflicting and at times unclear.”

This perception is understandable. An atmosphere of seemingly relentless uncertainty and confusion has been created by a combination of scientific realities, media practices, some less-than-ideal communication from policy makers, and the spread of misinformation and conspiracy theories.

The science surrounding COVID was – and, for some topics, continues to be – highly uncertain. While a growing body of evidence has emerged around the most contested issues (such as the value of masks and physical distancing strategies), early in the pandemic there wasn’t much that was unequivocal. The science evolved and, as you would hope with any evidence-informed approach, the resulting science advice and recommendations evolved too. But for some, shifting policies, even if appropriate, just added to a sense, rightly or not, of chaos.

In addition, the media has been reporting on the research as it unfolds, including referencing studies that have not yet been peer reviewed. Often the preliminary or uncertain nature of the relevant research is not reported in the media, thus creating a false impression about the actual state of the science – as exemplified by the “hydroxychloroquine works!” debacle (PS, it doesn’t). Perhaps worse, relatively fringe perspectives – such as those pushing the value of “natural herd immunity” – have been given a relatively high profile in both the conventional press and on social media. This can create a false balance (fringe idea vs. broad scientific consensus) that we know can be detrimental to both public discourse and health behaviours.

Despite the frustration that uncertainty can create, the public has a demonstrated preference for honesty about the limits of our knowledge. A recent study from Germany found that “a majority of respondents indicated a preference for open communication of scientific uncertainty in the context of the COVID-19 pandemic.” This finding agrees with other research that has found that when uncertainty is relevant to their lives, the public wants to know about it.

People may want to hear about uncertainty, but will communicating it do more harm than good? Will it just add to an already confused information environment? The data on this point are actually fairly mixed, but recent research exploring the impact of communicating scientific uncertainty found that it either increased perceptions of trust in science or had almost no impact. This is good news. As the authors of one of the studies notes, “this should allow academics and science communicators to be more transparent about the limits of human knowledge.” Other studies have found that being honest about uncertainties in media reports about research can actually boost the perceived credibility of journalists.

And over the long term, honesty about the uncertainties of the evidence used to inform policy seems essential to the maintenance of public trust. For example, being overly dogmatic about a policy or predictive model could hurt the credibility of decision makers if new evidence requires a revision of a past positions.

When possible, public health authorities (or anyone seeking to communicate science) should start with well-defined and well-supported takeaway messages (e.g., please get vaccinated with whatever vaccine is available to and recommended for you!).But then be honest about what is not known (e.g., while vaccines are our best defense, we aren’t sure how long immunity will last).

Depending on the medium used (a social media post, for example, may not be the best venue for a long discourse on methodological challenges), it may also be wise to explain the limits of the research approach (e.g., observational studies can’t prove causation). If there are areas of scientific disagreement, be honest about that too – but be specific about what is being disputed. Often there is broad agreement about the big stuff (e.g., vaccines work!), but academic debate about some details. Often those trying to sow doubt – like those in the anti-vaccine community – will try to weaponize and over-emphasize small academic disagreements. Don’t give them that room.

When communicating about uncertainty it is also important to highlight what is being done to reduce it, such as forthcoming research or new data analysis. This provides a road map forward and invites the public to follow the science as it unfolds. It is also a way to stress that uncertainty is a natural part of the scientific process.

For the public, try not to let the uncertainty kerfuffle distract you from the big picture. Remember that there are many clear knowns. Vaccines, physical distancing, hand washing, masks, and being responsible when symptoms emerge will get us through this pandemic.

Finally, it is also important to take a break from all the uncertainty noise. Studies have shown that the constant consumption of conflicting COVID news can (no surprise here) add to our stress. Put down the phone, back away from the screen, and take ten from “huh?”

Digital media and communication scenarios

It’s not food safety, it has more current relevance to Covid-19, but this paper has some important insights for communicating during an outbreak. The Australian lesson from cornavirus seems to be, go fast, hard.

Expert-lay mass media communication (a phrase I always despised) in public health prevention campaigns has been at the forefront in knowledge dissemination before digital communication gained in momentum.

The advent of digital media has radically changed communicative scenarios and strategies used to actively involve population, for example promoting large-scale change in awareness, behaviour, and attitude. However, research still has not fully documented how digital environments orchestrate different multimodal resources, including, among others, language, still and moving images. Other research gaps deal with understanding how users can be actively engaged in websites and how the identity of participants is projected with reference to their distance from the voice of the expert.

The paper combines linguistic and visual analysis in a multimodal perspective to investigate the interplay of identity and distance in the website and integrated social media of the Centers for Disease Control and Prevention (CDC, https://npin.cdc.gov), an operating component of the Department of Health and Human Services (US).

Linguistic and visual analysis of the Vital Signs monthly reports on campaigns for HIV prevention will focus on the revision of the notion of deixis to see how this has been reconfigured in multimodal environments. Findings show that person, time, and place deixis have been reshaped in digital scenarios with the aim of engaging participants and disseminate knowledge to prompt change in behaviour.

The image, left, shows person deixis, place deixis and time deixis in English.

“The time is now”: A multimodal pragmatic analysis of how identity and distance are indexed in HIV risk communication digital campaigns in US

May 2021

Journal of Pragmatics, vol.177 pg. 82-96

Maria Sindoni

https://doi.org/10.1016/j.pragma.2021.02.012

https://www.sciencedirect.com/science/article/abs/pii/S0378216621000680