The Chinese Center for Disease Control and Prevention recently announced that it has found living coronavirus in the packaging of imported frozen cod. According to an article in the Global Times, this discovery might have implications for tracing the origins of the COVID-19 pandemic. But another Global Times article focuses on a different aspect of the story: the concern that people might catch COVID-19 from frozen foods or their packaging, or from workers in the frozen food industry.

Public relations consultant Andre Shen asked me to comment not on this concern itself, but on another, resulting concern: whether stories like this could ignite widespread fears of frozen food. Andre especially wanted my take on how to manage the story to minimize that risk. It’s a reasonable question. A June story about coronavirus on chopping boards used for imported salmon at a Beijing wholesale food market sparked fears across the country. Andre wrote me that business at one of his favorite restaurants is still profoundly affected by the scare.

I’m an American risk communication expert. So my opinions about whether imported frozen fish is dangerous are worthless. And my opinions about how Chinese news stories are likely to affect Chinese consumers are, if not worthless, at least tentative. Even so, I want to offer a western expert’s cautious answer to Andre’s question.

The scientific question the second Global Times article raises is whether it’s possible to catch COVID-19 from a package of imported frozen fish. But the practical question consumers ought to be thinking about is whether it’s likely to catch COVID-19 from a package of imported frozen fish.

If it’s likely, then precautions are called for. Officials might decide to test workers in the fish importing industry and downstream industries – and of course also test the fish themselves, other cold-chain products, and their packaging. Ordinary people might decide to avoid buying, cooking, eating, or touching imported frozen fish – or all frozen fish – or even all fish or all frozen foods. And they might hesitate to spend time with friends and neighbors in the fish importing industry.

Such precautions are worth considering if catching COVID-19 from a package of imported frozen fish is likely. If it’s possible but unlikely, on the other hand, many of these precautions will be deemed excessive. If it’s barely possible but very, very unlikely, probably no precautions at all are called for.

American medical students have a word for weird symptoms or cases that are interesting but rare, and therefore unlikely to afflict any other patient they’ll ever see: “fascinoma.” (It’s a coinage from “fascinating” and the Greek suffix -oma, meaning disease, morbidity, or tumor.) A highly unlikely risk is a fascinoma.

The problem is that news stories that say something “can” happen often give the impression that it happens a lot. And that problem is even worse when something has actually happened, as in this case; live virus really was found on a sample of imported frozen cod. Even if they’re rare, maybe especially if they’re rare, memorable events stick in people’s minds. The technical term for this in risk communication is “the availability heuristic”; vivid memories come readily to mind. Memorable scary events, moreover, tend to make people fearful, and that naturally makes us want to take precautions. It can be hard to make ourselves stop and consider how unlikely that memorable event is to happen again, how unlikely it is to happen to us.

I have no right to an opinion on the likelihood of COVID-19 transmission from imported frozen fish.

Most newly discovered phenomena are rare. They’re fascinomas. If they were common they’d have been discovered long ago. But obviously that’s not always true. Sometimes a newly discovered phenomenon is the tip of the iceberg. It might have been there all along – and once we’ve found it, we find it everywhere we look, including back in history. Or it might be genuinely new and rare so far but on its way to becoming widespread. Imagine dismissing those early respiratory disease cases in Wuhan as fascinomas!

So experts and officials can’t afford to ignore a weird one-off. They need to investigate to make sure it’s really a one-off – really just a fascinoma and not a newly discovered serious risk.

But should they tell the public? As a risk communication expert, my standard answer to all “should we tell the public” questions is always yes. Or nearly always. My clients’ impulse to keep secrets is much, much stronger than the rationale for keeping secrets. The public usually finds out anyway, and is far likelier to overreact to a small problem officials tried to hide than to a small problem officials matter-of-factly acknowledged.

So even if you think your newly discovered risk is probably a fascinoma, and even if you think the public is likely to overreact (stop eating imported frozen fish, for example), it’s still a better bet to be candid than to try to keep the news secret. As far as I can tell from afar, both China CDC and officials in Quingdao (where the contaminated frozen fish package was found) were admirably honest about this discovery.

Here are some tips for minimizing public overreaction when announcing a newly discovered risk that will probably turn out small.

Make truth-telling the default.

The first time an organization that usually keeps small problems secret reveals one, the natural public reaction is “OMG, they’re telling us something is wrong! It must be a huge problem if they feel like they actually have to tell us the truth!” But if you routinely announce small problems, your decision to announce a new problem will stop signaling that it must be a big problem.

I have nursed clients through this transition, and it happens surprisingly fast. It happens even faster if you explicitly explain your new candor policy: “Until recently, we usually did not announce this sort of event. But our policy has changed. So the public will see more announcements like this one in the future – not because these events are happening more often, but because we have decided to go public whenever they happen.”

Remind people of the difference between “can happen” and “happens a lot.”

Explain that a newly discovered fact is sometimes newly discovered because everybody missed it till now; sometimes it’s newly discovered because it just started happening (like those first few respiratory cases in Wuhan); and sometimes it’s newly discovered because it’s rare.

And then speculate. Yes, I said speculate. Most risk communication experts advise against speculation, but I believe the very essence of risk communication is also the essence of speculation: talking uncertainly about probabilities. “We would be very surprised if frozen food or frozen food packaging turned out to be a significant source of COVID-19 transmission. We think it is probably rare – if it happens at all.”

Don’t stop there. Make sure you emphasize that your speculation is speculative: “But so far this is just a guess, albeit an informed guess. We are not certain we are right, and we are not assuming we are right. We need to investigate further. And we will.”

Say what you’re doing to find out.

I don’t know exactly what scientists ought to do to assess the COVID-19 risk of frozen imported fish. Presumably they will test more fish packages for virus. Presumably they will test people with occupational exposures for antibodies. Maybe they will try to culture samples of SARS-CoV-2 virus from frozen imported fish packages to see if they can replicate; possibly they’ll try to infect animals with virus from the packages to see if they can achieve actual transmission.

Whatever. The point is to tell people what you plan to do to assess the seriousness of the risk. And tell people when you expect to know more. And promise to let them know what you find, whether the results turn out alarming or reassuring. And, of course, keep your promise.

Give people “permission” to take precautions in the meantime.

When the authorities believe an unproven risk is fairly likely to turn out significant, they routinely recommend that the public take precautions while they collect more data. A typical example: “We think the water in the reservoir might have been contaminated as a result of flood runoff. Everyone should boil their drinking water until we have completed our tests and announced the results.”

Other times – and I’m assuming this case is one of those other times – the authorities believe there is very little reason for the public to take precautions. But some people are going to want to take precautions anyway. The question is how best to reduce the extent of the public overreaction. And the paradoxical risk communication answer: Validate the overreaction. Normalize it. Give people “permission” to overreact. Why do that? Because we overreact more if our overreaction is mocked or condemned. Labeling an overreaction as “panic,” “hysteria,” or “irrationality” just tends to make people more panicky, hysterical, and irrational. I wouldn’t even call it an “overreaction.” It’s just a normal, healthy reaction.

Risk communicators know it is normal for people to overreact briefly when they become newly aware of something alarming. We call this an “adjustment reaction.” If the risk turns out serious, the adjustment reaction helps people get emotionally prepared to cope. If the risk turns out minor or goes away entirely, the adjustment reaction helps people notice and stand down. Rather than criticizing people for having an adjustment reaction, good risk communicators guide them through it.

Copyright © 2020 by Peter M. Sandman