Communicating COVID-19 risk changes: Signalling with words, phrases, and messages.

During COVID-19, governments issued messages to trigger action, encourage sustained behaviours (e.g., social distancing, hand hygiene), and manage system wide risk. This study examines messages issued across two stages established by the World Health Organization (WHO): (a) pre-pandemic early intervention stage and (b) within-pandemic escalation stage. In April 2020, approximately one month after COVID-19 was declared a pandemic, an experiment using a sample of 769 Australian participants was conducted. Using a between-subject design, participants assessed the way messages (curated and then expertly attributed to the two stages) were perceived and influenced behaviours. Next, it examined the power of words and phrases, selected from the same messages, for (a) their potential to signal risk, warning, and behavioural response and (b) the extent to which they reflected pandemic stages. Results showed that between the two stages, messages were differentiated by negative affect, assertiveness, and risk. Subsequently, increased negative affect, assertiveness, and risk indication increased adaptive behavioural intentions. However, increased assertiveness also increased non-adaptive behavioural intentions, though increased risk indication reduced non-adaptive behavioural intentions. Signal words and phrases, which hold potential as iconic features for biological hazard messages, showed varying performance across message stages, indicating an opportunity to improve them. Taken together, the findings contribute to academic and policy approaches for adapting communication to changing risk.

Creating a Palliative Care Inpatient Response Plan for COVID-19-The UW Medicine Experience.

CONTEXT: The coronavirus disease 2019 (COVID-19) pandemic is stressing health care systems throughout the world. Significant numbers of patients are being admitted to the hospital with severe illness, often in the setting of advanced age and underlying comorbidities. Therefore, palliative care is an important part of the response to this pandemic. The Seattle area and UW Medicine have been on the forefront of the pandemic in the U.S. METHODS: UW Medicine developed a strategy to implement a palliative care response for a multihospital health care system that incorporates conventional capacity, contingency capacity, and crisis capacity. The strategy was developed by our palliative care programs with input from the health care system leadership. RESULTS: In this publication, we share our multifaceted strategy to implement high-quality palliative care in the context of the COVID-19 pandemic that incorporates conventional, contingency, and crisis capacity and focuses on the areas of the hospital caring for the most patients: the emergency department, intensive care units, and acute care services. The strategy focuses on key content areas, including identifying and addressing goals of care, addressing moderate and severe symptoms, and supporting family members. CONCLUSION: Strategy planning for delivery of high-quality palliative care in the context of the COVID-19 pandemic represents an important area of need for our health care systems. We share our experiences of developing such a strategy to help other institutions conduct and adapt such strategies more quickly.