Transparency is essential during medical and mental health crises.

Transparency is required regarding initiatives and information relating to COVID-19.  The high and ongoing anxiety, panic, hostility and conflict reported within the public in many countries, regarding different debate topics relating to COVID-19, will likely not contribute to reduced risk, it will likely contribute to increased immediate and long term risk and harm; as is supported by longstanding well established evidence-based research. 

The public has to be informed of relevant statistics to reduce panic and chronic anxiety.  Dr Michael Ryan, Executive Director, WHO Health Emergencies Programmes, stated on 5 October 2020, that “our current best estimates tell us about 10% of the global population may have been infected by this virus”.  The WHO reports a global population of 7.6 billion, therefore more or less 760 million have been infected, with 1 034 837 deaths at the time and an infection mortality rate of more or less 0.136%.  These figures have to be published widely and explained in a clinically relevant context to reduce anxiety for the general public. 

Hawaii’s government circulated a fast facts sheet to the public stating that illness due to COVID-19 is usually mild, especially for healthy children and young adults, and that most people recover from COVID-19 without needing special treatment.  We observed that this initiative contributed to significant calm within Hawaii. 

It is essential for good clinical outcomes that individuals believe that it is possible and probable to remain healthy or recover without complications if they follow medical advice, which, considering evidence-based research, has to include risk reducing behaviours (eg washing hands before touching the face) and protective factors for the immune system, general and mental health (eg relating to advocating calm, normalcy, liberty and autonomy to make informed and educated decisions regarding own health).  

Clinical outcome is often affected most by simple measures to prevent harm and to protect.  Simple protective measures cannot be neglected in initiatives to safeguard the public.  

Decisions in the context of the pandemic will have consequences for years to come in many communities and countries, therefore transparency, diligence, clinical responsibility (considering that this is a clinical crisis) and accountability are required.

#BritishMedicalJournal #BMJ #FirstDoNoHarm #covid19 #transparency