Issue link: https://www.ascpskindeepdigital.com/i/1235208
18 ascp skin deep COVID-19 special issue 2020 Essentially, the scientific community has one narrative, based exclusively on the data; the layperson has another; and the educated adjunct to the health professions is somewhere in between. Each of these groups will develop their own narratives that subconsciously reflect their own understanding of the situation, with their own anxieties and fears built in. Just as is the case when examining patient values and preferences in a therapeutic scenario, public health and political officials need to address these anxieties and narratives if they are to be heeded. Not doing so often leads to widespread panic and noncompliance on the part of the wider public because they simply do not believe what the authorities are saying. People may prefer to believe rumors and anecdotes because they still have a human, emotional dimension, which is stripped away in scientific, factual language, leading to clear miscommunication between the scientific and lay communities. 6 Narratives that fill in the gaps provide meaning, make the situation relatable, and satisfy the anxiety caused by the situation. In a public health emergency, these factors fall by the wayside as officials rush to face the more immediate threats of contagion and mortality. If scientists and science-literate officials and practitioners can cater to these needs, then it may be possible to improve the overall response to situations such as COVID-19. WHAT WE CAN DO The best we can do is attempt to reduce the layers of "noise" by looking at the evidence, while bearing in mind at all times that this, too, may be subject to error. However, rather than allowing our subconscious fears and prejudices to fill in the gaps of what we do not understand, we can still have some control over the conclusions we reach. It is then up to us to find ways of communicating this with our unique psychosocial context in mind. Calling out and shaming people for considering unscientific narratives has no place in this: people are frightened, just as individual patients may be afraid or crippled with anxiety due to a given condition. Even if we are not infected with COVID-19, the contagion of fear is almost as dangerous. Estheticians have highly developed skills when it comes to exercising and expressing compassion, and those skills are crucial. If we can identify where we, too, are allowing contagious narratives to cloud our judgment and educate ourselves first and foremost, we can then transmit that understanding to others in the same way we would speak to a client. This is every bit as important as the work being done in labs to find a vaccine for COVID-19. Here is a list of some key misconceptions and beliefs seen in headlines and online discussions in recent weeks. It is by no means exhaustive, but I have chosen some of the more common or outlandish claims seen in headlines and shared through social media in recent days and weeks. For each, I have sourced the most recent, relevant research, and critically appraised whether they stand up to scrutiny. To do so, I have asked the following questions: • What is the source? • Who are the authors? What are their qualifications and conflicts of interest? • Is this a peer-reviewed article? • How old is the source? • Are there additional sources confirming or disagreeing with my source? If so, what seems to be the consensus view? • What do the major independent institutions (CDC, WHO) say regarding the information in my source? • What, if any, discrepancies do I see in the source with an untrained eye? If the source material falls at any of these hurdles, and the discrepancies cannot be explained away as a failure on our part to understand the material because it is too technically complex, then it would be wise to refrain from fully believing it, and more so, refrain from sharing it unless it is with a colleague whose scientific understanding is more sophisticated. TRUE OR FALSE? COVID-19 is no more dangerous than the flu This misconception has been partially responsible for the slow responses of some governments around the world to address COVID-19. The actual answer is complex and uncertain. This uncertainty is due to a lack of scientific data on the virus, which specialists are having to study in different real-world environments as the pandemic evolves, rather than from the safety of a controlled lab. COVID-19 is a novel virus, meaning it has not been seen in humans before. The human immune system has not been exposed to it, and is therefore more susceptible to it. We do not yet fully understand all the risk factors. It is much more contagious than influenza, partly because of the lack of immunity, and partly because of the longer asymptomatic incubation period. Understanding the role of time in relation to the life cycle of a virus is key to understanding how and why it spreads. 7 It is thought that over time, more people will develop immunity to the virus, and with the help of a vaccine, it will be possible to reduce the risk it poses to levels similar to those of the common flu. However, we simply do not yet have enough information to judge this. According to the current understanding, COVID-19 causes a severe type of pneumonia in enough individuals to make the mortality rate around six to 10 times higher than that of the common seasonal flu. 8 It may be possible, in months and years to come, to reduce this rate or to access data that changes our understanding of the true mortality rate. However, as explained in a study looking at the mortality rate in Wuhan, China, any current estimates are based on uncertainties and what is known as "ascertainment bias," which is when a population sample does not fairly represent the target population (in this case, the total number of people affected). 9