Friday, January 15, 2016

More Korean Media Backlash On the MERS `Mutation' Story


Last week, in `The `M' Word' we looked at the media's first reaction to a study (Variations in Spike Glycoprotein Gene of MERS-CoV, South Korea, 2015) that found enough genetic variance among a small subset of the Korean viruses sequenced from last summer's MERS outbreak to place them into a new clade.

Two mutations were located in the receptor binding domain of the virus's spike protein, although scientists still don't know what effect - if any - they would have on the spread, or impact, of the virus. 

Last summer, when the virus was running rampant through Korean hospitals, the WHO (see Yonhap News report WHO chief says no mutation of MERS virus found in S. Korea) - and others - reassured that the Korean MERS Sequences Closely Match Middle Eastern Virus. 

The rub being that `Closely' isn't the same thing as `Exactly'. 

And determining what - if any - impact minor genetic changes might have on a virus's behavior can take months of observation. A fine point that officials - perhaps more interested in dampening concerns than in explaining the nuances - didn't exactly stress. 

Simple, reassuring statements are often preferred by governments and agencies in the midst of a crisis, but they sometimes come back and bite you.

Which explains why - seven months later - the scathing headline in the Korean Times today reads:

When the Middle East Respiratory Syndrome (MERS) outbreak swept the country last year, The Korea Times raised the possibility of a virus mutation (, citing its unusually high infection and low fatality rates.

Following the report, the World Health Organization (WHO) and the government conducted genome sequencing studies of the virus together and concluded that no genetic mutation had occurred.

Speaking to reporters on June 18 in 2015, WHO Director-General Margaret Chan said, "The virus has been sequenced. So far, no genetic changes have been detected that could make the virus easier to transmit among humans."

However, after their own sequencing program, a group of researchers drew a different conclusion this month: the virus apparently had mutated from the one found in Saudi Arabia, where Korea's first MERS patient was infected.


It is unclear whether WHO investigators lied about the virus mutation. If not, however, the study suggests that they failed to figure it out at a critical time of crisis.

I've only printed a few excerpts from a much longer story, so follow the link to read the (English Language) report in its entirety.

The problem with all of this is that we still don't know whether the genetic changes detected in the Korean MERS virus affected its transmissibility. The authors of the study that found these changes wrote `we cannot conclude that deleterious effects promoting spread of infection will occur because of these mutations.'

If we don't know now, it is hard to fault the WHO for not knowing seven months ago. Could they have been a little more up front about the limits of their knowledge of role of minor genetic changes?


After the declaration that `no mutations' were found, it would have been a good idea to add that the impact of small genetic changes are not always immediately apparent. An uncertainty I went into in my blog last June in some detail.

Highlighting uncertainties and unknowns is viewed by some, however, as complicating the message.  But doing so can help avoid the kind of second guessing we are seeing in the Korean media today.

Public health agencies have a habit of issuing overlyreassuring statements, or in not clarifying the limits of their knowledge.  And time after time, we see that come back to haunt them.

Last September, in FAO: Addressing Avian Influenza A(H7N9) Risk Communications, we looked at some sage advice offered by risk communications expert Dr. Peter Sandman, where he strongly advises:

• Inform early, often and transparently as the situation develops

—— Warn that messages designed early in an unfolding event may change as knowledge evolves.
—— Be open about your level of uncertainty.
—— Share your wish that you could be more certain.
—— When you modify your recommendations, highlight the fact that you are making a change and explain why the
change needs to be made.

—— Avoid both overly optimistic and overly alarming speculation.
—— Share the worst-case and most-likely scenarios that you are considering.
—— Show empathy (rather than contempt) for the excessive fears or undue complacency of your audience.
• Do not over-reassure—— Avoid the temptation to say “The situation is under control.”
—— Instead of saying “the government is taking all possible/necessary measures,” convey the honest extent of your activities and explain them in detail.

This is just a sample, you'll find a great deal more available on that blog.  For more on effective risk communications, you may wish to revisit:

Sandman & Lanard On Ebola & Failures Of Imagination

NPR: Jody Lanard On Addressing Ebola Fears

Sandman & Lanard: Ebola Risk Communications

No comments: