GRF 2nd One Health Summit 2013: Presentation by Kerstin Maja Dressel, sine-Institut gGmbH

1. How to integrate risk perception
findings in spatial and temporal risk
models? The Hanta virus case: Germany
Kerstin Dressel & Luigi Sedda
Sine-Institut Munich / University of Oxford (UK)
source: www.troutunderground.com
2nd GRF One Health Summit 2013
Davos, 20. November 2013

2. Content
1. An EDENext experiment – and where we got so far
2. Use of models for / by PH practitioners
3. Risk appraisal: integrating risk perception findings in
risk models – and vice versa
4. Questions – lessons to learn
2nd GRF One Health Summit Davos 2013 – EDENext Workshop
2

3. 1. An experiment – and where we got so far
• EDENext modellers produce findings in order to
explain the uneven distribution of the hantavirus in
Europe, identify environmental factors of presence of
the hanta virus, and try to develop predictive models
for the hantavirus.
• EDENext social scientists compare how the public in
different European countries perceive the hantavirus
risk and identify ways to improve Public Health risk
communication.
 C.P. Snow’s seminal book on ‘The Two Cultures’
(1959) – sciences and humanities – and the idea to
overcome the divide came to our mind
2nd GRF One Health Summit 2013 – EDENext workshop
3

4. An experiment – and where we got so far –
cont‘d
Joining forces will:
• reduce data gaps
• optimize the range of data to be used for defining risk
• lead to better models
• rationalize the choice in the model output
• assist the provision of more comprehensive and
complete advice to Public and One Health authorities
on this host (vole) and its disease (NE)
• lead to better PH risk governance
2nd GRF One Health Summit 2013 – EDENext workshop
4

5. 2. Use of models for / by PH practitioners
EDENext risk assessment workshop
was held in Stuttgart in July 2013
with PH practitioners and hantavirus
experts
• One session was committed to questions of the meaning of
models for PH purposes
• Model-based questions and examples were provided by
EDENext modellers
NE incidence ~ Φ1 +Φ2 + Φ3 + TxsummerY-2 +
………
One Health Summit 2013 – EDENext workshop
5

6. Use of models for / by PH practitioners cont‘d
Questions included:
• Advantages of maps vs. simple statements?
• Mean estimates vs. best / worst case scenarios?
• Most relevant spatial scale (landscape vs. regional)?
• Dynamic vs. static models?
• Scale of risk (presence / absence of risk)?
• Role of uncertainty for PH practitioners?
• More model training for PH practitioners?
 Valuable input for modelers was generated which in
turn will generate better models for PH
2nd GRF One Health Summit 2013 – EDENext workshop
6

7. Risk appraisal: integrating risk perception
findings in risk models – and vice versa, cont‘d
Risk prediction for Germany (global model by Luigi
Sedda, unpubl. )
2nd GRF One Health Summit 2013 – EDENext workshop
7

8. Risk appraisal: integrating risk perception
findings in risk models – and vice versa, cont‘d
Findings Risk Perception Study
Comments from Modelers
„Looking at various risk factors
participants of the rural and
occupational groups were more
aware about various risk factors than
participants in the urban group.“
This could lead to a different way to
present risk analysis (more
information is needed for urban
people).”
“Over all focus groups, many
participants felt unsafe due to a
general lack of knowledge about the
disease. One frequent question
which came up during the
discussions was what a bank vole
looks like.”
I think if I need to produce some material
for people, I would need to add some
pictures of bank voles.
With the warning that you can still have risk
even if you don't see it.
2nd GRF One Health Summit 2013 – EDENext workshop
8

9. Risk appraisal: integrating risk perception
findings in risk models – and vice versa, cont‘d
Findings Risk Perception Study
Comments from Modelers
Focus groups addressed questions of
information behaviour and
expectations, several aspects and
diverse media were reported
A possibility is to distribute posters with a
barcode (QR code) linked to the risk
information for the area (in order to
download it directly on their mobile).
“In the urban group participants
suggested a kind of traffic light
system instead of a standardized
warning signs, in order to get more
information about high risk and low
risk periods. Red, yellow and green
lights on the signs should inform
about the actual risk situation.”
We could consider all the risk >0.5 "high
risk" (red), those between 0.1-0.5 medium
risk (yellow) and those <0.1 low risk
(green). [the threshold of 0.5 is often used
for risk classification]
9
2nd GRF One Health Summit 2013 – EDENext workshop

10. Risk appraisal: intergrating risk perception
findings in risk models – and vice versa, cont‘d
Findings Risk Perception Study
“The ecological environment was a further risk
perception pattern. The location of the village
or neighbourhood close to a forest was
mentioned as a potential risk area over all
focus groups. By tendency, older people were
more sensitive in regard to the perception of
their ecological environment. For example,
older participants observed how the mice
population changed from year to year in the
nearby forest or in their garden. Obviously,
participants of the occupational group, who
were mostly employed as park rangers in a
national forest administration, were more
sensitive in regard to ecological determinants
influencing the mice population, such as the
occurrence of beech forest and the link to
food resources for bank voles or the influence
of the climate, such as a hot summer.”
Comments from Modelers
It determines a pre-level of risk
of infection (as quantitatively
assessed by the model).
Most of the variables (4 out of 7) selected by the model show a 2 year lag
difference, i.e. cases in 2007 are related
to temperatures in 2005.
Hot summer is the 2nd best variable
associated with human cases and 1st for
power in explaining changes in the disease pattern. In short hand, the hotter
is the summer the higher is the risk. 10
2nd GRF One Health Summit 2013 – EDENext workshop

11. Risk appraisal: intergrating risk perception
findings in risk models – and vice versa, cont‘d
Findings Risk Perception Study Comments from Modelers
“However, I can´t work every
day with a breathing mask and
a protective suit. You can be
careful, however I think you
can´t avoid it because it is
everywhere and with every
move air is put into motion,
which can transfer it to the
respiratory tract.” (Quote:
woman, 44 years, occupational I'm starting to think that we probably
need information about wind patterns
group)
in the model
11
2nd GRF One Health Summit 2013 – EDENext workshop

12. Lessons learnt
Models should not be limited just to the disease data. New approaches and
visions are required when problems are complex, uncertainty high and involve
a high dimensionality (stakeholders, practitioners, vulnerable people,
organisations, government, etc.).
Question to address
How to define the level of involvement of the public and how to
implement concern assessment in modelling process?
Investigative approach needed! (who, when, where, how?)
2nd GRF One Health Summit 2013 – EDENext workshop
12