What are the risks of a diagnosis using artificial intelligence, of health information websites or of health apps? The Harding Center for Risk Literacy, which was founded by the renowned psychologist Gerd Gigerenzer at the Berlin Max Planck Institute for Human Development, deals with such questions. At the beginning of 2020, the center became part of the Faculty of Health Sciences in Potsdam. But as soon as the moving boxes were unpacked, the Covid-19 pandemic broke out. And suddenly there were new questions …
The Harding Center for Risk Literacy stands for education and knowledge. Its goal is to help people better understand the risks they face every day and to be able to deal with them more competently. For example, it summarizes the best scientific evidence on the potential benefits and harms of treatment, vaccination, and early diagnosis as well as medication and nutritional supplements in a way that is understandable to laypeople. But how can you properly assess the risk of a new type of virus that has been little researched? “People have to learn to critically inform themselves,” says psychologist Dr. Felix Rebitschek, who is the head of the center.
In order to contribute to this goal, his team has prepared facts known so far about SARS-CoV-2 and COVID-19 in graphics and tables. The so-called ‘Fact boxes’ of the Harding Center, for example, are an effective and approved remedy against ignorance. The researchers have specialized in developing analog and digital tools that enable people to make informed and efficient decisions.
Their first challenge was to compare the risk of a Covid-19 infection with other risks. For illustration purposes, they chose a football stadium with 10,000 seats. The graphic compares the number of cases of COVID-19 in 2020 - converted into a proportion of the 10,000 stadium seats - with other diseases, everyday hazards such as traffic accidents and previous epidemics. The frequently cited flu season 2017/2018 is also deliberately listed here. An unusually large number of people fell ill and died at that time. But even in comparison with this extreme outbreak of influenza, the Covid-19 cases in the “football stadium” occupy significantly more seats. These cases are, however, still estimates for the year 2020 as a whole.
In order to show clearly and explicitly what can happen to people of different ages when they encounter the SARS-CoV-2 virus or what can happen to their fellow human beings if they spread it, the Harding Center has created various information boxes that enable a direct comparison with the flu but also clarify the existing uncertainty: out of 1,000 adults under the age of 60 who come into close contact with a person who is infected with the influenza or Covid-19 pathogen during a meal, for example, 3 - 70 people get influenza, but 90 - 170 people get COVID-19. 6 - 30 Covid-19 patients have to be treated at a hospital for severe symptoms, compared to a maximum of eight who contracted influenza. For adults under the age of 60 without preexisting conditions, even with COVID-19 there is only a minimal risk of death, but they fall ill more often and more seriously than from the flu, against which you can also be vaccinated.
The difference is even greater among people over the age of 60. Of 1,000 people who had close contact with infected people, 3 - 70 contract influenza, but 200 - 330 COVID-19. While up to 40 flu patients with severe symptoms have to be hospitalized, this number can be twice as high for Covid-19. In addition, a fatal course of the disease is much more likely. Of 1,000 people who had close contact with infected people, about two die from influenza, but 8 - 30 die from COVID-19. These are clear figures, which make the danger obvious despite existing uncertainties, but at the same time help to correctly assess the risks.
At the moment, many people are unsure whether they have already been infected without noticing and could infect others without knowing it. Especially for people who do not use the Corona warning app, the Harding Center has created a “decision tree” that goes through all eventualities step by step: The first question is “Have you had at least 15 minutes of contact with a person who has been proven to be infected?“. If the answer is “Yes” an arrow directs you to a red box with an exclamation mark: “Higher risk of infection! Please contact your local health authority!” If you answer “No”, you will be directed to the next question. “Have you been in the same room as a person who is known to be infected? „If the answer is “Yes” you will be directed to a red box again. “Lower risk of infection! In case of flu-like symptoms, contact your local health authority!” Those who have answered no may turn to the next question and so on until they can be ruled out as a contact person. In addition, the Harding Center provides easily understandable explanations of transmission routes and symptoms. People with a suspected infection are advised to keep a diary in which they record current symptoms, body temperature, activities, and contacts. Anyone who is sick is given clearly defined rules of conduct.
Decision tree, explanations, and recommendations - there is space for all of this on a single sheet of paper, clear and concise. This is the strength of the Harding Center: unraveling a tangle of related facts, separating them from false reports and arranging them graphically so that they can be logically understood. The “VisRisk” project, a cooperation of the Harding Center and the Federal Institute for Risk Assessment (BfR), researched how results from health risk assessments can be visualized. They found that the combination of verbal and graphic communication reduces incorrect assessments and promotes risk-literate decisions. A team of psychologists, health and natural scientists translated the scientific findings for the general public, both verbally and visually. Using the knowledge and methods of cognitive decision-making psychology, it was possible to create informative, transparent and evidence-based visualizations that enable laypersons to quickly and easily assess the risk potential of food or consumer goods, for example.
In addition to such research projects, the Harding Center also conducts surveys of experts and the general public. “Advanced education and specialist training of physicians, journalists, and consumer protection activists are particularly important to us. Patients, consumers, and the general public depend on these multipliers and their ability to correctly interpret risks and communicate them in an understandable way,” Rebitschek emphasizes. “During a pandemic in particular, distorted media coverage is a problem because without having personal experience with rare risks, reports and statements from any other source, reliable and unreliable, become more important for the individual.“
Dr. Felix Rebitschek holds a PhD in cognitive psychology. Since July 2020, he has been the Head Research Scientist and CEO of the Harding Center for Risk Literacy.
“Our goal is to help people in their struggle to understand and assess the risks they encounter. We believe that our work can contribute to this”, says Prof. Gerd Gigerenzer, founder of the Harding Center for Risk Literacy. The former Director of the Center for Adaptive Behavior and Cognition (ABC) at the Max Planck Institute for Human Development (MPIB) and at the Max Planck Institute for Psychological Research is a psychologist and author of many books such as “Gut Feelings” and “Calculated Risks: How to Know When Numbers Deceive You“, which both were “Science Book of the Year (2007 and 2002). These books deal with the question of how to make a rational decision when time and information are limited and the future is uncertain. David Harding, Global Investment Manager and Director of Winton Capital became interested in Gigerenzer’s work after his book “Reckoning with Risk” (US: Calculated Risks) was nominated for the Royal Society’s „Science Book Prize“. Their shared vision of an informed society led to the official inauguration of the Harding Center at the MPIB in 2009. After Gigerenzer was conferred emeritus status, the Harding Center’s time at the MPIB came to a close in 2019. Thanks to further funding by namesake and patron David Harding and the support of the University of Potsdam, the center can now continue its work at the Faculty of Health Sciences, a joint faculty with the Brandenburg University of Technology Cottbus-Senftenberg and the Brandenburg Medical School.
This text was published in the university magazine Portal Wissen - Two 2020 „Health“ (PDF).