COVID-19 in Armenia: A Case of Failed Risk Communication

PM Nikol Pashinyan pictured during a briefing (June 2, 2020)

The decision of the government of Armenia to reopen the economy starting on May 4 was followed by a steady growth in the number of new COVID-19 cases and spurred criticism about the early timing of the removal of the two to three weeks lockdown. The surge in the number of cases observed since lifting the lockdown has been attributed by the government to the non-compliance of the public to preventive measures as well as to a consistent increase in the number of tests (around 1,000 per day). The government has been calling for citizens’ “individual responsibility” and using this as its main message to entice people to abide by self-protective measures put in place, such as wearing face masks, demonstrated by the Prime Minister himself in recent media appearances.

On May 29, Armenia’s government announced that the number of cases of COVID-19 infections per one million population has now surpassed the number registered in Iran and in France and blamed the public for non-compliance with recommended self-protection measures. Prime Minister Pashinyan did not anticipate re-imposing the lockdown hoping for compliance in the midst of an unprecedented spike in the number of cases that kept rising over the last 10 days, reaching a daily high of 460 and a total of 8,676 cases in addition to 120 deaths by May 29—a heavy toll for a country with a population of around three million.   

Lockdown was issued in Armenia in late March. Relaxing of restrictions began in mid-April despite the absence of sustained decrease in the number of new cases. In addition, the government’s response lacked a national risk communication strategy and is fraught with contradictory messages to the general public which recently was demonstrated in a victim blaming approach in an effort to force compliance.

The government’s current response consisting of obligatory use of face masks while keeping businesses open is heavily driven by economic considerations. Lockdown is an evidence-based public health measure that aims at flattening the curve of the outbreak while the country prepares its healthcare system and strengthens its epidemiological surveillance system to be able to effectively test, contact trace and isolate when the lockdown is lifted gradually. There are also short and long term economic and health effects of the lockdown that need to be considered in decision-making when battling the pandemic. The recent rising numbers of COVID-19 cases is straining the health care system in the country that is still unprepared for a surge in the number of cases. Actually, the latest statements of the Health Minister demonstrate that authorities are sounding the alarm on the restricted number of remaining hospital beds and calling for shortages in medical supplies and personnel.

A national risk communication strategy seems to be missing in Armenia. Initially, officials downplayed the severity of the outbreak. The Health Minister claimed that it was not serious enough to consider specific control and preventive measures. These non-evidence based messages were at the core of the official discourse at the beginning of the outbreak and sent out contradictory messages contributing to the circulation of misinformation about the disease. Lately, with the ease of the lockdown and the surge in the number of cases, the government announced that personal responsibility of the citizens is the principle tool to fight the outbreak coupled with a punitive response to enforce public health measures. Subsequent official messages focused on individual responsibility for behavior change.

As a consequence of contradictory official messages over the course of the pandemic, the public has failed to comprehend the risk involved. First, the official discourse did not contribute in shaping the public’s perceived susceptibility which is determined by the subjective assessment of perceived risk and predicts individuals’ engagement in behaviors that reduce the risk. Second, conflicting messages are known to further heighten concerns within this global context of public anxiety and uncertainty. The public is therefore expected to react by refuting the acceptance of risk as a defense mechanism to control this anxiety. Third, the contradiction in messages will also contribute to reduced trust in the source of information as well as in the government responsible for managing the outbreak, ultimately manifesting as non-compliance to recommendations.  

In the absence of strategic communication in the management of the COVID-19 outbreak in Armenia, the general public cannot be expected to form an accurate perception of risk. The attributed “irresponsible behavior” of citizens and the call for individual responsibility to revert the course of the outbreak in the country are examples of this failed communication. Risk communication during emergencies and crises should not only address the threat but also how people perceive the threat and respond to it within their socio-cultural context. The call for individual responsibility has been criticized by scholars for its lack of equity and the use of victim blaming in health communication. Implying that people’s actions solely influence health outcomes is questionable when other structural and situational factors of importance are not considered. 

The didactic, message-centered communication adopted by the authorities in Armenia needs radical transformation. A risk communication strategy that prioritizes the engagement of the public and embeds the social understanding of risk and disease is urgently needed to protect individuals and communities as well as to save lives in Armenia during this public health emergency.

Tamar Kabakian-Khasholian

Tamar Kabakian-Khasholian

Tamar Kabakian-Khasholian, MPH, PhD, is an Associate Professor at the Department of Health Promotion and Community Health, Faculty of Health Sciences, at the American University of Beirut in Lebanon. She holds a Master’s in Public Health in Epidemiology and Biostatistics from the American University of Beirut and a PhD in Maternal Health from the London School of Hygiene and Tropical Medicine. Her research focuses on maternal and reproductive health. She aims to find ways to improve maternal health outcomes through interventions that advance quality of care and enhance a positive and respectful childbirth experience. She also works on health communication and health literacy. She serves as a consultant for local and regional governmental and international agencies for maternal health and health communication issues. She teaches health communication, implementation research, maternal health and research design in the graduate Public Health program and the undergraduate Health Communication program at the American University of Beirut.
Tamar Kabakian-Khasholian

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1 Comment

  1. It is important to note that the Armenian government restricted the reporting of independent news organizations on COVID-19.

    23. Public dissemination, transfer of publications, information materials, interviews, reports (hereinafter referred to as “report”) on the current and new cases of infection having had in the Republic of Armenia, as well as outside the Republic of Armenia, state of health of persons, sources of infection, scope of other persons having contacted with already infected or potentially infected persons, number of persons undergoing examination (infection testing) and those having been isolated, as well as on the information causing panic or containing risk of creating a panic situation, including in the form of their publication on the internet websites and social
    networks, shall be carried out by natural and legal persons, including the mass media, exclusively by making reference to the information provided by the Commandant’s Office (hereinafter referred to as “official information”).

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