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Posts Tagged ‘covid-19

Disclaimer: My reflection below is not authoritative information about the new health protocols for Singapore’s COVID-19 strategies. The authoritative source is MOH (see points 21 and 22) and the reporting article is from CNA. My focus is the design of a job aid.

Maybe it is the educator who provides feedback or the instructional designer in me, but I look for clarity in any work. So I thought that the protocols presented by CNA could have been better.

I watched the video briefing, read the article, and studied the protocol summaries. The original protocol by CNA was:

The improvements (in blue) might include:

  • For clarity, the numbers refer to protocols, not steps to follow. Each should be labelled “Protocol #”. This sends a message: Do one of the following depending on which category you fall into.
  • I swapped the positions of protocols 1 and 2 because the majority of people (almost 99% according to point 5 of the MOH source) do not have mild or no symptoms. So the first protocol should address the majority.
  • Protocol 2 (formerly the first protocol) lacked the instruction to see a doctor. The CNA article stated that you are “encouraged” to do this; the MOH source has stronger wording (“should see a doctor, point 21). In the video briefing, the doctor’s diagnosis seemed to be a given. This instruction is not clear in the summary. This is remedied with the phrase “After you see a doctor”.
  • Protocol 3 should provide information (or a link) to where ART results should be uploaded. If an ART result is positive, the instruction should be to follow protocol 1 or 2 depending on the person’s health.

In the presence of a lot of information, people tend to refer to summaries, lists, job aids, etc. These are succinct versions of the long form instructions. Short forms tend to lose information and context, but they do not have to lose quality or clarity if we take care to design them carefully for communication or education.

I do not claim to have a perfect job aid. My background of instructional design simply gives me a critical eye for usability and clarity. It is a skill that transfers from the design of materials for teaching and learning to communication to the general public. I leave this critique here should I need it later as a reference for instructional/consultation material.

A local news report seeks to clickbait with its headline instead of educate. Again.

The number 129 might seem like a large number. It actually represents just 0.03% of all students in Singapore (primary to pre-university levels). That is part of the context.

The other part is that students are actually safer in school due to safe management measures [1] [2]. The distancing, hygiene, and modified classroom practices [3] mean that students are probably at greater risk in transit to/from school when they interact with adults who are less fastidious.

Such context provides quantitative and qualitative arguments for educating the general public. Such arguments make us smarter and more confident of our actions. Reading clickbait keeps us in the state of ignorance and fear.

One aspect of modern information literacy is not just reading beyond the headline, it is also about reading wide to other valid and reliable sources of information. Then another element of information literacy should kick in: Evaluating the original article for its worth.

Video source

The video above is about how mistrust for the SARS-CoV2 vaccine grows. I highlight a late segment with an educator’s point of view.

A paediatric group created its own communications department to educate its stakeholders and to counter misinformation and disinformation about COVID-19 and vaccines. It did this because lives and reputations were at stake.

Educators need to adopt a similar mindset as well. It is not enough to just keep our heads down and toil away. We need to speak up against bad ideas, policies, or practices. We need to share our ideas and resources openly and freely.

In our case, lives and reputations are also at stake, but seemingly not as urgently and not as obviously. Educators deal primarily with infodemics not epidemics. If we do not fight against bad ideas like learning styles, ill-informed policies like online proctored exams, or practices like e-doing instead of e-learning, then we passively enable them.

The epidemic lockdowns raised our collective profiles and reputations. Instead of returning to a normal of unseen educator work, we need to rise up and share. We do this to maintain or raise our reputations as knowledge workers. We do this to beat back the infodemic.

Recently, five Singapore doctors cautioned against inoculating younger males with mRNA-based vaccines because of a small chance of myocarditis, i.e., heart inflammation [source].

Their view was informed more by “heart inflammation” than by “small chance”. How small? According to this CNA article, there were 1,226 cases of myocarditis out of almost 400 million vaccine doses in the USA. This works out to a 0.0003% chance of getting myocarditis.

The same article reported that Singapore reported 6 cases out of about 5 million doses. This is an almost one in a million chance. You might be more likely to win a lottery than to get myocarditis.

The doctors also cited a USA report of the “death of a 13-year-old boy after being vaccinated with the second dose of an mRNA vaccine”. However, an expert committee here countered that by stating that “the news report cited by the doctors did not state death from heart failure as alleged”.

The small group of doctors might be well-meaning, but they have chosen to write a fear-based headline, speculated a causal link between vaccine and death, and ignored the statistical part of the narrative.

The group of five doctors overlaps with the 12 doctors who wrote an earlier letter, which like the latest one, was roundly debunked by the expert committee. Eleven of the 12 doctors who wrote that letter retracted what they said [CNA] [Today].

What damage both letters caused is difficult to determine. We might get some inference by measuring vaccine hesitancy and queues outside private clinics that offer non-mRNA-based vaccines, i.e., Sinovac in our case [source].

We have vaccines as a class of weapons against the current pandemic. We are less well-equipped with the infodemic. We need to learn to read, think, and act beyond a headline. If we do not, infected minds will lead to infected bodies.

I am a fan of reflective pieces like behind-the-scenes (BTS) peeks at people and processes behind prominent products.

Video source

This televised townhall featured how the Moderna SARS-CoV2 vaccine was borne over the weekend. I wonder how many people watched and listened long enough for a lead scientist to explain how it took at least a decade of work and preparation for that to happen.

I also wish that people would read about the people behind the BioNTech and Moderna vaccines [NYT] [Reuters] [StatNews]. 

There was the lead scientist, Katalin Kariko, whose ideas and findings provided the foundation for both vaccines. Kariko struggled for years on how to deliver a therapeutic mRNA into cells. She could not get funding because her ideas were untested and she was demoted. 

Kariko’s emigration to the USA was also the stuff of movies. She hid money in her daughter’s teddy bear to avoid the US$100 export limit enforced by her home country of Hungary.

The couple behind BioNTech are of Turkish descent. BioNTech’s Chief Executive is Ugur Sahin and is described as “humble and personable”. The husband and wife team are medical professionals and were responsible for building on Kariko’s proof of concept and then getting Pfizer to produce their vaccine.  

By contrast, the story of the Moderna vaccine is fraught with infighting and Wall Street bro culture, e.g., putting money-making potential ahead of everything else. During the vaccine development, Moderna did not publish its findings; BioNTech published about 150 articles.

I am glad that Singapore is partnering with BioNTech in establishing a regional HQ and manufacturing facility here. Good people matter.

Rising above, I am reminded why something that looks quick and/or effortless really is not. There was a lot of toil, pain, and learning from failure that led up to the glam shot.

Teachers and educators can learn from press briefings.

Press Q&As are important for both politicians and the press. Amongst other things, they allow politicians to explain policy and journalists to clarify.

But politicians must communicate as best they can first. Take this important press briefing to remind us about using better masks as a pandemic control measure.

Video source

The general public needed to be reminded or educated on why cloth and single layer masks were insufficient. But I wondered why the ministers and experts did not provide examples of better masks.

These examples could be images or actual samples of such masks. The visuals or physical artefacts would illustrate and reinforce the verbal message of what “better masks” meant. See what this newspaper did the next day.

As an educator, I am not about to cite the bunk myth of what we remember aurally vs visually. That pseudoscience “theory” was a misused version of Dales Cone of Experience.

However, there is support for providing multiple stimuli for cognitive encoding. This is why teachers are taught to provide more than one medium and method when teaching a new concept to students.

Rising above, it is easier to stick to what one is comfortable with, e.g., just speaking and expecting people to listen. The problem is that your audience or learners do not see what you see in your mind’s eye. With just a bit more effort, e.g., bringing a few different mask samples, you get your point across more efficiently and effectively. Don’t just tell, show and tell.

Video source 

Video source 

The easy thing to do with videos like these is to show them to students who complain about going to school and telling them how grateful they should be.

The more difficult thing to do is to draw out meaningful questions, generate discussion, and educate our students on empathy and action. 

How do you balance the need to create a headline good enough to get readers to click through and getting an important message across? These should not be on opposite sides, but they are in a CNA news article.

This was the tweeted headline from CNA (screenshot below, in case the original tweet is deleted).

The actual article reported this:

First, ask yourself: How many people bother to click through, i.e., read beyond the headline?

Next, if readers do not read the article, they are left with the information that there are at least 2,700 reports of adverse vaccination effects among 2.2 million doses.

The potential impact of the headline is the attention paid to the 2,700 reaction cases. This creates or reinforces fear that fuels vaccination hesitancy. 

How many then learn that the adverse effects were classified into not-so adverse (common reactions) and actually adverse (serious reactions)?  The latter was represented by 95 cases.

That number of cases is 0.004% of doses administered (95/2,213,888 x 100). The article stated 0.04% which is 10 times higher. The same article has a table which reports the correct figure of 0.004%. The percentage in the main body of the text and the table do not match.

Finally, how many rationalise that 0.004% is a very small incident rate? How low is this chance? You have a 1 in 25,000 random chance getting a severe reaction to vaccination.

How unlikely is 1 in 25,000? I found a summary site of statistics maintained by someone who mined NSC and CDC data. If we were in the USA in 2002, each person had a 1 in 25,000 chance of being murdered with a gun.

If that is hard to relate to, then you get my point. The tiny chance and the large number of doses are difficult to rationalise. Suffice to say that the chance of reacting severely to the vaccination (or being gunned down) is very small.

Think of it this way: If you were in the USA and not terribly afraid that you were going to get shot, you should not be afraid that you are going to react severely to the vaccination.

The issue that writers and editors of newspaper headlines do not seem to understand is human psychology. People tend to focus on the part of the headline that screamed “reports of suspected adverse effects”. The headline also includes the initialism HSA, Singapore’s Health Sciences Authority. So it might come across as a warning. The number of cases could have been 27 or 270, but the focus would have been on the authority and the adversity.

The messaging is important. Recipients have a right to know the possible side effects of the vaccination. The HSA was transparent with its statistics. However, the news agency was irresponsible with the clickbait headline and the wrong calculated figure of the severe cases in the main body of its text.


Video source

If Johnny Harris has his facts straight, then there is a surprising and enlightening historical link between Belgian imperialism of the Congo and the Johnson and Johnson (J&J) COVID-19 vaccine. The video is well worth the watch for the story and the skill with which Harris serves it up.

For me, this is a reminder to always be aware of the history of any policy, process, or product. In my field, all three are ingredients of edtech.

Like the J&J vaccine, each form of edtech has storied histories. Some might have dark or dirty roots. While we cannot change the past or if the present might be positively unrecognisable from a shady past, knowing the history is still valuable.

How so? After being informed about the past, I believe that we can do something about making the present policy or practice better. For example, content management systems with strict command and control might be giving way to more open platforms that encourage co-creation and collaboration.

We can also can be humble about what we are involved in. This approach is particularly relevant if we are part of a successful intervention, e.g., the provision of mobile devices and Internet dongles to students-in-need. We acknowledge what others have done to enable online and distance learning, and do our part to keep everyone moving forward and upward.


Video source

This video is timely given the misleading way some people use the efficacy numbers of different COVID-19 vaccines.

The efficacy of the a vaccine is not the same as its effectiveness. I recommend this NYT article for an explanation of how something like “95%” efficacy is derived.

Vaccine trial efficacy is not the same as real use effectiveness. A trial use of the vaccine includes a placebo for one sampled group of people and the vaccine for another group. Actual use only includes the vaccine and is applied across a much larger group of people.

The J&J vaccine trials were also conducted in South Africa and Brazil. Vox video (https://www.youtube.com/watch?v=K3odScka55A) on why the vaccine efficacy numbers cannot be compared.

The J&J trials were also conducted outside the USA — in South Africa and Brazil.

The J&J vaccine trial was conducted over a more severe infection period. Vox video (https://www.youtube.com/watch?v=K3odScka55A) on why the vaccine efficacy numbers cannot be compared.

The J&J vaccine trial was conducted over a more severe infection period.

Back to the video — it explains why efficacy numbers cannot be compared. For example, the Moderna trial was only in the USA. The Johnson & Johnson (J&J) trial also included countries outside the USA (Brazil and South Africa) where variants of SARS-CoV-2 emerged. It was also conducted over a more severe infection period compared to the Pfizer/BioNTech and Moderna trials.

Here is something the video did not point out. The Pfizer/BioNTech and Moderna vaccines have high efficacies after two doses. The J&J vaccine is a single-dose shot.

Screenshot of the range of outcomes after vaccination. From Vox video (https://www.youtube.com/watch?v=K3odScka55A) on why the vaccine efficacy numbers cannot be compared.

The range of outcomes after vaccination.

The video also highlighted that all the vaccines are not designed to absolutely prevent COVID-19 symptoms. If after vaccination people got mild to moderate symptoms, the vaccine is considered effective.

During the trials, all the vaccines mentioned in the video prevented hospitalisation and death among sampled participants. By that measure, all the vaccines were just as good. If we focus only on trial efficacy numbers, we lose sight of this more important outcome.

One general takeaway that applies in any problem-solving and policy-making is this: Numbers are a start, but they are not the end. The explanations and narratives that accompany them provide depth, nuance, and exceptions. If we do not go beyond the numbers, we risk misinforming ourselves and others.


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