key: cord-264769-gp2tie7k
authors: XiangNg, Qin; De Deyn, Michelle Lee Zhi Qing; Loke, Wayren; Chan, Hwei Wuen
title: A Framework to Deal with Uncertainty in the Age of COVID-19
date: 2020-06-20
journal: Asian J Psychiatr
DOI: 10.1016/j.ajp.2020.102263
sha: 
doc_id: 264769
cord_uid: gp2tie7k

nan

Uncertainty seems to be a constant in this evolving pandemic. Our current understanding of the SARS-CoV-2 is still limited, especially with regard to the epidemiologic features of the virus (Wang et al., 2020) . We are 'assaulted' with new (and even contradictory) findings and interpretations on an almost daily basis. Research studies are being published at a feverish pace (Laine et al., 2020) ; researchers have now highlighted and then disputed a previously underappreciated reservoir of asymptomatic 'spreaders' (Gandhi, Yokoe & Havlir, 2020; Wei et al., 2020) .

There is also no definitive treatment or vaccine at present. Many have touted the efficacy of hydroxychloroquine despite the lack of rigorous clinical data (Molina et al., 2020) . This can be seriously confusing and dangerous for the layperson. In an extreme example, an Arizonian man died from consuming a form of chloroquine used to clean aquariums, days after the anti-malarial drug was touted by some as a potential cure for COVID-19 (Waldrop, Alsup & McLaughlin, 2020) . Governments worldwide have also adopted an assortment of approaches, from the partial or complete closures of public facilities and spaces, rigorous contact tracing to a less intensive approach, albeit with variable success (Forman et al., 2020) . There is a need to recognise which approaches and proposals work.

The VUCA framework, which is commonly applied in business and military settings (Bennett & Lemoine, 2014) , well encapsulates the challenges individuals and governments face in these uncertain times. The framework also outlines the approach one should take, with due consideration of the amount of information available and the certainty of the situation. We adapted some of the key elements of the VUCA framework and correspondingly, we see in Figure 1 , that the complexity and uncertainty inherent in the COVID-19 pandemic mandates that governments must face "unknown unknowns". This also means enlisting the expertise J o u r n a l P r e -p r o o f of relevant specialists and building up resources to address the complexity; and being transparent with information to alleviate the ongoing uncertainty of the situation.

An important lesson we have learned from this evolving pandemic is that the lack of transparency creates further confusion and undermines public trust (Alwan et al., 2020; Tandon, 2020) , and the bureaucratic process should aid and not hinder crisis management.

Early reports of a 'SARS-like' illness were ignored by the Chinese government (Enos, 2020) , which led to widespread outrage at the injustice and inaction. (Stafford, 2020; Cousins, 2020) . On the other hand, much J o u r n a l P r e -p r o o f

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The authors report no conflicts of interest. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors alone are responsible for the content and writing of the article.

None.
