This article was originally published on LinkedIn on 22 April 2020. It has been moved to the riskfacilitator Insights library so the website remains the permanent source.[1]
Connecting the dots between infection and prevention.
COVID-19 infection prevention is plagued by what is referred to as causal opacity. We are rarely, if ever, able to connect cause to outcome. In infection prevention, causal opacity is the result of two factors. First, the transmission event is silent since the pathogens are invisible to the eye. Second, the incubation period temporarily separates cause from effect, COVID-19 incubation is usually some where between 1 and 14 days!
Causal opacity also negatively impacts hand hygiene compliance. Imagine if you failed to wash your hands, interacted with another person, and the infection in the other person manifested within seconds after touching the person. Like an instantaneous electric shock, the immediate feedback would probably keep you from ever failing to wash your hands again.
Society is not designed to prevent the opacity of infection, we just don't have the instantaneous feedback required to change our behaviour, hence why regulated isolation and social distancing are excellent first lines of defence in reducing the risk of infection.
Recently, causal opacity has hampered the ability to understand the effectiveness of personal protective equipment such as face masks and gloves, but countless studies demonstrate the effectiveness in reducing the risk of infection when used correctly, however, when dealing with risk, human factors will defeat procedures every time.
The end result is that causal opacity makes it harder to hold persons, systems and practices accountable with regards to infection prevention. But we all have a responsibility to reduce the risk to as low as reasonably practicable. Isolate, practice social distancing, and wear personal protective equipment in high risk situations, not every situation!
Paul Chivers, Risk Advisor
References
- Paul Chivers, COVID-19 Causal opacity, LinkedIn, originally published 22 April 2020.
- World Health Organization, COVID-19 health and safety in the workplace, accessed 10 August 2026.
- World Health Organization, COVID-19 ventilation and air conditioning, accessed 10 August 2026.
- Safe Work Australia, Model Code of Practice: Managing the risks of biological hazards at work, accessed 10 August 2026.