By Assoc Prof Dr Nazri Che Dom & Oswald Timothy Edward

When the COVID-19 pandemic swept across the globe in early 2020, the world came to a halt. Governments imposed lockdowns, economies slowed, and societies collectively braced themselves for a health crisis unlike any in recent history.

Fear surged through the public consciousness, fuelled by graphic imagery of overburdened hospitals, death tolls rising on news tickers, and stringent policies aimed at curbing the spread of the virus.

Yet amid this understandable panic, a quieter, far more persistent killer continued its grim work largely unnoticed – the mosquito.

Mosquitoes, often dismissed as mere nuisances, are responsible for more deaths annually than any other creature on the planet.

According to the World Health Organisation (WHO), mosquito-borne diseases such as malaria, dengue, Zika, chikungunya, and yellow fever collectively claim more than 725,000 lives each year.

In comparison, as of early 2025, global deaths attributed to COVID-19 have reached around 7 million over a period of nearly five years, based on available data. This equates to an annual average of approximately 1.4 million deaths, with numbers significantly lower in recent years due to vaccinations and herd immunity.

Yet, despite this disparity, the fear of mosquitoes remains minimal, while the fear of COVID-19 was – and in some quarters still is – palpable.

This discrepancy invites critical reflection. Why is there such a stark difference between the actual risk and the perceived risk in the public psyche? And what lessons can risk management practitioners, public health authorities, and policymakers learn from this contrast?

The science behind the mosquito threat

Mosquitoes are not just irritating pests – they are disease vectors. The female Anopheles mosquito transmits Plasmodium parasites that cause malaria, which alone killed approximately 608,000 people in 2022, mostly children under the age of five in sub-Saharan Africa, according to the 2023 WHO Malaria Report.

The Aedes aegypti species is a known transmitter of dengue fever, a disease that has seen exponential growth, especially in Southeast Asia and Latin America.

In 2023, Malaysia alone reported over 120,000 dengue cases with 100+ deaths, a number that far exceeds the nation’s COVID-19 fatalities in the same year.

The danger lies not in the insect itself, but in its ability to carry and transmit pathogens. The challenge with mosquito-borne diseases is that they thrive in tropical climates, where stagnant water, urbanisation, poor sanitation, and insufficient healthcare infrastructure create ideal breeding grounds.

Unlike COVID-19, which requires close human contact for transmission, mosquitoes act independently, transcending human efforts to self-isolate or socially distance.

Perceived risk vs actual risk

The field of risk management emphasises two core concepts: actual (objective) risk and perceived (subjective) risk. Actual risk refers to the measurable likelihood and impact of an event, while perceived risk is shaped by emotional, cultural, and psychological responses.

COVID-19, with its newness, rapid spread, and media amplification, created a high perceived risk. People feared it because it was visible – death tolls were reported daily, masks became symbols of fear, and the virus altered our daily lives drastically.

In contrast, mosquito-borne diseases are normalised in many regions. They have been part of the health landscape for so long that they are often seen as unavoidable or routine.

This mismatch between perception and reality reflects what scholars call the "availability heuristic" – a mental shortcut wherein people assess the probability of an event based on how easily examples come to mind.

COVID-19 dominated news cycles; mosquito-related deaths did not. This cognitive bias clouds rational risk assessment and results in skewed prioritisation in public health funding and attention.

Media influence and public messaging

Media plays a central role in shaping risk perception. COVID-19 had the benefit – or curse – of being a sensational story. Its novelty, its impact on affluent nations, and its implications for global mobility made it headline-worthy.

Conversely, malaria and dengue are often viewed as diseases of the poor, confined to developing nations, and hence receive limited coverage unless there's a massive outbreak.

Moreover, public health campaigns around mosquitoes are often seasonal and reactive rather than continuous and proactive. Fogging exercises, for instance, are more symbolic than strategic and tend to occur after outbreaks rather than before.

In contrast, COVID-19 responses were well-funded and coordinated globally, with mass vaccination campaigns, continuous media updates, and policy attention.

Implications for risk management

From a strategic risk management perspective, the failure to allocate proportional attention to mosquito-borne diseases highlights a gap in risk prioritisation. Effective risk management involves evaluating both likelihood and severity, developing mitigation strategies, and investing in long-term resilience.

Governments and health systems must move away from reactionary health governance to one that anticipates and addresses chronic, ongoing risks like vector-borne diseases.

The overemphasis on pandemic preparedness (while crucial) must not overshadow the persistent threat posed by mosquitoes. Risk managers must recognise that high-frequency, low-visibility threats can be as dangerous – if not more so – than low-frequency, high-visibility threats.

This also calls for public re-education. Schools, community groups, and media platforms must reinforce the reality of mosquito-related risks. The use of data visualisations, local case studies, and survivor testimonials can help counteract cognitive biases and build a more accurate public understanding of threats.

What can be done?

1. Strengthen Surveillance Systems
Real-time data collection on mosquito populations, bite rates, and disease clusters can allow for targeted interventions.

2. Invest in Community Education
Community-led initiatives that teach people how to identify breeding sites, use repellents, and adopt preventive behaviours have proven effective.

3. Support Research and Innovation
Genetically modified mosquitoes, larvicides, and new vaccine technologies (like the RTS,S malaria vaccine) show promise but require consistent investment.

4. Incorporate Risk Communication into Policy
Authorities must learn from the success of COVID-19 campaigns. Consistent, credible messaging tailored to cultural contexts can shift public perception.

The fear of COVID-19 was legitimate, but it inadvertently overshadowed a more persistent and equally lethal threat: the mosquito. The disproportion between actual deaths caused by mosquito-borne diseases and the public’s fear of them exemplifies the human tendency to misjudge risk.

For Malaysia – and indeed, the world – this is not just a health issue, but a risk management challenge.

As we move forward in a post-pandemic era, it is crucial to recalibrate our societal focus. Instead of being driven solely by what is novel and terrifying, we must also pay heed to what is familiar and deadly.

Only then can we design health systems and risk management strategies that are truly fit for purpose – grounded in facts, not fear.

-- BERNAMA

Assoc Prof Dr Nazri Che Dom (nazricd@uitm.edu.my) is Senior Lecturer at the Faculty of Health Sciences, Universiti Teknologi MARA Puncak Alam, Selangor.

Oswald Timothy Edward (oswaldte@gmail.com) is Senior Lecturer (Risk Management) at Universiti Teknologi MARA Johor.