The Asian disease problem has been widely used to demonstrate the framing effect, whereby different wording of the same options leads to predictably different choices. Notably, it is highly evocative of the COVID-19 pandemic. Accordingly, we investigated how participants would respond to the problem as part of a large-scale international survey (Nincluded = 88,181) conducted from March to May 2020. As predicted by the appraisal-tendency framework, we found larger risk aversion and a larger framing effect than under typical circumstances. Also consistent with the appraisal-tendency framework, we found that perceived stress and concerns over coronavirus were positively associated with the framing effect, while lower levels of trust in the government’s efforts to handle the pandemic were negatively associated with the framing effect. However, the findings did not support predictions regarding the associations between distress, concerns, and trust, and risk aversion in general. Our findings showed that the framing effect is magnified under conditions of high distress and concern, and mitigated under conditions of high distrust. This work might also provide important practical implications regarding the optimal way of framing public messages involving risk, and the possible cross-national variability of the perception of these messages.