Since COVID-19 arrived in the U.S. earlier this year, the virus has infected more than 5 million Americans, claimed at least 167,000 lives and caused financial ruin.
Some Americans have solemnly followed the recommendations of public health experts – recommending counseling, canceling the trip, staying home with young children at work. Others overcame the most basic precautions, refused to wear masks and continued to gather in large groups.
Psychology and public health experts say that variations in how people respond to public health recommendations can be attributed to differences in how they navigate threats, as well as social and cultural factors. These factors can also affect whether people are able to sustain behavior change for the long term ahead – exhausted parents, exhausted frontline workers, the millions of Americans who are lost through isolation.
“It’s easy to think that people do not follow the recommendations because they do not want to, but there are also systemic and situational problems at play that affect people’s behavior,” said Stephen Broomell, a associate professor at Carnegie Mellon University who studies judgment and decision making under ambiguity. “These can range from problems with communication, understanding and personal risk assessment.”
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While many countries have successfully stopped the spread of COVID-19, the US on Thursday reported the most COVID-19-related deaths in a single day since May. Successfully combating the pandemic, experts say, requires large-scale cooperation for much longer than one expected.
“Until we get a vaccine, our only real tools are behavioral behavior. We have to think through the lens of behavioral science. What can we do to hug and encourage people and motivate them to do the right thing?” said Jay Van Bavel, an associate professor of psychology and neural science at New York University.
“I think a lot of people hope we’d shut everything down for two weeks … and then go back to normal. But because we did not do it well originally, we’re in this ongoing nightmare.”
What health officials are working against
A 2016 study found that changing health-related behaviors is neither obvious nor common sense, but rather ‘requires careful, thoughtful work that leads to a deep understanding of the nature of what motivates people and the pressures that’ t act on them. “
Human behavior is complicated. Telling people what they need to do to keep themselves and others safe seems basic, but behavior change does not happen in a vacuum. They occur in the context of the societies in which people live and the groups in which they belong.
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In the US, health officials are asking people to think about the collective good in a country that is rooted in individualism. Countries that emphasize the importance of duty and obligation, such as Asian societies, have an easier time motivating people to do what is right about what is desirable.
“If you look at countries that are more collectivist … people feel more pressure to go along with what’s good for the group,” Van Bavel said. “Here we have traditions of individualism, which are great most of the time, but in the context of a pandemic are not so great, and often very dangerous for everyone.”
Some people may also want to follow the recommendations but may not. They can live with someone who does not follow CDC guidelines, or they have a job, in particular a low-wage one, where they can not take social leave or take paid sick leave. People who are homeless cannot hide in place. Some survivors of trauma may find it difficult to wear masks.
Missed opportunities meant an upward climb
Experts say what happens in the early days of a crisis can be the key to how well people respond to what is asked of them.
Earlier this year, Trump said “the coronavirus is very much under control.” In February, he said cases would “go down.”
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Trump’s statements have often been attributed to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who has repeatedly stressed the need for behavior change to curb the spread of COVID. Research shows that people are more likely to adopt public health recommendations if they are communicated clearly and consistently.
Masks, for example, were not a recommendation at first, and even if they had become one, there were conflicting messages from the White House about their importance. The president wore a mask for the first time in July.
“Unfortunately, wearing a mask was not one of the behaviors that people adopted during the first weeks of the pandemic,” Broomell said. “Because of this, most people survived the onset of the pandemic without a mask. Only the small part that resisted the virus and became ill had the accurate feedback that their behavior was not actually as effective as they thought.”
Focus on shared national identity and avoid shame
America is deeply polarized. One of the most persistent gaps in adherence to social distance, handwashing, masks, soon-to-be faxes – is the difference between Democrats and Republicans.
A recent Gallup poll found that 81% of Democrats are willing to be vaccinated if a free and FDA-approved one was available, while 47% of Republicans say the same.
So-called filter bubbles – where people only encounter information that matches their existing beliefs – can create changing realities about risks and actions needed to reduce them. Social media is ripe for collusion theories and misinformation, making it difficult for some people to get their news online to separate fact from fiction.
Van Bavel says to encourage cross-pollination of good health-related behaviors, people need to concentrate more on their shared sense of national identity.
“Appeal to someone who is politically different from you, appeal to … your sense of shared purpose,” he said.
Shame and humiliation are not effective tactics to change behavior, experts say. If you want to convince a Republican to wear a mask, Van Bavel said, show her the recent photos of Trump wearing one, like those of Dick Cheney who went viral.
Provide leadership on the importance of vaccination
Health experts say to win the battle against COVID-19, widespread vaccination is essential, but the Gallop poll generally found one in three Americans do not receive the vaccine when it is available.
Different strategies will be needed to address different causes of faxing hesitation. People who are concerned about security will need confidence; people of color will need to be involved in a process that builds trust; and people worried about too much government should be heard, said Monica Schoch-Spana, a senior scientist at the Johns Hopkins Center for Health Security.
Visible leadership will be the key.
“You’ll need people like the president to get a fax at a press conference,” Van Bavel said. “That’s the type of leadership you need. Role models, showing the right standards, illustrate that it’s easy and harmless, that he trusts the process.”Reviews: Decided COVID-19 by vaccination needed for all. It’s not un-American, it’s patriotic.
Now is the time to model behaviors you want to see in others
People are more likely to cooperate when they believe that others are cooperating.
“Even if you do not agree with wearing a mask, if you see everyone around you in your community or in your neighborhood doing it, you are more likely to do it,” Van Bavel said. “That’s part of human nature, and there’s a lot of evidence that norms matter for our behavior in many different situations.”
Everyone has the opportunity to make an impact – the president, the media, individual members of the community. Peer pressure can be an effective nudge.
“We all influence others around us,” Van Bavel said. “What we wear, how we act, what we post on social media. These provide guidance to other people on how to behave.”
Remember to talk about these changes as the ‘new normal’
Broomell says when people think about what changes as the new normal versus a response to a temporary crisis, it may promote the healthy behaviors experts want to see.
Exhaustion can come from, among other things, having to pay special attention to your behavior, waiting for the day when you no longer have to perform it, and not knowing when it will end. For certain behaviors, one way to help people wait to maintain is to establish a standard for their performance, ”he said.
Remind people what they are doing matters
People are fearful, and experts say it’s worth remembering Americans for what the country has already survived, including two brutal world wars.
To warm up to this crisis, people need to be reminded that their actions matter – that those actions are what the country will see through the pandemic with less lost lives.
“If we all pull together for another six months, the faxes will be on course and we may be through here,” Van Bavel said. “We may not have to lose our grandparents or colleagues as neighbors. Can you still go through six months doing the right things? Because we will look back and be truly devastated if we have lost loved ones because we just couldn’t be patient enough. “
Participant: Karen Weintraub, USA TODAY
