1123 GMT April 05, 2020
The UK government’s new measures, its experts said, took into account these behavioral factors, such as the potential for “fatigue” – the idea that public adherence to quarantines might wane over time, the Guardian reported.
The implied logic was that asking less of the public this week could buy greater compliance down the line, when it is most crucial. Factors such as the potential for loneliness and stress in isolation were also considered.
Professor Susan Michie, director of the Centre for Behaviour Change at University College London and a member of the government’s advisory group, the Scientific Pandemic Influenza Group on Behavioural Science, said these assumptions are in part based on observations of human behavior during past pandemics.
The body of research included a rapid review published in the Lancet last month on the psychological impact of quarantine, which found that self-isolation can lead to post-traumatic stress, anxiety, depression and public anger.
Indefinite quarantines with no well-defined end point – such as those imposed in Wuhan – risk having the most negative side-effects, the paper suggested, recommending that quarantines be restricted to the shortest time period possible and that the public be given a clear rationale for such measures.
Other influential research includes a paper by the Economic and Social Research Institute in Dublin on how to harness behavioral science to fight the coronavirus. It found that extending isolation periods beyond initial suggestions risked demoralizing people and increasing noncompliance.
“Thus clarity and certainty about timelines are both important,” the paper concluded.
The term “fatigue” conjures up middle-class sacrifices, such as feeling cooped up at home and being unable to visit friends or shops. But for some there are harsher realities that make compliance with extensive social distancing measures – like those employed in Italy – more difficult. So providing community-level practical support, as well as getting people to buy into public health advice, is crucial.
“There are so many communities at the margins in terms of finance, who might not have enough food, whose homes are cold. I really haven’t heard enough detailed plans about that yet,” said Michie.
According to Michie, governments often use what is termed the COM-B model of behavior change, which states that in order to arrive at a particular, desired behavior, people need to have the requisite capability, opportunity and motivation (COM).
“Unless you can tick all three of those, the behavior is not going to happen,” she said.
The three essential ingredients can also be interlinked, she said. “People will accept losing things and making sacrifices if there’s equity. People need sick pay at a decent rate from day one, otherwise the inequalities could get greater and we want them to be reduced so people feel we’re all in this together.”
To gauge public opinion in the current pandemic, Michie said, the UK Department of Health had conducted weekly surveys looking at attitudes and awareness, with input from behavioral and psychological scientists. “That’s feeding into the government [decisions],” she said. “From the surveys, some people are worried, but some people are not that worried and are not changing their behavior. There’s a real mixture out there.”
Against a backdrop of public ambivalence, expecting people to recede into prolonged quarantines might prove ineffective. “The more concerned you are, the more likely you are to adhere to it,” Michie said. “If a big bunch of the population is not that concerned and you’re asking people to sacrifice quite a lot, it won’t be as effective if those two things are well-matched.”
The government may also be factoring in spontaneous changes in behavior, such as businesses allowing people to work from home, which have not required government intervention.
“We’re having change instigated at lots of different levels of society,” said Michie. “That’s great, because we’ll move as a whole. If you have a very top-down approach, you can build up resentment and lose people.”
Michie said that while she was aware of some psychological evidence that is likely to have informed government decisions, she, and others, would like greater transparency about the evidence base.
“It would be really helpful if they explained why we’re not going further down the road of cancelling big events and so on,” she said. “We do know that transparency is really important for trust. And trust is really important for adherence.”