This is the first of a series of posts about behavioral science and COVID-19.
Government officials are trying to yell life-saving instructions over the roar of social media. And some of us are trying to follow those instructions and encouraging stubborn family and friends to do so, too. These directives aren’t just hard to communicate, they’re also hard to follow – even for people with the best of intentions. Behavioral science research helps us understand why and suggests key ways that we can make it easier for everyone to do what they need to during this time of uncertainty.
We will focus here on two of the most important behaviors: social distancing, and seeking medical help.
Social distancing – which we prefer to reframe as “healthy distancing” – is a powerful public health tool, and it’s one of the few tools we have at this moment to slow the spread of the virus and save lives. Why is it that we may fail to act? And, what can we do about that? Behavioral science offers a few key insights:
Make consequences salient. When the benefits of an action are in the future or nebulous, but the costs are immediate, we tend to overweigh those costs and avoid the action. When there are tempting options available, we find it even harder to do what we should. Do you go to that friend’s small gathering or stay home alone? Even if you know that society is better off with you staying home, you can’t resist seeing your friends. The more vivid we make the benefits of social distancing and/or consequences of inaction, the more likely people will be to adhere to guidance. We also know from behavioral science that people respond more strongly to losses than gains, so telling people they could cause others to die by going out should be more effective than telling them they’re saving lives by staying home. Behavioral researchers are testing messages such as this one in Rome: “You could be infected without symptoms. If you go out, you could infect 45 people within two weeks, and 2000 within a month.”
Make it visible that most people are following distancing guidelines. We are all heavily influenced by descriptive norms – that is, what we see others doing and how others around us are acting – and people tend to do what is most common. But descriptive norms can be particularly powerful when people are uncertain what to do; if someone does not know what to do, they are likely to look around to see what others are doing. If people are visibly social distancing, more are likely to follow; but social distancing is a largely unseen behavior. Unfortunately, the streets aren’t totally deserted and the places we’re going – supermarkets, pharmacies, and parks – are still crowded. In this case, publishing statistics about reduced ridership on mass transit or photos of empty streets can make it more salient that others (who don’t need to leave their homes) are following guidelines.
Give focused and specific guidance. If you’re sharing guidance with constituents, friends or family, reduce – and simplify – information whenever possible. We know from behavioral science research that when people are overwhelmed with choices, they choose nothing. Not only are we all seeing a constant flow of information and advice from media outlets and social media, but even the official instructions out there are extensive and sometimes ambiguous. For example, healthy distancing guides list dozens of do’s and don’ts, when shorter lists of the most common behaviors would be more effective to share.
Behavioral research suggests that people may not even try distancing because it feels unachievable. It’s amorphous, broad, requires too many changes in lifestyle, and has no end in sight. More specific instructions can make healthy distancing feel more achievable. Also, asking people to try the new behaviors for a week or two can feel more achievable to them. As people get familiar with the new behaviors, and form new habits, engaging in these new behaviors for longer periods could feel less daunting.
More specific instructions also avoid the problem that people try to distance, but end up doing it poorly. That may happen because they misinterpreted a vague instruction, or it could happen if they didn’t plan their new behavior. For example, it’s quite easy to wind up going to the grocery store more often than you intended because you underestimated how much you need to buy. Every family member eating every meal at home is not something people are accustomed to in many places. Grocery shopping is going to be the most frequent outside errand with exposure to the most number of people, so we must make it as efficient as possible.
Instead of simply “don’t leave your house except for essential activities,” we might supplement this advice with:
- Plan meals for a week for you and your family. Remember that you have more people eating all their meals at home so you need more groceries than usual! Make a shopping list. Only then go to the grocery store or order delivery. This will minimize the number of times you have to go shopping and the time you’ll spend in contact with others.
- Call/video chat with your friends and family instead of visiting in person.
- Get outside while maintaining a safe distance of at least 6 ft from others, e.g. your yard, take a walk in a park. Keep these outings to less than an hour.
- Invent a new version of old socializing, such as chatting with people who are on the opposite side of the street. Or even play a game – with no contact – across the street, like charades.
- Walk or bike instead of taking public transit whenever you can.
We also need to communicate instructions for when to seek medical help much more clearly and frequently. Our quick review of various websites reveals that information about symptoms vary, and the instructions for when to seek help are confusing or too lengthy. Because there has been so much press about the lack of testing infrastructure, people are much more likely to form the impression that they should get tested if they have even the slightest of symptoms. Many may even feel that they should be tested even without any symptoms manifesting. But such requests can overwhelm hospitals and take resources away from those who actually need them.
Very simple instructions, communicated repeatedly, could help. For example, “If you have a fever, cough and/or difficulty breathing, and have been in close contact with a person known to have COVID-19 or have recently traveled from an area with ongoing spread of COVID-19, stay home and call your healthcare provider. Your doctor will determine if you have signs and symptoms of COVID-19 and whether you should be tested. If you have severe symptoms, contact your healthcare provider or emergency room and seek care immediately.”*
These are just a few ways to apply behavioral insights to communications to help people follow guidelines about healthy distancing and when to seek medical care. We will continue to share insights about how behavioral science can strengthen efforts to address the problems that arise due to the pandemic.
*This message is an illustration, and specific policies could differ from one locality to another.