Thursday, 24 December 2020

Mitigating the new variant SARS-CoV-2 virus: How to support public adherence to physical distancing

Journalists often ask me how the public will behave when the next set of Covid-19 restrictions begins. Will they accept the rules or ignore them? This matters crucially right now. With rising infections in many areas of the country, and with the new variant of the virus rampant, physical distancing and other behavioural interventions are more important than ever.

The first thing I point out in response is that adherence to most of the behavioural regulations has been very high (often over 90%) throughout the pandemic.

The second thing I say is that adherence to physical distancing and avoiding contacts with others goes up in lockdown periods This probably reflects the recognition in the public that the greater restrictions signal greater need to adopt the mitigating measures.

Yet both anecdotes and the survey data suggest that adherence to 2m physical distancing declined in early December following the end of the second ‘lockdown’. It’s worth looking more closely at these dynamics of physical distancing, because this behaviour is perhaps the most visible form of adherence, and it is the one where breaches are often the subject of critical comments.

The UCL Covid-19 Social Study (data collected up to 13th December) shows that ‘complete’ and ‘majority’ compliance went up during the November ‘lockdown’, but that ‘as these [restrictions] have been eased in the past month, compliance has started to decrease again’.

The Office for National Statistics weekly survey for data collected in the period 2 to 6 December noted a drop (albeit small) in distancing behaviour (whereas for other protective behaviours the compliance rate remained high).

Journalists and others are ready to frame any such decline in adherence to physical distancing as public ‘fatigue’ - an ‘explanation’ we have heard from the beginning of the pandemic.

It is true, of course, that the behavioural interventions are hard to endure – and some (such as self-isolation) are a lot harder than others (such as handwashing). But recent analysis of public responses over the course of the pandemic is not consistent with the notion of ‘fatigue’. The review showed that (1) Overall adherence has been high, as already mentioned (2) There is not a linear decline (3) Intention has also remained high.

What is the real psychology that determines levels of adherence to physical distancing? There is now plenty of evidence on the psychological predictors. First, knowledge and perception of risk matter. Second, there is the belief that physical distancing is effective in providing protection. Third, a number of studies show that social norms, and in particular whether relevant others are doing the same, predicts own adherence. Fourth, group identification has been found to be a predictor, including national identification and identification with the family. Fifth, linked to this, we physically distance as a way of caring for others, and so empathy for those most vulnerable to the virus is also a predictor. Finally, a negatively predictor is low trust in government. This last point ties in with what we know about predictors of other behavioural mitigations, confidence in government action against the virus, being one of the most important.

Levels of public adherence to physical distancing have varied over time. There is evidence that key public events have affected the psychological predictors and hence adherence to distancing.

In May, there was a clear reduction in reported distancing (identified in both the ONS survey and the UCL Covid-19 Social Study) which appeared to be linked to two developments. First there was a change in the messaging (from ‘stay home’ to ‘stay alert’); this impacted upon people’s understanding of what they should actually do, as it was an injunction about how to feel rather than a specific behaviour.

Also in May, there was for some people an alienation from the government in response to the Cummings incident, which starkly revealed that while most people would be fined for breaking the rules, some would not.

There was a further decline in adherence levels in July. This appeared to be a result of a signalling effect whereby there was a media fanfare around ‘freedom’ and ‘end of lockdown’ leading up to the relaxation of restrictions on July 4th.

The decline in public adherence to physical distancing observed in early December may be due to a signalling effect similar to that in July. The positive publicity around the vaccine (approved December 2nd), the announcement of the relaxation for 5 days at Christmas (made on 24th November), and the ending of the second ‘lockdown’ (December 2nd) all came at the same time. Together they may well have communicated that risk is now lower and therefore less stringent adherence to physical distancing is required.

But with rising Covid infections in many areas of the country, and with the new variant of the virus at large, physical distancing and other behavioural interventions are more important than ever. For the public, it’s worth reminding ourselves that:

-       Physical distancing works (efficacy)

-       Most of your neighbours and wider circle are observing physical distancing most of the time (norms)

-       Think of those most vulnerable to the virus (empathy)

-       Do it for ‘us’ as a way of showing you care (group identification)

For the UK government, it’s important to avoid those actions that undermine these public beliefs and perceptions, and to increase those actions that support public understanding of and engagement with physical distancing and the other mitigating behaviours. This would mean:

-       Respond early to the threat instead of leaving it too late

-       Avoiding hyperbolic messaging on future ‘successes’

-       Provide practical advice on areas of risk and precise behavioural mitigations, in particular around close contact

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