Opinion

Author: Dr Hannah Durand, School of Psychology

Analysis: people need to see clear evidence that their sacrifices are making a difference in order to stick to ongoing restrictions rather than fines or arrests

Last Sunday night, the National Public Health Emergency Team (NPHET) sent a letter to Government which recommended that all counties in Ireland be upgraded to Level 5 of the Resilience and Recovery 2020 – 2021: Plan for Living with COVID-19 plan. Instead, the Government opted to place all counties under Level 3 restrictions and to implement a new campaign of enforcement with additional funding provided to the Garda.

But is additional enforcement of Level 3 restrictions the key to both avoiding another lockdown and flattening the curve? Data from the International COVID-19 Awareness and Responses Evaluation (iCARE) study suggests probably not.

This study is an online survey of attitudes, concerns and behavioural responses to the pandemic. It's led by the Montreal Behavioural Medicine Centre in collaboration with more than 150 researchers from 40 countries, including Ireland, and has received more than 65,000 responses from over 140 countries to date. Findings from the survey are already shedding light on which approaches may be more (or less) effective for promoting public adherence.

When asked which measures were most likely to convince them to adhere to preventive measures implemented to slow the spread of Covid-19, people consistently said that threats of fines, arrest, and quarantine are least likely to persuade them to practice self-isolation or social distancing. This has crucial implications for government policy and communications strategies. Not only are these penalties not likely to be effective at changing behaviour, they may have unintended consequences. For example, imposing fines may exacerbate  existing inequalities and escalate social disorder and conflict. They may even reduce adherence, particularly if penalties are perceived as being unfair.

So, if strict enforcement and penalties are not the answer, what can we do to ensure public adherence to preventive measures? Behavioural science, specifically operant conditioning, may hold the key. This is a process where the strength of a behaviour is modified by reinforcement or punishment. To reinforce a behaviour makes it more likely to occur again, but to punish a behaviour makes that behaviour less likely to be repeated. Any behaviourist will tell you that it is far more effective to reinforce a behaviour you want to see more of, than to punish a behaviour you want to decrease.

Not only is reinforcing desired behaviours more effective, it also works much faster. Data from the iCARE study shows high levels of adherence to Covid-19 prevention measures across the board. Between 84 to 90% of people report adhering to physical distancing, avoiding large gatherings, maintaining good hand hygiene and practicing good coughing etiquette most of the time. With public adherence already at such a high level, it appears that efforts to maintain these behaviours through reinforcement may have the greatest impact.

But how do we reinforce these behaviours? This is an important question, particularly given that many people may now be experiencing Covid-19 fatigue following six months of restrictions. Data from the study suggests that people are adhering less strictly to physical distancing measures now than they were in March. Respondents also reported that receiving information about how Covid-19 is spread, as well as feedback on how their behaviour is slowing the spread of the disease and saving lives were most likely to promote adherence. People need to see evidence that their sacrifices are making a difference in order to stay motivated to adhere to restrictions over the coming weeks and months.

One way of ensuring information about how Covid-19 is spread is understood is by providing case examples of transmission in the community. Data visualisations and narratives help people to see just how easily this virus can be transmitted through close and casual contacts in a way that just reporting numbers is unlikely to achieve. It is essential, though, that the flipside of this is also clearly communicated – that our actions can and will slow the spread and save lives.

READ: Will fines make people comply with Covid-19 restrictions?

Physical distancing, hand hygiene, and wearing a face covering are the most powerful tools we have in the fight against Covid-19, and those tools are in our hands. Government communications need to be clear, and to reflect the continued efforts the vast majority of Irish people are making to reduce Covid-19 transmission to promote continued adherence. Future strategies must foster trust and provide support to those who face systemic barriers to physical distancing to empower all of us to keep our distance, keep washing hands, keeping wearing masks and keep saving lives.

The iCARE study is still ongoing. To take part and help to inform future government communications around the pandemic, visit the Montreal Behavioural Medicine Centre website.