I wrote this series of articles for Change.org during the H1N1 pandemic. Now that the topic of pandemic has returned to the media I thought it was worth taking them out again (I made slight edits in the spots that made me cringe to reread them, but not change to content.)
Fear, Sex, and Pandemic
Think back to July 2009, mid pandemic, waiting to see if the novel H1N1 virus will mutate to become even more dangerous than the killer it is. You wouldn’t be able to tell by looking at the actions and attitudes of the general public though.
After an initial period of hyper awareness, the world’s population calmed down to a point where we see none of the changes needed in behaviors and policies to reduce the impact of a mutation.
There is a direct connection between the initial over reaction, and the current under reaction. Too many individuals feel as if they were duped, having once vested emotions, they don’t plan on being duped again. That initial response, however, as counter productive as it was, it was entirely predictable and will happen again the next time unless Pandemic risk communicators change the way they talk about pandemics. Pandemic risk Communicators don’t seem to get human nature.
Psychology, meets cognitive neuroscience, meets biology. Risk communicators work to influence human behavior through information and education. The only way to do this is through understanding what it is that makes us tick. In the past few years, great strides have been made in explaining the source of some consistent human behaviors. The NYT’s Nicholas Kristof has an editorial summarizing the tendency of our brains to irrationally prioritize threats, For the most part, we stop everything to focus on a threat that feels like it may be imminent, but we are heavily inclined to ignore thoughts of risk, this despite the fact that most risks are easily avoiding when objectively analyzed.
We don’t have a multi-dimensional reaction when we encounter danger or a really attractive person. Our reaction to both danger and sex isn’t very advanced. It’s like the on/off volume dial on a cheap portable radio–we sense a threat or sex-and you can almost hear the click as the dial turns to on. If we sense the danger/sexual anything is minor, like a bee-or a potential wardrobe malfunction, the dial cranks a little and our typical reaction is to divert a bit of attention away from what we are doing. The closer to home a situation hits, the higher the dial is cranked, until we can notice nothing else, our hearts are beating, our breathing coarse. Sex or danger, we won’t be sleeping well until it is resolved.
These innate reactions are used to manipulate us. That is inevitable in a market economy, since it is the most effective way to get people to do what you want them to. Advertisers link their products to our longings for social status and happiness, companies do everything possible to help us focus on the low initial price knowing that we won’t take the huge later cost seriously-heck, we may be dead by then. News companies tell us to turn into 11 to see why we are all going to die. They do this because enough of us do so even when we know better.
Which, of course, brings us to naked flight attendants. Safety educators try to use human nature to get the behaviors they want as well. Air New Zealand finally figured out a way to get people to look during the preflight safety messages-having the message done by flight attendants in nothing but body paint: http://blog.seattlepi.com/aerospace/archives/172644.asp.
If sex and danger are tops, how can we get anything done? For sex, our systems seem to have handled it by building in a counter compulsion away from embracing our sexual desires-how that counter compulsion plays out varies, clearly influenced by environment, culture, age, spirituality, opinions, etc.
For the most part, it seems we take the compulsion to focus on sex, and the counter compulsion, and let it mess us up. And yet, so far species wide, there has always been a next generation, so despite everything, it is working for now.
We are surrounded by danger: the earthquakes, the land slides, disease, and Dick Cheney. How does our species handle omnipresent danger with our unidirectional response? The planet is in a state of constant change, all over the globe, physics happens. If our subconscious responded to each of these real dangers, we would exist in a constant state of fear response (indeed, some people do, and find it very hard to even leave their house.)
We reduce the threat of constantly being obsessed with the thoughts of danger by being inclined to ignore all but the most glaring. You would assume that is irrational though, since ignoring future risk means that we set ourselves up to be taken by surprise, to walk right off of cliffs (which certain percentage of us literally do, sad to say). The implication is that on a species wide level, it is more beneficial for some of us for some of us to blithely walk right into danger than to stay in a constant state of fear arousal.
When we stay focused on risk, we stop focusing on living. If we all do that, species wide, we would never have started wandering, we wouldn’t interact, trade with or fall in love with people from other tribes, we wouldn’t be in a state of constant migration, over ice bridges, under fences-we would have isolated ourselves and most likely failed as a species.
So, hurray, we live better when we don’t worry about risk! ….Or do we? Admit it, if you are like most people you nodded your head at the thought that life is better if you don’t worry too much about risk. What will be will be-of course you do, that’s what I’ve been saying, we are all inclined to feel that way. But in reality, on a personal level.
All over the world people are inclined to ignore thinking about future risks, how this plays out varies around the world, clearly influenced by environment, culture, age, spirituality, opinions, etc. Some regions and cultures feel that it is inappropriate to take steps to reduce risks, since it shows a lack of faith that things will be OK, vs. others that are more accepting towards the idea of identifying what can go wrong and fixing it before it does.
Turns out that if you reduce the number of bad things that will happen, you increase the number of good things. Regions of the world that adopted safety education programs decreased the number of ‘unintended injury childhood fatalities’ by 50% in less than 30 years.
Pandemic flu preparedness advocates want to increase the number of good things that happen around the world, by showing that it is possible to avoid the really bad thing that is pandemic flu. They blew it though.
To encourage the adoption of steps to reduce a pandemic, pandemic preparedness advocates worked to make the threat feel vivid and real. If you’ve never read the studies pointing out that people work really hard to avoid taking risk seriously, it seems like the best way to encourage people to adopt actions to reduce a threat is by pointing out the threat. This doesn’t work, of course. When people have read all of the studies, they often then decide that they need to change their focus-work to make the threat feel more vivid, more real-bring the threat home. The combination of these methods not only didn’t work, but they are the cause for the counter productive response to the emergence of the current pandemic.
Just because people weren’t responding, doesn’t mean they weren’t paying attention. Pandemic Preparedness advocates intend to provide a one two punch, first a vivid description of what can go wrong if we don’t act, and then information on what actions are needed. Most of the population doesn’t get that far though, (human nature wins) so the majority of the population simply received multiple descriptions of just how bad things will be. This set up the situation we saw at the beginning of the H1N1 pandemic.
Six reasons Pandemic Risk Communicators need to abandon the use of ‘the horrible outcome’ as an emotional lever for funding and action.
- Only a small percentage of the public will respond in the way the educators want. Yes, a small percentage will respond to the ‘useful parts’ of the message and change habits, but almost everyone else’s sub-conscious will remember the “danger” bit. Our wiring makes us strongly inclined to reject thoughts of future risk.
- All ‘call to action’ messages that trigger our fear response-are not sustainable, healthy, or useful. The fear response is supposed to provide a surge of activity to get out of a problem that is supposed to end so the system can normalize. Sustained triggering of the fear response leads to excessive stress and burn out. Effective preparation for Pandemic flu doesn’t require a surge of focus and energy, instead it requires changes to lifestyles and habits. Fear response is very useful for achieving funding-explain the possible situation to decision makers and you can succeed in having a short term burst of action: the decision maker can allocate funding-then their system go back to normal-they’ve funded the problem, done their bit and can relax.
- It’s hard to make good decisions if your subconscious thinks you may be in mortal danger, so the message hurts more than helps. Having explained in vivid detail the horrible consequences of non action, those consequences become the focus of thoughts when there are signs that a pandemic maybe starting. Even the individuals who adopted the message have the image of what will be happening to everyone else, and they must get past that image to act. It is almost impossible to make good reasoned decisions in this circumstance, and that is what we saw.
- It creates misleading expectations about what a severe pandemic is like By creating a vivid narrative of a pandemic emphasizing the number of deaths and the risk of social breakdown from a pandemic, it is very easy to have the impression that life under pandemic that is vastly different than what it actually is like. I suspect if surveyed, the general public would have no idea that during the 1918 pandemic, only 24% of the population got sick, and of those that did, 98% recovered. This point was left out, probably because it reduces the power of the argument to act or face dire consequences-it gives individuals the excuse not to act they were hoping for (I probably won’t get it). What that really succeeded in doing, was creating expectations for pandemics to feel vastly different than they do. So many of the population looked up, rationalized their threat, and have now looked away-vowing never to be tricked into feeling so horribly scared by news of a pandemic again. We are currently experiencing life in a pandemic. This is probably pretty close to what the initial days of the 1918 pandemic felt like as well. We actually are really good at pushing awareness of deaths out of our consciousness, we have learned to ignore the yearly toll of the seasonal flu, and a good number of people have already learned how to ignore the additional deaths from pandemic. That would have been true in 1918. This isn’t that far off from what it would have felt like, not what the population and news media expected: instant horror.
- It makes counter productive backlash easy to happen. The entire point of advocating preparing for a Pandemic is to keep it from happening. If the dire outcome does happen, it means all efforts failed-and if it doesn’t happen, when faced with the general populations inaction, the assumption then is that clearly outside factors led to the change in fate-not preparedness efforts.
- Ultimately, the potential for a ‘horrible outcome’ of a pandemic has always been beside the point. The risk of a horrible outcome is a reason to prepare-just one of them, and a counter productive one. Human nature is such, that by evoking the threat, it became easier to focus on the existence of the threat than any other message provided-but knowing that the threat exist does nothing at all to help and quite a lot to hurt when the threat is played out. The actions needed to reduce a pandemics progress will lead to increases in over-all health, productivity, resilience for other disasters-they solve a lot of problems for the population, potentially avoiding a dire consequence is just one of the benefits. The existence of potentially dire outcomes shouldn’t be swept under the table or distracted away from, it should simply not be the point that is repeated most frequently and definitely not used as an emotional lever.
How we communicate about emergency preparedness is a way that does work:
Switch the focus of the call to action from consequences to benefits. It makes sense for individuals and companies to take steps to avoid illness and disruptions. A population with fewer illnesses is a more productive, healthier and happier population. Quantify the benefit of health. Increases in productivity, quality of life, life expectancy, thriving families,
Remind people that staying healthy helps others. The current focus has been on the direct threat to individuals and their families if they don’t prepare. People have most two likely options: feel vulnerable, which usually triggers the counter-productive stress response and non sustainable actions, or secretly convinced that they are going to be fine, or fated to go, so move the focus off them to their ability to change the world and help others simply by making simple changes to their habits that will make them unlikely to get sick. This attitude reflects reality as well. Most people won’t face the worst consequences of the pandemic, but some will. We all need to work together to help everyone avoid harm.
Focus the attention of communication efforts on the actual changes needed to make pandemic reduction the most likely outcome of every day behavior. Spend more time defining what specific changes need to take place to make health the most likely outcome. What practices are being adopted by schools, organizations and companies that bring about the desired change-regardless of whether they realize it has benefits to pandemic reduction. Help those changes become mainstream.
How Can We Reduce the Impact of Pandemic Flu?
We need both behavior and policy changes to make it possible, much less most likely, for people to avoid being negatively affected by pandemic flu:
People need to be able to stay away from others when they are likely to be transmitting viruses. Currently this is very difficult for most, both because some companies will fire you if you do not show up, but also because of a cultural expectation that it is a good thing to work through colds and sickness-to tough it out, and get back to work as fast as possible.
Necessary policy changes: people need to be able to stay home: end the right of employers to say ‘go to work or be fired’.
Behavior changes: need to reduce the social pressure to ‘tough it out’
Promote change enablers: Promote teleconferencing, distance learning, telecommuting and other new technologies that let people be productive from a distance.
Quantifiable benefits: Flexible work policies are already considered best practice because they increase the ability of companies and schools to keep functioning even during other types of disruption as well. It should be possible to calculate the loss in productivity from sick days and project the gains that can be achieved for every % drop in the number of people out sick.
People need to be able to distance themselves, but still be able to function and feel connected to society. Almost all people have strong built in desires to do things that feel useful, and to interact with others. Pandemic planners recognize that short periods of physical isolation can radically reduce the impact of a pandemic, but this ignores the drive for people to connect so is unlikely to be feasible unless more is done to create situations where people can feel socially connected to others regardless during times they physically are distanced or isolated.
Changes to Policy: Work to adopt policies to increase the population’s access to the internet, such as the creation of publicly funded wireless internet zones. Increasing the number of public computers, classes.
Behavior changes: Help demonstrate ways that people can stay connected and involved with the outside world, even if they are keeping to themselves for short periods.
Promote change enablers: Social networking sites are doing a lot to re-connect individuals and increasingly, it is becoming easier and more affordable to access these networks. Reward and encourage technology companies who take steps to increase the ease of use of their products, either by making it available through multiple technologies (affordable phones, pagers, Netbooks and computers) or by improving user-interface so that it is more comfortable for individuals of the widest scope of age, education, and ability.
Quantifiable Benefits: Increasing the connection between people reduces problems related to social isolation and provides individuals more resources in times of emergencies.
We need to reduce crowding: rush hour commute-work to bring about flexible hours.
Necessary policy changes: flexible work hours-reduce the need for everyone to surge on to the streets at the same time during rush hour.
Behavior changes: point out ways that individuals can make small changes to routine to avoid crowds: don’t take public transportation during rush hour. Avoid movie premiers during pandemics, watch the movie at less crowded times.
Promote change enablers: show how ordinary people and businesses are figuring out ways to function without close face to face contact-sales kiosks, internet based orders/sales, business process adjustments to build extra space and barriers in situations that require client interaction.
Quantifiable benefits: Reduced pollution, less strain on public transport. Improved -time not spent waiting can be spent on more useful things-thus, improving quality of life, and again, greater productivity.
Reducing the health impact on the poor is social equalizer steps to reduce the impact of health problems of the individuals who face the highest challenges in our society, can go a long way in solving many of our most difficult problems.
If helping create a healthier world for the most vulnerable isn’t good enough, then Remind everyone that we are all in this together. The more people who get sick, the harder it is for all of us to stay well. It makes sense to create policies and adopt behaviors that allow the whole population to stay well. We all need to focus on creating a reality that makes it easy for everyone to avoid getting and passing on the flu.
Taking steps that slow down the spread of viruses increases the quality of our lives. Pandemic planning is do-able and logical but we need to change the way we talk about pandemics to move towards responding by reducing risks, instead of fearfully reacting to them.