This week Ireland hits some grim records. We have the highest coronavirus infection rates in the world right now and rates of hospitalisations, admissions to intensive care units and deaths are escalating apace. We find ourselves in the highest level of restrictions, Level 5, with all the trimmings. This includes home-schooling, which was the most highly rated stressor by the Irish population during the first lockdown.
The nightly RTÉ News brings little hope. We hear about escalating virus numbers, health services in crisis and to top it all, the Garda has just received a range of new coronavirus enforcement powers, including the power to fine people on the spot for engaging in non-essential travel.
Having a sense of control over the virus is critical to our willingness to engage in the public health measures
Hospital Report
We’re the worst in the world. And it’s our fault, because we socialised too much over Christmas. We face the threat of punishment if we do not comply with restrictions. These messages contain some deadly ingredients, which are highly incompatible with effective public health messaging.
So, what can we do to get us through these dark days? What have we learned so far from the pandemic to inform what we do now? We need to get back our sense of control over the virus, we need to manage our fear, we need to reinvigorate our sense of solidarity and we need to rekindle hope.
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Having a sense of control over the virus is critical to our willingness to engage in the public health measures. Many politicians and public health experts are warning us that the virus is now “out of control” in Ireland. Such a message is anathema to a successful public health communications campaign. It is also inaccurate. We can control the virus. We have done it before and we will definitely do it again.
We know the behavioural measures work: physical distancing from others, reducing our social contacts, hand-washing, mask-wearing, timely responding to Covid-19 symptoms, and testing and tracing are highly effective measures to control this virus. Moreover, we also know from data provided by the Amárach Public Opinion Tracker that people in Ireland have consistently reported high levels of compliance with, and support for, public health restrictions since the outset of the pandemic. While none of us likes the restrictions, we are willing to adhere. This is still the case, 10 months into the pandemic.
We also know that fear is a dangerous ingredient in public health campaigns. Emotionally-laden, fear-based appeals were one of the hallmarks of the early global AIDS public health campaign in the 1980s. These ultimately faced deep criticism for being ineffective and for increasing levels of stigmatisation among individuals with HIV.
Fear-based health communication messaging is ineffective at changing behaviour. It can result in a host of unintended consequences such as denial, backlash, avoidance, defensiveness, stigmatisation, depression, anxiety, increased risk behaviour and a feeling of lack of control. Another problem with coronavirus fear appeals is that they exclusively focus on the individual’s behaviour, neglecting highly-influential external and societal factors, which need to be in place to support people to follow the guidelines.
We all have the power to control this virus now. Our behaviours are the key
There is a delicate and difficult balance for coronavirus-related public health messaging: people need to know that the virus is severe and that we are all susceptible; however, they also need to know they have some level of control. In reality, this means that for each message emphasising the severity of the situation, we also need a reminder that we can reduce this virus by what we do.
We also need a sense of hope for the future. Last night, my 13-year-old son, asked me did I think it was a bad thing to spend too much time looking forward to things. I realised he was suffering, like many of us, from a complete absence of anything to look forward to. The calendar is empty of plans. Without hope and a sense of looking forward, human beings are susceptible to depression and anxiety, problems in themselves, but also highly problematic for public health campaigns.
Of course, news of the vaccine is a reason for hope. Ireland has 15 million doses of a range of different vaccines on order for 2021 and 2022, more than enough to vaccinate the entire population. However, to navigate our current situation and this third wave of the pandemic, we need more immediate and tangible causes for hope. In reality, the full benefit of the vaccination programme is only likely to be realised in the second half of 2021. Dr Mike Ryan of the World Health Organisation has emphasised that the vaccine is one tool in the entire toolbox of the public health response to the virus. We cannot neglect the importance of behavioural measures.
We all have the power to control this virus now. Our behaviours are the key. We need to regain the sense of solidarity, trust and a shared goal, which carried us through the initial response to the virus in March of last year. Our public health communications need to revitalise these powerful motivators, avoiding blame and excessive fear arousal. We do have reasons for hope.
Molly Byrne is professor of health psychology and director of the Health Behaviour Change Research Group at NUI Galway. She is a member of the Department of Health’s Covid-19 Communications and Behavioural Advisory Group who advises Nphet