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Covid

Keeping our distance

Holly Carter, Dale Weston, Clifford Stott, and Richard Amlôt on evidence-based strategies to promote adherence to COVID-19 social distancing measures.

04 May 2020

The UK Government has implemented a range of measures designed to protect public health during the COVID-19 outbreak, from cancelling mass gatherings and closing pubs, bars and cafes (UK Government, 2020), to emphasising effective hand and respiratory hygiene procedures. These measures are based on scientific evidence from a range of disciplines, including modelling, epidemiology, virology, economics, and behavioural science, and are designed to reduce the scale of the outbreak. As behavioural scientists working within Public Health England, we provide behavioural science support to the public health response to the pandemic. As part of our role, we provide evidence-based advice on various aspects of the COVID-19 response, including: how to communicate effectively with members of the public (e.g. the importance of providing honest, consistent information about the nature of the outbreak and the actions people can take to protect themselves and others); how members of the public might experience and respond to different protective measures (e.g. respiratory hygiene advice, self-isolation, school closures); how different management strategies might affect public behaviour; and the likely longer-term psychological effects of both the outbreak itself and the protective measures implemented. We will continue to provide advice and support as the outbreak progresses and recommended protective and preventative measures evolve.

On 23rd March the UK Government introduced more stringent measures to enforce social distancing. This included telling people to leave their homes only to obtain essential food and supplies, carry out essential work, or take exercise (once a day) (The Guardian, 2020). Crucially, with the introduction of new legislation and police powers the Government is now in a position to move toward a much more securitised approach with non-compliance now punishable by police action.

As noted above, a key role of behavioural and social scientists is to provide advice on these social distancing measures, using theory and evidence (e.g. Michie, Rubin, & Amlôt, 2020). Two areas of theory and research that are relevant to understanding public adherence with such measures, particularly in the context of increased securitisation, relate to social identity dynamics (Stott & Drury, 2017) and procedural fairness (Tyler, 2011). The science in these areas emphasises that legitimacy is important because if people perceive authorities' responses as fair and proportionate, they are likely to identify with the authorities and others affected (e.g. other members of the public). These social and psychological processes then enhance 'self-regulation' whereby people regulate their own and others behaviour within the context of Government directives. However, if authorities' responses are perceived as illegitimate, the opposite can occur which can result in refusal to adhere to protective measures, and the potential for confrontation and conflict to emerge (Stott, Hutchison, & Drury, 2001).

A first step in enhancing legitimacy and increasing adherence is for authorities to explain to members of the public what measures they can take to protect themselves and others, why such measures are effective, and why certain actions are (or are not) being taken by authorities (Carter et al., 2018). It is important to communicate this information regularly, even if there is no change in the message. The daily Downing Street briefings held by a senior government official alongside appropriate subject matter experts exemplify this process. Such communication demonstrates respect for members of the public and engenders trust in those providing the information. It should therefore enhance legitimacy and promote public willingness to adhere to recommended measures (Carter, Drury, & Amlôt, 2018).

However, it is not enough that people are willing to adhere to recommended measures; they must also be able to. The implementation of social distancing measures will cause a high level of social and economic disruption. There are various socioeconomic factors that will mean that stringent social distancing measures will impact on individuals, social groups and communities in different ways. For example, those who may experience more negative impacts include (but are not limited to) people who: live alone; live with vulnerable individuals; live in multi-house families; have no personal access to outside space; experience domestic abuse; have pre-existing mental health conditions. In this way, the current stringent social distancing measures are likely to inequitably disadvantage those groups who may already be experiencing greater levels of hardship. 

As Government management has moved from voluntary to compulsory and has become more coercive (e.g. fining those who do not comply) (BBC News, 2020), the risk that authorities' actions will be perceived as illegitimate has increased. Given the disproportionate effect that measures are likely to have on those sections of society who are already disadvantaged, it is members of these groups who may be most likely to experience enforcement as unjustified or illegitimate. As noted above, increased perceptions of illegitimacy reduce adherence to protective measures and increase the potential for conflict with enforcement agencies. It is therefore important that the Government understands the potential for measures to be perceived as inequitable or illegitimate and takes what action it can to prevent this. When advising on the implementation of protective measures we emphasise the need for effective communication (e.g. clarification of guidance, such as that concerning multi-house families) and economic and social support (e.g. providing financial support to employed and self-employed workers). 

To conclude, we suggest that there are key actions that authorities can take to enhance legitimacy, engender trust and promote public adherence with recommended measures during the COVID-19 outbreak:

  • Communicate clearly and transparently about measures being taken, including: providing consistent information about measures people can take to protect themselves and others; communicating why recommended measures are effective; and explaining what actions authorities are taking and why. 
  • Take appropriate responses at the appropriate time, based on available evidence. Ensure that evidence underlying policy is made publicly available, to enhance transparency around policy decisions. 
  • Ensure that as far as possible, policy does not unfairly disadvantage certain groups. This may include economic policies, continuation of vital support services, and ensuring that guidance meets the needs of all groups.

Holly Carter PhD, Behavioural Science Team, Emergency Response Department Science and Technology (ERD S&T), Public Health England, Porton Down, Salisbury, Wilts SP4 0JG, UK
[email protected]

Dale Weston PhD, Behavioural Science Team, Emergency Response Department Science and Technology (ERD S&T), Public Health England, Porton Down, Salisbury, Wilts SP4 0JG, UK

Clifford Stott PhD, Dean for Research, Faculty of Natural Sciences, Keele University, Staffordshire, ST5 5BG, UK.

Richard Amlôt PhD, Behavioural Science Team, Emergency Response Department Science and Technology (ERD S&T), Public Health England, Porton Down, Salisbury, Wilts SP4 0JG, UK

References

BBC News. (2020, 3 April). Police issue 144 fines during virus lockdown. Available from: https://www.bbc.co.uk/news/uk-scotland-52150516.

Carter, H., Gauntlett, L., Rubin, G.J. et al. (2018). Psychosocial and behavioural aspects of early incident response: outcomes from an international workshop. Global Security: Health, Science and Policy, 3(1), 28-36.

Carter, H., Drury, J. & Amlôt, R. (2018). Social identity and intergroup relationships in the management of crowds during mass emergencies and disasters: recommendations for emergency planners and responders. Policing: A Journal of Policy and Practice, pay013. 

Michie, S., Rubin, G.J. & Amlôt, R. (2020, 28 February). Behavioural science must be at the heart of the public health response to covid-19. The BMJ Opinion. Available from: https://blogs.bmj.com/bmj/2020/03/03/behavioural-strategies-for-reducing-covid-19-transmission-in-the-general-population/.

Stott C., Hutchison P. & Drury J. (2001). '"Hooligans" Abroad? Inter-Group Dynamics, Social Identity and Participation in Collective "Disorder" at the 1998 World Cup Finals'. British Journal of Social Psychology40(3), 359-384.

Stott, C. & Drury, J. (2017). Contemporary understanding of riots: classical crowd psychology, ideology and the social identity approach. Public Understanding of Science26(1), 2-14.

The Guardian. (2020, 25 March). UK coronavirus lockdown: what you can and cannot do. Available from: https://www.theguardian.com/world/2020/mar/25/uk-coronavirus-lockdown-rules-what-you-can-and-cannot-do.

Tyler, T.R. (2011). 'Trust and Legitimacy: Policing in the USA and Europe'. European Journal of Criminology, 8(4), 254-266.

UK Government. (2020, 20 March). Government announces further measures on social distancing. Available from: https://www.gov.uk/government/news/government-announces-further-measures-on-social-distancing.