'Cancellation pushback': If authorities keep ruling out the holidays, people will stop listening
Psychologist Baruch Fischhoff is considered a giant in the field of risk communication and decision-making.
When asked for his quick analysis of Prime Minister Justin Trudeau’s somewhat un-prime-ministerial assessment this week that the COVID-19 pandemic “really sucks,” and that unless people are “really, really careful” usual holiday gatherings might be off the table, Fischhoff offered that, for people predisposed to the PM, “it probably speaks to their heart that he’s really worried and he’s willing to kind of let his professional guard down.”
Too often COVID risk communications have been chaotic, don’t recognize the diversity of situations people are in, and are too focused on rules, Fischoff said — “’thou shalt X’ without giving people a mental model of why that is true.
“And the mental model that people need here is not all that complicated — it’s something about how much disease is out there, how is it transmitted in different kinds of settings, how well different practises protect you, how likely are you able to actually implement practises when you’re having a good time.”
The current COVID outlook doesn’t promise a huge number of good times ahead. “It’s going to be a tough winter,” Trudeau warned this week. “This winter will be difficult,” German Chancellor Angela Merkel warned Thursday as that country prepares for a month-long partial shutdown beginning Monday. “The virus is circulating at a speed that not even the most pessimistic forecasts had anticipated,” French President Emmanuel Macron said in a televised speech announcing a new national lockdown until Dec. 1.
In Canada, COVID-19 is resurging outside the fortress of the Atlantic Bubble and Northern Canada. In Manitoba, Premier Brian Pallister this week upbraided those Manitobans doing “dumb things” to “grow up.” The province’s chief public health officer said some of those testing positive have had “way too many contacts,” so many they can’t remember them all. And despite pleas to limit turkey dinners to “immediate households,” Thanksgiving weekend is being tied to rising case counts in Ontario, Manitoba and Alberta.
After months of well-meaning but sometimes cloying slogans, about marathons, not sprints and how “we’re all in this together” — COVID, as the annual report this week from Canada’s chief public health officer highlighted, is in fact disproportionately harming and killing the marginalized, racialized communities and the elderly, not the privileged and powerful. A new Ipsos poll for Global News suggests Canadians are feeling sapped; half (48 per cent) said they’re tired of COVID public health recommendations and rules. While the majority (nine in 10) are following masking rules, parents (88 per cent) were less likely than those without kids (94 per cent) to say they’re doing everything they can — “perhaps an indictment of how workable many social distancing measures are in practice for those with young families,” the pollster said in a release.
Renowned epidemiologist Dr. Michael Osterholm says a trifecta of risk issues — fatigue, anger and winter weather that will drive people indoors — is creating a perfect incubator for COVID-19. Add in the holidays, with travel and family get togethers, “and we’re going to see a major increase in transmission in family settings or social settings around the holidays,” predicted Osterholm, director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota. Osterholm, by the way, in a Jan. 20 statement, warned that the coronavirus would cause a global pandemic.
Without vaccines, “We’re in this period where we don’t really have anything to offer people to limit transmission except their own behaviour at a time when that is a huge challenge to get the public to do it,” Osterholm said.
“If you just make it all dark with no hope, that’s not helpful.”
We’re somewhere between total darkness and total light, he said, borrowing time until vaccines are approved. “What we’re really trying to give people is a sense that this is your COVID year. It’s not going to be like last year. But hopefully it’s not going to be for next year if we have vaccines,” Osterholm said.
To that end, people should limit holiday gatherings to their bubbles, he said. “Don’t fall for some concoction that says, ‘well, we’ll all get together in the dining room and the kitchen and the living room, and we’ll all stay 15-feet apart and, oh, by the way, there are 32 of us in that dining room, kitchen or living room.’ How are you gonna do that? That math doesn’t work out here,” Osterholm said on a CIDRAP podcast this week.
Dr. Zain Chagla has called “cancellation pushback” a canary in the coalmine. “We’ve got several months/possibly years here — if the attitude is nope, people are going to stop listening,” Chagla, an infectious diseases physician at St. Joseph’s Healthcare in Hamilton tweeted after health authorities urged no trick-or-treating in Ontario hotspots.
Businesses, urban planners, regional and municipal governments can help create opportunities for people to get low-risk human contact, Chagla said.
“Outdoors is still OK — it has to be done safely where something like the Rose Garden doesn’t occur,” he said, referring to the White House super spread event where U.S. President Donald Trump announced Amy Coney Barrett as his nominee to the Supreme Court. At least a dozen in attendance later tested positive for COVID-19.
“Maybe Christmas is not the typical indoor event where you have 12 family and a large dinner and people sleeping over,” Chagla said, “but maybe dedicated green space where kids could meet Santa, decorative lights that get people inspired, pot lucks or markets. They’re not going to be zero-risk, but you can make them low-risk.”
It’s possible that people who paid little heed to advice to limit their Thanksgiving gatherings to their households “thought they were taking a reasonable risk, but didn’t understand what that meant,” said Fischhoff, of Carnegie Mellon University. Abstract concepts like exponential growth are unintuitive; they can be difficult to communicate and grasp. But it also didn’t help that there were differing definitions of “immediate household.”
“We learn top-down from principles if they’re well established, and bottom-up from personal experiences,” Fischhoff said. If someone has been exposed, the ordeal of getting tested and waiting for the results becomes something visceral. “Some people would say it was not such a big deal, but others will say, ‘I don’t want to go through that again, I didn’t sleep for a week.’”
Risk communications should avoid simplistic solutions; they should be respectful, informed, and people should be treated like adults, Fischhoff said.
“I think people could be helped with better information and better options. That will be enough for a lot of people, given they don’t want to get sick and they don’t want to get other people sick,” he said. “They will say there is light at the end of the tunnel. ‘Eight months from now life will become more normal. I want to be there when we get to the end of the tunnel.’
“For other people, it won’t be enough, but it might once the horror stories continue to spread. I don’t know how many people are zero or one degree from a serious scare.”
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