In March 2020, 36 behaviour change experts came together to summarise how a pandemic like COVID-19 can affect behaviour. We summarise their key insights and findings from other research below. Their full article is available here.

Fear is one of the key emotional responses people have to an imminent threat to themselves or their loved ones. Fear is contagious and with mass and social media exposure prominent in most parts of the world, the threat of a modern pandemic is quickly perceived to be imminent and the feeling of fear can become widespread. We can see evidence of this in the case of the COVID-19 pandemic from the ‘panic-buying’ of food, toiletries and medicines ahead of any confirmed cases of the virus in a country. Care must be taken not to amplify this fear to the extent that it causes psychological harm or negative behaviours, such as panic-buying. Instead, fear should be used constructively to encourage people to make positive changes to their behaviour, in order to mitigate the threat. Examples are physical distancing and frequent handwashing with soap. This approach will be effective with most people. However, we find that some people will have an unfounded belief that they themselves are less likely to encounter the threat and hence they will be reluctant to properly adhere to the public health guidelines. This is what we call ‘optimism bias’. We must use strategies to overcome fear as well as optimism bias for public health strategies to be effective.

During an outbreak, new social norms develop with changing government mandates. Promoting positive social norms such as physical distancing and handwashing through various communication channels in a way which leads people to believe that the others around them, and specifically those whom they identify with, are adhering to these behaviours is likely to encourage people to adopt these behaviours themselves as new social norms. Furthermore, ‘quarantine shaming’ - chastising those not practicing physical distancing - could quickly become another new social norm. Using role models can also encourage the formation of new social norms by exemplifying the behaviour. For example, young adults’ behaviour is less likely to be influenced by how older adults are behaving but they will pay more attention to how other young adults are behaving.

From the threat of an outbreak and the shared experience of a disaster, a sense of shared identity can emerge and we may see people acting in altruistic ways. We can leverage this by urging the public to act for the common good. Stories of panic and people acting in self-serving and competitive ways, such as hoarding goods, undermines this sense of collectivity and should be discouraged in the mass and social media. Positive new norms, role models and altruistic behaviours should be encouraged instead.

A combination of the previous two factors leads people to want to wash their hands more during outbreaks. This is because our perception of disgust is heightened - now everything around poses a disease risk and so we feel an urge to clean and be clean. So, the most important task for hygiene promotion is simply to enable people to do the right thing. For this reason, the highest priority task should be to create an enabling environment, through handwashing infrastructure and water and soap access. Where possible, it is important to maintain the cleanliness of these facilities in order to minimise disgust and allow the new social norms to form. Coughing and sneezing into our elbow, and using a face mask if a government mandate, are other important hygiene behaviors to promote.

Unfortunately, the increased behaviour we see during outbreaks often doesn’t last. As fear subsides or if the outbreak becomes endemic and becomes normalised, behaviour can often start to decline. However, this could be mitigated if hygiene promotion programmes consider the long-term sustainability of their activities.

Written by: Julie Watson
Reviewed by: Sian White, Elli Leontsini
Version date: 04.04.20