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By Dr Deepak Gupta/15/04/2021

The humanity was attacked and subsequently gripped by a highly vicious virus by the end of 2019. This contagion was christened as SARS-CoV-2 by the WHO, whereas the disease due to this virus was termed as COVID-19. Due to its transmission through respiratory-tract and being aerosol borne, it has managed to devastate millions of people and their families. It necessarily includes a very high mortality in some select vulnerable age groups and a large cohort of people with co-morbidities.

It is globally recognized that this outbreak is a public health concern of mammoth proportions with highly critical environmental and economic impacts. Scientists have developed vaccines and clinical treatments for the COVID19 with an unprecedented speed. Nevertheless, the vaccination continues to throw a challenge of hesitancy and skepticism in many regions. Clearly, it’s a bi-dimensional challenge, i.e. ensuring equitable access to vaccinations and managing cold-chain logistics, together with demand aspects, which denotes positive behaviour change and risk-communication strategies.

Leaders, and communities alike, well acknowledge that the COVID19 pandemic is about bringing a positive change in ‘behavioural practices’ issue - both at individual and community levels. Although there still exist, like in most other public health concerns, a few hard-core ‘laggards’ who defy easy acceptance of any positive behaviour practice. Needless to emphasize, such a group of people have their own reasoning based on myths, rumours or incorrect beliefs. In addition, conspiracy theories and a vast ocean of misinformation is thriving abound. Cyber space too is making things rather difficult in more than many ways as the sustained ‘internet campaign’ as an ‘infodemic’ (spread of misinformation during pandemic) is gaining currency.

An inherent and very critical dimension to such public health emergencies is invoking and managing – almost on a 24x7 basis – a tailor-made and research-driven risk communication & community engagement (RCCE) strategy. Yet, it is noted that the highly technical area of public health communication and the risk-communication, is still being largely managed by non-technical generalists or administrators in most cases, and in some contexts, has even assumed a high-level of tilted ‘political communication’ in many countries. This defies the very premise of results-driven and community-owned health communication, wherein ideally most health messages should not be disseminated through the top-down prescriptive mode.  It is time the citizenry witnessed more of science in politics than politics in science.

The current pandemic largely being a ‘behavioural practices’ issue, a large cohort of populace will adopt practices as are being disseminated by the credible and trusted sources. People have gained the necessary understanding that this virus is a new pathogen without any prior history of transmission. Therefore, it is still being researched and studied that includes the emerging mutants of this virus. Soon upon the declaration of a global public health emergency, the respective national health authorities, scientists, clinicians and epidemiologists invested relentless efforts in locating its mode of transmission, appropriate therapeutic/clinical treatments and fostered further research on possible vaccination. Needless to mention, some initial slippages included delay in declaring the pandemic and the constant discouragement for the use of face-masks by the general public with an exception of health providers. Both these ‘missing links’, nevertheless did a huge damage which led to unchecked spread of virus within communities, provinces and countries.

With the onset of the SARS-CoV-2 pandemic, most people gradually acquired familiarity with the concept of risk compensation. It denotes that in most circumstances which are perceived as risky, individuals strive to modify their behaviours, thereby compensating to minimize a specific risk. People who perceived the SARS-CoV-2 as a major threat to health, in most cases, would wear appropriate masks, wash their hands regularly, and maintain physical distancing by avoiding large crowds. These pandemic appropriate practices become a more sustained ritual when cases began to surge. Research evidenced that the effects of risk compensation tend to dilute over a period of time as the ‘fear and risk’ perceptions wear off.

In recent weeks, the gradual rise in COVID19 cases across the country is attributed to the possible “pandemic fatigue”. It is also observed that many communities have drastically reduced adherence to the highly recommended risk reduction strategies. It is, therefore further heightening the complications in the ongoing public health efforts.

A few months back COVID19 vaccinations were launched across the globe. It apparently generated optimism and created euphoria. In the current scheme of developments, risk-communication professionals will have to be appraised of another significant element of risk compensation. The vaccine served as the panacea to the pandemic risks; therefore, it further weakened the adherence to other pandemic appropriate behaviours such as, regular hand washing, physical distancing and face-masking. This is one typical phenomenon, wherein individuals respond to safety measures with a compensatory increase in risky behaviour, which is named as the “Peltzman Effect” (named after Sam Peltzman who first described it in 1975).

Even subconsciously, many of those who have not received even a single dose of vaccine may slack in wearing face-masks and in maintaining physical distancing in crowded places, when these people know that others are receiving the vaccine since a last couple of months. With an increase in the number of people vaccinated, the Peltzman effect may also evolve. This is directly due to a higher misplaced sense of security wherein populace assumes setting in of ‘herd immunity’. This throws up a mammoth challenge to the health communication experts because the ‘optimism’ – otherwise essential to encourage widespread acceptance of the vaccine could contribute to the fostering overconfidence among people, which can ultimately worsen this effect.

Behavioural communication experts have been in dilemma, i.e. whether or not the COVID19 vaccinations would result in increased risk-taking behaviour? Multiple studies attempted to seek solution through the lens of the Peltzman Effect. Behavioural research identifies four lead factors as the possible contributors to risk compensation; these are well found in the COVID-19 pandemic. To present an increase in a risky behaviour, a measure must first be ‘visible’. This factor is overtly found with the COVID19 vaccination, for it has generated substantial amount of discussions and publicity. And each individual who has received the vaccine would be well aware that they have done so. The next phase two points go together, i.e. ‘motivation’ and ‘control’. Compensating risk is more likely to occur when people are highly motivated to take on the risky behaviour and while it is within their control to do so (such as, removing mask in a public space). Both of these well apply to the current pandemic because it is desirable and easy to return to pre-pandemic behaviours free of face-masks and attending crowded gatherings. The final factor, nevertheless, is the overall ‘effectiveness’ of the intervention, which entirely depends on the vaccine.

Misinformation and a highly politicized public health space have influenced varied behaviours in response to COVID-19. These include refusal to practice pandemic appropriate behaviours, such as “anti-maskers” and those who disregard physical-distancing. Unfortunately, as it is, the highly technical area of public health communication is still largely managed by the ‘generalists’ and has assumed a high-level of tilted ‘political communication’ in many countries. However, it’s time we reckon more of science in politics than politics in science.  

NOTE: Author is Sr. Consulting Adviser (Strategic Communication & Programmes), UN System in Asia and the Pacific. His analysis is personal.