Purdue Social Scientists Reflect on Community-Level COVID-19 Responses to Improve Future Epidemic Decision-Making

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Careful observation of Ancient Greek society led Aristotle to argue that humans are by nature social animals. Centuries later, scholars in Purdue’s College of Liberal Arts have reached similar conclusions after reflecting on the COVID-19 pandemic. Human behavior is often influenced by factors such as social norms and trust in others, meaning that responses to the coronavirus epidemic cannot be attributed to a single individual, but are instead the result of shared decisions made in communities across the world. Understanding what went well, what did not, and what may change as a result of an unprecedented global pandemic requires critical reflection of groups and cultures. 

We turned to several leading College of Liberal Arts social scientists to consider group-level responses to the COVID-19 pandemic: Dr. Hwanseok Song and Dr. Ilwoo Ju, both Assistant Professors of Communication, and Dr. Andrew Flachs, an Associate Professor of Anthropology. These scholars have extensively studied human behavior and aspects of decision-making processes and may provide new perspective on how societies met the changing circumstances of an unprecedented pandemic as well as the “lessons learned” to improve our responses if another epidemic arises in the future. 

The interview was conducted by Dr. Sorin Adam Matei, Professor of Communication and the Associate Dean of Research and Graduate Education. 

(Left to right): Dr. Hwanseok Song, Dr. Andrew Flachs, Dr. Ilwoo Ju, and Dr. Sorin Adam Matei

Dr. Matei: What did the COVID-19 crisis reveal about modern, highly urbanized group responses to pandemic threats? Any insights about traditional communities? 

Dr. Flachs: One of the biggest takeaways from this current crisis is that it exists alongside other inequalities and health disparities present in our society. This is because of both the comorbidities that made COVID more deadly and the unequal access to healthcare infrastructure around the country. Obesity and diabetes, for example, are both illnesses that disproportionately affect poorer people in the United States, while poorly resourced health care centers are found both in poorer parts of cities as well as in many rural areas around the country. For example, one of the reasons that the outbreaks at the meat packing plant in Logansport were so damaging to the surrounding community back in May was not that meatpacking could not be done safely – slowdowns and safety equipment have significantly curbed the spread of disease – but because the rural hospitals near this and other meatpacking facilities were quickly overwhelmed by the volume of new patients for this highly contagious disease. As with many outbreaks in the past, the initial spread of disease was facilitated by people in a relative position of privilege traveling around the world, but the people who faced the most risks from that disease were communities with far less mobility, access to healthcare resources, or remote work options.  

Dr. Ju: During the course of the COVID-19 pandemic, we have been observing that the public’s risk perception and emotional responses affect their protective health behaviors, including protective measures suggested by public health agencies (e.g., CDC). Statistically, highly urbanized communities, such as metropolitan areas, showed larger percentages of the disease spread compared to more traditional communities with less density. Among others, what I recently found is that COVID-19 risk perception (susceptibility or severity) induces anxiety and fear and the heightened negative emotions motivate people to engage with protective behaviors. The level of risk judgment and emotional responses are influenced by a variety of factors and differs across individuals. Suggesting one fool-proof remedy seems impossible given the differences. In general, however, less urbanized communities showed a lower level of risk perception and affective responses that often result in a lack of compliance with protective measures. This may be partially due to optimistically biased beliefs that they are less likely to get the disease compared to denser areas. On the other hand, it was found that risk perception and emotional responses are influenced by a complex mix of many factors. I found political views, race, education, residential areas, and personality can come into play in shaping the public’s risk perception and health behavior decision-making. The cultural and social climate also played a critical role in protective health behavior engagement. Public health agencies may need to consider tailored health communication approaches to the different people in different areas or social segments. 

Dr. Matei: What social scientific finding, of your own or broader, about COVID-19 surprised you the most? 

Dr. Song: In a project that I’m working on with Dr. Ju in our department, we interviewed and surveyed Purdue students to investigate confrontation as a mechanism enabling social norms during COVID-19. Behaviors such as wearing masks on campus cannot be enforced through law or disciplinary action every time. This is where the influence of social norms steps in, creating an atmosphere of disapproval against those who engage in behavior threatening the community. Upon observing deviant behavior, such as someone walking around in a densely populated space without a mask, people motivated to protect the group can intervene in several ways. They can directly confront the person, they may report the behavior to an authority who can handle the situation, or glare at the person to tacitly signal their disapproval. We wanted to ask students what these episodes creating and sustaining social norms looked like during the ongoing Protect Purdue initiative on campus. 

In a typical week on campus this semester, students reported that they witnessed about 7.9 incidents of someone not wearing a mask properly. We asked participants to think about 10 random events over the semester in which they saw someone fail to wear their masks properly during the semester. On average, more than 3 of these incidents occurred outdoors on campus and nearly 3 of them off campus within the community. Also, approximately 2.5 of them were witnessed in residential halls, off-campus student housings, or amenity buildings.  

When asked about how they reacted to their 10 events, they avoided the violator or simply ignored the incident in three quarters of the occasions. In about 1.7 events (16.5%), they chose to tacitly signal their annoyance. In only about 0.5 (5%) of such occasions did they explicitly request that the person wear his or her mask properly. 

While students seem not to expect a hostile response when they ask someone to wear their masks properly on campus, a majority expected hostility when they were in a drinking establishment or off campus in the Greater Lafayette area. 

It appears that one of the key factors in facilitating intervention (as opposed to simple avoidance) is having clear rules for as many types of spaces as possible. This seems to help students feel legitimized in their decision to confront or at least signal some annoyance to the person failing to wear masks.  

Dr. Ju: The research community on public health communication have believed that health risk information may motivate people to engage with protective behaviors for a long time. There is also much evidence on that. However, more recently, my research team found that the public’s emotional fatigue may prevent people from protective health behaviors during the pandemic. We have been exposed to a wide range of health risk information that usually consists of COVID-19 outbreaks, transmission, deaths, risks, etc. In this case, public health risk communication campaigns may lead to backfire effects such as a lack of compliance with protective measures or message avoidance. Traditionally, many social behavior change campaigns have used fear appeals or risk communication to encourage the public to take proper measures. However, we are tired of so much health information that is negatively framed. All of us have been experiencing intense and negative emotions such as fear and anxiety for a long period of time. Even if COVID-19 health risk information has been circulated by the mass media, social media, personal networks, and more, simply providing more risk information does not mean improved health behavior compliance. As noted previously, as the face of COVID-19 changes, audience targeting, tailored messages, carefully planned media approaches are warranted. Our ulterior goal should be public health. However, public health should be redefined by incorporating not only physical but also mental and emotional well-being. 

Dr. Matei: What seemed to work in helping people make the right decisions and what backfired? 

Dr. Song: Clear science-based guidelines communicated in a consistent fashion has always helped people make the right decision. We can see this from countries that have displayed more disciplined responses to the pandemic as a group such as many in Asia, Oceania, and even parts of Africa. Many of these countries had prior experience fighting serious outbreaks such as SARS, MERS, avian flu, or Ebola. For example, their guidance on mask wearing has been consistent from the beginning—they have not only required their citizens to have their masks on but recommended that those masks be equipped with some functional filters.  

In contrast, messaging around mask-wearing has been quite confusing in Western countries. Early in the pandemic, even the Surgeon General tweeted that masks are not effective in preventing catching of coronavirus. Many opinion leaders have also signaled strong disapproval of wearing masks. Inconsistent messages eventually damaged public trust in our health authorities badly enough to hurt efforts promoting mask wearing, and more recently, vaccination.  

Dr. Flachs:   Throughout the pandemic, I have been struck by the ways in which the maps of COVID transmissions and fatalities diverged from population maps. Many maps of social phenomena, say those of energy use or light pollution or internet traffic are really just proxies for population density. And that would make some logical sense for a contagious disease. But in this case the maps where this illness was most serious were often areas where population was lower, reflecting not a distribution of human density but a distribution of political decisions around masking and social distancing. In areas where public spaces were not de-densified and masks were uncommon data throughout the pandemic has consistently shown that the virus spread, people got sick, and people died. Clearly, people also needed options to work remotely, which not all jobs were able to provide. Purdue was able to be successful in offering students remote options, intensely cleaning areas, requiring masks in all places where people were likely to inhale others’ breath, and structurally changing high-density encounters like dining halls, fraternity events, sports, and large lecture classes. The biggest lessons are that public health decisions became entangled with a partisan politics, thus eroding trust in institutions charged with public safety.  

Dr. Matei: What cultural or social approaches can or should be used in the future to minimize epidemics and also keep societies functional? 

Dr. Song: We are learning that COVID-19 requires a group-level response. Simply promoting protective behaviors at the individual level is not enough. We need to mobilize entire communities or countries to engage in a coordinated response and influence their members to create and sustain helpful norms. At least part of Asia’s better response can be attributed to their communitarian values as opposed to the West’s more individualistic ones. Even within Western culture, we see some countries more accepting of group-level responses than others despite their shared individualistic values. These countries seem to better recognize that global or national-level crises like COVID-19 impose a personal responsibility to each member to do their part to protect the group.  

A phenomenon I found interesting was the stigma attached to “snitching” in the U.S. For example, in South Korea, you can easily report minor violations such as unlicensed use of disability parking spaces and illegal waste dumping to relevant authorities with a cell phone app. During the pandemic, the same system has been expanded to encourage reports of gatherings beyond the capacity limit or businesses opening against mandates. It appears that societies with more communitarian values see practices like reporting in a different light—protecting the group and sustaining the norms while sanctioning those who exploit the inconvenience of others.  

When a crisis like COVID-19 hits us again, messaging toward the public should go beyond simple advice to protect oneself and better highlight one’s responsibility to protect the community. This is not a completely foreign or new idea. For example, in response to terrorism threats, the Department of Homeland Security launched an “If You See Something, Say Something” campaign, underscoring and approving of individuals’ role in reporting suspicious behavior. In a pandemic situation, masks work not only by protecting the person wearing it, but also others interacting with the person, effectively protecting the health of the group. Messages that emphasize one’s responsibility in relation to the group could improve public responses in future pandemics by characterizing the impact of our behavior more accurately.  

Dr. Flachs: Fundamentally, institutions will have to work to regain trust beyond the particular partisan politics of this moment. That will be a difficult task because many people do not see institutions as serving in their best interests – either because trusted leaders have told them to ignore advice from those institutions or because they have a history of harm against some of those communities. Long-term investments in public health infrastructure will also be critical from a public health perspective. By providing higher standards of care that lower the risk of comorbidities and exacerbating health and socioeconomic factors, the overall deadliness and rate of spread of such contagious viruses will be lower. Institutions that see public health measures like sanitizing, contact tracing, remote work, and masking as an important part of keeping the organization running, provide a model that keeps stakeholders engaged without cutting them off from their work or placing them at unnecessary risk. It is likely that the increased attention on hygiene and a flexibility with remote working for at least some activities is here to stay. 

Dr. Ju: Our society has focused on medical therapies to cope with infectious diseases or other health issues. More recently, social scientists increasingly examine behavioral aspects of public health. From the communication perspective where I view the phenomenon of COVID-19, the public should be properly and timely informed about a disease and its coping strategies (awareness). Their cognitive and emotional responses will follow and public health communication campaigns should contribute to effective coping strategies by affecting the cognitive (comprehension) and emotional responses (attitudes). Knowing is not sufficient. People enact behaviors when they are convinced (conviction) and able to engage (efficacy) with the behaviors. Throughout this process, the role of public health communication using mass media, social media, professional experts, and even influencers in personal networks play a part. The key is a timely and persuasive communication. Communication can contribute to keeping societies functional. My research team and other social scientists are conducting research projects to better understand and suggest working communication approaches for the local governments, public health agencies, and social networks. Effective and strategic public health communication is possible when we understand the target audience with their needs and wants. I hope we can share better insights soon. 

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