Across the globe, adversities faced by humanity during the ongoing pandemic have taken a severe toll in more than many ways. Due to the virus’s primary transmission route through the respiratory tract and being aerosol borne, it has managed to devastate millions of people and their families. It necessarily includes very high mortality in some select vulnerable age groups and a large cohort of people with co-morbidities.
With its long-term consequences on human health and socio-economic impacts, the pandemic continues to rage through with its multiple sub-variants and mutations. Scientists have developed vaccines and clinical treatments for COVID-19 with unprecedented speed. Although to a lesser degree in India, the vaccination continues to throw a challenge of hesitancy and skepticism in many regions of the world.
Clearly, it has been 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 in strategic communication and public health well acknowledge that the COVID-19 pandemic is primarily about bringing a positive change in the ‘behavioural practices’ issue – both at individual and community levels.
Nevertheless, there still exist, like in most other public health concerns, a few hard-core ‘laggards’ who continue to defy easy acceptance of any positive behavioural practice. An inherent and very critical dimension to such public health emergencies is invoking and managing 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 result-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.
‘Mutations’ Invade: Pandemic Surges
With the current pandemic largely being a ‘behavioural practices’ issue, a large cohort of the populace will adopt practices as are being disseminated by credible and trusted sources. 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, as is being witnessed across India and giving ample way to the subsequent mutations to surge ahead.
Pandemic Fatigue and ‘Peltzman Effect’
In recent weeks, the gradual rise in COVID-19 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. In the Indian context, COVID-19 vaccinations 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 the “Peltzman Effect” (Sam Peltzman, 1975).
Misplaced Sense of ‘Security’
Even subconsciously, many of those who have not received even a single dose of vaccine may slack in wearing face masks and maintaining physical distancing in crowded places, when these people know that others are receiving the vaccine for the past over a year. 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 the 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 of overconfidence among people, which can ultimately worsen this effect.
An Uphill Task for Behaviour Change Scientists
Behavioural communication experts have been in dilemma, i.e. whether or not the COVID-19 vaccinations would result in increased risk-taking behaviour? Multiple studies attempted to seek a 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 risky behaviour, a measure must first be ‘visible’. This factor is overtly found with the COVID-19 vaccination, for it has generated a substantial amount of discussions and publicity. And each individual who has received the vaccine would be well aware that they have done so. In 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 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.
Appropriate Political Messaging: The Key
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 with science in politics than politics in science.
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