What would you say is strongest single predictor of behavior and attitudes towards COVID-19? What factor makes it most likely that someone will follow masking and social distancing guideline?
You would be considered reasonable if you answered that those with the greatest risk of dying would be the most cautious. You would be wrong. You would be considered a rational thinker if you answered that healthcare workers that are confronted with the sick and dying from COVID-19 would have the strongest emotional response motivating them to extra caution. You’d be wrong. You would not be thought crazy if you answered that those with more education would be more careful because they have more of an understanding of the complicated factors at play. Again, you’d be wrong.
Race? Wrong. Gender? Wrong. Employment status? Wrong.
The single strongest predictor of behaviors and attitudes towards COVID-19 is political affiliation.
This was based on study from the Brookings Institute that analyzed the data from a survey of 50,000 Americans which found that which political party you affiliated with influenced your behavior and attitude towards COVID-19. It was a better predictor than things which increased your risk of dying from the disease.
But why is this? Shouldn’t our attitudes towards the greatest public health emergency in a century be influenced more by doctors and scientists who study these issues for their entire careers and not politicians who we all know will manipulate our emotions to coerce our votes?
I think there are reasonable explanations to explain this phenomenon.
Statistics are hard to see
The challenges of getting our minds around COVID-19 are fueled by two major factors related to the virus itself. The first is that SARS-CoV-2 causes severe infection in only a minority of people, the second is that it is very contagious. Therefore, only a minority of those infected get severe disease. In spite of that, because of its contagiousness, enough people will get infected to make that minority a significant number in total. To put it differently, a mortality of 0.5-1% is very small, but 0.5-1% of 300,000,000 is a lot of people.
We tend to believe what we see more than numbers, even when the numbers are far more accurate. What we see is filtered through or beliefs and preconceptions. We don’t believe what we see, we see what we believe. This means that, unless you or someone you’re close to gets a severe case, it will feel like the disease is not that bad to you because you are not seeing it with your own eyes.
The virus is hard to research
You don’t have to be a trained epidemiologist or infectious disease expert to know how hard it is to understand this pandemic. The is fueled by limitations on how the virus can be studied.
As an example, there is still controversy about how the virus is spread. You would think something as fundamental as viral transmission would be easier to study. It’s not. This is true for both logistical and ethical reasons. To fully understand viral transmission you would need to expose large populations of uninfected individuals to the virus under varying conditions to see if they get infected. This is obviously unethical. For that reason we are left with circumstantial sources of data. We can see what happened on a cruise ship and in environments with a heavy exposure such as hospitals or homes where there was an infected individual. We can also study how droplets (without virus) behave in various environments and make assumptions about how the virus would behave in those droplets. We then combine a large amount of circumstantial evidence to come up with a conclusion.
These forms of evidence can be weak and subject to refutation. There is also more likely to be contradictory evidence. With time the circumstantial evidence accumulates and becomes convincing but things can be murky until then.
Everything keeps changing
One of the problems that stresses us all greatly is the constantly changing recommendations and guidelines. It feels like the experts can’t agree, make up their mind, or get things straight. This is compounded by the fact that the media is constantly flooding us with the latest science decorated with flashy graphics and riveting headlines all of which gives the impression that the information you are about to read or hear is both earth-shattering and solidly proven. It usually isn’t.
In normal times science intentionally moves forward slowly. The process starts with hypotheses. This leads to small exploratory studies which generate further questions for further study. This leads to the organization of larger studies which are more complicated and take longer but are more convincing. These are then replicated for confirmation. All along there is debate, analysis, and reanalysis. Eventually consensus is reached and confirmed further. This is all a process that can take several years or even decades.
If the mask on your face and you kids being home schooled didn’t clue you in, these are not normal times. The world is on edge and doubly anxious for any news and public health decisions need to be made with incomplete data. This is unavoidable. Recommendations need to be made even if the science is imperfect because people’s lives are on the line.
Because recommendations need to be made with imperfect information, new research will inevitably lead to changes. In fact, not changing the recommendations would be far worse than providing no guidance (in fact, the vast majority of the recommendations have held up to further study). The problem is that the news media, the public health institutions, politicians, and all of the self-credentialed medical experts on social media do not begin all of their reports, press conferences, videos, articles, posts, or tweets with the phrase “the following is based on the information we know as of today” or something similar. Even though they do not say it, know that it is the reality.
This all leads people to not trust the public health authorities because it appears as if they don’t know what they’re talking about. In reality they know as much or more than anyone and listening to them is always your best bet. Unfortunately people take any level of uncertainty as proof of incompetence giving them room to disregard the science altogether and follow their political beliefs instead.
Let’ recap that last part to expose how absurd it is. In essence, what people are doing is saying that, because there are flaws in the data, they can’t trust the doctors and scientists, so instead they’ll trust facebook, twitter, and politicians. These are certainly maddening times.
The virus is just hard
On an almost regular basis a few times a week I find myself temporarily overwhelmed by how difficult this situation is on so many levels. It hits me like a giant weight in my stomach and I have to stop for a few moments to take a deep breath and let it all sink in and pass by. The problems are just unrelenting in their complexity and often soul crushingly heart breaking. The decisions that families are having to make both in the realms of their health, their finances, and their sanity are often overwhelming.
For these and other reasons people are understandably desperate to ease the burden on themselves and their loved ones. They are going to muster all of their psychological defense mechanisms to counter any data, arguments, or guidelines that would put that burden back upon them.
The bottom line
If you put all of these factors together (and I’m sure there are others) you get a perfect storm for creating unhealthy skepticism, disbelief, or even magical thinking. You have a rapidly evolving worldwide pandemic caused by a virus that is maddening in its complexity and very difficult to study. It is caused by a virus that impacts people differently. For some, the impact of the virus is very real and painful leading to intense anxiety. For others the impact of the restrictions are far worse leading to intense resentment. Throw in the magnitude of the burden the all places on people and it all combines to make people vulnerable to opportunistic politicians, news outlets, or websites that tell them that it’s all a hoax, the public health institutions are either corrupt or untrustworthy, and there’s nothing to worry about.
It’s going to take a long time to recover from all this.