COVID-19’s Threat of Death Keeps Masks and Other Preventive Measures From Being Used

This article was originally published on Aug. 22, 2020, by NBC News THINK.

We need to look at why the dire messaging around the coronavirus hasn’t convinced everyone to wear masks and what could be more effective.

Avoiding congregating in large groups, wearing a mask and washing your hands seem like easy, albeit inconvenient, pieces of advice to follow. Instead, social media is filled with examples of outbursts against these proven infection-control measures. In some cases, mask reminders have even led to violence — including the recent attack on a 17-year-old employee of Sesame Place amusement park, who suffered a broken jaw.

Plenty of Americans are angry about this behavior and are calling out those who can’t follow the simple rules for containing the spread of a deadly pandemic. No less than Sharon Stone took to Instagram this week to rebuke whoever infected her sister with the coronavirus: “One of you Non-Mask wearers did this,” the movie star wrote. “The only place she went was the pharmacy.”

Her outrage is understandable, and many of us share her frustration. However, it is clear that despite dire warnings and emotional appeals by health authorities, business owners and fellow humans, there is a large segment of the American population that has not been persuaded to do the right thing. Since it’s in everyone’s interest to encourage compliance, we need to look at why these messages aren’t working and what could be more effective.

As it happens, a recent study suggests that connecting prevention behaviors like hand-washing and social distancing to extreme, even fatal, personal consequences from the coronavirus might be discouraging people from acting in their own interest, let alone others’. Reshaping our public messaging to focus on immediate benefits — like getting back to work and school — could be far more effective at motivating individuals to take preventative measures.

Associating health issues with death can make them seem uncontrollable, which discourages action to prevent them, the study noted. This concept, referred to as “health fatalism,” is not new. Avoidance of potentially lifesaving prevention and diagnostic activities has long been observed, for example, among people with cancerdiabetes and HIV.

Now researchers are looking at how this phenomenon applies to COVID-19. They’ve found that the common factor among those who were reluctant to engage in prevention behaviors was associating coronavirus with death. Surprisingly, young adults were more likely than older people to make this association. Just as concerning is that segments of the population that have seen the most dire outcomes from this pandemic may be some of the least likely to follow prevention advice, particularly Black Americans.

The flawed strategy that helped get us here started with a common mistake in health messaging: failing to understand the needs of the audience. Audience research is always a key component of strategic communications, but in the case of a crisis like a pandemic, urgency often dictates that the message be relayed quickly without the benefit of investigation.

Instead, when a serious threat emerges, health leaders already have tremendous evidence in front of them that proves death is a potential outcome. Like many of us would, they relay the information in a fear-based frame. Imagine if you saw a child walking too close to a campfire. Would you stop to figure out how best to warn the child without causing trauma or a fall, or would you yell a warning right away? It’s this same instinct that often drives health leaders in a crisis to use dramatic language and speak of lethal scenarios before considering whether that approach will be most effective in achieving compliance.

Given these habits and COVID-19’s all-too-real dangers, how can we ensure that messages don’t discourage behavior that can save lives? What can we do now to recalibrate how we think about preventing the virus?

First, it’s important to understand that human beings are driven by immediate benefits, rather than far-off consequences. While the number of fatalities related to COVID-19 continues to rise, 170,000 people is just a small fraction of the U.S. population. Unless you personally know someone who has died of the coronavirus, acting to prevent something that might happen is far less persuasive than an instant payoff.

To effectively reach everyone, we should be talking about the more immediate benefits of masks. Recently, Centers for Disease Control and Prevention Director Robert R. Redfield noted that if everyone in the U.S. wore a mask, the pandemic could be under control in four to eight weeks. Getting back to work and school and enjoying the nice weather are nearly universal desires among Americans, so messaging should communicate how wearing masks can help us get back to those activities more quickly.

There’s also a more effective way to help individuals prioritize the future consequences of their actions: Emphasize legacy, the desire to provide for future generations. When faced with the concept of death, most people discount personal consequences, but paradoxically, they care deeply about what they leave behind.

This innate human desire to impact the future can be a key motivator to adhere to prevention measures. We need to be asking people how they want to be remembered: as someone who selfishly refused to take precautions, or as a person who wore a mask to ensure the safety and continuity of their families and communities?

We have a long, painful road ahead as we work to tame this pandemic while researchers in labs throughout the world search for a vaccine. Until that comes, we need to use the research and tools we already have to make progress: better messaging around health and prevention. Being smart about how we talk about the pandemic and its effects has the potential to speed compliance with behaviors that can help the nation recover more quickly.