The coronavirus didn’t seem like a big deal to Craig Buescher at first. Still, he thought he was being careful.
Buescher was 69 and in good health. Surely, he thought, the virus wouldn’t be that bad if he came down with it.
While he doesn’t know how he ultimately contracted the virus, it was, in fact, quite bad. Nine days in the hospital, as he struggled to breathe, convinced him that not only did he need to be more careful to avoid the virus, but also that he should persuade others to do the same.
“I couldn’t walk across the room without stopping,” said Buescher, of South Bend, Neb. “That proved to be the thing that made a believer out of me.”
For all those like Buescher, who has become more cautious since the pandemic was declared in March, millions of others continue to resist recommended precautions or have stopped following public health guidance because of pandemic fatigue. Officials and health experts are sounding the alarm about the virus’s dangerous surge — the United States is logging more than 160,000 new infections per day on average — while many desperately try to determine how to persuade people to change their behavior.
To be sure, plenty of Americans are heeding officials’ advice to limit their time in public places, avoid small gatherings and stay away from large crowds. But a Gallup poll conducted in September found that the numbers of people who report doing each of those things have been trending downward and are at their lowest levels since March: 70 percent said they had avoided large crowds in the past week, 53 percent had stayed away from public places and 45 percent had forgone small gatherings.
Most people who are ignoring public health recommendations probably either don’t perceive themselves as at-risk for severe consequences of the coronavirus or don’t believe the suggested behaviors will protect them, experts say.
Social norms also have a big impact on decision-making. In places where most people are following the guidelines, others are likely to follow. Because the United States did not create uniform norms early in the pandemic, wearing masks and maintaining distance are still unpopular in some places.
Changing those norms by highlighting the many people who are following the rules could be key to persuading others to alter their behavior, research shows.
“Even when we know what we SHOULD be doing, if we find out that other people aren’t doing it, we probably won’t do it,” Vanessa Bohns, who teaches organizational behavior at Cornell University, wrote in an email. “Interestingly, lots of persuasive messaging undermines itself by saying, ‘You should do this,’ and then immediately afterwards saying, ‘But most people aren’t doing this.’”
Meeting the virus face-to-face
Despite attempts to shift social norms, experts say the most effective factor in shifting people’s behavior may still be personal encounters with the dangers of the virus. While many Americans still flout public health measures after having close experiences with the pathogen, psychologists are hopeful that there’s a tipping point at which the amount of people who act more cautiously after a personal experience will affect the pandemic’s trajectory.
For Buescher, it took getting sick for him to buckle down on mask-wearing and social distancing. His brush with covid-19, the disease caused by the coronavirus, came in September, when he noticed that his legs were weak and he felt tired all the time. He said his doctor prescribed him medication and urged him to go to an emergency room if his blood-oxygen level dipped below 90 percent.
Soon it did, Buescher said, and his wife drove him to the hospital. After eight days of supplemental oxygen, his daughter told him that his doctors warned her at one point that they would have to put him on a ventilator if his breathing didn’t improve.
The experience left Buescher a changed man — one who keeps two or three masks in each of the family’s cars so they’re always prepared, and he has tightened his social circle to one other couple. He and his wife celebrated Thanksgiving with their four adult children over Zoom, and they’re rethinking their Christmas plans.
“There’ll be other Christmases,” Buescher said, “unless we’re not responsible.”
Buescher has also become an evangelist for coronavirus-conscious decision-making. He makes sure to wear a mask when he goes into a business, even though he’s now unlikely to be infectious, because he wants to set a good example. He’s been sharing his covid-19 experience with others through Facebook posts. And he recently spoke at one of Gov. Pete Ricketts’s news conferences to urge fellow Nebraskans to be cautious.
“Is this something we’re going to do every year?” Buescher said at the news conference, of his family’s plan to celebrate Thanksgiving virtually. “No, we’ve got to do it this year so that we have the capabilities of getting back on track next year.”
As word spread in his small town that the virus hit him hard, Buescher said others have told him that hearing about his experience changed their own behavior. One of those friends was Chuck Baum, who said he felt at the onset of the pandemic like the constant crush of coronavirus news might be just a lot of crying wolf.
It wasn’t that Baum and his wife weren’t taking any precautions. He got sent home from his job in the livestock industry. They paused their habit of eating at a restaurant every other week. Neither of them went to big weddings or funerals anymore.
But the virus seemed to be on every TV station, all the time. Who knew how bad it really was?
“At some point in time, you tune the news media out,” said Baum, of Denton, Neb. “Until you start knowing people that are dying, then it becomes real.”
Buescher wasn’t the only person who helped make the virus feel more real to Baum. First it was a friend in his 60s, who died in March. Then his college roommate’s father succumbed to the virus. In October, one of his customers died two days after Baum found out the man was sick.
The biggest change Baum said he has made since seeing friends die of the virus is no longer going inside his 92-year-old mother’s house. He has visited her twice in the past month, but now he opens the kitchen door and the screen door and talks to her from outside.
That kind of change is unsurprising to Donald Edmondson, who leads the Science of Behavior Change, a network supported by the National Institutes of Health that uses experimental medicine to study behavior change. As more members of a community become seriously ill and die of covid-19, Edmondson said, the norms in that area are likely to eventually change.
“There has to be a point at which there’s a feedback loop that begins to shift behaviors,” he said.
Choosing the right messenger
Talking to people about the dangers of the virus can also influence people’s behavior, but only if the message is coming from someone they trust, experts say. A breakdown of faith in institutions has left many skeptical of anything they’re told by government officials, academics or journalists.
Some people are so mired in disinformation that experts believe it would be hard to persuade them to change their behaviors. Nearly 1 in 5 U.S. adults believes the coronavirus is less lethal than the seasonal flu, and 41 percent think the official coronavirus death toll has been overstated, according to a Gallup/Knight Foundation poll conducted in September.
“The best bang for your buck is going to be those people who are on the fence who are just tired,” said Jay Van Bavel, an associate professor of psychology at New York University. “You can probably get through to more of them than people who are just very far gone.”
For those who consume mostly accurate information, the key is for people to directly encourage their family members and friends to make safe choices. Van Bavel pointed as an example to social media campaigns such as the “Ice Bucket Challenge,” which made waves online in 2014 and raised millions of dollars for amyotrophic lateral sclerosis (ALS) research.
It’s important for public health officials to communicate risk-mitigation measures to people who will listen, Van Bavel said, but it’s equally crucial that those people share them with their loved ones who aren’t inclined to believe authority figures. People are more inclined to agree to requests from people they like, research shows.
For those who have been convinced by arguments that wearing masks or maintaining social distance are an assault on freedom, Van Bavel said he would redefine freedom as the ability to move through society more freely if everyone takes precautions such as wearing masks. He said people are sensitive to the idea that they are losing something, so he would also suggest that the real risk is not losing freedom.
“I would frame it as, the real risk of loss is not missing a holiday with the family,” Van Bavel said. “It’s missing the family — having them die or have permanent lung damage or brain damage or psychiatric problems.”
With access to coronavirus vaccines on the horizon, experts say there’s another strategy for persuading people to be cautious: reminding them that the pandemic’s end is in sight and they wouldn’t want to contract the virus soon before they could have been inoculated.
Van Bavel compared the situation to the “marshmallow test,” a well-known psychological experiment in which a child could either eat a marshmallow right away or stay unaccompanied with it in the room for up to 20 minutes and then receive two marshmallows as a reward for her patience.
“We’re now in a marshmallow test as a society,” Van Bavel said. “We need to tell people that you can have those two marshmallows, you can have lots of gatherings with family, lots of trips, lots of economic activities, if you can just hold off for a few minutes and not eat the marshmallow right now.”