For about two months now, Americans have been told the same thing over and over again by public-health officials and influencers everywhere: Stay home to stop the spread of the coronavirus.
The message is true. If we all stay hermetically sealed in our homes for long enough, the virus will die out; if we don’t, it will linger. But framing the message in such a stark way may inadvertently encourage people to make worse choices. A less extreme, more nuanced, set of recommendations may get more traction—perhaps a public-health equivalent of “Reduce, reuse, recycle.” Something like “Stay close to home, keep your distance, wash your hands,” but catchier.
I think a lot about this public-health balancing act in other contexts, mostly pregnancy and parenting. For example, I’ve written about safe-sleep messaging. Doctors tell parents to put babies to sleep alone in a crib, on their back. This is indeed optimal. But the messaging doesn’t allow for parents to understand—if this is simply impossible—what the next-best alternative might be. Are all other sleeping situations equally risky? It turns out they are not.
One of the most dangerous sleeping arrangements for infants is on a sofa with a parent. This is far more hazardous than in bed with a parent, especially if the bed contains no pillows or blankets. If health professionals communicate “Everything other than alone-in-crib is extremely dangerous,” parents may end up on the sofa, possibly because they’re trying to avoid falling asleep in the bed. This can have tragic consequences. It would be better to communicate that while the safest sleeping arrangement is alone-in-crib, bed-sharing is much safer than sofa-sharing.
COVID-19 messaging has sometimes had a similar flavor, whether it comes from civic leaders or friends and family. Just stay home! Everything else is risky. One mother wrote me to say that she’d mentioned on Facebook that she had taken her child out for a walk—and people shamed her. Some people are getting paranoid. They’re afraid to go to the park, because they can’t stop thinking about all the what-ifs. What if a sick person breathes on a plant and then a few seconds later you happen to touch it and then scratch your nose under your mask and then you get sick? This is not completely impossible, but it is extremely unlikely.
When people are advised that one very difficult behavior is safe, and (implicitly or not) that everything else is risky, they may crack under the pressure, or throw up their hands. That is, if people think all activities (other than staying home) are equally risky, they figure they might as well do those that are more fun. If taking a walk at a six-foot distance from a friend puts me at very high risk, why not just have that friend and a bunch of others over for a barbecue? It’s more fun. This is an exaggeration, of course, but different activities carry very different risks, and conscientious civic leaders should actively help people choose among them.
Stark messaging may also discourage people from taking reasonable precautions. Public-health officials tell people to wash their hands and wear masks. But because the above-the-fold message is “Just stay home,” people may struggle to understand the purpose of these other pieces of advice. If the only truly safe thing to do is stay home, then how should I think about the mask suggestion? Is it a futile gesture, like putting a Band-Aid on a gunshot wound? (In fact, mask wearing and hand-washing are both important steps people can take to lower their risk of getting and transmitting the virus. Neither of these lowers your risk to zero, but they affect it a lot.)
As the economy reopens, it makes sense to communicate a range of risks, and to speak in terms of probabilities rather than in binaries. Staying home and not seeing anyone is the safest way to avoid the virus. But seeing people at a distance with masks on is safer than a spring-break party. Grocery shopping can be made safer with a mask, and with appropriate hand-washing protocols. If you see your older parents, don’t hug them, and consider choosing an outdoor venue.
One way the pandemic differs from the sleep example is externalities—the fact that our actions affect other people. If I go out and risk a chance of infection, I may then hurt others. But if we as a society keep the bar for correct behavior very high (“Just stay home”), and then suggest that not reaching the bar is shameful (“How dare you take a walk with your daughter?”), we may create a situation where people who suspect that they have the virus fail to act responsibly (by telling contacts they have it and then isolating themselves) in order to avoid stigma. The message ought to be that people may get infected even if they take precautions, and that having the coronavirus isn’t some kind of moral failing.
Ultimately, the public needs to better understand the virus. People need to see, for example, why hand-washing matters—because even if you get a virus particle on your hand, if you wash it off before you touch your face, you will not become infected. People need to be less afraid but more careful. Stark messaging can’t bring that about, but smart messaging can.
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