Keep calm, and listen to the experts

Chris Keyworth on information and misinformation during the coronavirus outbreak.

As a nation seemingly poised for the apocalypse, many Britons have spent the last fortnight stockpiling toilet rolls, dried pasta and UHT milk, leading some supermarkets to enforce a style of rationing not too dissimilar to WW2. What we are seeing might be described by some as a form of mass hysteria and panic, with seemingly little regard to the facts and expert advice being given to us. 

COVID-19 is a major public health concern and should be taken very seriously by all, but in ways that are productive in taking action, taking care of ourselves and others around us, both physically and psychologically. We must limit the amount of popular news media we are exposing ourselves to, and instead focus on concrete advice from the experts. The World Health Organisation outlines a series of mental health considerations, which includes limiting the amount of news you watch if likely to cause you anxiety or distress, and instead focusing on the practical steps to protect yourself and those around you. Limit the number of times you get those updates. Stick to the facts and seek out trusted sources, such as the Coronavirus resources centre produced by John Hopkins University, or the resource from ArcGIS and Public Health England, making the latest information easily accessible to the public. Listen to the expertswhen making specific steps to reduce the transmission of COVID-19. There are many important examples of steps you can take to slow the spread of COVID-19, including specific behaviours, as simple as good hygiene practices as matter of habit. Follow Public Health England for the latest advice and guidance.

Informing people about any risk to their health is not an easy task. We have known for some time that simply telling people about a health risk is often not enough to motivate people to take preventive action. This is particularly true of COVID-19, a virus that currently very little is known about, where so much has been written about those people most at risk (for example older people with pre-existing medical conditions). We have moved beyond information giving and dictatorial stances when making recommendations for effective public health campaigns. The same can be said about COVID-19. Informing us that we should be washing our hands regularly, for 20 seconds each time, is sound advice, specific and achievable. But we also need to know why this is important and how we can do this effectively over a sustained period of time. We need to know why increasing hygiene behaviours are important for ourselves and protecting those most at risk around us (this is particularly true for people who may not be considered ‘at risk’, but maybe prone to passing the virus onto others). 

Public health messages, particularly those in the media, which aim to arouse fear, often do little to motivate action. Instead there is a danger that such messages cause unnecessary anxiety and stress. For example, the recent Cancer Research UK obesity campaign was accused of ‘fat-shaming’, being highly stigmatising, discriminating, and ultimately uneffective in reducing risk behaviour. Whilst good intentions were obvious, an opportunity to deliver an effective health message, with a ‘why’ and a ‘how’ was potentially missed. 

We only have to look to the cognitive psychology literature to understand how people respond to threatening health information, and why fear messages, which are often portrayed in the media, sometimes don’t work. Communicating sometimes complex information (such as statistics and large numbers) involving risk and uncertainty is challenging. We have systematic biases in the way we process information. These are sometimes referred to as emotional biases, or emotional reactions to health information, which may act as a barrier to peoples’ understanding. This consequently diverts our attention away from the content of the message and leads us to focus on how the message makes us feel, rather than what we should do. We make fewer systematic decisions, which may limit our motivation to take preventive action.

Important health messages about COVID-19 shouldn’t simply sensationalise the facts to sell newspapers. They should clearly explain the risks of the virus, but most importantly what people can do to minimise their risk of contracting it. The messages could be made specific and targeted, with a particular focus on the elderly and those with pre-existing medical conditions who are known to be amongst the most vulnerable. 

When it comes to informing the public of the risks posed by COVID-19, this should be done in an informative and sensitive way. For example, the statistics should not be looked at in isolation, and should always be understood with a sense of perspective. Statistics are often presented in the media as a way of sensationalising news stories, with often little interpretation of those numbers. Lots of statistics are thrown around in the public domain, often in isolation; ‘80% of the UK population could be infected with the coronavirus’, and ‘Coronavirus could kill half a million Britons’ are just two of the headlines that have been circulating, no doubt causing panic. Whilst COVID-19 represents a major public health challenge, and numbers are expected to continue to rise for some time, statistics must always be interpreted by the public with a degree of caution and always in context; both of those headlines refer to the Governments ‘worst case scenario’. But of course that last part is often disregarded. 

We know a huge amount about the dangers of poor communication of health messages; and particularly what happens when this goes wrong. One of the seminal health communication papers explained the massive health and financial repercussions of the contraceptive pill scare of 1995, which was caused through a misrepresentation and misunderstanding of unpublished scientific data. We have a responsibility to maintain a level of calm, and take the necessary steps to protect ourselves and others around us. Ignore the fear messages, and let the experts guide you through the statistics, the forecasting, and the steps you can take to slow the spread of COVID-19.

Dr Chris Keyworth is a Chartered Psychologist and Research Fellow at NIHR Greater Manchester PSTR, Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, University of Manchester.

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