In every walk of life we accept that some degree of risk is inevitable. Crossing the road, taking a shower or playing golf in a thunderstorm all bring with them a small but definite chance of death. The reality is that the cost of eliminating these risks entirely is simply too high for people to accept.
When it comes to coronavirus, different rules seem to apply. Polls show that in countries that have imposed a lockdown compulsory mask wearing and social distancing are popular policies, despite the inconvenience and economic hardship they have entailed.
In the words of the former Conservative MEP and author Daniel Hannan, “something unattainable, namely total security” is being demanded of governments. And governments are trying their very best to attain it.
But why this apparently unique level of risk aversion when it comes to coronavirus?
According to the cognitive behavioural scientist Sweta Chakraborty, an Associate Director of the Institute of Science for Global Policy in Washington D.C., it is due to the failure of those in power to communicate accurately to the public how much of a threat coronavirus actually poses.
The lack of communications strategies, exacerbated by an alarmist media environment, has meant that many countries – including the UK – are stuck with the policy of lockdown or lockdown-lite and unwilling to seriously consider alternatives.
To understand why messaging is so important it is crucial to note that humans are naturally very poor at judging risk. Since a flurry of studies in the 1980s we have known that people don’t gauge threats by undertaking cold cost-benefit analyses. Instead, risk perception is based on mental shortcuts and the emotional responses they produce.
When you contemplate a potential risk, your brain searches for past experiences of it. If it pulls up multiple alarming memories then your assessment of the danger is high. What isn’t considered is whether these memories are representative of how things actually are.
“The world in our heads is not a precise replica of reality,” Daniel Kahneman, the Nobel Prize-winning economist, wrote in his 2011 book, Thinking, Fast and Slow: “Our expectations about the frequency of events are distorted by the prevalence and emotional intensity of the messages to which we are exposed.”
For those who are most at risk, fear of coronavirus is far from irrational. But how the disease has been presented to us makes the precise nature of the threat hard to grasp.
“Covid-19 hits all of the cognitive triggers for how the lay public misjudges risk”, Chakraborty writes in a recent paper. “It is unfamiliar, invisible, dreaded, potentially endemic, involuntary, disproportionately impacts vulnerable populations and has the potential for widespread catastrophe.”
Data on public perceptions bear this out. A recent poll has revealed that the UK population thinks that coronavirus is far more widespread and deadly than official figures show. The research, conducted by Kekst CNC, showed that on average UK citizens believe that 7% of the population have died from Covid-19- around one hundred times the actual figure of approximately 0.076%. The infection rate – about 6% in reality – is believed to be as high as 22%.
“When you see people dying on the frontlines – overworked doctors telling their stories – it’s emotional.” Chakraborty told Reaction. “It triggers something in our brains. It’s very salient. It’s covered by the media. It allows for ease of recall. We watch it, we’re upset by it and then we demand that our politicians do something about it.
“Unless risk is interpreted by the experts and communicated effectively to politicians and then to the public, perceptions will win out. Having no communications strategy in advance makes policymakers vulnerable to perceptions and the media amplification of those perceptions.
“They then have to play catch up and respond to that perception. This leads to policy decisions that are politically expedient – reflecting the demands of terrified constituents – rather than being based on what the scientists know.”
The idea is that this feedback loop has meant the government is now stuck in a trap of its own making. In order to persuade the public to take the virus threat seriously and to justify the unprecedented suspension of civil liberties, the rhetoric at the beginning of the crisis needed to be serious – “Stay Home, Protect the NHS, Save Lives” is about as emphatic as it gets.
The government is now trying to soften its tone, encouraging people to visit restaurants and defending the planned reopening of schools. But it’s proving difficult to get the genie back in the bottle.
“There was no exit strategy”, says Chakraborty. “Initial communications are always front-ended with the worst case scenarios, as with the Imperial College study. This causes public outrage and demands for action. Proactive communication plans were needed, where you release relevant information in such a way that means people will be able to interpret the information and respond in a proportionate way.”
The task of communicating coronavirus risk is complicated by the huge skew in the threat it poses across the generations. For 0-4 year olds, the chances of dying from coronavirus are about one in a million, roughly the same mortality rate as driving 250 miles in a car or the odds of being struck by lightning in a given year. If you’re under the age of 45 in the UK, the risk increases to 22 in a million, making it about seven times more likely that you die from cancer.
The risk of death increases exponentially with age, doubling every five or six years, with 90% of coronavirus deaths among those 65 or older. For the over 90s, the risk of death is one in 50, or 20,000 in one million, roughly the same as base jumping. To put these numbers into further context, the chances of dying in a motor vehicle crash in a given year are 200 in a million.
Despite the inter-generational gulf in risk, government messaging and policy has been one-size-fits-all. “The UK – and many other Western countries – have invoked the precautionary principle with their lockdown policies” says Chakraborty. “The idea is to just err on the side of caution – it’s the politically safest, most expedient move.”
The irony is that lockdown, on the face of it the cautious, low-risk response, is looking increasingly like a huge gamble. As well as failing to communicate the risk posed by the virus, many governments appear not to have fully understood the risks that their responses to it pose.
Advocates of a heavy response have framed lockdown and social distancing as policies which, despite the inevitable economic cost, will save lives. In one sense this is irrefutable. There are many thousands of people who are alive today who would have died from the virus had lockdown not been imposed.
The picture, however, is far more complicated than deaths versus economy. There is mounting evidence to suggest that lockdown’s economic and healthcare ripple effects will, in the long-term, be counter-productive on both fronts.
As Professors Jayanta Bhattacharya and Mikko Packalen have pointed out, delays to non-urgent but essential healthcare – vaccinations, chemotherapy, surgery and cancer screenings – are risks produced by lockdown that will manifest in years to come. In the UK, cancer deaths have been predicted to rise by around 18,000 due to the disruption to treatments.
The alarming uptick in domestic violence cases, the impact on education, productivity and mental health all make lockdown a riskier proposition than it initially seems. From an international perspective the costs are staggering. According to the UN’s World Food Programme the economic downturn will mean the number of people facing extreme food poverty is set to double to 265 million by the end of the year.
These risks are difficult – perhaps impossible – to quantify, which is perhaps why they have been largely sidelined in policy decision-making. The emphasis on the death rate as the ultimate barometer of coronavirus response “success” reflects this simplistic approach and the disproportionate emphasis on mitigating against primary health impacts.
“When you realise that the coronavirus risk exists in a complex landscape in relation to other risks then our response and behaviour is completely irrational” says Chakraborty. “Ultimately, there is no real cost-benefit analysis to get to the bottom of whether these policies are doing more harm than good.”
Difficult and brutal trade-offs are inevitable. But making these decisions is the task of government. Without understanding the importance of risk messaging and the dangers of defining risk too narrowly, policy will remain little more than guesswork.