The history of epidemics is rife with examples of society rebelling against tough public-health edicts, such as the breach of plague quarantine in 18th-century Marseille or protests against face masks during the 1918 influenza pandemic. The grim consequence is a fresh wave of deadly infections.
Covid-19’s million deaths may pale in comparison to the estimated 50 million lives lost in 1918, but the cycle risks unfolding again. France, the U.K. and Spain face a triple threat: A jump in cases, a population exhausted by lockdown-induced recession, and rising resistance to tougher measures.
Curfews and closures of restaurants and bars have seen business owners literally throw their keys to the ground in present-day Marseille. In Madrid, protesters have bristled at a targeted local lockdown they view as discriminatory. It’s not just conspiracy theorists on the streets in London and Berlin who are angry.
Those protesting shouldn’t be dismissed as the selfish exceptions to the rule. Beyond the vocal minority, there are signs that the silent majority is also losing faith in increasingly bureaucratic strictures. Policymakers need to restore it.
While respect for mask-wearing and personal hygiene is broadly high, according to YouGov surveys of European countries, support for quarantine and self-isolation is wavering. In France, only 48% of people currently support quarantining those who’ve had contact with infected patients, down from 78% in March. It has also fallen in the U.K. and Spain, though to a lesser degree.
There’s mounting evidence that people who are asked to stay at home aren’t doing so. A recent King’s College London survey in the U.K. of over 30,000 people between March and August found that only 18.2% reported remaining at home after developing symptoms and a measly 10.9% after being alerted by contact tracers. That’s worrying given the critical importance of self-isolation in breaking chains of transmission before they reach the vulnerable and the elderly.
Obviously being cooped up is nobody’s idea of fun, and it brings the psychological stress of altruistically choosing long-term pain over short-term pleasure. But for those who don’t have the luxury of jobs they can do from their kitchen table, isolation also means being deprived of a decent wage. Around 10%-11% of respondents cited “going out to work” among reasons for non-compliance. That echoes an earlier finding that half of Britain’s low-income workers couldn’t actually afford to self-isolate because mandatory sick pay is so low, according to the Trades Union Congress. Other reasons given included caring for a vulnerable person (10%-12%) and mental stress (8%-11%).
This isn’t the case for all countries. In Austria, where quarantined workers are entitled to be paid as normal, compliance is over 98%, according to the Washington Post. A lot of focus has been put on European countries’ approach to lockdown, but relatively little on their welfare systems, reckons Joan Ramon Villalbi of Barcelona’s Public Health Agency. The OECD is rightly encouraging countries to extend sick leave and other benefits to more workers, especially the self-employed. Europe should, too.
Rewarding those who self-isolate should ideally be accompanied by punishment for those who don’t. But this requires confidence in the rules and their enforcement, which has been lacking. Test-and-trace infrastructure is bursting at the seams in several countries, with delays so long that people don’t see the point in following official guidelines. And in the U.K., increasingly complex limits such as “the rule of six” are patently unenforceable, with politicians encouraging people to spy on their neighbors and rat them out. More testing capacity and rules that can actually be enforced with fines would help.
On top of carrots and sticks, transparency and education can help compliance. New rules such as closing restaurants and bars at 10 p.m. rather than 11 p.m. haven’t been justified with any scientifically backed explanations, the kind of thing that can chip away at public trust. Worse, some doctors reckon they may simply shift parties to private homes indoors. Clear and understandable rules tend toward better obedience, according to Joan Costa-Font, associate professor at the London School of Economics’s health policy department. This is one area where Sweden, despite criticism of its more individualist approach to stay-at-home curbs, is doing well.
Given the public is starting to lose trust in rules handed down from above, the least policymakers could do is stick to their own guidance. Yet they are proving their own worst enemy, whether it’s Dominic Cummings flouting lockdown or French Prime Minister Jean Castex’s feeble “I no longer take the metro” excuse for not downloading France’s contact-tracing app. Apparently the U.K. government doesn’t even understand its own rules, judging by three confusing errors by officials explaining new restrictions in just three hours on Tuesday — one by Prime Minister Boris Johnson himself.
Covid-19 disobedience goes deeper than we think. Those whose fingers are hovering on the lockdown button can, and should, do more to curb it. –Bloomberg
Also read: Why voluntary isolation and not Covid lockdowns just for the elderly is the way forward