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When Boris Johnson stood up in parliament to announce England’s new Covid-19 restrictions on September 22, people were quick to point out how arbitrary the new rules seemed. Would shutting pubs an hour earlier really make much of a difference to how the virus spreads? Why are six people allowed to meet outside, but not seven?
The confusion around Covid-19 guidelines has led to a new favourite sport for TV and radio presenters: watching politicians squirm as they try and pinpoint the boundaries of their own rules. On Sky News, health secretary Matt Hancock cringed as he tried to explain who was allowed to have sex under rules that exempt “established relationships” from social distancing guidelines. The only advice Hancock could offer is that he and his wife are in an established relationship, which is great news for their sex life but doesn’t offer much in the way of clarification for everyone else. A week earlier home secretary Priti Patel also tied herself in knots as she struggled to decide whether two families bumping into each other on the street violated the rules against more than six people gathering outdoors.
All this confusion shares a common root: our understanding of risk. What is safe to do during the pandemic, and what isn’t safe? What’s so risky that it should be against the law, and what is merely ill-advised? Should we shame people we see breaking the rules or is there a better way to get them to fall in line?
Navigating the constant risk assessment that life has now become is frustrating, but changing how we think about risk can make things easier. WIRED spoke to two experts in how humans perceive and respond to risk to figure out how adjusting our attitude to uncertainty can help us make better decisions. These five rules for thinking about risk won’t solve all your pandemic dilemmas, but at the very least they’ll help you understand why you feel so conflicted in the first place.
Think about risk on a spectrum
Rules are a pretty blunt instrument when it comes to minimising risk. They place clear boundaries between what is allowed and what isn’t. On the one hand that’s inevitable because governments need to find a way to make people change their behaviour, but rules can also suggest that there’s a clear line between activities that are risky and those that are risk-free.
Risk in the real world doesn’t work like that. “Risk is not binary, it’s on a spectrum,” says Julia Marcus, an infectious disease epidemiologist at Harvard Medical School whose research focuses on preventing new HIV infections. Marcus says that instead of only telling people what they can’t do, we should also be helping people minimise risk in whatever situation they end up.
“I think it’s pretty clear from decades of the HIV epidemic that we can’t take an abstinence only approach to sex or substance use, and it’s the same for social and sexual contact during this pandemic,” Marcus says. In The Atlantic Marcus wrote about the Dutch government’s recommendation that single people should try and have sex with just one consistent partner during lockdown: a quarantine seksbuddy. While Hancock floundered with the definition of “established relationship” the Dutch seksbuddy idea puts pragmatics first: acknowledging that people need physical intimacy and offering them a way to lower their risk of contracting Covid-19 while fulfilling that need.
“If you start from the framework with the assumption that social contact is essential, then you can think about how to support the lowest risk ways for people to gather, which is really outdoors,” says Marcus. The Welsh government has done this. In Wales, meetings indoors are limited to six people but outdoors gatherings of up to 30 people are permitted. In England the “rule of six” applies to both indoors and outdoors.
This might be counterproductive, Marcus says. Keeping the same limit on indoor and outdoor gatherings implies that the risk of transmission is the same in both situations, and that’s just not backed up by the science. Six people meeting in a poorly-ventilated room is likely to be much riskier than seven people meeting outside, even though only the latter meeting falls foul of the government’s new laws. But if we shift how we think about risk to more of a spectrum, we can identify easy ways to encourage people to adapt their behaviour to be lower risk without having to forgo social contact altogether.
Consider risks beyond catching and spreading Covid-19
When people talk about risk during the coronavirus pandemic, they’re usually talking about the risk of individuals catching the virus or spreading it to other people. Those risks are extremely important – they’re the whole reason why we have social distancing regulations in the first place – but they’re not the only risks in play. Other risks, like the impact of isolation on our mental health, are important too.
Research from University College London suggests that young women were particularly likely to be affected by depression, anxiety and loneliness during lockdown while a survey from mental health charity Mind suggests that 75 per cent of people aged 13-24 with a pre-existing mental health condition said it had become worse during lockdown. “A compassionate approach might help us see how important social connection is to young people. And we might also consider the mental health challenges that they may face if they don’t socialise,” says Marcus.
It’s not enough to simply point out that people aren’t following lockdown laws, it’s important to figure out why they break them. The government doesn’t publish statistics on how many people don’t self isolate when they’re asked to by NHS Test and Trace, but a preprint paper from the London School of Hygiene and Tropical Medicine found that of people who experienced Covid-19 symptoms in the last seven days only 18 per cent of them followed self-isolation guidelines. The reasons people gave included needing to go to work, providing care for a vulnerable person or being too depressed or anxious to stay home. From September 28 people in England who don’t comply with the self isolation rules risk a fine of up to £10,000 although the government has introduced a £500 grant for people on low incomes who lose money as a result of having to self-isolate.
Remember that risks are constantly changing
One of the most frustrating aspects of the Covid-19 pandemic is that risk is not stable or evenly distributed. A month ago the number of new cases in the UK seemed fairly stable, but in the past few weeks it has trended upwards at a worrying rate, which is why the four nations now have new restrictions. Your risk of catching coronavirus is also hugely dependent on where you live in the country. Bolton currently has the highest transmission rate in England with 213 cases per 100,000 of the population each week while parts of the country, particularly in the southwest, have just a fraction of that rate.
Although we know that a significant portion of people who contract Covid-19 suffer long-term consequences, older people are at a much greater risk of dying or becoming seriously ill if they are infected with the disease. “It’s complicated for people who are trying to work out what to do,” says Nick Pidgeon, director of the Understanding Risk Research Group at the Cardiff University. The dynamics of the pandemic are always changing which means that what might have been a sensible decision two weeks ago might not be so wise if cases in your area start going up.
It’s worth considering your personal circumstances when you’re weighing up how much risk to expose yourself to. Visiting your elderly grandparents soon? You might want to pay more attention to your own exposure to the virus in the two weeks before your visit.
Shaming won’t get you anywhere
When lockdown started easing in early summer the newspapers were quickly filled with pictures of people cramming beaches and enjoying the good weather, inspiring social media pile-ons that accused the beachgoers of acting irresponsibly.
Marcus says this kind of shaming can be the result of governments not doing enough to support citizens in risk reduction. “When the government takes a more active role, I think people feel more supported and there will be less of that individual blaming culture that is so prevalent right now,” she says. She points to New Zealand as an example of a government that has emphasised not just vigilance but also empathy. There, prime minister Jacinda Ardern ended almost all of her public appearances with the same message: “be strong, be kind”.
Rules should come from people you trust
“In a crisis like this [trust] is absolutely critical,” says Pidgeon. How we perceive risk – and how likely we are to take up advice given in relation to that risk – is closely linked to how far people trust the organisations giving that advice, he says.
That might explain why, Chris Whitty, England’s chief medical officer, and Patrick Vallance, the government’s chief scientific advisor, have been prominent fixtures in announcements about changing regulations. Both of the scientists gave a televised briefing to the public on September 21, ahead of the changes in Covid-19 restrictions that came a day later.
In the US, trust in scientists has remained firm throughout the Covid-19 pandemic, and is actually higher than it was in 2016, with the public trusting doctors and scientists significantly more than Congress, president Trump or Joe Biden. If governments want citizens to take their coronavirus guidelines seriously then they need to tap into that trust to get people on board, Pidgeon says.
Matt Reynolds is WIRED’s science editor. He tweets from @mattsreynolds1
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