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December 16, 2020

He didn't think the coronavirus was 'a big deal.' Then he spent 9 days in the hospital.

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    Craig Buescher, a 69-year-old man in good health, didn't think the coronavirus was "a big deal" until his own infection landed him in the hospital for nine days—making Buescher just one example of what experts say is the most effective way to influence people's behavior: "personal encounters with the dangers of the virus," Marisa Iati writes for the Washington Post.

    How Covid-19 will impact perceptions of health care

    Buescher's story

    Before his infection, Buescher "largely followed" the recommended precautions, such as wearing a mask and limiting his friend circle, Iati writes. But he "admits … he occasionally stretched them," thinking that the "virus wouldn't be that bad if he came down with it." That's in part because Buescher considered himself to be in good health. But when he did fall ill, his oxygen levels required him to be hospitalized, and according to Iati, he nearly required ventilation. The experience "convinced him that not only did he need to be more careful to avoid the virus, but also that he should persuade others to do the same," Iati writes.

    As a result, since his recovery, Buescher has "become an evangelist for coronavirus-conscious decision-making," Iati writes. He and his wife keep multiple masks in their car, limit their circle of friends to just one other couple, and recently celebrated Thanksgiving with their children over Zoom, rather than in-person—an experience they are considering repeating for Christmas.

    Speaking at Nebraska Gov. Pete Ricketts' (R) news conference to encourage other Nebraska residents to be careful about the virus, Buescher said of his holiday plans, "Is this something we're going to do every year? No, we've got to do it this year so that we have the capabilities of getting back on track next year."

    And according to Buescher, sharing his own experience has encouraged others in his small town to be more cautious themselves, Iati writes. His friend, Chuck Baum, who despite taking some precautions wondered if the coronavirus news "might be just a lot of crying wolf," said he only began to feel the pandemic was "real" after Buescher fell ill and two people he knew passed away.

    A larger pattern of behavior

    According to public health experts, for every one person who, like Buescher, begins to take the pandemic more seriously, there are "millions of others [who] continue to resist recommended precautions or  have stopped following public health guidance," Iati writes. She cites a September Gallup poll that found the number of people who report following recommended guidance on the novel coronavirus—such as avoiding large crowds and public spaces—were "at their lowest levels since March."

    Experts speculate that there are several reasons for this tapering, Iati writes, such as pandemic fatigue, people's belief that they themselves aren't at risk for a severe case of Covid-19, doubt that the recommended precautions will actually protect them, and even social norms.

    As Vanessa Bohns, a professor of organizational behavior at Cornell University, explained, "Even when we know what we SHOULD be doing, if we find out that other people aren't doing it, we probably won't do it." She added, "Interestingly, lots of persuasive messaging undermines itself by saying, 'You should do this,' and then immediately afterwards saying, 'But most people aren't doing this.'"

    How to (effectively) change behaviors

    While experts say individual experiences with the virus' dangers are "the most effective factor in shifting people's behavior," they noted that "[t]alking to people about the dangers of the virus can also influence people's behavior," so long as "the message is coming from someone they trust," Iati writes.

    But that's easier said than done, she explains, given that a "breakdown of faith in institutions has left many skeptical of anything they're told by government officials, academics, or journalists." In addition, some people are so surrounded by misinformation that experts think it would be difficult to change their minds, Iati writes, citing a Gallup/Knight Foundation poll that found nearly 1 in 5 U.S. adults think the coronavirus is less deadly than the flu, and 41% think the virus' death toll has been overstated.

    Jay Van Bavel, an associate professor of psychology at New York University, said for those hoping to improve people's adherence to recommended precautions, it's best to focus on "those people who are on the fence who are just tired. You can probably get through to more of them than people who are just very far gone."

    And according to Iati, among "those who consume mostly accurate information, the key is for people to directly encourage their family members and friends to make safe choices." As research demonstrates, she continues, "[p]eople are more inclined to agree to requests from people they like."

    Van Bavel outlines a few strategies to effect change, such as reframing recommendations to wear masks among those who think such a measure is an assault on freedom "as the ability to move through society more freely if everyone takes [such] precautions," Iati writes. Similarly, now that a vaccine has been approved, Van Bavel advised people to compare waiting just a little longer to be vaccinated to the "marshmallow test"— a psychological experiment in which children could either eat a marshmallow right away or wait and get two marshmallows—saying, "We need to tell people that you can have those two marshmallows, you can have lots of gatherings with family, lots of trips, lots of economic activities, if you can just hold off for a few minutes and not eat the marshmallow right now" (Iati, Washington Post, 12/1).

    How to communicate with patients amid Covid-19


    Consumers are eager for credible information about Covid-19, when and how to seek various types of health care services, and what to expect if they do require in-person care.

    Yet many health systems are providing less frequent information or less detailed safety information than companies and service providers in other industries. As a result, many consumers are deferring care of all types.

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