All the changes currently being made amount to a massive disinformation campaign that undermines the conditions for informed decision-making, says Stephen Reicher

In his statement of 6 July 2021, the UK prime minister, Boris Johnson announced that “we will move away from legal restrictions and allow people to make their own informed decisions about how to manage the virus.” [1] The statement raised many questions about the wisdom of removing covid measures at a time when there is a surge in infections which, as Sajid Javid the secretary of state for health and social care acknowledged, could rise to 100,000 a day or more. [2,3] I want to concentrate less on the consequences of such a shift in approach than on its conditions. Previously, in these pages, I have concentrated on the conditions of responsible action and stressed that this is only possible if you give people the support to do what is necessary (such as decent sick pay so people can stay home when unwell). [4] Now I want to concentrate on the conditions of responsible decisions, and, more specifically, on Johnson’s reference to these being informed decisions. That is, what must government do to ensure that people have the information they need in order to act for their own safety and that of others.

The first point is obvious: government must give us the necessary information. But they aren’t. For instance, if you want people to get tested quickly when they get covid symptoms, they need to know what they are. At the start of this year, only about half the population could name the main symptoms (cough, high temperature, loss of taste/smell). [5] Worse still, since then the delta variant has become dominant and the symptoms have changed: loss of taste/smell is no longer so relevant, a runny nose now is. But the descriptions of symptoms on official websites (such as the NHS website) have not changed to reflect this. [6]

The second point may be a little less obvious, but equally important. The way that messages are framed is critical to the considerations that people put into their considerations of risk and hence what they use to inform their decisions. The constant government emphasis on the individual and on personal responsibility points people towards the risks to themselves. But it is clear that what is critical to the success of the pandemic response is that people consider also the risk to others and hence act to stop community transmission. [7] Indeed, a sense of connection to and concern for one’s community is a key determinant of adherence to covid measures. [8] A broadening of the frame from personal to social responsibilities is important in order to invoke these wider concerns and hence to encourage behaviours that safeguard the whole community.

The third point is critical. When we discuss providing information to the public, the emphasis is usually placed on formal communications and messaging—what the government says to the public in the way of formal statements, media appearances, and advertising. But messaging is about far more than this. Indeed, it is as much about what they do as what they say. 

On the one hand it is about what individual members of the government do. This has received huge publicity during the pandemic, first with Dominic Cummings’s ill-fated trip to Barnard Castle and more recently with Matt Hancock’s infamous embrace with his departmental advisor. What made these events so toxic was not the act itself, but the way that both were defended by the prime minister—hence turning an individual indiscretion into a systemic message that there is “one law for us and another for them.” [9]

Such a message was certainly corrosive of trust, and also gave a warrant to those who already opposed restrictions to act accordingly. [10,11] But it is not so clear that it had a major effect in adherence. Many of those most angry at Cummings became more adherent in order to denote their opposition. [12] People followed the rules despite, not because of the government.

On the other hand, then, what may be more corrosive than the personal behaviours of members of the government are the policies promoted by government and the messages that these send. Policies send strong messages about the importance of particular measures and the degree of threat posed by the pandemic in general which, in turn, is of key importance in determining the degree of adherence both to the specific measure and to covid regulations more generally. [13]

So, take the example of masks. After the emergence of evidence that masks do constitute an important protection against both acquiring and transmitting infection, the UK government began to urge people to wear masks in shops and other indoor public spaces. However, it had little effect, with adherence staying stubbornly low at about 20-30%. But as soon as it became policy to require masks in such spaces, adherence rose very rapidly to around 80%, where it has stayed to the present day. [14] This was not because of enforcement (the police maintained a policy of enforcement as a last resort) but because of the way that the introduction of policy indicated the seriousness of the situation and the importance of the mitigation. [15] By the same token, removing the requirement to wear masks sends an equally clear message that such action is unimportant and that the pandemic is less serious.

This message is echoed in a swathe of recent policies: the reopening of mass events such as the Euros (ostensibly as test events for scientific study even though the choice of events to open was made by politicians, not scientists) where tens of thousands mingle and embrace without any mitigations; the removal of requirement to self-isolate as a contact of positive cases if doubly vaccinated or to quarantine on return from amber list countries, the abolition of “bubbles” in schools—there is no denial that all of these will increase the levels of infection and indeed this is made explicit when the health secretary acknowledged that the government’s bonfire of restrictions could lead to 100,000 cases per day or more. [16,17]

All this communicates that infections don’t matter any more and that the danger of the pandemic has largely passed, even if Boris Johnson says otherwise. This view has been entrenched through all the rhetoric of “freedom” and “freedom day” as restrictions are lifted—though thankfully, over the last few days the government has changed it’s tone, the “freedom talk” has been dropped. [18] Indeed, at his press conference of 12 July, Boris Johnson was at pains to stress that the pandemic “is not over” and that it is absolutely vital that we now “proceed with caution” (even while confirming that most measures will be lifted on 19 July). [19]

But here’s the problem. Even if the population actually listened to every prime ministerial statement, they are only made once. By contrast, the removal of restrictions will become apparent to us many times a day as we enter shops and other public spaces and each time it will send us message that “this is no longer necessary.” So, even if the government want to replace formal restrictions with informal decisions about how to stay safe, and even if they implore us to exercise caution, the very act of removing protections in the midst of soaring infections sends a far stronger signal that there is no longer any need to do anything because we are safe already. If infections don’t matter (especially for the young) why should anyone be bothered to do anything to stop getting infected or infect others? 

That logic is already creating problems—seemingly decreasing the take-up of vaccines among young people. [20] And so, we end up in the worst of all worlds: the practical effect of removing restrictions as the pandemic is compounded by the effects of the messaging which flows from such a policy. The state no longer protects us and we are lulled into not protecting ourselves against covid-19. All the changes currently being made amount to a massive disinformation campaign that undermines the conditions for informed decision-making. 

Stephen Reicher, School of Psychology and Neuroscience, University of St. Andrews. 

Competing interests: SR participates in the UK’s Scientific Advisory Group for Emergencies and its subgroups, and is a member of Independent SAGE. SR participates in the advisory group to the Scottish chief medical officer. 

References:

1. PM statement at coronavirus press conference: 5 July 2021. Full text available at https://www.gov.uk/government/speeches/pm-statement-at-coronavirus-press-conference-5-july-2021
2. Gurdasani, D. et al. (2021) Mass infection is not an option: we must do more to protect our young. The Lancet. July 7th. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01589-0/fulltext
3. https://inews.co.uk/news/politics/sajid-javid-warns-covid-cases-climb-summer-restrictions-scrapped-1088457
4. Reicher, S.D., Michie, S. & Phoenix, A. (2021) After restriction: why the public cn only fulfil its responsibilities if the government fulfils theirs. The BMJ Opinion. https://blogs.bmj.com/bmj/2021/06/29/after-restriction-why-the-public-can-only-fulfill-its-responsibilities-if-the-government-fulfills-theirs/
5. Smith, L.E. et al. (2021) Adherence to the test, trace and isolate system in the UK: results from 37 nationally representative surveys. British Medical Journal, 372:n608. https://www.bmj.com/content/372/bmj.n608
6. https://www.nhs.uk/conditions/coronavirus-covid-19/symptoms/main-symptoms/
7. Jetten, J., Reicher,S.D., Haslam, S.A. & Cruwys, T. (2020) Together Apart: The Psychology of Covid-19. London: Sage
8. Van Bavel,J.J. et al. (2020). National identity predicts public health support during a global pandemic. Results from 67 nations. https://psyarxiv.com/ydt95
9. https://www.theguardian.com/politics/2020/may/24/one-law-for-dominic-cummings-another-for-the-rest-of-us
10. Fancourt, D; Steptoe, A; Wright, L; (2020) The Cummings effect: politics, trust, and behaviours during the COVID-19 pandemic. The Lancet , 396 (10249) pp. 464-465. 10.1016/S0140-6736(20)31690-1.
11. https://www.bbc.co.uk/news/uk-wales-52912216
12. Jackson, J. et al. (2020) Public compliance and COVID-19: Did Cummings damage the fight against the virus, or become a useful anti-role model? LSE Blogs. https://blogs.lse.ac.uk/politicsandpolicy/public-compliance-covid19-june/
13. Webster, R.K. et al. (2020) How to improve adherence with quarantine: rapid review of the evidence. Public Health, 182, 163-169.
14. https://www.statista.com/statistics/1114248/wearing-a-face-mask-outside-in-the-uk/
15. https://www.police.uk/advice/advice-and-information/c19/coronavirus-covid-19/coronavirus-covid-19-police-powers/
16. https://www.gov.uk/government/publications/events-research-programme-phase-i-findings/events-research-programme-phase-i-findings
17. https://www.theguardian.com/world/2021/jul/06/covid-cases-rise-above-100000-a-day-sajid-javid-concedes-england
18. https://www.bbc.co.uk/iplayer/episode/m000y1y0/house-of-commons-live-covid19-update-statement
19. https://news.sky.com/story/covid-19-boris-johnson-says-ending-of-most-restrictions-not-an-invitation-for-a-great-jubilee-12354432
20. https://www.theguardian.com/world/2021/jul/08/vaccine-uptake-coronavirus-england-near-halves-mixed-messages-manchester-sheffield-19-july