The writer is director of the NIHR Health Protection Research Unit for Emergency Preparedness and Response at King’s College London
A lot can happen in a short time at the moment. When I started writing this piece last weekend, my wife was in America, whose borders were open. I was looking forward to watching the football team I support, Chelsea, play against Aston Villa today.
A week later, all football is off and it is likely that all large scale public events will be banned. The US is closed to all but a few. My wife is back in the UK, but she has tested positive for Covid-19. Luckily, she has recovered quickly and I remain well. But the advice that I have received as a contact has changed dramatically. At the start of week, I would have had to self-isolate for 14 days. Now, there are no restrictions on me unless I develop symptoms. Confusing isn’t it?
While this week it has all become personal, my interest in such advice is usually professional. I am one of the many scientists called on to give advice to government at times like these. When my colleagues and I speak to those charged with communicating to the public, we start with three basic principles: don’t give premature reassurance; don’t tell people not to panic; get doctors and scientists on television as soon as possible.
Usually the official asks what is wrong with telling people not to panic. First, those who are already panicking are unlikely to listen. Second, those who aren’t will start to wonder if they should. But, most important, we know that during emergencies most people don’t panic for most of the time.
For example, the evacuation of the World Trade Center during the 9/11 terror attacks took place almost entirely without the help of the emergency services, or “first responders” as they are misleadingly known. The real first responders — those already in the towers — behaved in a calm and collected manner, helping each other leave.
True panic, or collective behavioural disorganisation, usually happens in only two circumstances. The first is when people fear they are in a dangerous situation but see no way out. A fire in a nightclub where exits have been blocked is a classic example. The other is when people perceive they are being denied a life-saving treatment, especially due to official disorganisation.
What about panic buying — all those empty supermarket shelves? We have been warned to prepare ourselves for the increasingly likely chance of spending two weeks in self-imposed isolation. Stocking up on necessities is not panicking; it is a rational and appropriate response. I myself have bought enough loo paper, dog food and red wine to see the family through. Reports of crowd disturbances in Milan disappeared as soon as the supply chain was secured. What is striking about the coverage of Italy is the calm that seems to pervade the streets, not the tension.
We know that as people start to appreciate the gravity of a situation, anxiety levels increase, but so does compliance with guidance on protective measures. Polling of the British public at the moment shows a rise in anxiety, but also in reporting of preventive behaviours, such as avoiding handshakes.
Nevertheless, historians draw attention to the capacity of global epidemics to cause serious civil disturbance, going as far back as antiquity. More recently, Laura Spinney’s chilling Pale Rider describes the chaos that engulfed Rio de Janeiro in the flu pandemic of 1918.
The disease was devastating. Sanitary services, hospitals and food supply failed. Bodies littered the streets, and those who had not died from the infection started to starve. Public order broke down, people took to the streets and looted. But was this panic or justified anger against authorities who had allowed the medical system to deteriorate? Civic disorder most definitely, but not irrational or pointless behaviour.
It is time that we banned the word panic in these circumstances, reserving it instead for individual states of extreme distress. Portraying natural public responses as panic can lead policymakers to conclude people should be controlled for their own wellbeing, or that information should be withheld.
When people do panic, usually someone is to blame. But it’s not all bad. As Samuel Cohn showed in Epidemics: Hate and Compassion from the Plague of Athens to Aids, as well as hate, stigma, violence and even murder, epidemics can also bring societies closer together. Already we are seeing this in the current crisis.
I have described how often the real first responders, bystanders suddenly involved in dramatic and dangerous incidents, run towards, not away from a dangerous incident. Altruistic behaviour is also a prominent motive for those who are self isolating now. Appeals to protect others, especially the old and the sick are far more effective in persuading people to co-operate than the coercive powers of the state.
So let’s hope that we see #coronaheroes trending in the difficult weeks that will come.