Of all the longer-term consequences of the pandemic responses, the most harmful could be the manipulation of fear to encourage social distancing compliance. Since March 2020, people have been exposed to daily reports of case numbers, hospitalisations and virus deaths without any context of much more relevant statistics, such as excess mortality. It is little wonder, then, that the emergence of any new variant with high transmissibility, such as the Omicron variant, leads to calls for restrictions to suppress case numbers, irrespective of the effectiveness or costs of increasing restrictions.
With vaccines significantly reducing hospitalisations and deaths, and the new variant less likely to cause severe illness than its predecessors, the relative costs and benefits of restrictions have changed significantly: they still cause significant health, economic and social harms but now their already questionable contribution to reducing deaths from Covid is even smaller. So why, when so many of us have offered up our arms to start living with Covid, are so many people demanding that basic human needs like human contact be limited yet again? And why are so many members of the public still supportive of draconian state intervention? The answer is, in large part, because we are still living in a state of fear.
National lockdowns have prevented the early detection of cancers
Manipulating public emotion is a dangerous and costly exercise that will impact lives and livelihoods for a long time to come, potentially long after the virus has been dealt with. My colleague Amanda Henwood wrote about how our emotions affect our responses to Covid-19. Fear produces intense negative feelings and is often accompanied by strong bodily manifestations such as raised heart rate and shortness of breath. These responses are adaptive, but fear that is excessive and/or disproportionate has longer term effects, such as sleep disturbances and impairment of the body’s ability to fight infections. It can also lead to the onset of an anxiety disorder. Lockdown measures have been shown to make people more prone to psychological problems, including stress and post-traumatic anxiety. There is also some initial evidence linking fear to worse mental health outcomes during Covid-19.
At the same time, the fear of the virus has also resulted in the postponement of appointments for non-Covid-19 related medical conditions. The effects of lockdown on cancer care have been highlighted by Carl Heneghan and colleagues. This report shows how national lockdowns have caused widespread treatment delays and prevented the early detection of cancers. Fear is bound to have played a significant role in these delays.
The frequency and intensity of the reported deaths from the virus, and the fear-inducing narratives that have supported these figures, have escalated the emotional response. The more aware we are of the risks associated with a given phenomenon, the more fearful of it we become. The constant diet of Covid cases continues to promote hypervigilance in the population, which is known to prevent healthy adaptation to fearful stimuli.
Fear is not like a tap that can be easily turned off
The UK government appears to have consciously adopted the promotion of fear at the population level, as a tactic to increase public compliance with virus mitigation policies. The importance of increasing “the perceived level of personal threat” was stated explicitly in a document prepared by the behavioural scientists on SPI-B advising government in the UK. To achieve this aim, they advised the government to use “hard-hitting emotional messaging”. Such techniques “could be negative”, they admitted, but offered no further details on how to mitigate the harms.
Raised levels of fear impact our preferences for different policy options because what we want is driven by how we feel. The more fearful of the virus we become, the more likely we will be to select tough restrictions on social contact without properly thinking through their impact on other social goods. This may explain our failure to properly evaluate the long-term effects of closing schools, for example, and our general reluctance to challenge policies that focus on health concerns to the exclusion of other priorities.
We need a systematic approach to gathering data on the psychological impacts of the virus and related policy responses. Fear measurement tools can be easily developed and implemented if they are afforded greater priority. At a minimum, we should be doing much more to understand the causal effects of policy changes on the public’s emotional states, and how these feelings play directly into their choices. Fear is not like a tap that can be easily turned off once it has been turned on. My own fear is that the pipe has burst, and we will see many people suffer greatly, for a very long time, from constantly being made to feel scared.
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