Is Government at risk of ‘losing the room’ in Covid-19 fight?

Experts say State must balance restrictions with rewards to maintain public buy-in

By next Saturday, April 3rd, the Republic’s third Covid-19 lockdown will have lasted longer than the first two combined, and yet the virus is still circulating at far higher levels than after last year’s lockdowns.

New cases are stuck at between 500 and 700 a day. The reproduction rate of Covid-19 is estimated at a level showing the virus is spreading again. The seven-day average of daily new cases – a key measure that smooths fluctuations in the daily figures – hit a low of 480 on March 9th but has risen 18 per cent since then.

Even Tánaiste Leo Varadkar conceded on Thursday that it was "very hard to see" the numbers dropping under 500 new cases a day due to the more transmissible "B117" mutation, the Covid variant now dominant here that is causing a third wave of infections across Europe and washed over Ireland after Christmas, after first being detected in Britain late last year.

For a public fed up with 88 days of lockdown since the end of December, there has been no reward for complying with the greatest upheaval ever experienced in their day-to-day lives.

This week, the National Public Health Emergency Team put the “stasis” in the fight against Covid-19 down to “small slippages” – people returning to workplaces and increased social mixing.

New research showed that, despite being prohibited under the current Level 5 restrictions, social visits to other households have doubled, rising from a situation where 5 per cent of people in late January were undertaking them to 11.5 per cent now.

All this has raised questions about the effectiveness of lockdowns. With an alternative solution through mass vaccination proving painfully slow with the protracted rollout of jabs, is the Government facing the risk of “losing the room” and putting wider compliance with public health measures at risk?

"We are in a particularly tricky situation. The case numbers have plateaued or are even veering in the wrong direction. We might take from that that the Government has maybe lost the room a little bit already," said Dr Hannah Durand, a behavioural science researcher at NUI Galway.

While the country cannot afford to ignore restrictions, people are “really worn down” by the pandemic and need to have some sense that they have some control and that their sacrifices are helping to slow the spread of the virus in order to encourage them to stick with the measures, she said.

Carrot and stick approach

Some reward with a relaxation of restrictions, however small, could from a psychological perspective help when the Government decides in the coming week on post-Easter restrictions measures. A carrot and stick approach might help to improve and maintain compliance with public health measures.

Taoiseach Micheál Martin has said that there will be an emphasis on outdoor activities in the changes to restrictions from April 5th. Extending the 5km travel limit might be one carrot to offer; relaxing contacts outdoors might be another.

“It is really difficult to convince people that meeting up with one other person outdoors at a social distance with masks on is not a safe thing to do, when it was a safe thing to do and we were allowed to do that previously,” said Dr Durand.

“So I think some sort of easing of social meetings with very small numbers of people in very specific settings might help people to get through it.”

Immunologist Luke O’Neill puts the slippage down to “pandemic fatigue”, which is essentially a lack of compliance where people are fed up and don’t trust the public health guidelines.

“One reason to cut them some slack is to decrease pandemic fatigue and then they are more compliant,” he said.

“In other words, people will buy into the stringent business of no household mixing if you are allowed to play a game of golf or whatever it might be, because that is giving people relief.”

Prof O’Neill points to the HIV/Aids crisis in the 1980s where the initial recommendation of abstinence from sex was quickly abandoned over widespread non-compliance, in favour of a shift towards “harm reduction” and safe sex campaigns to prevent the spread of the virus.

“We will be seeing a shift in Covid towards harm reduction and that would include things like: ‘It is okay if you want to meet your grandchild; there is a tiny risk there and you can take it if you wish. If you do, it may be wise to wear a mask or limit your contact to a short time,’” he said.

Complicating response

Growing anger and frustration among the public is undoubtedly complicating the State's pandemic response and weakening the resolve of some to continue to adhere to the most severe restrictions. The latest public opinion survey by Amárach Research for the Department of Health showed that one of the biggest jumps in frustration levels during the pandemic occurred in the third week in March.

Some 44 per cent of respondents said they were feeling frustrated – the highest such level of the pandemic – up from 33 per cent the week before, while 22 per cent said they were angry – again, the highest such level of the pandemic – up from 18 per cent the week before.

"That anger can give you the sense of moral righteousness to say, 'To hell with solidarity, I am going to go my way.' I think that is happening but it is a minority of people," said Ian Robertson, professor of psychology at Trinity College Dublin.

The figures support this latter statement – if the Government is losing the room, it is only losing part of it so far. The Amárach survey found that a massive majority of 82 per cent of people think that the current restrictions are either appropriate or insufficient, while just 18 per cent consider them too extreme.

Prof Robertson warns that the perception of angry people reaching "some limit" and needing to break restrictions was "highly dangerous", because it increases anxiety and, long term, will not make people feel better, particularly if case numbers keep rising and this lengthens the lockdown.

The concept of people approaching their limit is a myth and “really pathological”, he said.

Equally dangerous

A minority of people taking a risk to breach guidelines is equally dangerous, threatening a repeat of the Christmas reopening that caused so many deaths and potentially slipping down the slope Brazil has fallen down as it struggles with reinfections from a more dangerous new variant.

“The trouble with that is that other people see them [people breaching guidelines] taking the risk and they say, ‘Well if they are doing it, why can’t I do it?’ It corrodes that sense of solidarity,” Prof Robertson said.

“Defying Mother Nature – a virus – is a very immature way of expressing one’s anger and a very destructive one for the 80 per cent of people who are sucking it up.”

Dr Durand says there can be no room for confusion in the Government’s public statements in relation to what the public can and should do from this critical moment, particularly with people disengaging on the issue over negative talk on “losing control” and “going in the wrong direction”.

“We need to focus on what we can control and the messaging should reflect that,” she said.

“That is making sure people are aware that by adhering to the restrictions, by taking those extra precautions, they are helping to get us out of this pandemic sooner rather than later.”

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