Newton Emerson: How ‘behavioural fatigue’ is shaping Covid-19 response

The UK government did not wait until March 23rd to introduce a lockdown because of some unique aspect of the British character. It waited because of a particular type of scientific advice that now appears disastrously flawed, yet which the UK and everyone else must shortly return to and depend upon more than ever.

That advice is the behavioural science concept of ‘fatigue’, used to assess how long the public will adhere to restrictions.

When London published its action plan for the epidemic on March 3rd it did not envisage there would ever be a general order to stay at home, as the term ‘lockdown’ might be broadly understood. Instead, there were to be phased social distancing measures, most of them optional.

UK action was finally determined by copying Europe, not by trying to go it alone

This was in line with the consensus across Europe, Asia and North America that no democratic society would endure the kind of restrictions imposed in China.

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The Italian red zone, then affecting 50,000 people, was still seen as a last-ditch attempt to quarantine the virus, rather than a model to manage it.

Even the limited measures planned by London were to be imposed as briefly and belatedly as possible, as fatigue was expected to unravel them within three weeks.

Prime minister Boris Johnson and his chief scientific adviser Patrick Vallance were blunt about this in daily press conferences, saying measures had to be timed for maximum effect or people would get "fed up".

This made fatigue a prominent topic of debate in the UK media throughout last month, during which the government began publishing all its scientific advice. There was no doubt the advice was based on theory, modelling, evidence from past epidemics and extensive contemporary opinion polling. The problem was that behavioural science was more like sociology than physics, making disagreements irresolvable. On March 16th, an open letter was signed by 681 academics from around the UK saying “we are not convinced that enough is known about ‘behavioural fatigue’ or to what extent these insights apply to the current exceptional circumstances”.

The government's advice was already changing, however. A study that week on intermittent lockdowns suggested stricter measures would be tolerated by the public. A decisive Imperial College paper on March 16th warned of a catastrophic death toll without stricter measures. Meanwhile, the lockdown in Italy had "opened up the policy space", as one government adviser told Reuters earlier this month.

UK action was finally determined by copying Europe, not by trying to go it alone.

Most European countries announced lockdowns or strict social distancing measures within days of each other, yet at critically different stages of the progression of the epidemic. They jumped past the science into the policy space.

A vestigial tail of the fatigue advice remained in the three-week reviews of lockdown measures adopted in the UK and elsewhere, meant to give people a psychologically manageable time horizon.

The Republic has followed the same path, including use of the same advice, some of it from the Economic and Social Research Institute (ESRI).

As recently as March 23rd, Taoiseach Leo Varadkar said he wanted to avoid a lockdown as fatigue would cause it to end sharply and make the virus "come roaring back". When Varadkar announced a lockdown four days later, it also had a three-week review.

Crucially, neither the UK or Ireland have introduced lockdowns of Italian severity – yet. Our behaviours are still being managed.

Even in a story as fast moving as coronavirus, it is extraordinary how the fatigue debate has been forgotten. However, it is about to return.

Lifting lockdowns will be as contentious as introducing them, and must be balanced against not just economic concerns but the need to keep reintroducing measures until a vaccine is available. What role should behavioural science play in making these judgments?

Behavioural science promised to depoliticise management of the epidemic. On that score at least, it has certainly failed

It was wrong about the fatigue limit in democratic societies. Problems in southern Italy after three weeks were specific to a cash economy and have not occurred elsewhere. The UK government is now concerned it will have difficulty persuading people to come out of lockdown. Opinion polls last week showed almost half the UK population supports restrictions for as long as deemed necessary and a third do not think current measures go far enough.

In Ireland, the ESRI says “we cannot see – as of now – any evidence that there is any kind of behavioural fatigue setting in”.

But it must set in eventually, perhaps with a vengeance. There is a case we have only begun needing behavioural science and its understanding of these exceptional circumstances will improve.

On the other hand, fatigue may never be understood well enough to produce advice that outranks the ‘policy space’. There may simply be too many variables. No model foresaw that England’s 39 police forces would corrode authority with inconsistent enforcement, for example.

Behavioural science promised to depoliticise management of the epidemic. On that score at least, it has certainly failed.