Author: Anna Bernard

To be successful, public policies need to convince these conditional cooperators to comply with the restrictions. Behavioral economics identified several tools that policy makers can mobilize to sustain norm compliance. 

The best immediate response to the COVID-19 health crisis may appear simple and within everyone's reach: wash hands regularly, avoid face or mouth touching, and maintain physical distance in case of social interaction. Yet, the world struggles in fighting the pandemic. 

The short-term public policies to control the pandemic are eminently behavioral. They rest on basic actions performed by each of us, and things will remain so up until the day medicine grants us a cure or a vaccine. The behavior-oriented measures aim, and have been effective, at mitigating the pandemic and “flattening the curve” (1). 

However, these behavioral measures face the classic collective action dilemma: the benefits are common while the costs are individual. While we need to keep in mind that evidence in behavioral economics generally does not come from pandemic situations, I discuss here key insights that may allow us to increase compliance to public policies. 

Convince the agnostics

Behavioral economics teaches us that policy framing is crucial to raise citizens' cooperation due to the high share of conditional cooperators among citizens. Our world bears only a minority of citizens that would be either unconditional cooperators, who will stay home for the common good, or selfish individuals, who will go out anyway. 

Many people, referred to as “conditional cooperators”, are indecisive on what to do. Crucially, these people will wait to see what others are doing before making up their own minds. To be successful, public policies need to convince these conditional cooperators to comply with the restrictions. Being convincing in these matters is actually a challenge, as naturally occurring positive feedback of compliant behaviors are hardly perceptible (e.g. how many lives do I save by wearing a mask?) while rule infringements are highly visible (e.g. why should I stay home if others are hanging out in the park?). 

However, behavioral economics identified several tools that policy makers can mobilize to sustain norm compliance (see the recent review of Pete Lunn and coauthors (2)): 

• Providing clear information on the correct behaviors to opt for 
• Informing citizens about the positive feedback of cooperating (e.g. in France, one month of lock-down has been estimated to have saved about 60.000 lives (3))
• Enforcing punishment, in the form of fines or (polite) social disapproval, to discourage the free-riders and lower their visibility

Foster group identity in a heterogeneous population

We are not equal when it comes to the costs and benefits of social distancing. First, it is not necessarily easy for individuals in overcrowded areas to keep the necessary physical distance, making them bear a higher cost. Second, initial data shows that young individuals face substantially lower risk of dying from COVID-19 while the impact of their compliance is potentially great for society, making them face an extreme difference between their private benefit and the social benefit of their compliance. These asymmetries in the costs and benefits of prevention can lead to a lower aggregate level of cooperation (4). 

To overcome these pitfalls, public policies can:

• Foster group identity: the sense of belonging to a group increase pro-social behaviors and cooperation (5) 
• Induce empathy: inducing empathy for those most vulnerable to the virus promotes the motivation to adhere to physical distancing (6)

The importance of habit-formation

Despite the considerable effort of the scientific community to find a vaccine, we are far from achieving herd immunity and the risk of one (or more) subsequent waves needs to be taken seriously. Prevention measures are bound to remain even if the form they take may be adjusted, hence the imperative to create some core health habits. Immediate strong public policies to foster health habits will have impacts on our future capacity to cope with pandemic crises. In a recent study, Pogrebna and Kharlamov (7) suggest that pre-crisis hand washing culture strongly and negatively predicts COVID-19 spread magnitude (see Figure 1). So how can we efficiently create new habits? 

Obviously, any public policies aiming at increasing such habits should first make them actionable. Assuming that infrastructures can provide the proper environment, existing research suggests three main avenues to increase habit uptake:

• Education and information: informing individuals about the consequences of risky behaviors have been shown to be efficient in many health domains, such as insurance, hands washing, sexual behavior (7)
• Leveraging communities: good practice diffusion thanks to leaders and within a community can be quite effective. For instance, a study in Nepal found that high school girls whose friends received a menstrual cup were more likely to adopt them as well (8).
• Nudges: environmental cues, such as painted shoeprints and arrows leading from the latrine to the hand washing station, can orientate habit formation and has been shown to be efficient for hand washing (9)

References

1. Morse SS. Pandemic influenza: Studying the lessons of history. Proc Natl Acad Sci. 2007 May 1;104(18):7313–4.

2. Lunn PD, Belton CA, Lavin C, McGowan FP, Timmons S, Robertson DA. Using Behavioral Science to help fight the Coronavirus. J Behav Public Adm [Internet]. 2020 Mar 29 [cited 2020 Apr 28];3(1). Available here.

3. Roux J, Massonnaud C, Crépey P. COVID-19: One-month impact of the French lockdown on the epidemic burden. 2020;

4. Zelmer J. Linear Public Goods Experiments: A Meta-Analysis. Exp Econ. 2003 Nov 1;6(3):299–310.

5. Kramer RM, Brewer MB. Effects of group identity on resource use in a simulated commons dilemma. J Pers Soc Psychol. 1984;46(5):1044–57.

6. Pfattheicher S, Nockur L, Böhm R, Sassenrath C, Petersen MB. The emotional path to action: Empathy promotes physical distancing during the COVID-19 pandemic [Internet]. PsyArXiv; 2020 Mar [cited 2020 Apr 29]. Available from: https://osf.io/y2cg5

7. Pogrebna G, Kharlamov A. The Impact of Cross-Cultural Differences in Handwashing Patterns on the COVID-19 Outbreak Magnitude. 2020;

8. Oster E, Thornton R. Menstruation, Sanitary Products, and School Attendance: Evidence from a Randomized Evaluation. Am Econ J Appl Econ. 2011 Jan;3(1):91–100.

9. Grover E, Hossain MK, Uddin S, Venkatesh M, Ram PK, Dreibelbis R. Comparing the behavioural impact of a nudge-based handwashing intervention to high-intensity hygiene education: a cluster-randomised trial in rural Bangladesh. Trop Med Int Health TM IH. 2018;23(1):10–25.

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