A behavioral cheatsheet to India’s COVID-19 response

A public health emergency in the form of a global pandemic has caused a lot of uncertainty and anxiety in society. However, in times of uncertainty, anxiety and unregulated information, people do not always act rationally. Using the Indian context of the pandemic so far — from the announcement of Janta Curfew to the current state of lockdown, from a lens of behavior science, we explore the key barriers, the COVID-19 response and steps which can be taken.

With the initiation of the one day ‘Janta Curfew’ the risk of COVID-19 as salient as possible, without causing a riotous panic and easing people into the reality of a pandemic. The use of phrases like, ‘Laxman Rekha’ in the Prime Minister’s address, contextually translated and anchored concepts of self-isolation and social distancing with relevant reference points to the Indian population. This trend continued in his speech which extended the lockdown.

The Indian government-imposed measures of a nation-wide lockdown until May 17. Strict measures like these compound an individual’s tendency to start evaluating long term losses, to possibly fleeting, short term gains. This is known as hyperbolic discounting. This is also what we saw in the period leading up to the Janta Curfew, where due to incomplete information combined with hyperbolic discounting, individuals started hoarding items like food supplies.

On the day of the announcement of the Janta Curfew and, upon the call to action to appreciate medical and essential services staff, we saw a vast majority, at least in urban India come out and show solidarity. This action can be seen as the setting up of pro-social norms. This is also when individuals feel compelled to comply with actions that can be seen as contributing to the greater good.

Coming down to the lockdown phase, we saw many instances of individuals venturing out for non-essential visits, defying common sense. Behavioral factors such as overconfidence, loss aversion and rational ignorance can be blamed for the same. Overconfidence in one’s own ability to be in control, or here, to not get infected by the virus. Loss aversion is where the fleeting satisfaction of missing out on stepping outside may force people to not practice self-isolation.

Additionally, we also observed the issue of reactive devaluation, where individuals actively choose to devalue and de-prioritize information coming from authorities. Anecdotally, these may be comparable to a rebellious teenage child going against the authority of their parents. It is thus no coincidence that these violations may be observed more amongst young to middle-aged adults, who have been seen to be highly mobile.

During this period of lockdown, few of the prescribed preventive measures are that of sanitizing with an alcohol-based sanitizer regularly or handwashing for 20 seconds and social-distancing. However, failure to adhere to both these practices can be due to a combination of loss aversion and hyperbolic discounting. What can also be at play is the role of optimism bias and rational ignorance, where individuals fail to update their beliefs in time, leading them to think that they won’t catch the virus, or they are at lesser risk than others. This has also been seen in the belief where only foreign travel is associated with the virus or that because of the lockdown the virus will not spread.

Various parts of the government communicated information on preventive measures, statistics, best practices, myths and fake news, as a coordinated response led by the Ministry of Health and Family Welfare. Based on past evidence and also experience of the Pulse Polio Campaign in India, celebrities are known to be very effective in communicating information on Public Health. This insight has been leveraged in the COVID-19 response as well, with many celebrities being roped in to share messaging. Additionally, some of the government's existing framing of messaging, leverages the need to practice handwashing, social distancing, not just for an individual's own health but for the health of others who may be more vulnerable. This appealed directly to people’s pro-social nature.

However, false and incorrect information has been rampant, especially on social media. This led to certain biased and incorrect beliefs being favored, suited to an individual’s own preferences. This is otherwise known as a confirmation bias. This is evident in the spread of unverified claims, fake news around preventive measures like holding one’s breath or rituals like drinking cow urine.

A manifestation of the same was witnessed in places like Indore and Moradabad, where violence was unleashed against those providing medical services, based on the individual's perception that medical service must be carriers of the virus. To counter these, one of the biggest endeavors of the COVID-19 response has been to tackle information and (mis)-information with fact-checking, not just by the government but also social media platforms.

In such a public health crisis, a single individual’s cooperation becomes essential for the larger public good. With measures like social distancing here to stay, individuals will need to change their behavior drastically. One way to achieve this is by directly addressing behavioral barriers through ways of communication and the ‘framing’ of public health messages. This needs to be coupled by other measures like the ‘circles’ outside shops, which marks out the safe distance or ‘hand-washing kiosks’ which can make handwashing salient and accessible. More such measures will need to be tested and ramped up. While the answer to the virus will come from virologists and epidemiologists, behavioral science in the meantime can help people adapt to the new post-COVID world.