Blame psychology. First off, foresight is not a particular skill for most of us, experts say. And “live free or die” is more than a slogan; it’s an apt description for the mindset of many Americans. Finally, it is hard to assess the threat of an enemy you can’t see.
For all the public health models, charts, and predictions this pandemic has brought us, people are not particularly good at estimating what’s going to happen next, said Thomas F. “Tim” Shipley, a psychology professor at Temple University.
“Part of the reason why people found the onset of the pandemic disconcerting was that they may not have had a mental model of why things were accelerating,” he said.
In our era of vaccines and other public health advances, infectious disease is not the threat it once was. Most Americans die of chronic conditions that can take years to develop. But in a pandemic, Shipley notes, one infected person can expose numerous other individuals, sending cases and deaths soaring.
That is what scientists call a positive feedback loop — when the product of a reaction leads to an increase in that reaction. Health experts saw that out-of-control situation happening in China, and knew it could spread. The rest of us? Not so much.
“Helping people recognize that early action will be important in future pandemics means that we have to have an effective early warning system,” Shipley said. “We need to pay attention to people studying the earliest signs and increase understanding of how feedback loops work in these types of situations."
Shipley said the virus’ invisibility may also be causing many people to underestimate it. People are not as responsive to threats they cannot see, and may experience a false sense of security, he said.
Plus, it’s also possible to be a carrier without symptoms — adding to the air of unreality.
Even Mayor Jim Kenney remarked Monday that lot of people who appeared to be 30 years old or younger are not wearing masks. “Young people for some reason or another refuse to put the mask on. … These young folks don’t think of their parents or their grandparents or themselves when they do this,” Kenney said at a virtual news conference.
Natural disasters like hurricanes and earthquakes occur with some frequency. But the last worldwide pandemic — the 1918 flu — happened more than a century ago. Hardly anybody remembers it, much less what led up to it.
Robert Hicks, former director of the Mütter Museum of the College of Physicians of Philadelphia, said the American mindset is another reason it’s so hard to enforce strict public health measures. Americans are independent-minded, he said, meaning we don’t willingly sacrifice personal freedom for the sake of the wider society. That’s especially so for people who distrust science, detest government regulations, and have never seen a situation like this pandemic with their own eyes.
Demonstrations in Harrisburg and other state capitals against stay-at-home orders have made the news lately, but it’s also individuals pushing against restrictions. A recent Inquirer analysis of cellphone tracking data across the United States last month found that fewer residents are staying home as the weather gets warmer, the outbreak lasts longer, and the number of new cases flattens. Even if cases aren’t dropping and are just leveling off, that’s been enough encouragement for some.
Syon Bhanot, a behavioral economist and assistant professor at Swarthmore College, noted that public health measures in Asian countries were more successful because people there are more willing to follow government orders.
“In the United States, people really push back against authorities,” he said. “When you feel like someone’s going after you, you try to defend your ground.”
A disjointed political response has in some ways encouraged people to take social distancing measures less seriously.
All over the country, politicians have repeatedly downplayed the threat of the virus. And even in cities that closed businesses to keep the virus from spreading, there was disagreement between health experts and political leaders on how best to proceed. In New York City, the epicenter of the U.S. outbreak, Mayor Bill de Blasio instated social distancing rules only after two top leaders in the city’s Department of Health and Mental Hygiene threatened to resign.
“Compared with other countries that managed COVID, the U.S. seems to be a disaster at the moment,” said Hicks. “It’s because of the difficulty of aligning the political authorities, from the president on down, with what people in the medical community are telling us, with the public’s mood.”
Hicks said that when all three of those factors align, an effective public health response is possible. He cited the 1886 cholera outbreak in New York City as an example. After two outbreaks in 1832 and 1849, a group of physicians formed a task force in 1864 to conduct a survey that linked unsanitary conditions to the spread of the disease. The city acted upon the physicians’ recommendations, and the death toll was much lower than expected.
“That’s the model that would still work today,” Hicks said.
In contrast, the federal government’s COVID-19 plan has at times been at odds with health officials’ accounts. President Donald Trump claimed that the U.S. is the best in the world at testing, saying that U.S. health officials have tested more than “every country combined,” frustrating experts who have identified the lack of tests as a key failure in the government’s response to the pandemic.
Trump has also been repeatedly criticized for dismantling the National Security Council’s global health security office, which was responsible for overseeing the U.S. response to a deadly pandemic, in 2018, even as experts warned that the country was woefully underprepared for dealing with one.
Hicks said he hopes the COVID-19 pandemic will change future conversations about what needs to be done to stop a disease from spreading.
“The world’s population has increased,” he said. “Pandemics are real. They’re going to happen, and we need to allocate resources in advance and expect that sometimes, those resources can be outstripped. The scientific mentality is that we have to get to a point where we are prepared, and politicians need to get that.”