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Coronavirus (COVID-19) brief: protection motivation theory, outbreak appraisal, and understanding collective behaviour

The world is in chaos. The coronavirus has accelerated at an unprecedented rate, leaving planet Earth feeling vulnerable and in a state of collective sorrow. Things have never been like this. Unless you are over 100 years old, you have never witnessed this level of transnosological danger in your entire life. Due to the panic-ridden headlines, many people are experiencing an aversion to potential loss or potential grief. Others seem to be in denial. Where is the balance? This article aims to explore some of the facts, figures, and dynamics determining coronavirus-associated behaviour.

“Protection motivation theory describes adaptive and maladaptive coping with a health threat as the result of two appraisal processes: threat appraisal and coping appraisal“.

Norman and Conner (1996, p. 11)

Threat Appraisal

Worldometers (2020)

As of 28/03/2020:

TOTAL GLOBAL CASES: +602,000

TOTAL GLOBAL DEATHS: +27,400

TOTAL GLOBAL RECOVERIES: +133,500

How severe is the threat?

The threat is perceived by the public as extremely severe and unprecedented. Here in the United Kingdom it has been set as high risk; and this is why Primer Minister Boris Johnson has enforced the draconian lockdown (Cabinet Office, 2020). The virus is very contagious, and due to the increasing death rates people are feeling very susceptible with this disease threatening their physical integrity, and potentially their life or the life of those whom they love. Nevertheless, it must be objectively said that 95% of recorded cases worldwide report mild symptoms. Yet, from mild symptoms have arisen many deaths.

How susceptible am I to the threat?

It seems that among the high risk groups are people over 80 years old, those with underlying health conditions, and smokers with chronic pulmonary problems. Furthermore, according to the United Nations (2020): “The risk depends on where you are – and more specifically, whether there is a COVID-19 outbreak unfolding there”. In other words, demographic variables will indicate the level of risk in specific areas. For instance, the South West area where I live in the UK is the area with the lowest risk of contamination (GOV.UK, 2020b), and my city (Plymouth) has only 26 cases so far (O’Leary, 2020). Furthermore, commenting on the safety of packages and deliveries, the UN (2020) further states: “The likelihood of an infected person contaminating commercial goods is low and the risk of catching the virus that causes COVID-19 from a package that has been moved, travelled, and exposed to different conditions and temperature is also low”. So if you are concerned about me, don’t worry, I am ready.

I sanitise my body, my environment, and my mind. Call me mad, but I’ll survive.

How is the virus appraised by the global government?

The World Health Organization (WHO) has warned the world about the fact that no antibiotics, no medication, and no vaccination has proven to prevent or cure the coronavirus. Therefore, they appraise this as a serious situation.

World Health Organization (2020).

What are mental health experts saying?

Mental health experts understand that this is without a doubt a stress-generative situation. The uncertainty that COVID-19 triggers is in many cases inevitable. Furthermore, the unpredictability and uncontrollability that manifest with the facts and figures are a source of anxiety for many people. Nevertheless, this does not mean that pre-emptive and preventive action cannot be taken. The GOV and the WHO have issued specific guidance which can help reduce the hazard and intensity of the situation. Sanitary action is in this case reasoned action, and this can be planned, performed, and maintained in order to cope with the threat in an adaptive way. Moreover, because this is an extraordinary situation which has disrupted the standard routines of many people, there is a certain level of confusion, fear, and worry. Remember to:

  • Wash your hands with soap as frequently as possible for 20 seconds.
  • Stay indoors unless it is absolutely necessary to go out to seek medical care.
  • Order groceries online as infrequently as possible instead of going to the shop (even though online deliveries are the least unsafe option, there is still a risk of contamination through such medium).

Coping Appraisal

INTERNAL LOCUS OF CONTROL: Factors which can be totally controlled by and depend solely on the individual.

EXTERNAL LOCUS OF CONTROL: Factors which can’t be controlled by and do not depend on the individual.

(Norman and Conner, 1996).

I see people behaving like nothing is happening. Am I too paranoid?

No. What you see happening is a state of collective denial. People keep going to work, doing physical exercise outdoors, and attending social gatherings because they are underestimating the severity of the threat. The kind of self-absorption that is dominant in individualistic, Western societies is an intellectual disadvantage in this case which requires an analysis of global events and behaviour. It only takes analysing what is happening in China, the US, Italy and Spain to understand that due to the incubation period of the virus (up to 2-3 weeks; Worldometers, 2020) it is quite possible that the COVID-19 is having a delayed impact in the UK. The virus does survive a long time in the air, meaning that it can be breathed quite easily. This is why a two metre distance is advised. Those behaving as if nothing was happening are not able to rationalise the threat because being able to move around gives them a false sense of being in control of the situation. In my opinion, it is an unnecessary risk they are taking. Similarly, those going to work outside the emergency system are still playing down the risk.

According to Norman and Conner (1996), the more an individual perceives potential health susceptibility, and the more that the threat is perceived to be severe, the more fear arousal there is. This means that the way people respond to the outbreak will depend on their level of awareness about the high risk the coronavirus poses. For instance, here in the UK there are more deaths than recoveries, and the counter for recoveries has been stuck at 135 (GOV.UK, 2020b) for several days already, unlike the counters for new cases and deaths, which keep burgeoning. This is problematic and worrisome. So if you are feeling too paranoid and as if you are being too careful, rest assured that you are just being as careful and responsible as you and everyone else are expected to be.

What can I do to calm down?

This is a good question, as everything functions better when people remain calm. There are many variables that are within your locus of control, such as the way you interpret the situation (perception) which can be optimised by engaging in intellectually stimulating activities such as reading, watching films, or having conversations. The more you learn, the more confident you will feel in assessing risk, and the more you will engage in reasoned behaviours that promote health and prevent disease. Another variable that you can control and nourish in yourself is your emotional wellbeing, which can be enhanced by ensuring that you get enough sleep (this will also boost your immune system, and will therefore help you fight off infections; NHS.UK, 2018), that you eat well, and that you have a tidy and clean environment around you. If you have long-term conditions, it is necessary that you continue to take your prescribed medications during this time in order to keep healthy. Furthermore, remember that you have the capacity of preventing contamination by following the guidance. Successfully executing the recommended courses of action will help you feel self-efficient and safe. Engage in some yoga or pilates at home, entertain yourself, and stay in touch with your family and friends digitally. Keep the following points in mind:

  • Neither underestimate nor overestimate the magnitude of the situation. Stay tuned for the facts and figures.
  • You can sign online petitions to participate in requesting specific outcomes for the common good.
  • Plan for short to medium term supplies and associated variables of a lockdown.
  • Mental contagion can happen if you allocate too much time and attention to digital material which is sensationalist or misinformed. Be wise about the type of information you consume.
  • Double check that your beliefs about what is healthy are not based on misinformation. Here are some myth busters to keep in mind:

What factors are not under my control?

There are several variables that could become a source of frustration during the lockdown. Anything that is outside your mind, and outside your environment is outside your control. You are not responsible for the behaviour of others, and the best thing you can do is share the guidance with your loved ones and hope that they follow it. Moreover, you have no current participation in most of the decision-making processes of the jurisdiction (e.g. the legal measures being duly taken by the GOV in relation to this pandemic). If you are not able to work from home, and cannot make money as a result, you might feel like everything is going to collapse, and in such case all you can do is hope that the GOV will protect your welfare, as such decision is within their locus of control. If you are a key worker, you might feel that your life is being put at risk in order to save the life of others. All you can do is hope that the GOV will listen to the healthcare industry in regards to the much needed protective equipment, spaces, and ventilators. This too is within the GOV’s locus of control. For example, medical staff in Spain are being forced to sedate and asphyxiate the elderly to death in order to use their ventilators on younger patients. Because providing equipment is a decision which only the Spanish political leaders can make, doctors are having a psychological breakdown and are accusing the authorities of genocide for neglecting the welfare of vulnerable citizens. Take a look at this video:

References

Cabinet Office (2020) ‘Guidance: Staying at home and away from others (social distancing)’, GOV.UK, 23 March [Online]. Available at https://www.gov.uk/government/publications/full-guidance-on-staying-at-home-and-away-from-others (Accessed 27 March 2020).

GOV.UK (2020a) ‘Coronavirus (COVID-19): what you need to know’ [Online]. Available at https://www.gov.uk/coronavirus (Accessed 27 March 2020).

GOV.UK (2020b) ‘Total UK COVID-19 Cases” [Online]. Available at https://www.arcgis.com/apps/opsdashboard/index.html#/ae5dda8f86814ae99dde905d2a9070ae (Accessed 27 March 2020).

Hamzelou, J. (2020) ‘How long does coronavirus stay on surfaces and can they infect you?’, New Scientist, 25 March [Online]. Available at https://www.newscientist.com/article/2238494-how-long-does-coronavirus-stay-on-surfaces-and-can-they-infect-you/ (Accessed 27 March 2020).

Johnson, B. (n.d.) ‘About Boris’, Boris Johnson [Online]. Available at http://www.boris-johnson.com/about/ (Accessed 27 March 2020).

NHS.UK (2018) ‘Why lack of sleep is bad for your health’ [Online]. Available at https://www.nhs.uk/live-well/sleep-and-tiredness/why-lack-of-sleep-is-bad-for-your-health/ (Accessed 27 March 2020).

Norman, P. and Conner, M. (1996) ‘The role of social cognition in health behaviours’, in Conner, M. (ed) Predicting Health Behaviour, Buckingham, Open University Press, pp. 1-22.

O’Leary, M. (2020) ‘Four new coronavirus cases confirmed in Plymouth’, Plymouth Herald, 26 March [Online]. Available at https://www.plymouthherald.co.uk/news/plymouth-news/four-new-coronavirus-cases-confirmed-3989498 (Accessed 27 March 2020).

United Nations (2020) ‘Coronavirus (COVID-19): Frequently Asked Questions’ [Online]. Available at https://www.un.org/en/coronavirus/covid-19-faqs (Accessed 27 March 2020).

World Health Organization (2020) ‘Coronavirus disease (COVID-19) advice for the public: myth busters’ [Online]. Available at https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters (Accessed 27 March 2020).

Worldometers (2020) ‘Coronavirus Update (LIVE)’ [Online]. Available at https://www.worldometers.info/coronavirus/ (Accessed 27 March 2020).