Posted by There is an apocryphal story of a politician during the Revolution of 1848 desperately running after a crowd in Paris’s Jardin du Luxembourg. “I’m their leader,” he cried. “I must follow them!” A couple of years ago most national pandemic planners were occupied with procuring stockpiles of antivirals, worrying about the lack of a vaccine and reassuring people that they had the matter under control if a pandemic were to strike. No one believed them and they knew they were whistling past the graveyard, but the poverty of vision was amazing. There has been much progress since then. Now there is open talk about the need and potential efficacy of non pharmaceutical interventions, or as the jargon has it now, “community mitigation guidelines.” Whatever you call it, the objective is to reduce contact through measures of social distancing (closing schools, theaters, etc.). So the planners are getting there. Now a just published survey in CDC’s journal, Emerging Infectious Diseases, shows the public was there long before the planners.
Some 3500 subjects in Europe and Asia were asked which of the following responses would be most likely in the event of a pandemic:
- Avoid public transportation
- Avoid going out for entertainment
- Limit shopping to the essentials
- Take leave from work
- Keep children out of school, even if it remains open
- Limit physical contact with friends and family
- Avoid seeing doctors, even when sick from something unrelated to flu
- Stay indoors at all times
CIDRAP has an excellent summary of the study. Here’s some of it:
A recently published survey of Europeans and Asians showed that, when faced with an influenza pandemic, most would avoid mass transit and limit shopping to essentials, and many would avoid other public places, including restaurants, theaters, and the workplace.
The study, published online Jul 20 in Emerging Infectious Diseases, found that “avoidance of public transportation was consistently reported across the region as the most likely precautionary behavior,” with about 75% of respondents choosing that option.
Reactions to other risk-avoidance measures varied by region. For example, 79% of Europeans would likely avoid places of entertainment such as cinemas, restaurants, and theaters, while only 33% of Asians said they would. And 52% of Asians said they would stay home from work, compared with 35% of Europeans. (CIDRAP News)
The responses didn’t seem to be conditioned on whether the pandemic was mild or severe. And the survey was done in late 2005, before the time when planners were seriously discussing these kinds of social distancing policies. People were already someplace it would take planners another year to get to.
I am not inclined to give much weight to the specific differences or levels for the various responses. This is a hypothetical question and not quantitatively transferable to what would happen in a real event. What it does show, however, is that a substantial proportion of people have a good idea of what they might do in the way of spontaneously altering their behavior. While political leaders and planners wring their hands over what the criteria will be for closing schools (a Draconian measure with huge economic and social implications for most communities), the decision will most likely be made by people without reference to what the planners think. The governor or prime minister or provincial leader will officially close the schools when students and teachers stop showing up.
This isn’t an argument for not thinking about what should trigger a school closure. But it is an argument for shifting the major effort away from trying to figure out what the trigger will be to planning to manage the consequences. Similarly for the effects on trade, commerce and travel.
People will vote with their feet. And the leaders will follow the crowd. Both should think ahead about what this will mean.
July 29, 2007
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