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Epidemiologist On Why 'Pandemic Shaming' Isn't Working

MICHEL MARTIN, HOST:

Let's talk some more about what to do about the holidays. For many families, this holiday season has already been emotionally fraught as they've tried to balance their desire to be together with the pleas from public health officials to stay home. And even before Thanksgiving, the message was that traveling is irresponsible, and the hashtag #covidiots appeared, calling out people who ignored official warnings. Yet millions of people did make the decision that it was worth traveling in order to be with family.

So is shame really the best way to stop the spread of coronavirus? Julia Marcus is an epidemiologist and associate professor at Harvard Medical School. She recently wrote a piece for The Atlantic where she considered this. It's titled "The Danger Of Assuming That Family Time Is Dispensable: Americans Who Are Desperate To See Their Loved Ones Need Advice That Goes Beyond 'Just Say No.'" And Julia Marcus is with us now.

Professor Marcus, welcome. Thank you so much for talking with us.

JULIA MARCUS: Thanks for having me.

MARTIN: So to begin with you, would you just talk about pandemic shaming? What is it, and why isn't it working?

MARCUS: I think I first saw pandemic shaming happening way back in March, when spring break was happening and there were college students traveling to Florida, and it started to explode on social media - these photos and videos of people, again, with this hashtag #covidiots. And that kind of shaming has continued and, I think, expanded during the course of the pandemic and has started to come from elected officials as well, who have said things like, you know, if you would all just be smart and stop being so selfish, then we wouldn't be in this situation.

But we know from other areas of health that shaming and blaming people is not the best way to get them to change their behavior and actually can be counterproductive because it makes people want to hide their behavior. And we really saw this a lot around Thanksgiving with, you know, the idea that people who were traveling and gathering were irresponsible.

But even the people who were trying to take precautions were called irresponsible - those who were waiting in lines for testing, for example. And I think we have to recognize that when huge numbers of people did gather with people outside of their households, we have to give people practical advice about how to reduce risk without telling them that they're bad people if they want to see their loved ones.

MARTIN: And one of the comparisons you make in your piece is how shaming during the HIV/AIDS epidemic did not really do much to deter risky behavior and, in fact, made prevention efforts more difficult. Could you talk a little bit more about that and how you see that playing out in the current situation?

MARCUS: I mean, these are very different viruses and different epidemics that are going to have a different duration. You know, there's a lot of limits to this analogy. But I think there is a lot we can learn from the HIV epidemic. And as an HIV prevention researcher, I see every day in my research the ways that stigma is still a major barrier to ending the HIV epidemic.

And just for example, there are people who will not tell a health care provider about the kinds of sex that they're having because they're afraid of the kind of judgment that they may experience. And we see that now in the COVID pandemic in a very different way, but I think parallel, that people are afraid to disclose if they may have exposed somebody because they're afraid of being judged as, you know, having taken some reckless risk.

And so the answer here is not to just condone risky behavior or accept that it's happening and sit quietly. In fact, we do need to give people very clear and consistent messaging about the high risks of travel and gathering, especially over Christmas, which I think is going to be even higher-risk than Thanksgiving as communities spread increases in many areas.

MARTIN: Just to stay on this one point just for one minute before we move on to what more you think should be happening is that, you know, I've seen this just in my own, you know, community - people jumping on neighborhood discussion boards to kind of call people out for playing basketball or for, in their view, kind of running too close when they're jogging or something of that sort. And I think people who do that think that they're being helpful.

MARCUS: Yeah. I mean, I think there is also a feeling that people get when they shame others - a sense of control, you know, in a situation that really makes us all feel out of control, that's very uncertain and scary. And, you know, one way to feel better is to say, I know who's responsible here. It's you who has the bad behavior, and so I'm going to try to, you know, shame you into better behavior.

And that may relieve people's frustration in that moment, you know, by expressing it. But I think it does little to actually change that behavior. And, in fact, that outrage may be better directed toward, let's say, the people in power, authorities who have the ability to create better pandemic policies that have yet to be seen.

MARTIN: One point you do make in your piece that I don't think that we've fully explored is that people aren't really recognizing just how important it is to people to get together, just in the same way that people who are religiously committed have complained bitterly that they don't feel that necessarily public health authorities are acknowledging the degree to which people need their religious practice.

But having said that, one of the other points you make in the piece is that you say that messaging from state officials has been nonsensical. Tell us a bit more what you mean by that.

MARCUS: Yeah, I think it depends on the locality, of course, because we have different sets of pandemic policies in different areas, and they are dynamic. But there are places where, at least around Thanksgiving, people were being told that they should not gather with other families or with their extended family for Thanksgiving. And, in fact, in some places, gatherings with people outside of your household were entirely banned, even outdoors. And in those same places, in some cases, people could meet another family at an indoor restaurant unmasked. People could have a large catered event if it was at a formal event venue. So some of these policies are legitimately confusing for people. You know, where is the risk? If you're telling me it's safe to dine indoors with another family, why can I not see them in my household?

MARTIN: So what would work better?

MARCUS: Well, I think on that point, transparency around pandemic policies, I think, would go a long way. For example, for governors who are in a really difficult position, where they are faced with this choice around, let's say, closing indoor dining and they don't have the resources from the federal government that they need to support businesses in staying closed, support workers in staying home, tell the public that. And I think also around Christmas and gatherings, I would hope to see messaging that doesn't blame the public - instead, comes from a place of compassion, acknowledging that people really miss their loved ones, but also giving people some hope that if we can just wait a few more months, we are - we're rolling out vaccines. There really is an end in sight at this point - and at the same time, giving people practical advice on how to reduce risk if they do travel or gather and maybe even taking that a step further - giving them safer spaces to gather, putting fire pits in parks so that people who lack a private outdoor space where they can, you know, have a yard gathering can actually go to the park and have a fire with their loved ones.

I mean, these are ways that the government could - local governments can, you know, not just say no to people but, in fact, say, we know this is important, and here's how we're going to support you.

MARTIN: That was Julia Marcus. She's an epidemiologist and associate professor at Harvard Medical School.

Professor Marcus, thank you so much for talking with us.

MARCUS: Thanks for having me. Transcript provided by NPR, Copyright NPR.

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