Shoppers stand apart as social distancing measures amid concerns over the Covid-19 epidemic, while queueing outside a supermarket in Manila on March 17, 2020. Photo: AFP / Maria Tan

For the first time in years, economic risks are taking a back seat to health concerns, and worries about the coronavirus pandemic getting out of control are growing. The ongoing Covid-19 outbreak is an unfortunate example of why the world urgently needs improved capacity to provide health care.

The global response to the Covid-19 outbreak was late, inadequate and slow. The serious shortage of health-care workers, facilities and supplies means many people will never receive treatment as the virus continues to spread. At the same time, fear of Covid-19 has hampered trade, shuttered businesses, and restricted travel in the affected countries.

The world has taken a major economic hit and we expect to see negative economic growth in 2020-2021. Better preparedness to tackle pandemics requires investing both in strengthening public health systems and in prevention efforts throughout the developing world, as well as in new and flexible financing instruments.

Pandemics have killed millions in the past and it is likely that Covid-19 is an imminent threat. People have been asked to take action to help limit its spread, unpleasant actions like shutting down entire countries and giving up travel plans. 

Psychologically, people have less of a reaction to viewing an unpleasant image or experiencing an electric shock when they know it is coming than when they are not expecting it. That is because uncertainty, a long-known cause of anxiety, makes it difficult to prepare for events or to control them.

The problem is people are notoriously unwilling to make sacrifices for others when the benefits are uncertain. In the case of pandemics, this means people are unlikely to spend time going to a clinic or to cancel a vacation because it is not guaranteed that such steps would help stop the spread of disease. Thus the uncertainty inherent to infectious diseases provides the ideal conditions for their spread: risk-seeking decisions in social situations. When people have to make decisions that might harm others, they tend to act as if things will work out just fine. 

It’s a general observation that when people are asked whether they would stay home from work if infected with Covid-19, which would be costly for their income or their career but might help limit the spread of disease, they hesitate because it is not a certainty that they would indeed infect a co-worker. This uncertainty makes people less willing to make a sacrifice and stay home. In other words, people are willing to risk hurting someone else for their own benefit when in their mind the harm is not certain to occur.

Luckily, it turns out there is another, more effective way to communicate uncertain threats like pandemics. When instead of dwelling on uncertainty about human welfare, certainties are emphasized – for example, how much infected people suffer – people are more likely to strive to prevent the worst-case scenario. 

Many of the most serious global threats today involve a high degree of uncertainty. Limiting the damage of such threats hinges on human choices, such as deciding to get socially isolated, vaccinated or quarantined. But we humans are famously bad at making decisions in uncertain conditions. How can unpredictable global threats be communicated to guide our decision-making most effectively?

It is likely that when people know the chance is high that going to work will infect an elderly person for whom the disease could be very serious, they are more willing to make a sacrifice and stay home. In other words, directing people’s attention to the certain impact of their actions on the well-being of others makes them more willing to take on personal costs to prevent others from potential harm. Perhaps this is how journalists, global leaders and health-care professionals can more effectively communicate the nature of certain  devastating threats like pandemics.

Sometimes this approach may be counterproductive when it comes to motivating the costly, altruistic individual choices that may ultimately prove crucial for limiting the impact of a pandemic. Psychiatrists are of the opinion that humans tend to put their self-interest first when it is not certain that doing so will cause harm. But when the human costs of selfishness are made salient, people are more willing to forgo the personal and prioritize social interests, even amid uncertainty.  

Maybe leaders should emphasize how selfish responses to global threats risk endangering the most vulnerable among us, such as people who have compromised immune systems due to cancer or chemotherapy, pregnant women and the elderly. Focusing on certainty over the uncertainty, on how our actions might impact others – for example, how much they might suffer – can inoculate us against selfishness.

Fawad Kaiser

Dr Fawad Kaiser is a professor, Fellowship Diplomate of the American Board of Psychotherapists, and a member of the International Association of Forensic Criminologists. He is currently a consultant forensic psychiatrist in the UK.