What makes people ignore COVID restrictions?

Lockdowns, social distancing and mask wearing have become part of the Australian way of life over the past 18 months.
 
Together with contact tracing efforts, these public health measures have helped reduce community transmission in the absence of widespread vaccination. But their success relies heavily on individuals choosing to change their behaviour.
 
So why do some comply, while others purposefully choose not to?
 
New research, led by Associate Professor Sabina Kleitman from the University of Sydney School of Psychology, found during the pandemic’s first wave, roughly 10% of people were non-compliant and that they had common characteristics.
 
Conducted in March and April 2020, 1575 people across Australia, the UK, the US and Canada participated in an online survey, reporting on their behaviours, attitudes, personality, as well as their cognitive and decision-making ability.
 
They also gave insights on their resilience, adaptability, and coping, and commented on political and cultural factors and their information consumption.
 
The results showed that those who were non-compliant were more likely to be male, less agreeable, more extroverted and reactant. They also prioritised freedom and their own self-interests, and were generally older.
 
They tended to use maladaptive coping strategies, such as denial, substance use and disengagement, and engaged less with official news sources.
 
In contrast, those likely to comply with COVID-19 restrictions were more often young, female, and educated. They were also more likely to be prone to worrying, be at greater risk of the virus due to poorer health, and also have greater trust in government-mandated protective measures.
 
They also coped with stress and anxiety more productively, and used strategies such as distraction and planning.
 
Published just days after anti-lockdown protests were held in Sydney and Melbourne, Associate Professor Kleitman says the insights psychology holds are integral to managing the pandemic going forward.
 
‘This research is still relevant, because at the time the behaviours that non-compliant people were planning to do the following week – in the middle of all this uncertainty and craziness – they were still planning to go out and see family and friends, to “exercise their right to freedom”, for religious reasons and because they are bored,’ she told newsGP.
 
‘And what is happening now? We can see a lot of community infections for exactly the same reasons – because people go and see their family and friends, and because they go exercise their right to freedom.’
 
This is certainly a concern in New South Wales, where a number of local government areas are in their seventh week of lockdown and daily confirmed cases continue to grow by hundreds.
 
On Sunday, NSW Police issued a plea for people to comply with restrictions after attending to 1888 COVID-related reports, resulting in 454 infringement notices for breaches, including 115 for failing to wear a mask, over a 24-hour period. 
 
Christine Jenkins is a Professor of Respiratory Medicine at UNSW Sydney and Head of the Respiratory Group at the George Institute for Global Health.
 
She told newsGP that while high vaccine uptake should be a key focus to both avoid future lockdowns and shorten the current lockdown period, it can take weeks to have an effect.
 
‘It takes approximately three weeks for a person’s antibody levels to rise to a level that reduces the risk of symptomatic infection with SARS-CoV-2 by about 50% after the first dose, and a further 2–3 weeks after the second dose to approach the maximum benefit from two doses,’ Professor Jenkins said.
 
‘On the other hand … household transmission is reduced within 14 days of the first jab by 50%, and it’s slightly less with AstraZeneca than with Pfizer, but … it’s a very small percentage difference.’
 
Professor Jenkins also said other public health measures will be a part of life for some time to come, even with high vaccination rates.
 
‘We will not just suddenly go from being fully locked down to being free,’ she said.
 
‘We’re going to have a new normal, which will be about mask wearing; it’ll be about hand hygiene and social distancing, even in circumstances that we haven’t previously had to worry.
 
‘[But] we have to accept there may always be people in our community who don’t regard these laws as applicable to themselves.’
 
To achieve rapid vaccination, Professor Jenkins says multiple strategies must be employed, including encouraging and facilitating vaccination through convenient venues, as well as rectifying the ‘appalling’ messaging around the AstraZeneca vaccine and any misconceptions.
 
‘Thrombosis with thrombocytopenia syndrome [TTS] is a unique syndrome – it has nothing to do with people’s risk of clotting under normal circumstances. We should have demystified this completely months ago,’ she said.
 
‘A very, very vigorous communication process is essential to achieving earlier vaccination – it’s not just about supply; it’s also about enabling people to see the merits of it.’

Young, educated, females were more likely to comply with public health measures like mask wearing.
 
Associate Professor Kleitman agrees that more needs to be done around targeting messaging, especially in light of her research. She says so far none of the advertising campaigns in Australia have tapped into people’s different motivations.
 
‘The message “we’re all in it together” is fantastic, it’s great; it works for the great majority of people,’ she said.
 
‘But, in my opinion, it does not reach non-compliant people because … they prioritise their self-interests. So [by] appealing to their moral obligations, they’re not hitting the right button.’
 
Rather, she says Australia should look to advertising campaigns circulating in New Zealand, Singapore and France, where the message is one of hope and regaining various freedoms, be it seeing family and friends, or attending sporting events or religious services.
 
Associate Professor Kleitman suggests taking the concept of being a ‘freedom fighter’ – which some non-compliant people perceive themselves as – and flipping the message to those who have received the vaccine.
 
‘These people who are having the vaccine are freedom fighters,’ she said. ‘The people who get vaccinated would allow us to come back to some normality in our lives, to regain our freedoms. It’s [about] giving people reasons to get vaccinated and to do it soon.’
 
Both Professor Jenkins and Associate Professor Kleitman believe that incentives for vaccination will also be necessary.
 
Meanwhile, the research indicates that more needs to be done to regulate and monitor misinformation.
 
Associate Professor Kleitman says respected figures such as GPs have an important role to play in communication beyond the consulting room.
 
‘The non-compliant group, they did not have much trust in the government and official sources. So all these messages and news releases may not even get to them – they’re not consulting these sources,’ she said.
 
‘So having a community trusted figure, like a trusted GP, who does an interview on community radio, discussing the vaccine, talking about the positives of getting vaccination, explaining to people what it means, and catering to different cultures.
 
‘These people are trusted in the community.’
 
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