Dr. Joshua Barocas and Gregg Gonsalves, Opinion contributors
Published 4:00 a.m. ET Dec. 7, 2020 | Updated 9:17 a.m. ET Dec. 7, 2020
R-0 may be the most important scientific term you’ve never heard of when it comes to stopping the coronavirus pandemic.
Telling people to ‘just say no’ to human interaction won’t work. Cities, states and colleges should get creative and invest in safe socializing.
What we are doing right now is not working well enough to stem the winter tide of new coronavirus infections. To improve mask wearing, we have either made masks mandatory or shamed people into wearing them. Efforts to improve social distancing have been either theatrical or punitive. Grocery stores and other retailers have marked spots 6 feet apart at checkout or on elevators but have done little to ensure distancing elsewhere in the store. Colleges have taken a largely punitive approach by threatening students with suspension or expulsion for breaking the rules.
We need to make it easier to do the right thing. This means giving people incentives instead of scoldings or penalties.
Data on everything from HIV to vaccines to substance use disorders show that incentives work if they are done correctly. First, the gain of an action or a behavior must be greater than the perceived loss, also known as loss aversion. For example, if someone feels like they are losing personal autonomy by wearing a mask, the incentive has to exceed the real or perceived loss. Next, support must come now and not as some possible future incentive, especially applicable in the culture of immediate gratification in America. Third, incentives must increase over time for those who have changed their behavior, reinforcing cumulative behavior change.
Give out masks, prizes and discounts
What might incentives look like? They should be tailored to particular places and for particular people, so they will be different in different communities. Some states have already laid the groundwork for this.
The Massachusetts Bay Transportation Authority, for example, announced that it would provide riders with masks, in a program backed by New Balance. This type of program lowers the barrier to mask wearing and makes it easier to follow guidance. Other businesses along with the state and/or cities should support free mask distribution at grocery stores, gas stations and retail stores — especially because doing so will keep everyone safe while keeping the economy going during the holiday season.
In Sacramento, California, on Nov. 20, 2020. (Photo: Rich Pedroncelli/AP)
Where else could such partnerships exist? Local businesses could partner with schools to provide prizes for students or classes that have perfect mask wearing — like the Pizza Hut Book It reading program — which would also increase revenue for businesses. Stores can also offer discounts on products to customers who wear masks while shopping and companies could offer additional vacation days to employees.
In Cody, Wyoming, the “Mask Up” campaign enters local businesses that post a photo of their staff wearing masks into a cash drawing. Cities and towns, in partnership with chambers of commerce, can similarly incentivize businesses to encourage mask wearing by employees. Ultimately, the goal of these incentives is to motivate people rather than discourage, anger or dissuade them.
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Furthermore, many of us are craving human interaction, particularly at this time of year when we are used to seeing family and friends. Telling people to “just say no” to socializing won’t work. Therefore, we have to be creative with space, starting with colleges. As has been argued elsewhere, college students are going to gather and host parties, regardless of the consequences. Instead of punishing students for hosting indoor parties, why not have local breweries sponsor outdoor parties where students can socialize (and drink) safely.
Beyond colleges, why not equip more side streets with heat lamps and tent canopies to convert them into pedestrian malls with outdoor restaurants and pubs, as has happened in other parts of the country? Why not temporarily change licensing for food trucks or alcohol serving restrictions so that people can socialize safely outdoors?
Get creative with safe activities
And with winter upon us, states up here in the Northeast should invest in outdoor activities such as offering free entry to municipal skating rinks and subsidizing skate rentals. When it starts to snow, make opportunities in public spaces for families with children to build snowmen, have sleds available at sledding hills or reduced-price cross-country ski rental equipment available at retailers like REI. Just because it’s cold doesn’t mean we can’t make more use of the outdoors.
Some people, especially low-wage workers or others facing barriers to staying safe, need more than small incentives. Businesses should offer sick pay, paid time off, and free or reduced cost child care.
In some cases, incentives are needed for an entire entity. This is where the government can step in. Just as tax credits are offered for installing energy-efficient appliances, homeless shelters and jails and prisons should be given tax credits for upgrading ventilation systems and creating spaces that are conducive to health.
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We need to scale our efforts toward helping people make healthier, safer choices based on their needs. One size won’t fit all, and many people will require more than a nudge to be able to make it through this winter.
If government and other civic leaders are truly serious about ending this pandemic, then they must understand that their just “be smart” or “don’t be stupid” approaches are not working. Investing in helping people stay safe is the better way to break the chains of infection that the coronavirus depends on to flourish, and get us back to something like normal sooner rather than later in the United States.
Dr. Joshua Barocas is an infectious diseases physician at Boston Medical Center and an assistant professor at Boston University School of Medicine. Gregg Gonsalves is an assistant professor of epidemiology at Yale School of Public Health and a 2018 MacArthur Fellow. Follow them on Twitter: @jabarocas and @gregggonsalves
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