A vaccine could turn out to be a double-edged sword4 min read . Updated: 08 Oct 2020, 08:19 AM IST
Its availability could lower people’s risk perceptions and stoke attitudes that worsen the pandemic
There are many who believe that with the discovery of a vaccine, all the problems related to the covid pandemic will be solved once and for all. So far, all the measures taken were only to slow the spread of the virus. News of the development of a usable vaccine, a clear preventive solution, will be a relief for everyone. But there is a problem. It could set in motion new problems of human behaviour.
Until now, there existed a sense of vulnerability about the virus. Although a small segment of people refused to wear masks and maintain social distance, the majority displayed caution and obeyed regulations. But perceptions of risk are not constant.
Individuals behave more cautiously if they perceive greater risk or danger. Risk levels are reduced by the introduction of various safety measures and equipments. This is where the vagaries of human behaviour set in. Studies show that as risk levels are brought down, humans tend to indulge in riskier behaviours. This inadvertent increase in risk-taking after interventions are introduced to reduce risk is termed “behavioural disinhibition" or “risk compensation".
This concept has been observed widely in various contexts, such as road safety, contact sports, and HIV prevention. When drivers use safety features like seat belts, helmets and anti-lock breaking systems, an extra layer of safety gets introduced. But due to the added feeling of safety this gives, the phenomenon of risk compensation tends to take effect, leading drivers to indulge in riskier driving. Similarly, players in contact sports who use protective gear tend to indulge in more dangerous tackles. The phenomenon of risk compensation was visible during the HIV epidemic too. HIV-prevention measures, such as vaccines, topical microbicides, antiretroviral medications, and male circumcision, which had the potential to lower perceptions of risk, also encouraged risk-taking behaviour patterns.
Once news on the discovery of a covid vaccine is made public, risk perceptions associated with the virus are bound to get diluted. As the health threat is popularly seen to recede, a sense of safety would replace the current feeling of vulnerability to corona infection and illness. This is an ideal situation for risk compensation to set in. Behaviours like wearing a mask or staying apart from others in public, which are results of a heightened feeling of risk, could begin to disappear. Studies have shown that risk compensation’s greatest impact is on interventions that are seen as intrusive or conspicuous. Wearing masks and maintaining social distance in public places are not particularly intrusive but do stand out.
Thanks to the pandemic, people were denied the opportunity to congregate in groups for many months. Due to the phenomenon of risk compensation, people are likely to display a stronger tendency to indulge in the very activities they were restrained from. Governments, which are already under pressure to open up the economy, might find it difficult to strictly enforce the restrictions that earlier helped slow down the spread of coronavirus. All this could lead to another large spike in infections.
It will be ironic that a vaccine created to address the pandemic would in a way cause a huge spurt in it. It will take several months, if not years, after the availability of a vaccine for a substantial number of people to be inoculated. Until that happens, one would not be able to say that the covid pandemic has been successfully contained. So, it is important that no dilution of risk perceptions and resultant risk compensation take place until a sufficient number of people have been inoculated against covid-19. How do we do that?
First, we need to get world leaders to act more responsibly. There are several of them who had an air of invincibility before the pandemic. Some of them dismissed the seriousness of it. Others gave the impression that the fight against the pandemic would be quick. But as infections raged on for several months, some of these leaders had to eat humble pie. A few seem keen to use a vaccine as a personal victory over the pandemic. While doing so, they might convey a feeling that the problem is over. This will send out wrong signals to ordinary citizens. Such leaders should be advised caution and they must communicate that the fight against the pandemic is far from over. They must reinforce the need to stay cautious for a sustained period of time.
The HIV pandemic showed that it is very difficult to restrain individual behaviour. Once the initial fear of HIV subsided, it was difficult to get individuals to practise safe behaviour like using condoms. It was comparatively easier to get institutions to adopt safety measures. Blood banks introduced HIV tests of donors, health facilities adopted disposable syringes, and barber shops started using disposable blades. This holds lessons for covid management too.
The pandemic should help establishments introduce new institutional behaviours. They should insist on hand-washing before entering a building. Common places should be cleaned with disinfectants frequently. They should be encouraged to change their seating plans so as to help their customers maintain social distance. Establishments should also be advised to play up their own safety protocols.
A vaccine for covid is a double-edged sword. Policymakers should be careful how it is used.
Biju Dominic is the chief evangelist, Fractal Analytics, and chairman, FinalMile Consulting