The pandemic and the spread of contagious messaging

During this pandemic, we’d do well to be mindful of what we spread.

Contagious messaging

Foreword

At ELSE we dedicate time to R&D and self-initiated projects with varying themes. The following piece is the output of one such project, investigating the virulent spread of fear, uncertainty and doubt during the pandemic.

Introduction

As reports of a cluster of pneumonia cases first reached the public on the last day of 2019, few understood the disruption this novel Coronavirus was going to inflict on the new year.

But very early on, it became clear that the Coronavirus wasn’t the only thing spreading rapidly across the globe. With this global pandemic came another equally virulent infection – its three main symptoms — fear, uncertainty and doubt.

Wet markets, official announcements, ‘the science’, endless public discussion, masks — you don’t need them, you do need them — lockdown, essential businesses, flatten the curve, Protect the NHS, Save lives. Second waves, 24-hour news bulletins, ‘the data’, case numbers, death numbers, ‘COVID deaths’, deaths with COVID, deaths from COVID, excess deaths, R numbers and international league tables. All this brought more questions, skepticism and confusion, public judgement, ‘COVIDiots’ and ‘COVID marshals’. Not enough information, too much information, the wrong information, changing information. The new normal.

It all felt so overwhelming.

Messaging today is no longer the preserve of a few trusted sources. Gone are the days when government ministers and newspapers of record were the select purveyors of tightly focused information.

Coordinating messaging well today, especially crisis messaging, is close to impossible. Twitter, Facebook and a million other sources are all trying to get your attention — and succeeding. This makes it hard for national governments and global health organisations to keep their guidance clear, coordinated, and in step with fast-changing national and international situations.

Fear, uncertainty & doubt

As the information flooded in, so did the fear, uncertainty and doubt that comes with facing a new, unknown threat — an invisible threat. Fear of the virus, fear for ourselves, fear for our friends and loved ones, fear for our jobs and our futures. The fear was not only palpable, it was measurable — and that wasn’t an accident.

While the messaging put out by official sources was intended to encourage actions that protect public health, the bombardment of messaging hasn’t always been calibrated to reduce alarm and fear. In practice, some messaging has been specifically formulated to encourage a sufficient sense of baseline threat in order to increase public compliance with guidance and rules.

The perceived level of personal threat needs to be increased among those who are complacent, using hard-hitting emotional messaging.

UK Scientific Advisory Group for Emergencies (SAGE), 22 March 2020

But do fear, uncertainty and doubt effect action?

Research by the UK-based Behavioural Insights Team has pointed to a relationship between a person’s level of worry and their ability to recall guidance messaging, as well as their willingness to engage with it.

While low recall was predictable among those reporting low level of worry, this was only partly caused by shorter periods of engagement from low levels of interest. The research also suggests that those who were highly worried also struggled to recall guidance messaging. This points to a state of mind that disrupts our short-term memory.

This general relationship was present across all groups, regardless of other demographic factors.

There were also disparities in how different age groups reacted to prolonged periods of heightened threat from COVID-19. In the weeks surrounding UK-wide lockdown implementation on 23rd March, despite rising numbers of cases, under 25s held to a fairly constant level of worry, both before and after lockdown was implemented. The percentage of under 25s reporting ‘very’ or ‘extremely’ worried about Coronavirus was relatively stable at ~50–55%.

By comparison, 25s and over became increasingly more worried as the number of cases rose in the UK, peaking at ~70–75% in the week following UK lockdown. 

Source: Behavioural Insights Team

This disparity points to the need for additional emphasis to reach the under 25s group, most viably through methods and channels more targeted to that group.

The trust issue

…many people think of what they see as poor journalism and hyper-partisan political propaganda as parts of wider misinformation problems, and that people are often very worried about the authenticity and veracity of much of the information they come across online…

Source: Reuters Institute, Navigating the ‘infodemic’, 2020

Trust was among the first casualties of the pandemic. The ‘infodemic’ coupled with historically low trust in government and institutions, partisanship — or perceived partisanship — across many media outlets, as well as disturbingly low levels of trust, all points to another battlefront in the war against Coronavirus.

Source: Reuters Institute, Navigating the ‘infodemic’, 2020

While still among the most trusted sources, inconsistency and ambiguity in statements by government scientists and leading health organisations have further eroded public trust in Coronovirus guidance.

Quarantines, lockdowns & social Distancing

Testing our resilience, and piling on psychological stress

The world’s biggest psychological experiment

Source: World Economic Forum, 2020

The international response to COVID-19 has typically involved varying levels of national lockdown — with one of the early actions being to lockdown international travel to limit in-bound sources of infection. At national level, many countries locked-down quite harshly, closing non-essential businesses, with ‘shelter-in-place’ guidance for the general public.

At the peak of the lockdown, around one-third of the global population was in lockdown, with limits on many aspects of our normal daily lives such as ‘non-essential’ trips to the shops. We stopped going to work, with many put on extended furlough, while others lost their jobs altogether. Schools were closed with many kids and students forced to miss both their education and the social benefits of school. ‘Non-essential’ visits with friends and family were prohibited — we heard harrowing stories of families prevented from being with dying loved ones. Medical checks or treatments were postponed, while resources were prioritised towards the Covid medical response. And all the while we were being instilled with a general fear about basic person-to-person contact.

A lockdown such as this had never been attempted on this scale before — and the effects would be unknown.

Early plans were formulated on the expectation that lockdown would be limited to a few weeks — on the belief that populations would grow fatigued and intolerant of the measures. However, like many others, the UK’s national lockdown measures were kept in place for over five months — staying in place beyond every prediction. Measures were lifted in phases, with many still in place today. And some countries are now introducing measures that equate to a second lockdown. In the UK, we’re now live in tiers — according to our postcode — with the rules governing our lives changing on a daily basis.

Source: Statista.com

‘The New Normal’

The lockdown experience became so habituated it was referred to as ‘the new normal’. Many are concerned that lockdown measures will not be lifted well into 2021. And many fear we may never return to how society functioned pre-Covid.  Personal and social anxieties are becoming deeply entrenched.

However, we’ve only just begun to discuss the mid/long-term impact of this new normal. We’ve been so focused on the immediate threat from Covid-19 that the psychological impact of such comprehensive restrictions of our ability to interact socially, to earn income, and to get an education, means we’re storing up emotional and mental anxiety that will surface later, as personal resilience levels drop across the population.

This has been made worse by the confusing and sometimes contradictory guidance and data given by official sources, compounded further by erratic guidance from other unofficial sources.

The behaviour change challenge

As the UK confronts a possible second wave, the biggest challenge the government still faces during the Covid-19 pandemic is convincing people to change their behaviour and lifestyle.

In principle, there is nothing necessarily wrong with the guidelines and measures that are put in place, however, it’s fair to say that their effective adoption is far from being successful.

The government rightfully understood — on a macro level — the key to controlling the spread of the virus was social distancing, being able to track and trace infection cases, and maintaining a thorough hygiene etiquette while behaving respectfully towards those around you.

All that seems to make sense in theory, but in practice it is a much more nuanced challenge. How do you make sure that the message lands for every audience and behaviour change is adopted on a massive scale? 

The government’s belief appears to be that providing enough information would lead to people making the right decisions. However, even if we might argue that the message content was right, the platform that was used to engage with the public was definitely ineffective. 

The government’s approach has been to address the nation through traditional channels, hoping to reach maximum audience —  but in 2020 things are a bit different. 

Sure there’s still some boomers that rely on telly to get their news updates, but what about everyone else?

Designing a better experience for all

We’re talking about experience design — improving the experience for 65 million (UK) or 7.8 billion (global) users. The scale of this challenge means we can’t tackle it in the usual ways.

As experience designers, our first line of investigation before designing any solution is to understand the users. What is their context? What are their motivations, pain points and emotional states? What tonal qualities should our language have to make sure the message lands in the most effective way? There are an array of frameworks and models that can be effective… 

In this case, the main challenge presented in the brief is how to tackle behavioural change. So, in the next few paragraphs we are going to try and use some of the variables in the MINDSPACE model to see how we could have created a more effective platform to nudge new behaviours on a mass scale.

The messenger

‘If the audience can identify with the messenger, the more effective the message will be.

The reality is that the public seldom identifies with Westminster. The connection is too weak for the message to land effectively with this blanket approach.

Instead, we would look at creating a more decentralised communication network that delegates the diffusion of the message and promotes the right behaviours.

If we consider a single strand within the network, it could look something like this:


What we’re doing here effectively is minimising the distance between messenger and audience, making sure the connection is stronger and giving the message a chance to land successfully.

In other words, to reach wide you have to aim narrow.

Incentives

‘Give people something to gain as well as lose

Perhaps the biggest fiasco has been the failed attempt to launch the notorious Track and Trace app (original name used). Putting aside privacy concerns, there simply wasn’t any incentive for people to download the app.

Some will argue it was all about good citizenship and the greater good, but that was simply naive. If the target was maximum downloads and activations then the app should at least offer some perceived value to the user.

Failing that, research has shown people are more sensitive to losses than to gains. As such, rewards should be offered in a loss frame: “Miss out on priority testing if your household members are not registered” 

Priority passes could be activated on registration but revoked if usage was not sustained.

Norms

Source: Financial Times

Since the beginning of the pandemic, the public has been bombarded – in a never-ending news cycle – with data. Populations unversed in how to analyse and digest statistical information is being fed numbers of cases, numbers of deaths, deaths with Covid, deaths due to Covid, how those deaths were spread across age groups, risk exposure, how UK death rates compared to other countries — a practice impervious to genuine understanding and of almost no medical value due to the incalculably different social and structural circumstances of every other country.

Sure all these numbers have their place in understanding how we are doing at a macro level, but from an individual perspective it’s really hard to put them in context and make sense out of them. They are simply too abstract.

To remedy that, we should look instead at the communicating information at a smaller scale. People really want to know: How is my community doing? Is the school my children attend safe? How is it faring against other schools near-by? What are similar households to mine doing well and what can I do to minimise my risk?

Of course, this is not possible to cover in a 15-minute slot during the news. That’s why we think decentralisation and delegation of responsibility is key yet again. 

To enable community leaders to play that role we would look at building the right tools, channels and services that would allow them to monitor gather and share data in more meaningful user contexts.

Defaults

How do you convince 60+ million people to voluntarily install and use an app that offers no immediate perceived value to the user? You don’t. You simply can’t expect people to behave the way you want them to behave (rationally).

An opportunity was missed in the beginning where tech giants like Apple and Google offered help to co-develop the contact tracing technology as a built-in feature on their smartphones. If adoption of the app was vital to controlling the spread of the virus, then all smartphone users should have been automatically opted-in with the option to opt-out if they were not willing to use it.

According to Statista, approximately 95% of UK households own at least one smartphone. Of course, that doesn’t necessarily translate to 95% of the total population, but adoption numbers would have been a much greater than those of the original contact tracing app. 

In recent weeks (date of writing is the 16th October 2020) we have seen access walls put in place on some services. For example, high street coffee chain, Costa, won’t allow entry to anyone that doesn’t have the app installed. However, in times of crisis, decisive action is needed and that means this model needs to be put in place and communicated much more quickly as the default modus operandi for all services.

Another default that could have been put in place is the use of access walls for used services. For example, instead of using an Oyster card, use your phone to travel in the underground. If you don’t have the app or should be isolating then you can be denied entry.

The positioning could always be made more palatable to the audience. That’s where politicians can do what they do best and present it as gateway to access and safety instead of restrictions to access and freedom of choice.

Users are people

It may sound obvious, but it’s crucial to understand.

Today we won’t go on and expand the rest of the MINDSPACE model to see how each of the remaining variables (salience, priming, affect, commitment and ego) could help us design for behaviour change.

The main takeaway at this point is that as experience designers, whenever we are tasked to design around users, we study and empathise with them. We try to understand their context, motivations, pain points and behaviours to help us design something of value for them with the right incentives.

But before even doing that we need to know who these users are at a more meaningful altitude. It shouldn’t just be about geographical context and age group. It should be about Dave who has a family of four, a wife that has been made redundant and a nan that lives by herself. It should be about Lisa who is a single 20 year old freelancer that lives in London in a flat share, and Doreen who is 90 and doesn’t even have internet access.

If we’re asking these people to change their behaviour and lifestyle, we need to know and show them that we know who they are. Only then we can find the right message and tone to reach them.

Designing for emotion

If the MINDSPACE model gives a blueprint that can help us nudge behaviour, an adapted Experience Framework can help us build an emotionally intelligent platform capable of understanding user emotions. It can provide the right mechanisms to help us shift an initial emotional state to a desired one, and further drive behaviour change.

Since the start of the pandemic, we’ve felt a lot of things. We’ve been confused, fearful and panicked. We’ve felt isolated, tired and for a brief moment, we were optimistic only for the cycle to start all over again. 

Yet, information and calls to action were not nuanced. Delivery of information — whether through traditional (TV) or digital channels (.gov) — was done in a linear fashion with information catering for everyone and no one at the same time.

Instead, we could have put in place a service much more targeted to a person’s current needs. By understanding the emotional state of a user as they deal with the pandemic and the lockdown, we could allow him or her to access what they need and pre-empt what they might need next.

When someone is emotionally distressed, how we say things are as important as what we say. And for the message to land effectively, a lot of times we need to shift their current frame of mind to a more positive one.  

Firstly let’s have a look at some key emotional states that people are going through during the lockdown and the desired shifts we would like to achieve.

  1. Uncertain → Reassured
  2. Isolated → Supported
  3. Despaired → Hopeful 
  4. Angry → Calm/Appeased

These emotional shifts can be used as the mechanism to qualify users and serve them the right information at the right depth, with the right tone.

For example, for someone who has been furloughed and is looking for information about how to deal with the situation, the content served to him or her could be prioritised and nuanced with an emphasis on reassurance and support.

The imapct of Covid 19 messaging

Whereas for someone who has had to cancel a wedding and deal with emotional and financial losses, the content and tone could have a greater emphasis on appeasement and hope.

The imapct of Covid 19 messaging

We’ve written an in-depth perspective on this emotional design framework and you can read more about our approach here.

Why so serious?

It’s long been known that successful advertising often plays back relatable problems and uses fear to make you buy the solution (i.e. their product). And negative news will always spread faster than good news, especially if there’s a risk to our own lives, or to our inner circle.

We’re also seeing first-hand during this pandemic that giving us instructions ultimately has much less impact than showing us consequences. Consider the sudden rise of toilet roll sales: we all saw and many of us were scared of an impact, so rushed down to the shops to buy as much toilet roll as we could. It’s difficult for the government to control this type of behaviour, but it actually may have helped demonstrate the importance and seriousness of the epidemic itself. Seeing shelves empty in a local store for the first time ever made consumers question the scale of the problem.

It is worth noting here that the UK has seemed to be collectively dealing with the pandemic almost patriotically. Did this help the country come together and act collectively? The applause for the NHS definitely brought a sense of communal spirit. This positive messaging alongside the negative threat of the virus helped the country pull together as one and momentum increased. But, as winter closes in, the arrival of a second spike and another lockdown begs the question: will we see the same response a second time around?

One thing the UK government seems not to have accepted is that it’s nearly impossible to strike the right sentiment for everyone — from teenagers to ageing grandparents alone in a care home — at the same time. Varying tones of messaging and different approaches are needed. Along with different platforms and communication methods.

In their messaging, the government has leaned on science and facts to try and convince the nation they’re doing the right thing. But would a local, more focused approach have been more effective? Would that make things feel more real and related to me? Or would this give even more options for the message to get lost in translation?

There are five principles that make an advocacy programme work:

  1. Clarity of purpose

Helping me understand what, why and how my life is impacted is crucial. When there is clarity of purpose, you know what steps to take. You can then focus all attention on the collective goal.

2. Safeguarding

This term is used to denote measures to protect the health, well-being and human rights of individuals. For us to trust and comply with the rules, we need to feel comfortable and safe within them.

3. Confidentiality

It establishes a relationship of trust that enables people to tell their stories and explore the options available to them, without their data or information being used in the wrong way.

4. Equality and diversity

Advocacy projects should be able to meet the needs of diverse local populations.

5. Empowerment We need to know we can play a part and make a difference. Advocacy services need to be focused on the person they are working with. One way of achieving this is to make sure people have meaningful influence over the direction of that product or service.

How could this have been used to help communicate to the whole nation and use them as advocates? In a decentralised model it would be far easier to work with and tweak the messaging for specific groups as opposed to updating a blanket message for everybody.

So, what lessons have been learned?

What changes have the government made in their latest release to be more effective with the public?

Since the re-release of the Test and Trace app, the government have made some significant improvements — not only the way the app works, but also how they’ve communicated its usefulness and importance to everyone. The main change was the tone and positioning — from a casual download to a plead with the second SMS, directly requesting you to download and keep people safe.

Dido Harding, Executive Chair of the NHS Test and Trace Programme, said:

“It’s really important that we make it as easy as possible for everyone to engage with NHS Test and Trace. By launching an app that supports our integrated, localised approach to NHS Test and Trace, anyone with a smartphone will be able to find out if they are at risk of having caught the virus, quickly and easily order a test, and access the right guidance and advice.”

The updated Test and Trace app has a range of additional, enhanced features that will help to reduce personal and public risk from COVID-19 as part of the end-to-end NHS Test and Trace service:

  • Alert: letting users know the level of coronavirus risk in their postcode district
  • QR check-in: alerting users if they have recently visited a venue where they may have come into contact with someone who later tests positive with COVID-19
  • Symptoms: allowing users to check if they have coronavirus symptoms and see if they need to order a free test all in one place
  • Test: helping users book a free test through the app and get results quickly to know whether they have COVID-19.
  • Isolate: if a user is told to self-isolate, a timer feature will help count down that period and access will be provided to relevant advice

These new features reflect a more considered, empathetic understanding of our states of mind. They’re more informative, proportionate and helpful. In themselves, they may not alleviate the anxiety that has been building since the pandemic first hit, but we can be reasonably certain that they’re no longer adding to it at the same rate.

So when can we go back

We’re all keen to see some kind of return to normality; to return to normal work, normal school, normal days, normal evenings — normal life.

With second waves, new returns to lockdown, new lockdown programmes, and yet no real understanding of when a vaccine might become widely available, the reality is it’s likely to be a while before we can truly return to something resembling ‘the old normal’. As long as we don’t feel safe from this invisible threat, safe from fears of losing our jobs, and safe from feelings of separation and isolation, we’ll continue adding to our backlog of anxiety.

Messaging and communication will again play a critical roll, and we’ll need to see dramatic improvements over previous months.

And let’s not forget that with such an intense focus on our COVID response, thousands if not millions of people with ongoing physical and mental health concerns have been moved to one side. We need to start talking more, and more effectively, about these unique needs that will need to be met.

Even once we’re clear of COVID itself, we’ll be dealing with the consequences for years to come. We’re going to need to keep learning the lessons from this experience and making better choices in future. And the only way to do that is to take the time to truly understand one.

And this all starts with empathy.

Headline image Courtesy of Sky News: UK’s initial COVID-19 plan would have been ‘catastrophic’, says Donald Trump



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