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Mask Your Neighbour As You Mask Yourself

Mask your neighbour as you mask yourself: Lessons in Solidarity, Kindness, Forgiveness, and Love

Much of the NZ success in combating COVID-19 has come from a high level of public engagement with the stringent methods used to eliminate the virus. Social Psychology provides some key lessons for how we might further cocreate more meaningful and practical behavioural change. We only have to look to the recent resurgence in Auckland to understand the complex an unpredictable nature of the virus. And with ever increasing pressure to relax border control, and the increased likelihood of community transmission during winter months [1], one further cultural shift NZ could make is the psychological preparation for community mask use in the event of ongoing future resurgence. This blog explores the importance of identifying and fostering synergies between top-down and bottom-up Sociopsychological approaches.

This blog attempts to extend the epidemiological psychosocial approach to the web of causation [2], [3] by integrating key mechanisms from social psychology. Such an approach acknowledges that social dynamics constitute a critical and often under-acknowledged aspect to the theory and practice of epidemiology [4], [5]. Thus, a distinction between a reactionary stance to public health and a more meaningful approach might lie in how key individuals and groups might more mindfully engage with one another. Furthermore, a social-psychological approach acknowledges that such interactions within and between communities act as fundamental mechanisms which drive and shape long-term outcomes. Nancy Krieger and colleagues have coined the image of an eco-social epidemiology which views the agency and accountability of individuals as a critical element of population health and well-being. This eco-social image allows individuals to be rightly perceived as an integral part of society and yet still affords people their individuality [4].

Rather than battling the so-called “lockdown fatigue” seen in countries around the world, New Zealand due to the 100 days we had between confirmed cases of Community Transmission must be mindful of hubris and/or complacency. The WHO has recently come out and said in regards to COVID-19 there may be “no silver bullet”, and that we may need to learn to accept the challenges of living “with” rather than “without” this virus at least into the foreseeable future.

The Importance of Top-down Leadership and Science during Public Health Emergencies.

Not only has the steady hand of leadership and centralised fact based messaging played a key role throughout the New Zealand response, research has found that during times of crisis central individuals, such as politicians, experts and media personalities play a crucial role in the emergence of prosocial behavior [6]. Fortunately in New Zealand, central figures, including both public/private institutions and commentators have tended towards embracing science as opposed to sensationalism. In particular the science of epidemiology offers more promise to human flourishing than is captured by the narrative of simply preventing disease. Due to its multidisciplinary nature, epidemiologists have not always agreed on the most pressing determinants of population health. Although ‘multiple causality’ is generally accepted, there are still camps who prefer to take a more biologic, unidirectional approach [7], [8]. This functionally fixated approach does not acknowledge the complex digital world we live in today, where peripheral factors such as social contagion [15] and adjunct leadership can both help and hinder traditional medical interventions.

The Importance of Bottom-up Community and Social Dynamics during Public Health Emergencies.

The process through which public health interventions scale up is not always straightforward. As the disparity of successful interventions around the world illustrates, achieving full compliance on any one intervention, does not guarantee the desired population level outcomes. Research into social norms suggests that normative behaviours are always undergoing some form of evolution – for better or for worse. Under the right conditions, social norms can be gradually encouraged to support prosocial behaviour [9], [10]. Nobel laureate Ellinor Ostrom’s body of work may hold some of the answers. Ostrom highlights how communities can successfully manage common pool resources [11], and illustrates how, by incorporating a participative institutional design, communities can govern themselves to meet collectively desired outcomes [9]. Due to the complex social dynamics in play, New Zealand might look to leverage social norms as they emerge to effect behavioural change in a positive way [12], [9], [11], [13].

A starting point might be the framing of mask wearing in moral terms by pointing out the benefits to both individuals and the greater collective good. Unfortunately, the simple facemask, which should have been a straightforward public health intervention has found itself as one of the most contentious symbols of the pandemic. From the earliest days of the NZ lockdown, I have been arguing that mask-wearing needs to be reframed, to not just protect oneself, but to protect others, and as a gesture towards solidarity. This subtle shift in framing empowers individuals and their communities from the bottom up to take control of their individual and community health and wellbeing.

By enabling a participatory institutional design framework to evolve, New Zealand may be better suited to leverage the social network effects already in play and in turn avert the mask version of the tragedy of the commons [14], [15], [16]. For example, in East Asia, a strong sense of collective responsibility has emerged as a way to signal the importance of wearing a mask. South Korea in particular, who have embraced both mass-masking and digital technologies, perfectly illustrates how community-led sanctions emerge and scale up through loosely coupled social networks that reward prosocial behaviour. New Zealand’s leading community psychologist, Niki Harré, in her 2018 book ‘Psychology for a Better World’ [17] highlights that in order to achieve a more sustainable world, it is not necessary that everyone be morally driven, just that enough of us are, in order to nudge our collective behaviour towards the most desirable outcomes [18].

Lessons in Solidarity, Kindness, Forgiveness and Love

  • Solidarity

Humans are first and foremost social beings and learn best by observing and imitating one another [17]. This suggests that the examples individuals and groups set through their own actions within localised social networks and their wider community greatly influence macro level phenomena such as public health. An illustrative example of this has been the Czech Republic #Masks4all movement, which combined both fun and solidarity within a grassroots mass-masking campaign. Through leveraging the ingenuity of homegrown sewing enthusiasts and the collective spirit of social media personalities, the republic moved beyond both their supply chain issues and cultural hang ups around masking in a matter of days. New Zealand is already famous for its number eight wire mentality. To gain even further leverage we might do well to encourage public personalities and New Zealand leadership to don a mask publicly. This will send a powerful signal to our international fraternity that us Kiwi’s are an emphatic partner in the global fight against COVID-19.

  • Kindness

Inherently people want to do good, and especially during times of crisis, moral framings that nudge us towards notions of being kind resonate deeply [18]. Harré speaks of the importance of framing existential-like challenges in positive terms [17], which extend upon Rappaport’s community narrative concept of highlighting ‘tales of joy’, rather than ‘tales of terror’ [19]. Fortunately, our government has already incorporated notions of “being kind” into their public health messaging campaign. In practical terms, during the middle of the lockdown we saw New Zealanders respond positively to both the Teddy bears in the window and the ‘stand at dawn’ Anzac celebration. If the resurgence of COVID-19 were to go beyond the two week lockdown the masking debacle and arguments around loss of liberty would likely continue. As a country we might do well to take the message of kindness and frame the concept of ‘community-masking’ as a tale of joy, one in which wearing a mask is not just about being kind to oneself, but of showing kindness to our team of 5 million.

  • Forgiveness


As historian Carlo Ginzburg has chronicled, during severe outbreaks of disease, societies often resort to scapegoating others as a means of discharging all kinds of fears, hatreds and tension [20]. A modern-day example being the antisocial outbursts towards masks that has gone viral online. Instead, New Zealand’s approach has valued empathy and kotahitanga as a way of navigating this public health emergency. To further extend this approach, individuals, communities and government bodies might do well to embrace the practice of forgiveness and empathy for others, which can be made salient through community mask wearing. The philosopher Keith Yandell argues that forgiveness, when offered and accepted, demonstrates the human capacity to restore the common bonds of humanity. This is especially important if we share the cosmopolitan goal of flourishing together as communities and individuals [21] in times of crisis. As a starting point, this practice might entail learning to forgive and looking towards a spirit of compassion even when we are deeply disappointed at a social response. Practicing forgiveness sets the stage for present-day communities to leverage the ancient wisdom of the golden rule: “doing unto others, as you would have them do unto you”.

  • Love

Even prior to the Covid-19 pandemic, following the attacks against humanity which took place in Christchurch on March 15th, 2019, New Zealanders nationwide demonstrated their immense sense of fortitude. An outpouring of love flowed from the hearts of politicians and public figures and the New Zealand people as a whole. New Zealand’s sense of community and its focus on solidarity in times of crisis signaled to the world that through love, we can conquer even the most dire of adversities. In the current COVID-19 context, due to our relative success on the global stage, New Zealand is well placed to summon “our team of 5 million” to come together and share our kotahitanga and aroha with the world. Through the combination of public figures, community and heart, us Kiwis might do well to reframe the simple act of donning a mask as one that does not just contribute to individual level outcomes, but as a behavioural trace of our individual and collective intention to show love. We have all heard the famous maxim “love thy neighbour as thyself”. In effect, COVID-19 extends the logic underpinning this age-old maxim: mask your neighbour as you mask yourself.

References

  1. Sajadi MM, Habibzadeh P, Vintzileos A, Shokouhi S, Miralles-Wilhelm F, Amoroso A. Temperature and latitude analysis to predict potential spread and seasonality for COVID-19. Available at SSRN 3550308. 2020 Mar 5.
  2. Cassel J. Social science theory as a source of hypotheses in epidemiological research. American Journal of Public Health and the Nations Health. 1964 Sep;54(9):1482-8.
  3. Syme S. L. Social determinants of disease. In Maxcy-Rosenau-Last Public Health & Preventive Medicine. 13th edn. (Edited by Last J. M. and Wallace R. W.), pp. 687-700. Appleton & Lange, Norwalk, CT, 1992.
  4. Krieger N. Epidemiology and the web of causation: has anyone seen the spider?. Social science & medicine. 1994 Oct 1;39(7):887-903.
  5. Krieger N. Proximal, distal, and the politics of causation: what’s level got to do with it?. American journal of public health. 2008 Feb;98(2):221-30.
  6. Kovářík J, Brañas-Garza P, Cobo-Reyes R, Espinosa MP, Jiménez N, Ponti G. Prosocial norms and degree heterogeneity in social networks. Physica A: Statistical mechanics and its Applications. 2012 Feb 1;391(3):849-53.
  7. MacMahon B, Pugh T, Ipsen J. Epidemiologic methods. Little, Brown and Company Boston, 1960.
  8. Susser M. Epidemiology in the United States after World War II: the evolution of technique. Epidemiologic reviews. 1985 Jan 1;7(1):147-77.
  9. Ostrom E. Collective action and the evolution of social norms. Journal of economic perspectives. 2000 Sep;14(3):137-58.
  10. Cialdini RB, Kallgren CA, Reno RR. A focus theory of normative conduct: A theoretical refinement and reevaluation of the role of norms in human behavior. InAdvances in experimental social psychology 1991 Jan 1 (Vol. 24, pp. 201-234). Academic Press.
  11. Ostrom E. Neither market nor state: Governance of common-pool resources in the twenty-first century. Washington, DC: International Food Policy Research Institute; 1994 Jun 2.
  12. Neaigus A, Friedman SR, Curtis R, Des Jarlais DC, Furst RT, Jose B, Mota P, Stepherson B, Sufian M, Ward T, Wright JW. The relevance of drug injectors' social and risk networks for understanding and preventing HIV infection. Social science & medicine. 1994 Jan 1;38(1):67-78.
  13. Schultz PW, Nolan JM, Cialdini RB, Goldstein NJ, Griskevicius V. The constructive, destructive, and reconstructive power of social norms. Psychological science. 2007 May;18(5):429-34.
  14. Hardin G. The Tragedy of the Commons. science, 162. Journal of Natural Resources Policy Research. 1968;162(13):3.
  15. Gino F, Ayal S, Ariely D. Contagion and differentiation in unethical behavior: The effect of one bad apple on the barrel. Psychological science. 2009 Mar;20(3):393-8.
  16. Ostrom E. Tragedy of the commons. The new palgrave dictionary of economics. 2008;2.
  17. Harré N. Psychology for a better world. Auckland University Press; 2018.
  18. Thaler RH, Sunstein CR. Nudge: Improving decisions about health, wealth, and happiness. Penguin; 2009.
  19. Rappaport J. Community narratives: Tales of terror and joy. American journal of community psychology. 2000 Feb 1;28(1):1-24.
  20. Cohn SK. Pandemics: waves of disease, waves of hate from the Plague of Athens to AIDS. Historical Research. 2012 Nov 1;85(230):535-55.
  21. Enright, RD, North, J. (Eds.). Exploring forgiveness, University of Wisconsin Press, Wisconsin, 1998

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