Personal responsibility has become a defining feature of the Government and Nphet’s advice on dealing with Covid-19. An approach with very limited evidential value is now deeply embedded and deeply divisive.
As we face into another difficult few months, calls for increased personal responsibility, as well as having little value, are damaging. There are a number of reasons why this is the case. And each is worth rehearsing if we want to avoid the mistakes of the past.
First, personal responsibility is linked to an implicit – and even explicit – suggestion that rises in infections are the result of irresponsible behaviour. Those who were responsible for the increase in cases variously held house parties, didn’t mask or went on foreign holidays.
If people cannot follow advice due to life circumstances, solidarity between leaders and their followers is undermined. Messages fall on deaf ears
Emphasising personal action as key to prevention of any disease invariably results in criticism of those affected. This is the first step towards stigmatisation of a disease and those affected by it. The evidence is that it reduces the likelihood people will come forward for testing, and if they don’t, this ultimately increases transmission.
Second, advice that relies on personal responsibility assumes that the risks people encounter are all under their control. Consider the advice to reduce close contacts. Some people need to use public transport.
There they cannot avoid contact with others. Children of single or cohabiting working parents generally have contacts in creche, school or during post-school childcare. These contacts cannot be reduced. Advice to manage contacts responsibly is pointless if contacts are not discretionary.
In the current circumstances, those living a life without playdates and pantos can feel that the challenges they and their families face are not understood by leaders tasked with protecting their health.
If people cannot follow advice due to life circumstances, solidarity between leaders and their followers is undermined. Messages fall on deaf ears. And followers seek new sources of (mis)information and comfort from those who appear to share their concerns.
Third, stemming a surge of Covid-19 through individual action is a plan that defies science. My risk is linked to how infectious others are. And so is yours. Whether I choose to wear a mask, restrict my movements or keep my distance alters your risk. Covid spreads between individuals. Messages relying on personal responsibility make little sense because they run counter to what we know about transmission of Covid.
Divided we fall
Similarly available evidence including research undertaken in Ireland shows language matters. The most effective way to promote Covid-19 protective measures is by emphasising “we” not “me” – the collective, not the personal.
Addressing people to emphasise the collective, rather than the personal focus now being taken by both Government and Nphet, improves our ability to work together, emphasises our similarities and ultimately maximises adherence to protective health guidelines.
Fourth, this approach gives rise to increasingly divisive discussions about evidence-based public health measures. The reaction to the mask mandate for children, together with a directive that non-compliance would lead to exclusion of children from primary school, has been polarising.
To continue with personal responsibility as a solution to the greatest crisis of our times is a political choice
No wonder.
We have public health policy that plays personal responsibility as a trump card, though the WHO and multi-country studies consistently show a multi-level, co-ordinated and consultative approach offers the best path. If the basis of health behaviour is personal responsibility, then opinions are relevant.
If the basis of health advice is built on best available evidence, then knowledge and evidence matters. Because the Government uncoupled knowledge and evidence from its communication and policy, public health has become a political football.
Systemic failures
Insanity is doing the same thing over and over again expecting different results. Attempting to tackle this fourth wave with personal responsibility is nothing short of madness.
Individuals have already acted. It is clear from the Amárach polling data that many people have made sustained changes in response to the threat that Covid posed over the last two years. The basis of these actions have often if not always been communal – concerns about bringing Covid home, infecting others, being the weak link in the social chain.
Responsible actions now as we face the new wave depend on clear guidance and access to the resources that allow people to act in solidarity with each other. For example, knowing when you need a PCR test and being able to get one. Or understanding schools may present a risk to children and having all appropriate mitigations in place. This is layered protection and it is our best hope.
Eulogising personal responsibility is usually a counter-narrative designed to obscure systemic failures.
The failures in our systems are serious: an overburdened health service going back many years, a PCR testing system that cannot meet demand, a track and trace system that has not been able to keep up with the levels of reported infections, historically overcrowded classrooms where mitigations have been too long coming.
Many years ago, we decided that personal responsibility offered no answers to the death and disability that arose from smoking and road traffic accidents. To continue with personal responsibility as a solution to the greatest crisis of our times is a political choice. It is also a shameful abdication of political responsibility and leadership.
Orla Muldoon is founding Professor of Psychology and Director, Centre for Social Issues Research at the University of Limerick