5.7 Human Responses to Pandemics
Pandemic Denial & Anti-Masking Sentiments
Throughout history and within contemporary society, disease and pandemics have typically been accompanied by extreme accusations, denial, misinformation, and mistrust (Navarro, 2020; Newey, 2020), which only exacerbate the death toll (Little, 2020b). Examples of pandemic denial were evident during the Spanish flu. During the flu’s first wave in the spring and early summer of 1918, some European and U.S. newspapers claimed that the flu wasn’t a serious threat (Little, 2020b). In the late summer, during the deadly second wave, the Interior Minister of Italy denied reports of the flu spreading (Martini et al., 2019). Anti-masking claims were also evident during the Spanish flu pandemic (Carstairs, 2020; McMullan et al., 2020; Navarro, 2020). Although there was wide-spread support for wearing masks, support waned quickly and masking compliance levels fell, due to issues of comfort, doubts regarding efficacy, and impact on businesses/commerce (Carstairs, 2020; Little, 2020a; Navarro, 2020). This rings true during the COVID-19 pandemic as well. Less than half of the people in the U.S. follow health recommendations to wear a mask when out in public (Key, 2021; Miller, 2020).
Click the link below to learn more about the history of anti-masking sentiments:
Masking Resistance During A Pandemic Isn’t New – In 1918 Many Americans Were “Slackers”
Do Masks Work or Not? Do Mask Mandates Work or Not?
Because the COVID-19 pandemic became so politicized and polarized, it is likely that most people already have their minds made up about the benefits of masking or lack thereof. Further, as is the case with most claims about human behavior, a motivated individual with a strong opinion on the matter can likely find numerous studies to support their side of the argument and their conclusions. Political biases aside the most tenable – if seemingly paradoxical – conclusion is that masks work but mask mandates do not. In brief, individuals who wear the right type of mask that is fitted properly and who wear them with great consistency likely prevent spread and contamination of airborne viruses. Note for instance, that surgeons continue to wear masks in operating rooms and they meet the criteria above. The problem with mask mandates appears to be that the proportion of individuals who wear the right type of mask that is properly fitted and wear them consistently is probably fairly low. If a third of the population is opposed to wearing a mask and never do so, and another third wears poorly fitting, poor-quality masks inconsistently, they probably do not meet the standards necessary for prevention of contamination and infection. Even if the remaining third mimic surgeons (a proposition that is highly unlikely), it is probably insufficient to make a difference at the societal level. This is a clear illustration of the difference between theoretical efficacy and realized or actual efficacy. For detailed (and interesting!) discussions of methodological considerations impacting the efficacy of masking, see the links below.
https://insights.som.yale.edu/insights/no-that-new-study-doesnt-show-that-masks-are-useless
Misinformation & Scapegoating
The stigmatizing and scapegoating of convenient targets is common during pandemics (Cole, 2020). Pandemic misinformation, conspiracy theories and the impact of low-science literacy levels, are integral in creating and reinforcing “us versus them” mindsets that lead to stigmatizing, scapegoating, and targeting of certain populations during pandemics (Miller, 2020; Poos, 2020). During the Black Death, Jewish people were blamed for spreading the plague by poisoning wells and streams. This led to the mass murder of the Jewish population by Christian mobs, across hundreds of communities (Cole, 2020; Poos, 2020). In 19th century U.S, immigrants were blamed for a variety of infections, including polio and cholera (Cole, 2020). Despite the Spanish Flu being accelerated by the movement of soldiers during WWI, German submarines and “enemy agents” were blamed for the spread of the flu by allied nations (e.g., the UK, U.S.) (Newey, 2020). With AIDS, the 2SLGBTQi community was targeted, followed by people who inject drugs (PWID), Haitians, and people with Hemophilia (Altman, 1983). With COVID-19, hate, violence and blame has been levelled against people of Asian descent, resulting from its label as “the China virus” (Lu, 2021; Poos, 2020; Vazquez, 2020).
The Anti-Vaccination Movement
Another common feature of both past and present pandemics is disinformation, including: the denial of the safety and importance of vaccinations. The deep-rooted beliefs that underlie vaccine opposition have remained somewhat consistent since the introduction of smallpox vaccine in 1796, the very first vaccine created (Haelle, 2020; Youngdahl, 2016), although the exact concerns vary according to the cultural anxieties of the time (Haelle, 2021; Poos, 2020). Anti-Vaccination leagues, founded in the mid- to late-1800s in the U.K. and U.S, spurred anti-vaccination sentiments and distrust of medicine. This resulted in the questioning of the safety and efficacy of, and the motives behind, the smallpox vaccine and every vaccine developed since then (e.g., Diphtheria, Tetanus, Polo [DTP]; Measles, Mumps and Rubella [MMR]) (Haelle, 2021; McNamara, 2021; Youngdahl, 2016).
Vaccine hesitancy has had negative public health impacts. In terms of smallpox, anti-vaccination sentiments led to a significant decline in immunization rates, and the re-emergence of smallpox just a couple of decades later (McNamara, 2021). Over the past few decades, hesitancy has led to “outbreaks of communicable infections such as measles” (Geoghegan et al., 2020, p. 1). With COVID-19, we find rates of hospitalization and death increase in regions where vaccine hesitancy and resistance to other health preventive measures, like masking and social distancing, are prevalent (Hanna et al., 2021). We also see attacks against people associated with the virus, vaccines, and public health measures. This ranges from violence against people of Asian descent (Lu, 2021; Poos, 2020; Vazquez, 2020), to the picketing of hospitals, as well as harassment and assault of medical and hospital personnel (Larkin, 2021; Miller, 2021; Ungerleider & Warren, 2022). Not unlike the masking issue, what we believe we “know” about vaccine efficacy depends very much on how we know it (i.e., the quality of the evidence and the nature of the question and analysis). The importance and efficacy of vaccination largely depended on which strain or timepoint in the pandemic one considers (with earliest strain resulting in the most deaths) and, more importantly, whether one is elderly, obese, or immunocompromised. Vaccination status among these groups is arguably much more consequential than it was for younger and healthier populations in which vaccination status had a less pronounced impact on mortality. As with masks, one can easily find data to support their views but consideration of timing and subpopulations is critical to adequately answering the question about covid vaccine efficacy. For an interesting deeper dive, see the link below.
https://ourworldindata.org/covid-deaths-by-vaccination
The deliberate misleading of people "for political, ideological or other reasons" (Haelle, May 11, 2021).
