LONDON / ROME - It is dubbed the “nudge unit,” a section of London's Downing Street staffed with behavioral scientists set up to advise the British government. The scientists now trying to fashion strategies to coax Britons to improve their personal hygiene say the nudge may have to turn more into a shove.
Like governments across the globe, the British government has been running a massive public information campaign to try to retard the spread of the coronavirus and to get their citizens to ramp up their personal hygiene. “Washing hands for 20 seconds is central to the expanded public awareness campaign to prevent and slow the spread of coronavirus (COVID-19),” announces the government’s own website.
The advice is that you should wash your hands frequently and use paper tissues when coughing or sneezing — then promptly discard the soiled tissue securely. And the message is being hammered home relentlessly. The media obligingly have echoed the counsel, quoting Prime Minister Boris Johnson, who has been repeating that handwashing should last for as long as it takes to sing two renditions of "Happy Birthday" — or the country’s national anthem.
But the counsel appears to be falling on some deaf ears, according to a poll published this week by the YouGov pollster agency in which only 35 percent of respondents said they had improved their personal hygiene, such as by washing their hands. According to Britain’s Daily Mail: “British people are among the most relaxed people in the world about the threat of coronavirus – but are also the least likely to take precautions.”
Passengers 'just don't get it'
Cabin crews on all major international airlines, British or otherwise, are expressing increasing alarm. They believe there should now be mandatory public health announcements on all flights explaining the basic hygiene protocol to be observed. Other cabin crew believe their airlines should be encouraging them to remind passengers who ignore guidelines that they must wash their hands during the flight and cover their coughs and sneezes. The crews say they believe that passengers who don't comply should be handed a surgical mask and ordered to put it on.
“We aren’t asking our bosses to adopt a Chinese approach,” one flight attendant told me, a reference to an online video that showed someone being tied to a tree for failing to wear a face mask. “But a lot of the passengers just don’t get it, and research suggests a sick attendant can infect around three passengers.”
But the British government’s message about hygiene protocol wasn’t aided this week by the country’s chief medical officer, Chris Whitty, who during parliamentary testimony proceeded to cough into his hand.
The Italian government has also been trying to hammer home the message of the need for people to wash their hands. Despite the surge in new cases in Italy, residents there still seem to believe the virus can be contained. And they are counting the days to March 15, when schools and universities are slated provisionally to reopen after being closed because of the infection.
That date is also when the government’s top medical experts believe the drastic measures Italy has adopted — with the nationwide closure of schools, regulations for red zones and yellow zones, the banning of large public gatherings and advice to the elderly to stay indoors — should be showing signs of working. The number of cases should be falling by then, say the government’s experts.
There were more than 4,000 confirmed cases in Italy at the time of this writing. Among the sick a few kilometers down the road from me in Lazio is a specialist in infectious diseases. Ironically, he is believed to have contracted the virus not from his work but from his brother, a university lecturer, who’s thought to have caught it from an overseas student. There is now a race to trace all staff and patients with whom the doctor had contact at the local hospital.
Resigned to spread of virus
Marco Marsilio, the governor of Abruzzo to the south and west of Lazio, sounded a note of resignation Friday. “The virus knows no boundaries. Stopping an infection is like stopping the sea with your hands. We have to be realistic. But here we are still living good days. And this window of opportunity is giving us time to prepare ourselves, as far as possible,” he said.
Abruzzo, a mountainous rural region with low population density, only had its first confirmed cases this past week and has gone from zero to nine in a few days.
All those who have contracted the virus had traveled to the worst-affected areas in the north of the country, or to Abruzzo from the northern region of Lombardy. All of them are just ordinary people going about their everyday lives — including a young woman visiting her fiance, a teacher who had gone up north for a refresher course, and a family who had come to check on their vacation home. Now several hundred people who had contact with them have been asked to self-isolate.
Across Italy, there’s a sense we are in the early stages of a period of disruption that most of us have not experienced before. Frustration is already growing, though, and Italians seem split about whether the government is being too drastic or not drastic enough, with some saying containment measures, even school closures, should have been introduced in January.
Italian anxiety grew Friday when the civil protection agency reported big jump in the death-to-cases ratio. Deaths rose from Thursday’s 148 to 197, bringing the toll to around 4 percent of known cases. Italians are also questioning the effectiveness of some of the government’s containment policy. It is trying to shield the elderly and is restricting visits to social care homes and urging seniors to stay indoors. But the school closures have forced many parents to leave their kids with the children’s grandparents, who more often than not at some point during the day take them off to the parks.
Half a year of disruption
Most virologists say they think the best case scenario is three to six months of disruption. They also say there will be peaks and troughs in the numbers and times when lulls trick us into thinking the disease has run its course.
In A Journal of the Plague Year by Daniel Defoe, a fictional but highly researched account of the Great Plague of London of 1665 and written half a century later, the narrator notes similar ups and downs, with the number of burials ebbing one week as “the metropolis grew healthy,” only for “distemper” to return to dash people’s hopes.
Defoe was writing about the bubonic plague, a far more vicious and much deadlier bacterial disease than COVID-19. In the year of the London plague, many recalled the advice of Galen and Hippocrates, the great physicians of ancient Rome, who suggested the best course of action in the face of an unfolding epidemic was “Cito, Longe, Tarde” — leave quickly, go far away and come back slowly.