Harnessing behavioural science in public health campaigns to maintain ‘social distancing’ in response to the COVID-19 pandemic: key principles

Abstract

Coronavirus Disease 2019 (COVID-19), like Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), is an infection arising from a coronavirus. The COVID-19 pandemic is unprecedented in recent times in terms of the global spread of infection and the resultant morbidity, mortality and burden on health systems. In the absence of a vaccine, reducing transmission of the COVID-19 virus requires rapid and extensive behaviour change to enact protective behaviours and ‘social distancing’ across whole populations. Although ‘social distancing’ is the current most used term, it actually refers to maintaining physical separation by reducing the number of times people come into close contact with each other across whole populations. Social distancing applies regardless of infection status and is thus distinctive from quarantine or the isolation of those with suspected or diagnosed infection, which is also an important element of infection control.\n\nGovernments across the world are implementing a diverse range of interventions to promote adherence to social distancing measures, which include elements of education, persuasion, incentivisation, coercion, environmental restructuring, restriction and enablement. Interventions have been developed rapidly and could not be informed directly by evidence, given the novelty of the virus and rapid spread of the pandemic. Despite this lack of direct evidence, a body of behavioural science exists which can usefully inform the current interventions and promote adherence to these restrictive measures. This body of science has been developed through the study of other infections (including other coronaviruses such as MERS and SARS), other areas of health and other areas of behaviour. This body of science suggests a number of principles which could ensure that interventions are more likely to achieve their intended outcomes and less likely to generate unintended harmful consequences.\n\nAs a group of behavioural and social scientists who have shared their advice with government through the UK’s Government Office for Science, the researchers of this paper have collaborated to develop a series of principles to inform interventions to promote whole population adherence to social distancing measures. These were informed by members’ expertise and knowledge of existing theory and evidence, rather than by any formal review of the literature.