Why Aren’t People Self-Isolating?

One of the most alarming aspects of the COVID-19 outbreak is the phenomenon of people declining to self-isolate. Social distancing, as it’s called, is defined by the CDC as “remaining out of congregate settings, avoiding mass gatherings, and maintaining distance (approximately 6 feet or 2 meters) from others when possible.”

So, in other words, keep to yourself for a few weeks. Why is this so hard?

COVID-19 Remains a Mystery

This past weekend, while walking my dogs, I saw house parties, packed bars, and people out casually shopping. There was no strong sense of social distancing. It was as if people simply did not believe that the virus was dangerous.

COVID-19 is dangerous for people of all ages. While 80% of the deaths in China have been people over 80 , every age group had severe cases of the infection, which requires extensive medical intervention (respirator, extreme measures to keep a patient isolated, even intubation and ECMO ) to prevent death. While scientists have some early data to suggest why a small number of younger people get severely ill from the virus, they haven’t reached any firm conclusions yet.

In other words, we don’t fully understand why some young people get severely ill from COVID-19, while others have mild or no symptoms. Meanwhile, even people with no symptoms are transmitting the virus freely everywhere they go, which makes the risk to people with hidden susceptibility to the disease far more extreme, as they cannot isolated based on symptoms. As more and more people infect each other in public gatherings, the health care system risks beingoverwhelmed to the point of collapse — making treating anybody difficult if not impossible (which will further raise the death toll, as in Italy ).

This is why epidemiologists and other healthcare experts are terrified of COVID-19. It has a unique combination of factors that make our system uniquely ill-suited to respond to it. If it could be contained, the risk to everyone, of every age group, would be reduced.

And yet, we aren’t isolating. Why? In South Korea, the first 30 patients were tracked meticulously, which successfully limited the spread of the disease. But patient 31 refused to be isolated and infected thousands of people , directly leading to hundreds of deaths. There are rumors that this patient 31 was a member of a religious cult that had shunned social distancing because they were worried it was a backdoor for de-programming by the government. They are responsible for nearly 60% of the cases in Deagu, a small town outside of Seoul — they behaved so negligently, the mayor of Seoul sued them for murder .

American Anti-Quarantine

You can find a similar effort here in the U.S., as well. Conspiracy theorists and extreme right wing radio host Alex Jones has been singled out for hawking fake COVID-19 cures on his website (he denies it, but… eh). Even absent the snake oil he sells a lot of , Jones is at the heart of an extremist anti-government movement that denies and rejects expertise — in this case, falsely claiming that COVID-19 is some sort of deep state conspiracy by an inscrutable list of “bad” people to take down President Trump. Jones’ conspiracy-mongering has extended beyond his direct influence, with mainstream right wing pundits like Rush Limbaugh (who is extreme, yes, but also in the mainstream of the right wing) spreading conspiracies about the virus as well.

In this case, I would liken such groups to a death cult, one that is steadily amassing blood on its hands by intentionally spreading malicious misinformation.

That might explain why older people—by far the most vulnerable to COVID-19—are ignoring the dangers of the virus in alarming numbers, as they tend to be the largest target demographic for far right wing media figures. But that doesn’t explain younger people in cities also ignoring advice to self-isolate.

Why Ignore Medical Advice?

There are, however, clear, explicable reasons people of every age group have ignored the recommendations to self-isolate:

1. Tragedy of the commons — people want theirs, act in narrow self-interest, and do not concern with the needs or welfare of others.One of the chief roles of government is to mitigate the tragedy of the commons by balancing individual wants with collective needs. Right now, the government is not acting to safeguard the public interest and is allowing destructive narrow self-interest (such as large public gatherings and hoarding n ecessary supplies) to run rampant.
2. Humans in general are really bad at understanding exponential growth. It is one of the scariest things in the world: in an exponential environment, each step essentially doubles (this has been the pattern of COVID-19 infections). When you’re facing exponential growth, the numbers appear very small at first, and then become suddenly extremely large. And one step before total saturation, you’re only half there. Our brains just didn’t evolve to think this way — we are linear creatures.
3. Similarly, we are very bad at gauging risk . We get extremely upset about rare deadly events (terrorism), but are extremely casual about common deadly events (car crashes). We just aren’t good at it.
4. We should also consider the decades-long right-wing campaign to delegitimize effective governance . There’s a reason so many people casually say government doesn’t work for things, even though it does and it is often far more efficient at safeguarding the public’s interest than corporations: it was an intentional messaging campaign, backed up by deliberate efforts to hollow out the government and thus “prove” government cannot be trusted.

This last point is why the first three have come to define the American experience. Government exists, in large part, to mitigate personal self-interest and protect the common good. When you intentionally destroy that capacity , naked self-interest runs rampant. Selfishness overwhelms society.

Government Needs Legitimacy

More importantly, when government is delegitimized people, are less likely to listen to its warnings. The CDC’s abject failure to distribute testing kits early, and subsequent muzzling of its own experts transparently communicating about the virus raised alarm. Worse still, the CDC ended transparent reporting on the number fo COVID-19 testing on its website. There are credible fears that the agency has been coopted to defend the ego of a notoriously insecure President. It has permanently damaged the agency’s reputation, right when they need people to listen to them.

Failed communications are the final piece to the puzzle. The Trump administration is a walking disaster in terms of public health communication, though they remain eerily effective at keeping a tight hold on their most fervent political supporters. But Trump’s instinct to pander to the base is at odds with the public’s interest, especially during a pandemic, when people need vetted, fact-based information from their government. When lying, venality, and corruption interferes with that messaging, even the right advice can go ignored (especially when the President turns the crisis into a giant handout for unrelated industries ).

In a future post, I’ll talk about how we can be more effective in communicating the urgent need to act now, and what it will take to get people to do it. In the meantime, however, try to think through your own behavior and reaction to the news, and ponder if you are helping or hurting the situation.