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"Psychology of Epidemics"

What Happens to Communities When Exposed to a Sudden Epidemic?

03 April 2020

Throughout history, human communities have faced some epidemics that have spread broadly, infecting large numbers of people, claiming millions of lives over a short course of time. These crises affect individuals, who live through this exceptional experience, changing some aspect of their value system, raising several existential questions, and, in some cases, impacting the psychological structure of entire generations. Such a generation, in many instances, does not recover from the psychological and social effects of the epidemic, despite their physical recovery. 

This experience remains stuck in the collective conscience of communities as an essential component of its history, just as the plague or "black death" that has been rooted in the European history. Several literary works reflect the human experience of the European society over this period, which remains in the European public sphere even after the lapse of hundreds of years. For societies, epidemics resemble wars in the radical changes experienced in the daily lifestyle and aspects of life. The experience ends with establishing different meanings, values, ideas and patterns of human life.

Psychosociologists and sociologists have noted the existence of collective behavioral and psychological patterns connected to epidemics, such as the plague, the Spanish flu epidemic, or the unprecedented spread of diseases such as AIDS among some groups. This has led to the study of patterns of community responses during epidemics and caused the emergence of what is called "epidemic psychology".

This section of social science focuses on studying the behavior of societies during the outbreaks of epidemics. Impacted by epidemics, societies experience surges of collective fear and a revolution in interpreting causes of the collective suffering caused by such outbreaks. A wave of value contradictions, a momentum of attitudes, strategies and desperate attempts to confront the situation emerge, especially as epidemics are by nature "new" diseases with neither information nor expectations about the pattern of their spread, combat, and therefore cure. The more serious the disease is, the more time it would require to find the appropriate treatment. Consequently, there will be a broader space left for individual and social diligence, upholding of any hope for salvation, even if this includes irrational practices.  The following article focuses on the psychosociological features that emerge in societies during times of epidemics, based on previous historical experiences.  These phenomena may not necessarily have the same pattern in the current crisis of Coronavirus that is causing a global health crisis. 

The collapse of the "fragile rationality" of daily interactions: 

Contrary to the long-prevailing notion, based on human "rationality", and the assumption that humans make logical decisions and accordingly adopt a rational behavior, a new branch in economics known as behavioral economics emerged. This largely emphasized the irrationality of individual behavior at times and the presence of biases associated with emotions, particularly anxiety, fear, or stress. 

Epidemiology indicates a dual nature of human behavior, which is enveloped by rationality that conceals irrational trends and prejudices. Under normal circumstances, most people manage to maintain some degree of ‘rationality’, but during crises, irrationality takes over.  Fear, anxiety, and mistrust drive individuals towards contradictory and illogical behavior, which sometimes resembles ‘Witch Hunting’. The individual regresses to a primitive and uncivilized life driven by undeveloped feelings and needs, which eventually take full control of the individual. 

Similarly, Alfred Schutz, the sociologist, asserts that this "fragile rationality" governs daily life during regular times, which he calls "routine". This routine includes the common patterns of interactions, relationships, expectations and recognized solutions, which have been pre-tested in "normal" situations. While this is common, some events take a completely different path from this routine, challenging its facts and ‘ready’ solutions. In this case, the response to this threat takes the shape of panic that change daily practices. Things may get worse, as this situation feeds itself and multiplies, leading to a collapse rather than a solution. A simple example is ‘panic buying’ witnessed which may, in itself, cause another form of crisis that individuals are anticipating. Despite the initial ability of some governments to control the behavior of individuals regarding trends of buying, yet with the health crisis prolonging and people sensing its imminence and the possibility of a shortage in some goods, this may lead individuals to exaggerate in hoarding goods. Individuals herby do not act by logical calculations, but are rather driven by their emotions.  

Fears of living in "the unknown":

During the spread of epidemics, individuals do not only face the risk of uncertainty associated with the possibility of infection, but rather face a heavier burden linked to the unknown. This prompts heightened feelings of fear and anxiety compared to regular diseases, which may be more dangerous than the epidemic itself. This condition is not only linked to infected individuals but to the entire society. It is associated with the speed of the outspread, the vagueness regarding the time and means of its termination and the development of a treatment. 

Furthermore, there is the fear of falling prey to the epidemic itself, either by infection or by the loss of a surrounding person. The longer the epidemic spreads, the more stressed individuals become. Although the current situation is better than previous historical periods, the novelty of the epidemic itself does not avail the quantity or quality of information that would instill reassurance. Instead, the available information about the epidemic and its ease of spread reinforces fears among societies. This may be linked to people's trust in their governments. The more trusting people are in their governmental institutions and services, the more the ability to contain and reduce public anxiety, before its conversion into some fear-driven illogical behavior. 

It is noted that even the most developed countries may be subject to criticism, as in Britain, where there are public accusations of negligence and failure to adopt early measures to halt the transmission of the disease into the country, especially from Italy.

There is also an associated escalating doubt, a mistrust in others, suspecting the "near" other to be the source of the epidemic, and the emergence of many rumors representing an obstacle to social interactions. This may "theoretically" lead to what Thomas Hobbes describes as the war of all against all. 

British Prime Minister Boris Johnson's speech in the beginning of March was the object of surprise and criticism by everyone, as he demanded the British people to prepare for the departure of some of their friends and relatives. Unlike what is expected of speeches in such times, this fueled feelings of anxiety and fear

The rise and fall of religious patterns and the confusion of values:

According to European history, value systems and religious patterns of some groups are impacted by the periods of severe diseases and epidemics. During such periods, individuals maintain the values systems that explain events and guide towards a certain behavior of religious, charitable or another nature, which would alleviate suffering. Yet, with time extending and risk increasing and with the spread of the epidemic and psychological pressure, individuals grow confused. This may lead them to question their own beliefs and values, and resorting to practices of other beliefs for fear of being wrong about their own faith. People question why God would allow painful things to those who believe in Him and who is to blame for what is happening. Individuals waiver between the desire to adhere to values or religion and doubts about their ability to save them. For example, a field study on epidemiology indicates a record of religious conversion among people infected by HIV in the 1990s. 

Conversely, major crises and epidemics in other settings stimulate a rise of ‘religiosity’, attendance in houses of worship, a rise in religious practices, or at least a rethinking of the role of religion, especially among groups that were not practicing these types of religious rituals. According to Gallup, since the 1960s, less than 40% of Americans believed in the impact of religion on their lives, but after the Twin Towers incident, those who felt the need for religion reached 71%. 

Reproduction of ‘folklore’:

Folklore generally represents a cultural reservoir for the experiences of previous generations in the form of beliefs, qualities, quotes and proverbs, novels...etc. During periods of crises and epidemics, individuals do not know how to deal with the epidemic and its repercussions, which leads them to be self-reliant in the search for a way out.

The most important tracks that individuals resort to during such crises include examining the folklore, whether to try to deal with the disease itself, which is known as traditional or folk medicine, or in search for reassuring inspiration or famous quotes to circulate in order to adapt to the crisis. Each population has its own heritage associated with a vast array of experiences, religious identity, sanctities and history.

Chinese media reports indicate that 80% of COVID-19 patients in China received traditional treatment. Xu Nanping, Chinese Vice Minister of Science and Technology, stressed that 85% of COVID-19 patients received a mixture of drug and conventional treatments. Regardless of the effectiveness of conventional treatment in combating the epidemic, it impacts the individual's condition and may provide internal balance linked to believing in the efficiency of the folk treatment.

On the other hand, other practices related to folkways have emerged, such as drinking ‘cow urine’ in India as a folk prescription linked to religious beliefs. A Hindu group, for example, hosted a cow urine drinking party in New Delhi under the belief in its effectiveness in preventing COVID-19.  Whether it is true or not, many Hindus believe that cows are sacred and some believe their urine have curative properties.

Despite the peculiarity of folklores, communication availed by technology allows the peoples to share folklore and solutions to be experimented across nations. Methods of Chinese, Indian and other ancient civilizations are the most widespread globally.

Drifting to rumors and adopting conspiracy theories:

In Epidemics and Society, Frank Snowden pointed out that during the cholera outbreak, a conspiracy theory emerged in France that it is a man-made epidemic. Rumors spread that King Louis-Philippe's government placed arsenic in water wells. With the outspread of the epidemic killing about 19 thousand individuals, public violence erupted against the government, which could hardly be handled by the police. The public movement and anger continued, and the government was anxious about what it then called ‘dangerous classes’ referring to the poor, who were greatly impacted and revolted against the ruling regime. This may partly explain events of ‘class oppression’ in Paris a few years after the epidemic, in opposition to the French Revolution. 

Epidemics and lack of information are usually accompanied by a surge of rumors launched by a few and followed by millions, who believe in such hearsay in order to interpret what is actually taking place. These are prime times for conspiracy theories to evolve not only amidst peoples, but also between countries. Perhaps the mutual accusations between China and the US prove this. 

Things get worse with the exploitation of social media by extreme currents to stir terror and fear in a desperate attempt to provoke individuals, by showing governments as failing to deal with epidemics. Moreover, false information about methods of dealing with the virus is spread and widely circulated through them. This information in many instances causes harm to the public. A good example is the story of ‘South China Morning Post’ , where a woman read online that raw garlic could protect her from the virus, but she ate 1.5 kg of garlic that she ended up needing hospital treatment. It inflamed her throat and could no longer speak.

Ethnic stigma:

Some epidemics are linked to ethnicities, where they initially appear and then spread. These ethnicities may be subject to exclusion, discrimination or stigmatization. An example is the emergence of the term ‘coronophobia’ to embody the fear of all individuals with Asian features, despite the corruption and irrationality of linking a race to an epidemic outbreak. Signs of prevalence of this behavior in the Arab region are evidenced in the negative comments on social media and at times in practical reality. A Chinese student in the Lebanese University posted a video where he spoke in classical Arabic about his encountering racist practices in the Lebanese street after the outbreak of COVID-19, including being avoided and being subject to verbal abuse by people.

A sense of community and the emergence of social initiatives: 

During crises, the gap between the individual and the community diminishes, as their fates become interlinked. A sense of community and solidarity appears among members of society facing together a single threat. In countries where COVID-19 is widespread, residents of some neighborhoods were seen communicating by joint singing, clapping or praying through windows to support each other, and to motivate themselves to keep going, maintain balance and spread hope and solidarity. Diversely, these times motivate the creation of ideas and initiatives to help in the current situation. One example is what an Italian engineer at a printing company has done using 3D technology to design and print breathing valves for a hospital in Italy that has run out of these medical tools.

Finally, epidemics are social experiences with a long lasting impact. This may contribute to developing or changing the social features of countries, especially with the momentum of interactions during the period of the epidemic. Although the current crisis is quite different from similar historical crises, as technological solutions play a role in developing innovative solutions, and social media play another complex factor between spreading awareness or rumors and alleviating the intensity of the current ‘social distancing’, the coming period will witness the emergence of new trends of behavior and attitudes in response to the current situation.