What role does emotion play in our responses to coronavirus?

How we feel has a strong influence on what we do – and perhaps even more so during a crisis like the Covid-19 pandemic. An understanding of how emotions function is crucial if we are to guide more effective policy-making. In particular, we must stay alert to the dangers of fear.

Emotions play a pivotal role in our lives. For example, fear guides responses such as fight, flight or freeze – and it is often accompanied by perspiration and an increased heart rate (Steimer, 2002).

Unlike moods, emotions tend to be restricted in duration to particular circumstances (Bradley and Lang, 2007). They affect our behaviour through creating bias in attentional focus, thought patterns, risk perception and judgement. For example, people will spend a longer time reading text that reflects their current emotional state compared with text that does not (Forgas, 2017).

Acknowledgement of the myriad ways that emotions may affect behaviour is crucial for ensuring effective decision-making at the best of times, but especially during a crisis.

Pandemics are events that are turbo-charged with emotions, perhaps the most important of which is fear (Huang, 2020). Fear, like all other emotions, is generally thought to serve an immediate, adaptive purpose. It narrows our attention and promotes detailed information processing (Hofmann et al, 2012).

These changes allow risk to be more easily identified and mitigated. But there are also some functional properties of fear that pose a significant threat to our ability to evaluate the best course of action in a time of crisis.

Related question: Risk in the time of Covid-19: what do we know and not know?

What does the evidence from research tell us?

The dangers of fear

When we fear a stimulus, we tend to want to avoid it at all costs. This is an instinctive and, to a large degree, adaptive behavioural response: fearful stimuli tend to be dangerous and so avoiding them is usually in our best interests. Yet there are also many circumstances under which our avoidance of fearful experiences becomes maladaptive.

For example, socially anxious people tend to avoid situations where their anxiety levels may flare up, such as large social gatherings. Over time, this behaviour – though successful in mitigating anxiety in the short term – maintains and exacerbates overall anxiety levels (Pittig et al, 2018). Without intervention, such behavioural patterns can lead to chronic anxiety where anxious feelings are experienced both more intensely and more frequently.

In the case of Covid-19, fear of death and the process of dying have understandably resulted in a tendency for avoidance. This was evident in the decision of most countries around the world to impose strict social distancing measures to limit the spread of the virus.

It has also been evident in the widespread compliance with the lockdown measures demonstrated by the general public. This behaviour has no doubt been adaptive insofar as it has helped us to reduce the spread of the virus. But in trying so hard to avoid death, we have also blinded ourselves to the significant costs of such behaviour for other important concerns, such as economic, educational and mental health outcomes.

Arguably, the most important blind spot facilitated by our seemingly overwhelming urge to avoid deaths from the virus was the closure of schools. Across the world, schools are places where children can learn, play and interact with their peers. For many of those children, the benefits of school extend to it being the only place where they can eat properly and feel safe. Schools are therefore critical for safeguarding some of the most vulnerable in our society.

Yet, despite a distinct lack of clear evidence on virus transmission among and by children, and clear evidence from very early on in the pandemic that children were largely unaffected by the virus, 38 countries decided to close schools to avoid further deaths. This decision has led to children all over the world missing out on social interactions that are crucial to their development.

It has also resulted in a worsening of the already gross inequalities faced by poor children, around one million of whom in Europe alone will be forced to go without a meal every second day (Viner et al, 2020). Once the fear has lifted, the price paid by children to prevent the deaths of predominantly older people with limited life expectancies may be seen to be too great.

Related question: What will be the impact of lockdown on children's development?

Heightened fear

Stark consequences such as these are exaggerated in contexts where fear is artificially inflated, which is also the case with Covid-19. We know from risk perception studies that the more aware of risks people become, the more fearful of them they will be (Tversky and Kahneman, 1973).

Since the virus emerged, we have been subject to constant news reports on the absolute number of deaths without the figures ever being placed in context – for example, as a percentage of mortality by all causes. This has promoted ‘hypervigilance’ (Cole et al, 2013), which stands in the way of us adapting to our fears through an understanding of the actual levels of risk (Haegler et al, 2010).

Uncertainty is also associated with higher levels of fear (Solvic et al, 1981). It is unclear for how long the effects of Covid-19 will last, whether they will come back and which methods will be most effective in tackling them. This uncertainty surrounding the virus will have succeeded in heightening levels of public fear. The surge in conspiracy theories that have developed in response to Covid-19, of which high uncertainty levels are a well-established driver, are testament to this (Larsen, 2020).

Studies show that under conditions of uncertainty people place a larger weight on small probabilities if they are fear-inducing (for example, the probability of a car crash, Rottenstreich, 2001). It is likely, therefore, that people will have an inflated sense of fear in relation to virus, which may lead them to overestimate the likelihood of deaths that it will cause.

These raised levels of fear have important consequences for policy-making since our preferences for different options depend on the emotional reactions we learn to associate with different outcomes (Slovic, 2018). The exacerbation of fear surrounding contagion and deaths from the virus will have succeeded in making policies targeting the avoidance of death a particularly emotion-rich outcome.

It is likely that such an explicit focus on deaths caused by the virus will have made policies targeting outcomes whose main priority is not to reduce deaths caused by the virus – such as those targeting social or economic outcomes – relatively less emotion-rich and therefore less appealing.

The predisposition to play down other concerns in place of those we fear most is a good explanation for our negligence in relation to the long-term effects of school closures and our general reliance throughout this pandemic on policies that target avoidance of death over and above other important consequences. Since we tend to fear events that are imminent more than we do those that are further away in time, fear succeeds in orientating our attention to the short term.

When determining whether to implement lockdown and for how long, we focused on the outcome that we feared most, namely dying from the virus. We did not model the risks to inequality, educational attainment, other health problems including mental health, or the indirect deaths caused by a failing economy. In so doing, we allowed fear to govern our responses and define policies that will affect generations to come.

Related question: Coronavius and the economy: what are the trade-offs?

What are the implications for our response to Covid-19?

The first important way to ensure that the harmful effects of fear are mitigated as we come out of lockdown is to get our policy messaging right. Covid-19 has so far been characterised by unclear and mixed messaging, which reduces trust and creates confusion among the general public (Warzel, 2020).

Moreover, the reasons for important changes in policies, such as the decision to enforce mask wearing, have often not been clearly explained. Clearer guidance from the government will be necessary to reduce public uncertainty levels.

One way to provide clarity is to ensure that policy messaging is consistent, and that those communicating the message act in accordance with that messaging. Any important changes in messaging should be highlighted for transparency and clearly explained.

Although it might be argued that raising public fear was a necessary step for ensuring compliance with key policy decisions, such as lockdown, it is also a tactic with dangerous and lasting consequences, the long-term impact of which may be much more serious than the consequences of non-compliance. The reluctance of many individuals to resume normal life due to persistent fear of the virus is currently placing a significant strain on the economy at a time when recovery is paramount, as well as harming mental health.

Many parents and teachers are also now worried about how to navigate the school environment, putting children’s education in jeopardy. Clear messaging from the government about what is allowed and why as we come out of lockdown can help to increase public trust, thereby reducing excess fear and uncertainty surrounding the virus that has been built up since its onset. Positive messaging about the benefits of key policies that communicates the progress being made to combat the virus can also help to reduce some of this fear.

The media must also take responsibility for raising public fear levels and take action by presenting key facts and figures in a way that allows individuals to assess relative risk. It would be useful for people to understand how deaths from Covid-19 compare with deaths from other relatable causes such as car accidents.

Engagement with experts from a wide range of disciplines can also help to avoid an over-emphasis on one outcome as the only important consequence of the event in question. While on the face of it, this attenuation of risk may appear to conflict with the media’s reliance on fear as a tactic to sell stories, any media company that does it well can succeed in attracting audiences who care about fair reporting, the numbers of whom will be increasing in this era of growing institutional distrust (Suiter and Fletcher, 2020). There is space and appetite for more effective and transparent reporting galvanised by a team of journalists who care about their impact on the world.

An important longer-term goal for ensuring that the fear we experience during a crisis is proportionate to the risk involved is to consider the full range of consequences associated with any decision. The effectiveness of a policy targeting the avoidance of immediate Covid-19 deaths should also be evaluated in terms of its effects on mental health, inequalities, children’s wellbeing and further long-term social progress, as well as GDP.

At some level, and with some degree of quantification, this requires an estimate of the weights attached to the various parameters in a ‘social welfare function’ (SWF). These can be assigned by policy-makers and ideally informed by the preferences of the general public elicited in calm emotional states (for example, not in the middle of a major crisis).

Given that the extent of the impact of the virus on different factors will be different for different people, it is important to solicit opinions from key representatives of these differences. For example, people from different age groups, ethnic backgrounds and socio-economic status should be included.

Whatever the precise details, simply enunciating the concept of a SWF will mitigate the urge to favour policies targeting immediate, and more scary, direct deaths from Covid-19 over indirect deaths and a range of other health, economic and social harms. Echoing these concerns, the director of the World Health Organization recently said that ‘the avoidable suffering and death caused by children missing out on routine immunisations could be far greater than Covid-19 itself’.

In our response to Covid-19 – and in policy-making more generally – we must stay alert to the dangers of fear in preventing our ability to formulate an effective response. Now more than ever, economic and social progress depends on it.

Where can I find out more?

Emotion and avoidance motivation: This review discusses the integral role of emotion in determining avoidance behaviour.

Risk as feelings: In this study, George Loewenstein and colleagues discuss the importance of affect in determining risk perception.

Affect, reason, risk and rationality: Paul Slovic explains the dangers of relying on affective responses to guide decision-making.

Fear generalisation and anxiety: This study reviews both behavioural and neuro-imaging research on the generalisation of fear and avoidance in healthy and anxious individuals.

Emotional behaviour and approach-avoidance: Ira Roseman explains how emotion can be used to explain avoidance behaviour.

Acceptance and commitment therapy: Aidan Hart makes a useful distinction between helpful and unhelpful avoidance, and presents a framework for how to employ acceptance. While focused on a therapeutic context, these key insights may be usefully applied to other settings.