Epidemic Psychology

Epidemic psychology has, as the sociologist Phil Strong noted, two meanings. There is the psychology of an epidemic – how people react to the spread of a fatal disease, often a new disease for which people have no immunity. But the psychological responses to an epidemic have their own epidemic nature and spread as disruptively, as lethally throughout populations.

The first psycholopgical contagion is fear, which mutates into suspicion, distrust, and agitated uncertainty about the once familiar, trusted environment. Suspicion demands, “Are you infected?” and, “Are you going to infect me?”

This worry often hijacks our biases against certain groups or certain types of people. The AIDS epidemic was sometimes called the “gay plague," a sign, some believed, that God was punishing homosexual activity.

This righteous interpretation of an epidemic is not new. For Bishop Cyprian, the 3rdcentury plague (known as the Plague of Cyprian and which, from contemporary descriptions, seems very like Ebola) offered proof that Christianity was superior to the pagan Roman religion. There was a case, too, of an attack on a Chinese couple in London, on the grounds that “the Chinese started the coronavirus.” Though this was an isolated event, there was a concern that referring to COVID-19 as “the Wuhan virus” would lead to further stigmatization.

Epidemics provide platforms for moral crusades, which themselves can disrupt our way of life. Certain types of people can be condemned and scapegoated. Responses are framed by the thought, “You and your habits caused the disease and brought it here to destroy us. Now we must punish, expel or even destroy you.”

Sometimes, however, an epidemic is a wake-up call. The 19th-century cholera outbreaks in London were presented as evidence of the need to build a sewer system. And the greatly improved air quality in parts of China – a consequence of reduced air travel – might be the occasion to re-calibrate assumptions about what we should be permitted to do.

At the start of an epidemic, however, everything psychological is in flux. Ordinary meanings and ordinary activities and interactions are transformed. Things that we didn’t question, and certainly didn’t fear, such as the doorknob and the light switch and the kettle handle, the cat’s fur and the guest’s coat and the hand rail, now pose risk of infection. A few weeks ago, we leapt onto the crowded subway and worried only about transient smells. We shook hands. We scratched an itch to the side of our nose. We travelled when and where we pleased, as long as we had time and money. The moral tally of any environmental consequences was our to brood on, alone.

Psychologists who study the perception of risk point out that it is the newness of a particular disease that increases the fear, while familiar but higher risk illnesses are accepted as just one of those things we have to bear. But this doesn’t explain the volatile nature of the psychological epidemic. People vacillate between fear and complacency. They magnify the danger, and then minimize it. They talk about the number of deaths from seasonal flu – far higher than, so far, deaths from COVID-19, and settle down to a good night out. The next morning they re-focus on the percentage of deaths from the coronavirus, and spend the day in a state of dread. Fear returns, and with it returns suspicion of people and of the once taken for granted environment.

Epidemic psychology summons up images of panic, runaway selfishness, one-to-one battles for the last package of dried pasta, or disinfectant, or hospital bed, and stampedes for any token of safety. The social order of cooperation and tolerance is revealed as superficial and fragile, with brutal selfishness running just beneath the surface.

But this is an old, out-dated model of human behavior. New understanding of human nature highlights its the deeply social nature, with attachment and empathy as fundamental as the basic needs for food, shelter and safety. In fact, psychologists now understand that the human mind has evolved to be cooperative and empathic because without group support, food, shelter and safety would not be achievable. And much of the psychology of the current Covid-19 epidemic, shows continuing social responsibility, tolerance of new restrictions, and openness to medical expertize.

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Writing on in 1990, in the wake of the AIDS epidemic, Phil Strong reflected, “the human origin of epidemic psychology lies not so much in our unruly passions as in the threat of epidemic disease to our everyday assumptions.” It is the transformation of our familiar environment to one hedged with danger that is most salient in the psychology of the Covid-19 epidemic. What Alfred Shutz called the “routines and recipes” of daily life are disrupted. The things we assumed would work today as they worked yesterday, now fail us. Every simple act, from eating in the work canteen to visiting our parents, takes on new meanings. A few weeks ago, those of us living what was then a normal life, were able to concentrate on only a few puzzles and challenges during the course of a day. Now everything poses a pressing question of risk.

In addition, it is abundantly clear to most of us that the politicians, with access to an army of experts, are no better at this “let’s figure this out” challenge than we are. My approach to being helpless myself and concluding that, over all, the virus will do what it wants to do, has been to observe different responses and how these, so far, affect the epidemic psychology in different countries. The US government has gone for big gestures, but uses words such as “family” to promote the notion of altruism. After all, we all make sacrifices for family. The UK has gone for a far more subtle approach. It is trying to normalize the epidemic, telling us that we have to accept that we will lose people we love "before their time" (thus slipping in a reminder that everyone dies at some time) and instructing us that the best way to protect ourselves is by washing hands, finding a greeting ritual to replace the handshake, using a tissue for coughs and sneezes and staying home, alone, when they are ill.

The big gestures signal, “We have the power to look after you.” The small scale recommendations say, “Here are new routines and recipes by which you can live your daily lives.” The aim is to reduce the number of puzzles in each day, and even to reduce the perception of the risk of Covid-19 by incorporating it into everyday risks of car accidents and influenza. The aspiration expressed by the UK government - eventually we will develop ‘herd immunity’ that will reduce the number of cases in generations to come – asks more of its people than the US. It is one thing to be altruistic within a family, and quite another to “take it on the chin” (as the UK Prime Minister asks of people) for the “herd”. Amazingly, people are, so far, quiescent.

Each epidemic has its own psychology. For the Covid-19 epidemic, so far, neither the big, hugely inconveniencing gestures nor the small scale measures of routine and recipe have produced intense panic and social collapse. It may that, in the absence of the boils that heralded bubonic plague (the “ring of roses” in the nursery rhyme that is a precursor to “all fall down”), or the gruesome effects of the Cyprian plague where “the bowels dissipate in a flow…the eyes are set on fire from the force of the blood,” there is less to activate a visceral terror. Or perhaps today’s population is skilled at risk assessment and more socially responsible and compassionate. Perhaps we expect less protection from its leaders. But the epidemic is at an early stage, and we need to keep watch on the volatile psychology of this epidemic.