How behavioral economics’ nudges can help inform our COVID-19 post-lockdown strategy

25 July 2020 | First published here

10-minute read for national and local government officials, legislators, company decision-makers, non-governmental organizations, development agencies and problem-solvers

Google’s Community Mobility Report for the Philippines shows that the drastic lockdown in April and May, one of the longest and strictest in the world, has led to a sharp drop in movement among Filipinos. Some of the lowest points were recorded in the first half of April, showing up to 80 to 90 per cent decreases in visits to (a) transit stations, (b) retail and recreation, and (c) workplaces compared to pre-lockdown baseline days. Google’s mobility trends were derived from aggregated and anonymized sets of activity data from users who have turned on their location history in Google apps, which could translate to hundreds of thousands of data points. The baseline is defined as the median value from the five‑week period from January 3 to February 6.

With the easing of movement restrictions and the gradual reopening of the economy, Google’s mobility trends show a steady increase in movement among Filipinos. Visits to public places like parks, retail and recreation, transit stations and workplaces have started to pick up across regions and provinces. Meanwhile, coronavirus cases in the country continue to rise, breaching 70,000 as of July 21. Recent projections from the University of the Philippines’ UP COVID-19 Pandemic Response Team show that coronavirus cases could reach up to 95,000 by the end of August.

Draconian lockdown measures are easing across the world. Many governments are now shifting their focus to intensifying campaigns to improve public adherence to the latest medical guidance from the World Health Organization, alongside the scaling up of medical resources and capacities to ‘test, trace and isolate’. Similarly, in the Philippines, the post-lockdown relaxation signals a comprehensive policy shift towards scaling up health capacities nationwide to ‘test, trace and isolate’ and ensuring public adherence to the latest medical advice, like social distancing, handwashing, wearing of face masks, and isolating when sick, among others.

Paradigm shift in the COVID-19 lockdown easement strategy

'New normal' at a barbershop in the Philippines. Photo by John Karlo Mendoza on Unsplash

Public behavior change is one of the domains that will be key to our success in fighting COVID-19 and mitigating its effects. Since the lockdown, we have witnessed a dramatic change in the way Filipinos live, behave and do things. These behavioral changes range from macro trends like increased remote work setup and reduced mobility among the public, to micro behaviors such as social distancing and hand washing habits. Attention to these macro and micro behavioral trends will be a game-changer in our fight against the virus.

Behavioral economics is a rapidly expanding field which infuses perspectives from psychology and economics to understand how humans make choices in individual, organizational and institutional domains given resource constraints. The field focuses on various influences on human decision-making and judgement, pinning down cognitive biases and systematic deviations from the standard ‘rational’ model of agents in mainstream economics. Real world humans make thousands of decisions every day and many of our choices are automatic, fast, emotional and non-linear. For example, humans feel twice the amount of pain from losses compared to the pleasure they get from gains, and humans often overvalue smaller rewards in the present more than larger rewards in the future.

Nudge thinking is a key concept in behavioral economics introduced by Thaler and Sustein in their pioneering book “Nudge: Improving Decisions about Health, Wealth and Happiness”. They describe nudges as “any aspect of the choice architecture that alters people’s behavior in a predictable way without forbidding any options of significantly changing their economic incentives”. Nudging contrasts from heavy-handed policy approaches like enforcement, banning and compliance. Instead, it looks at soft policy touches through positive reinforcement and indirect interventions based on behavioral insights.

Small pushes, huge impact

Across the world, nudging is helping shape governments and local organizations’ COVID-19 responses. One overarching strategy is to leverage the science of human behavior to increase public adherence to the latest medical advice.

The United Kingdom’s Behavioral Insights Team (BIT) created a COVID-19 text service for the National Health Service, the UK’s publicly funded national healthcare system. In their communications campaign, the BIT developed “customized text messages informed by behavioral science with advice on what they [the public] and members of their household need to do to stay safe”. The team leveraged social norm and commitment to encourage people to stay at home.

In another study conducted by BIT through an online experiment, they demonstrate that the reframing of antibody test results as providing “antibodies” rather than “immunity” improved people’s perceived risk and behavior. Their preliminary analysis shows that people’s perception that antibody tests gave ‘zero’ risk of reinfection jumped from 2 percent (for “antibody” framing) to 6 to 10 percent (for the “immunity” framing). Antibody tests provide an indication whether someone has contracted the coronavirus. However, based on the medical evidence that is currently available, there is no strong evidence yet that those who have had the virus become completely immune to it.

In a field experiment in Denmark, researchers from iNudgeYou demonstrate that (a) changing the default placement of hand sanitizers to a more prominent spot and (b) providing a salient sign showing a positively framed message have resulted in a significant increase in hand hygiene compliance among hospital visitors. Attaching normative messages in bright red signages like, “here we use hand disinfectant in order to protect your relative” to hand sanitizers resulted in higher compliance. The use of hand sanitizers among hospital visitors jumped from 3 percent to up to 67 percent.

Similarly, in the United States, a recent study titled “The effectiveness of moral messages on public health behavioral intentions during the COVID-19 pandemic” show that social norm messaging that focus on duties and responsibilities towards family, friends and fellow citizens strongly shaped public health intentions and beliefs.

In Rio de Janeiro in Brazil, the city government sent drones with audio messages to nudge the public to avoid crowded areas and wash their hands. This initiative is being led by NudgeRio, a city government department leveraging behavioral science to inform communication strategies and policy decisions. In a new initiative aimed at addressing growing domestic violence, Rio’s nudge unit is currently looking at developing an app with a panic button for women to signal an emergency amidst the pandemic.

In different parts of the world, behavioral strategies are being leveraged to provide scientific solutions to promote behavior change and ease adaptation to the ‘new normal’. These strategies are being implemented across various sectors, scales and domains of governance. Nudges are being introduced not only by national governments but also private establishments, hospitals and schools, non-governmental organizations, local governments, and development agencies.

Nudge thinking is one of the many new and innovative policy approaches that our country can apply to defocus our strategy from heavy-handed measures towards more empathetic and human-centric, scientific solutions. Such behavioral interventions, however, require a deep understanding of the local context and distinct environmental constraints. They must be applied taking into consideration the complexities of our socioeconomic landscape, and assessing their replicability in a scientific manner. Nudge thinking has shown immense promise in other parts of the world which we can build on moving forward.