Have been thinking a lot about the kind of behavior change communication strategy the government needs to employ to contain the spread of #CoronavirusinPakistan so here are some ideas for what it needs to focus on. Thread.

For those who don't know, behavior change communication (BCC) is a term used in development & public health for a process of intervention with individuals & communities to promote positive & avoid harmful behaviors that are injurious to individual or public health/well-being.

Broadly, in any behavior change strategy, you need to give people both an appropriate understanding of the risks involved (people will only take sufficiently precautionary action if they know how they are vulnerable) as well as actionable knowledge of the viable solutions.

One of the issues in govt communication so far is the downplaying of risk ('like the flu', 'corona janleva nahi', 'young people not at risk' etc). There needs to be a distinction b/w spreading panic & giving people an objective understanding of the risks so they act accordingly.

(there are welcome signs this is now changing but the communication of objective risks from covid-19, as per the latest scientific findings that are emerging, needs to be actively accelerated in government communication)

1. Asymptomatic transmission: This is a key risk that isn't being properly communicated. Multiple studies have found covid-19 infections are frequently transmitted by individuals without symptoms (from 30% of infections in one study & upto 80% in Wuhan according to others)..

Covid-19's long incubation period (up to 14 days unlike 1-4 days with the flu) & often gradual onset is what makes it challenging as one can be infectious for a number of days prior to appearance of symptoms. This must be communicated as a key reason for physical distancing.

2. Risks to/from young people: There's a need to emphasize the fact that, even if less likely to die, the young can easily infect others (esp their parents/elders, people with chronic disease & weak immunity) whose lives will be endangered. Critical for our youthful population.

3. Risks to health system/workers: The distinct feature of covid19's impact is its rapid overwhelming of health systems & high fatality rates of health workers from over-exposure, which both reduces society's ability to fight it & drives up overall mortality from regular disease.

4. Moral framing: The decisions facing people right now are moral ones, requiring personal sacrifices to protect others. Research tells us that people generally respond more to risks to others, esp their loved ones & the vulnerable, than themselves. It needs to be framed that way

To overcome ingrained habits involving physical closeness, physical distancing must be described as a moral/ethical imperative for this crisis, as something we must religiously practice to protect the elderly, the sick & the vulnerable, as a collective struggle to save life.

5. Framing non-distancing as an active choice: Studies show people avoid harmful action more than harmful inaction. We need to reframe ‘carrying on as usual’ as an active choice rather than a default decision. This reframes the choice to not observe distancing as a moral wrong.

6. Unified stream & repetitive messaging: One of the govt's key weaknesses rn is inconsistency - dismissing risks one day, warning of them the next. BCC succeeds when all key sources of info- govt, scientists, media, clergy- give public repeated exposure to the same information.

7. Personalize risk: Research tells us people pay more attention to personal stories than statistics. All the key risks (asymptomatic transmission, super-spreading, young-to-old transmission, infection of medical staff) must be communicated through actual individuals' stories.

8. Certainty of benefits: People are less willing to act when benefits are uncertain. Hence, govt sources expressing uncertainty ('we dont know what works', 'not sure if lockdown will work') isn't helpful. The verified containment benefits of distancing must be mass communicated.

9. Instil confidence to act: Stress research tells us what makes people freeze in a stressful situation is the idea of it being uncontrollable. BCC must both convey specific solutions that can prevent infections & constantly instil confidence in people of their ability to do so.

10. Masks/face coverings: There is now solid scientific evidence & rising consensus that mass mask use (even homemade) reduces transmission of covid-19 droplets & aerosol. Communicating need for #masks4all must be a key element of lockdown exit strategy. https://www.theguardian.com/commentisfree/2020/apr/04/why-wear-a-mask-may-be-our-best-weapon-to-stop-coronavirus

11. Avoiding solution aversion: Research tells us people who aren’t able to easily practice solutions (eg, slum residents), come to believe they're not necessary. Need to tailor messages for vulnerable populations & explain how they can & must act in their specific circumstances.

For those interested, you can find some key resources for social and behavior change for covid-19 here. This includes guidelines for specific kinds of audiences & at-risk groups. Will continue to add to this thread as the evidence on covid-19 evolves. https://www.thecompassforsbc.org/trending-topics/covid-19-resources-social-and-behavior-change