COVID-19 Update

Maharashtra: Pandemic fatigue?

Print edition : November 06, 2020

Outside the Bombay Stock Exchange building in Mumbai, on October 12. Photo: Dhiraj Singh/Bloomberg

Even as the Maharashtra government is acutely aware that it will not be able to prevent large gatherings in the imminent festival season, understanding the phenomenon of “pandemic fatigue” or resistance among the public to precautionary rules is key to flattening the COVID-19 curve.

When Maharashtra Chief Minister Uddhav Thackeray announced the “My Family, My Responsibility” programme on September 13, it was essentially a move to make citizens accountable for their own health. It is increasingly being accepted that individual citizen responsibility is the surest way forward in fighting COVID-19 since there is little that governments seem to be able to do to control the pandemic apart from harsh measures such as lockdowns.

Under the “My Family, My Responsibility” programme, teams trained in the basics of measuring temperature, oxygen level in the blood and blood pressure were to visit housing societies throughout Mumbai in order to provide the Brihanmumbai Municipal Corporation (BMC) authorities with health maps of localities. This was based on the premise that documenting every individual’s health would go a long a way in containing the virus. But it did not quite turn out that way.

While slums and lower middle-class housing societies were amenable to the idea, the teams faced resistance in upper middle-class and affluent residential areas on the grounds of safety and allowing in strangers. It was also noticed that several areas of Mumbai not only rejected the government’s programme but also slackened on basic precautions such as wearing masks.

Also read: COVID-19 and the danger of complacency

On October 11, Uddhav Thackeray tackled the perceived problem in his public address. He said: “We are there to take full responsibility but you need to be alert. The public has not responded the way as expected. People are behaving irresponsibly and not getting tested. If you test positive, don’t worry about where you will be taken. We will take care of that. You will be looked after but it is very important that you let yourself be tested.”

Paternal tone

The recurrent underlying tone of Uddhav Thackeray’s speeches has been paternal. In his October 11 speech, he referred to the citizens as “my family” and repeatedly emphasised the importance of wearing masks, even resorting to a bit of laboured humour to make his point. He explained that it was out of concern for the public that local trains, places of worship and other places of mass gathering had not been opened up fully just yet. The government is, however, acutely aware that it will not be able to prevent large gatherings in the imminent festival season. Uddhav Thackeray said: “Navratri, Diwali and other festivals are coming up. We are slowly opening our doors for prosperity and good health but not for the coronavirus.”

He hinted that another lockdown was not an impossibility and said that the onus of this decision would be on the citizens themselves. “Elsewhere in the world,” said Thackeray, “there are heavy penalties for not wearing a mask, but I don’t want to do that, not yet. You think about it: would you rather wear a mask or would you rather have another lockdown? Do you want to slowly return to normal life or should we bring in another lockdown?”

Also read: COVID-19 Update | Karnataka: Fearing the worst

“Pandemic fatigue”, or general resistance among the public to precautionary rules, seems to be the next big hurdle to control COVID-19 the world over. The World Health Organisation (WHO) has recognised pandemic fatigue as a real issue. On October 5, the WHO hosted “a high-level virtual meeting for Member States of the WHO European Region to discuss strategies, principles and best practices for countering pandemic fatigue and reigniting public support for maintaining protective behaviours.” The meeting came about because “despite general public support for pandemic response strategies, member states are reporting increasing levels of pandemic fatigue among their citizens.”

In its report titled “Pandemic fatigue: Reinvigorating the public to prevent COVID-19”, the WHO states that pandemic fatigue is a “demotivation to follow recommended protective behaviours, emerging gradually over time and affected by a number of emotions, experiences and perceptions.” The report adds: “Behavioural insights surveys consistently confirm that the majority of people generally support national COVID-19 response strategies, uphold high knowledge levels and wish to follow recommended behaviours. This is notable after half a year of lockdowns, restrictions and significant impacts on all of our everyday lives. Still, member states across the WHO European Region are reporting emerging pandemic fatigue in their populations. We consider pandemic fatigue as an expected and natural reaction to the prolonged nature of this crisis and the associated inconvenience and hardship. However, it poses a serious threat to efforts to control the spread of the virus. Until a vaccine or effective treatments are available, public support and protective behaviours remain critical for containing the virus. The gains that each nation collectively achieved through lockdowns and other measures—sometimes at high social and economic costs—must be safeguarded. Very limited experience exists on how to best maintain or reinvigorate public support during a global health crisis that expands over months (potentially years) and that affects every member of every society in every country.”

Also read: COVID-19 Update | Chhattisgarh: A late upsurge

The report suggests a national plan of action that consists of “understanding people, engaging people as part of the solution, allowing them to live their lives, but reduce risk and acknowledge the hardship people experience”. The guiding principles overarching these key strategies are “transparency, fairness, consistency, coordination, predictability”.

It seems a tough challenge to persuade the public to follow precautions, restart normal life and keep the virus in control. The only realistic, long-term solution seems to be individual citizen responsibility. While the “My Family, My Responsibility” programme shares many similarities with the WHO report recommendations, perhaps understanding pandemic fatigue and seeing it as a new phase in the campaign against the virus will cut at the root of the spread and flatten the curve.

As of October 13, Maharashtra reported 1.53 million positive cases, 1.27 million recoveries and 40,349 deaths.

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