In October 2019, a month or so before Covid-19 began to spread from the industrial Chinese city of Wuhan, Steven Taylor, an Australian psychologist at the University of British Columbia in Vancouver, published what would turn out to be a remarkably prophetic book, The Psychology of Pandemics.
Even his publishers had doubts about its relevance and market potential. But in the 22 months since, the book has become like a Lonely Planet guide to the pandemic, passed around and marked up like waypoints along a new and dreadful global health journey.
Taylor’s book, as its foreword points out, is a picture of “how human factors impact the spreading of disease and emotional disturbance”. The stops along the way include prejudices, the role of the media, attitudes to vaccinations, how society manages rumors, and the psychology of conspiracy theories.
The western world, with its enviable access to healthcare compared with much of the planet, is approximately at Chapter 10 in this journey: improving vaccine adherence. “Vaccine hesitancy doesn’t really get at the motivational roots for why people don’t want to get vaccinated,” Taylor told the Guardian.
CDC data showing that urban and rural rates of Covid-19 transmission closely shadow each other, and broad availability of vaccines across much of the western world, suggests denser psychological complexities around “hesitancy” than described by political or economic orthodoxies to explain why 90 million adult Americans remain unprotected by any vaccine.
A preferable term, Taylor writes, and one that has been used by psychologists for close to 60 years, is psychological reactance – a motivational response to “rules, regulation, or attempts at persuasion that are perceived as threatening to one’s autonomy and freedom of choice”.
Despite this, Taylor says that what people say about vaccination is often different from what they do, and studies before vaccines were released predicted a lower take-up than what has actually taken place when faced with a lethal pandemic. That, in many ways, is an optimistic sign, as are signs that vaccination take-up is again rising as the Delta variant surges, especially among unvaccinated populations.
What is clear, Taylor says, is that anger directed politically or personally toward vaccinate-hesitant groups is likely to be counterproductive. Especially, when available vaccines are both overwhelmingly safe and highly effective.
“Psychological reactance has been an issue around any public health guidance, whether that’s increasing the intake of more fruit and vegetables, good dental hygiene or vaccinations and masks,” Taylor said. “The you’re-not-the-boss-of-me kind of response is seen particularly in people raised in cultures that take pride in freedom and individualism.”
He added: “The harder you try to push and persuade these psychologically reactive people, the more they are likely to push back because they perceive their freedoms are being threatened. While they may be a minority, they are also highly vocal, and so we see many different types of people joining in.”
That in turn, leads to what psychologists term “motivated thinking”, otherwise fantasy-thinking in which Covid-19, or climate change, are seen as hoaxes so people can tell themselves positive stories that everything is going to be fine and their freedom is not threatened.
What has often been depicted as conservative individualistic intransigence is in fact a stand-in for diverse groups comprising conspiracy theorists, white evangelicals, some historically traumatized communities of color, new-age believers in natural immunity and others who believe that vaccines are a con by big pharma to maximize profits. The list goes on.
“Putting a foreign object in your body via a needle, from an evolutionary perspective, is contaminating yourself. You’re not, of course, but you can see how some people have developed views about what is pure and faithful,” Taylor says.
Taylor, who has spent 30 years studying anxiety disorders, including excessive fears and phobias, or hypochondriasis, decided to write The Psychology of Pandemics in 2018 after reading about the Spanish flu a century earlier and disease modellers’ predictions of the next pandemic.
He interpreted that pandemics “are essentially a psychological phenomenon and about the behaviors, attitudes and emotions of people” and that “the psychological footprint is bigger than the medical footprint”.
That, Taylor says, is not to downplay the significance of the disease to those that have become sick or died, but that many more people have been psychologically affected. The analysis was fleshed out in another academic paper, published in Canadian Psychology, in which he wrote that “pandemics are not simply events in which some harmful microbe ‘goes viral’”.
He wrote: “Psychology plays a central role in pandemics, influencing the spreading and containment of diseases, and shaping pandemic-related distress and socially disruptive, divisive and potentially harmful phenomena such as panic buying, racism and protests against pandemic mitigation restrictions.”
The Psychology of Pandemics was rejected by the publisher of Taylor’s previous books, who commented that the subject was “interesting, but no one’s going to want to read it”.
The attitude, ironically, was characteristic of Taylor’s thesis – that people tend to be too preoccupied with the present to plan for the future and that left the world hugely underprepared to cope. Still, he says: “I was bummed out. Psychology is hugely important to pandemics.”
The ongoing Covid-19 pandemic, and its psychological effects, remarkably or not, is firmly in keeping with previous pandemics, including Russian flu, Spanish flu and the Sars outbreaks.
“I was pretty much surprised that pretty much everything in the book unfolded,” he says. “These were not Nostradamus predictions – they were predictions of reactions based on research of what happened during previous pandemics. So it was reasonable to expect that with a similar pandemic, with social restrictions in place, you would get broadly similar phenomena.”
What’s been different about this pandemic, Taylor says, is that all the basic phenomena seen in the past have happened on a broader, grander scale.
Part of the reason, he says, is social media and the 24/7 news cycle that can fuel these movements. Looking back to the anti-mask league in San Francisco in 1919, the reasons given then were the same as today.
“The anti-lockdown, anti-mask, anti-vax protests have been a lot more prevalent than they were 100 years ago, even if they were motivated for the same reasons,” he said.
One exception, Taylor says, is the prominence of conspiratorial thinking. “A lot of conspiracy theorists who had tended to communicate with one another emerged from their silos to promote their theories more widely and, I suppose, indoctrinated more people as a result of Covid-19.”
Taylor theorizes that with the Delta variant on the rise, any return to lockdown could trigger an exaggerated backlash and rebellion – part of the psychological phenomenon commonly known as pandemic fatigue.
Lockdowns, he says, are not a long-term strategy for managing pandemics. “They’re a necessary evil but if we have another wave when people have just got a taste of freedom it’s going to demoralize people and be bad for mental health,” he said.
By the same token, people’s desire to get back to pre-pandemic life doesn’t speak to health resilience any more than psychological reactance, he says.
“The consequence of people rushing out to socialize prematurely is part of the uncertainty, especially for people who see themselves as impervious or of robust health,” Taylor points out.
“We’re going to see recurrent outbreaks of Covid, but the desire to socialize is stronger than the fear of getting infected.” And that is psychology.