With the alarming growth of COVID-19 cases, our state’s media and leadership have obsessively focused on the public’s “bad behavior.”

All summer, we have read stories about people breaking quarantine and gathering in large groups. In many of these articles, experts and non-experts alike out those who went to work while sick or speculate on whether or not the infected person was wearing a mask when around others.

In nearly every daily news digest from the COVID-19 Joint Information Center, the public is reminded to take personal responsibility. They are shamed for their lack of regard for others: Governor Ige had strong words for people who have let their guard down contributing to the surge in cases.

All state leaders echo the personal responsibility rhetoric, using a public relations strategy that is known as framing. They directly attribute spikes and surges to a misbehaving public, one that is unable to take responsibility for its actions.

Here are a couple of examples.

A top public health official said, “As long as individuals in our communities fail to accept personal responsibility for the spread of COVID-19, we are unfortunately going to see continued days of triple digit numbers.”

Or, from our governor: “It’s clear that many across the state has relaxed their commitment in fighting against this COVID-19 infection … We have to take action to embrace the personal responsibility, to do what we can to slow the spread of COVID-19 in our community.”

Our major media outlets reinforce these sentiments, as demonstrated by a July 8 editorial in the Honolulu Star-Advertiser entitled, “Bad time to let down our guard.” Or more recently, in an Aug. 10 article in Civil Beat that asks, “So how badly are people behaving?”

Should we expect anything different? A story about an office where workers diligently wear their masks and sit 6 feet apart is hardly click-bait.

Nor are perhaps the more important questions about that office: Did the employer provide enough hand sanitizer? Is there sufficient ventilation? Do the workers have sick leave if they get ill? Are they paid enough to take time off?

Responsibility Rhetoric

While there is certainly evidence of poor decision-making, and we must all do our part, blaming the public for the current crisis obfuscates the responsibility of state and local leadership.

If the public is to blame for the current surge in infections, then our leadership is no longer responsible. It is an evasion technique that avoids asking hard questions, making hard choices, and more than anything, it avoids accountability.

Blaming the public allows for inaction on contributing factors to the spread of infection. These include limited access to health care for certain groups and for those that have lost their jobs, the lack of sick leave for many, insufficient wages to match the astronomical cost of living, and overcrowded housing that disproportionately affects our highest risk groups.

The use of personal responsibility rhetoric is one that the tobacco industry mastered in the early 1980s. As evidence mounted that Big Tobacco was responsible for the deaths of millions, it needed a public relations strategy that shifted blame elsewhere.

Through some trial and error, Big Tobacco realized that framing a public health crisis around personal responsibility was highly effective at reducing public outrage and in minimizing litigation. The tactic is so successful that it continues to be used by many other industries and interests to avoid accountability for public harms (e.g., gambling, firearms, etc.).

In the past month, Governor Ige reiterated the importance of personal responsibility at nearly every daily press briefing. Nearly all mass media venues have parroted this language, as have all the most prominent elected and appointed leaders involved in the response to COVID-19.

To be fair, our state leadership is not alone in using this framing. The rhetoric of personal responsibility is also coming from the federal government.

For example, here is a transcript from the Centers for Disease Control and Prevention: “We owe it to our nation’s children to take personal responsibility to do everything we can to lower the levels of COVID-19.”

Knowing the occupants of our executive branch, should we really be surprised that the federal government is applying techniques learned from Big Tobacco to defer responsibility for the crisis?

Punitive Action

If a badly behaving public is responsible for out-of-control infections, then a natural extension of this logic is to punish the public when it misbehaves. The criminalization of previously normal and healthy behaviors, such as walking on the beach or in a park, reflect this logic.

Our state is currently using police and other security personnel to enforce restrictions on a variety of behaviors for which such actions would have been unimaginable six months ago. What’s more, it is unclear if the targeted behaviors currently pose a risk to public safety.

State officials appear unable to provide epidemiological evidence to justify many of the restrictions. The lack of evidence of major outdoor transmission events, especially when juxtaposed against other known sources of outbreaks, threatens the perceived legitimacy of these restrictions.

Crucial consideration of the fairness and proportionality of the punishments for our misdeeds is lacking. Bad behaviors, such as hiking, walking in a park, and going to the beach, are all now subject to criminal misdemeanor charges that can result in a fine up to $5,000 and/or a year in jail. In other words, members of the public who engage in these behaviors are subject to the same punishments (actually, in many cases, less) as those who committed a DUI, assault, or minor drug crime.

A Cautionary Tale

Personal responsibility rhetoric is effective until it is not. In the face of public demand for greater accountability brought on, in part, by whistleblowers leaking evidence of the deliberate misleading of the public, Big Tobacco became vulnerable to a flood of litigation in the late 1990 and early 2000s.

The public relations strategy of Big Tobacco ultimately failed because the public can only take personal responsibility for their behaviors when they are empowered to do so.

For combating COVID-19, this means doing much more than giving daily press briefings and public safety announcements. People need clear messages, articulated in ways and languages they understand and across media platforms they actually use. They need support to follow the messages.

As we are learning, not everyone can access masks and other personal protective equipment. And, many people do not have or cannot afford to take sick leave.

For those with low incomes and no sick leave, the choice is often between paying for food and rent or staying at home when sick. Asking people to change “their bad behaviors” under such circumstances not only lacks empathy, but is almost certainly doomed to fail. Other actions are thus needed, including in this case, policy change to provide sick leave to our most vulnerable.

A Final Warning

The engagement of police in public health is risky business. As articulated in this excellent commentary, the use of police to enforce measures perceived as illegitimate fundamentally damages the relationships among the state, police, and public. This, in turn, can generate disorder and damage the foundations of democracy.

When done well, police can be successfully engaged in outbreak control, but their application needs to be targeted and information driven. The United Kingdom, for example, is using an approach built on the concepts of “engage, explain, encourage” and “enforce” only when necessary. It is an approach that seeks to build public cooperation, which is a necessary prerequisite to managing the virus.

COVID-19 restrictions will have to be applied to varying degrees for months to come. We need a maximum of public goodwill and cooperation.

Unfortunately, our response is eroding these fundamentals. At the end of the day, the question really begs asking, who is it again that is behaving badly?

About the Author

Catherine Pirkle is an associate professor in the Office of Public Health Studies at the University of Hawaii Manoa. She is a global health researcher and life-course epidemiologist who has done work in sub-Saharan Africa, Latin America, and the Canadian Arctic. She is also a lead investigator for the Health Hawaii Initiative Evaluation Team, which works in close collaboration with the Hawaii Department of Health.

Originally posted at Civil Beat