COVID-19: Marilou Gagnon—Don't allow a fear epidemic to undermine public education and support

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      Fear is one of the tools in the public-health toolbox. It is commonly used to discourage people from drinking and driving, engaging in unprotected sex, using illicit substances, or biking without a helmet, just to name a few.

      In the context of a viral outbreak such as COVID-19, public-health officials can use fear in an effort to get people to understand the risk of contracting or transmitting the virus, the severity of the health outcomes, and the importance of adhering to public-health measures such as physical distancing.

      However, fear is a double-edged sword. It can be effective but it can also backfire. For this reason, it should not be overused.

      Reflecting on the SARS outbreak, a health-communications official at the Centre for Disease Control’s National Center for Infectious Diseases wrote in a 2004 paper that “as we prepare for the next new or reemerging disease outbreak, we should also be preparing to deal with the fear epidemic that will likely accompany it”. This certainly rings true in light of the current situation in Canada. As governments are ramping up public-health measures and using fear to boost their effectiveness, we are also in the midst of a fear epidemic—one that should be taken into account as we plan the next waves of public-health messaging. 


      Over the past few weeks, a great deal of emphasis has been placed on putting the Canadian population on high alert. This is to be expected at the beginning of an outbreak, when the risk of contracting or transmitting a virus is not fully understood (and embodied) by the population.

      One way to change this is to emphasize the realness and immediacy of this risk, the severity of the health outcomes, and the measures people can take to “flatten the curve” (an expression that we all know too well by now). Initially, fear can make people more receptive and responsive to public-health messaging. However, too much fear can have the opposite effect.

      We have now reached a stage in the COVID-19 outbreak where Canadians are extremely fearful: fearful of the virus, fearful for their health and the health of their loved ones, fearful of what this outbreak means for their present and their future, and fearful of the toll it will take on their mental and physical health. Starting this week, many will become fearful of being arrested or facing sanctions if they fail to comply with public-health measures.

      Of course, some of you may think that Canadians are not fearful enough, that governments should instill more fear in order to gain in protection. Yet what we truly need at this point is education and support.

      Education is needed to make sure that risks are understood and contained, not amplified. Support is needed to make sure that Canadians can actually follow the recommended public-health measures during the next few months despite facing unprecedented levels of uncertainty and precariousness.

      Without rapidly scaling up education and support, we will start to see fear acting out in ways that can, potentially, worsen this outbreak. And if this happens, we will have learned nothing from previous outbreaks and the lessons learned by the public-health community.

      Marilou Gagnon, RN, PhD, is an associate professor at the University of Victoria school of nursing and scientist at the Canadian Institute for Substance Use Research.