10th Feb 2022
By Hannah Chappell
What Has the COVID-19 Pandemic Taught Us About Behavioural Fatigue?
When the coronavirus first emerged to ravage nations around the world, many policymakers expressed concerns about long-term restrictions on people's behaviour, citing behavioural fatigue as a mitigating factor that would make individuals unwilling or unable to cope with prolonged strictures. Concurrently, behavioural scientists questioned the legitimacy of behavioural fatigue as a concept, citing little supporting evidence and arguing that hesitancy in implementing behavioural safety measures would cost many lives (Harvey, 2020).
With two years elapsed since the onset of the COVID-19 pandemic, what have we learned about behavioural fatigue? To answer this question, we consider the United Kingdom's approach to tackling the virus and the public's reaction to these policies.
The British government's initial response to the Coronavirus outbreak evidenced confusion and disarray. First insisting in March of 2020 that mask-wearing was pointless and lockdowns unnecessary, U.K. authorities quickly changed their tune, and by March 23rd the first national lockdown was announced. This initial turbulence set the stage for two years of flip-flopping and last minute rule changes.
Downing Street's hesitancy to institute dramatic protective measures, such as lockdown and social distancing policies, was in part chalked up to fears over behavioural fatigue, the idea that citizens would become tired of these restrictions and eventually be reluctant to follow guidelines, which could prove problematic if the outbreak worsened over time. This notion was disputed by behavioural scientists, who penned an open letter to the U.K. government urging authorities to act swiftly in order to avoid catastrophe:
While we fully support an evidence-based approach to policy that draws on behavioural science, we are not convinced that enough is known about “behavioural fatigue” or to what extent these insights apply to the current exceptional circumstances. Such evidence is necessary if we are to base a high-risk public health strategy on it. In fact, it seems likely that even those essential behaviour changes that are presently required (e.g., handwashing) will receive far greater uptake the more urgent the situation is perceived to be.
Pointing to a lack of evidence for behavioural fatigue, these experts advised the government to act as swiftly as possible to mitigate potential worsening of the Coronavirus spread.
Meanwhile, some social science practitioners continued to warn against the consequences of behavioural fatigue. In a letter published in the British Medical Journal in August, 2020, psychiatrist Eugene Breen wrote:
[I]n the context of Covid and NHS and health workers and ordinary people living under restriction, behavioural fatigue is a real problem. People get tired washing hands and wearing masks etc, health workers become exhausted from extreme effort for 4/5 months now without a break, and the prospect of a long haul coming down the tracks. Behavioural fatigue is here already and has always been here. It is common sense and human experience that "you can only take so much before something gives."
Breen argued that behavioural fatigue is a ubiquitous human experience, seeming to liken this concept to a form of burnout (recently recognized by the World Health Organization as a legitimate occupational phenomenon).
There is no doubt that COVID restrictions in the U.K. brought about a host of unintended negative consequences. A review published in The Lancet in February 2020 surveyed the psychological impact of quarantine and identified post-traumatic stress symptoms, confusion, and anger as the most widely-experienced psychological experiences resulting from quarantine measures in the U.K. (Brooks et al., 2020). Globally, rates of depression and anxiety both increased significantly over the course of the pandemic, while school closures and routine disruption have been cited as causing significant distress to children and adolescents (Lee, 2020; Taquet, Holmes, & Harrison, 2021).
However, negative mental health symptoms and behavioural fatigue are not synonymous, and there is little evidence to support the notion that behavioural fatigue prevents people from practising protective health behaviours for an extended period of time. A study conducted in August 2021 found that while high-risk behaviours were more prevalent during the second U.K. national lockdown than during the first lockdown, the increase was not due to behavioural fatigue, as Professor Oriel Sullivan at University College London reported:
Instead, the main driver of high-risk behaviour seems to have been a return to the workplace. The potential reasons for this include schools being open, allowing parents to return to in-person work, and an increase in businesses such as takeaways remaining open during the second lockdown compared to the first.
These findings are reinforced by the information provided by the Office for National Statistics (ONS). Between 22 September and 3 October, 2021, 86% of surveyed adults reported wearing a face covering outside of their home in the past week, whereas between 15 December, 2021 and 3 January, 2022, this figure rose to 94%. Twenty-two months since the onset of the COVID pandemic, British citizens are still willing to engage in protective behaviours, and it appears that this willingness increases in response to novel threats (i.e., new variants of the virus).
In fact, people's response to a years-long pandemic gives evidence to humans' resilience and ability to cope with major stressors. Data from ONS gathered over the course of 2020 found that 64% of people surveyed reported coping well with the stress of the pandemic. Again, it must be noted that effective stress management does not rule out the possibility of behavioural fatigue; however, there is evidence to suggest that most people in the U.K. are able to contend with the COVID-prompted changes to their lives.
What We've Learned
Now, in the early months of 2022, the number of daily new cases in the United Kingdom hovers around 65,000. Protective measures remain minimal, consisting primarily of mask-wearing and the encouragement of frequent testing, despite infection rates soaring to record highs in mid-January, 2022. In December, 2021, survey data indicated that though the majority of British citizens were opposed to returning to strict lockdown, they remained largely in favour of social distancing measures (Kirk, 2021).
So, what does this tell us about behavioural fatigue? Though people in the U.K. may be hesitant to implement the strictest protective measures, there is little rigorous evidence to support the idea that people are unable to maintain inconvenient behaviours for an extended period of time. We may gripe and moan about COVID restrictions, but in actuality most of us are still willing to maintain these behaviours in the interest of public safety.