What the British Government should have learned from the AIDS public health campaign
People are dying of ignorance: not understanding how the virus spreads, or the risk of spreading it; not wearing masks properly, or at all; not observing social distancing. Boris Johnson’s government have clearly handled the pandemic badly. One of their failings has been very poor communication.
Two things really struck me. Firstly, there has not really been a coherent public health campaign. We get the cabinet and various chief science and medical officers on news briefings, but where is the national campaign of posters, fliers, and adverts explaining how and why to wear a mask? Where are the public information films about how Covid is spread? Why are we not being told to keep windows open, as Merkel is telling Germany? Why are we not being taught about viral loads? All we have is a government baffling everyone with convoluted rules, and this weird ongoing obsession with pubs. Arguably, modern media is less conducive to a national public health campaign. People stream specific programs, and download news, so there are fewer places into which to fit a short film or large advert that all people will see.
But when you read the rules you can, if you are well informed, begin to see how actual science informed them, but it is well hidden and entirely unexplained to the public. We know now that prolonged time spent in an enclosed space with people talking loudly and not wearing masks makes catching Covid highly likely. That basically describes a party in someone’s house. So that’s why we were previously allowed to meet indoors for business, but not to socialise. And that’s why we could not have groups of people in our houses. Groups at home are more likely to drink, lower their guard, and talk a lot for several hours. Business meetings are generally an hour, with coffee.
Without explaining the logic of the rules, to many people they just seem stupid. Stupid rules get broken. If those in authority explain why people are being asked to do something, they are more likely to comply. The government has completely failed, consistently, on that front.
Secondly, almost nobody is saying the most obvious thing: Covid is spreading because of people’s behaviour. We are, for some reason, terrified of calling people out for being stupid when it comes to Covid. Again, the government have barely attempted to look straight into a camera and talk straight to the people who are making all this worse. They talk about Covid as if it is inevitable, and as if it is somehow the ruler of its own destiny. We talk about the rising numbers of cases and deaths in a passive voice: case numbers have risen. We should be talking about spread, and about cause. Behaviour is leading to cases rising — people are spreading Covid.
Other countries, like Taiwan and New Zealand, have shown that if people adopt the right behaviour, Covid can be all but stopped. If you don’t adopt the right behaviour, the virus spreads. It is like any other virus. Yet the politicians are dogged by an underlying libertarian ideology that makes them uncomfortable, as The State, telling people what to do, or criticising their behaviour. That ideology is a disaster during a pandemic.
We have a lockdown because people have behaved in a way that has spread the virus, not because of some cunning plan by the virus. We are in the middle of a pandemic involving a virus that is airborne, and is spread by breathing and inhaling. It’s not actually that complicated. If it was impossible to win this fight, Taiwan and New Zealand would be in just as bad a situation as the UK.
All this made me think of the first pandemic I experienced. I was in my early teens when AIDS emerged. It dominated my teen years, as me and my peer group became sexually active at a time when being sexually active could kill you. At the time, the Conservative government launched a now famous public health campaign.
Back in 1987, this new virus was spreading around the world, killing people. In a very short time, it was necessary to change our culture completely, in particular to encourage people to use condoms to avoid this disease, rather than just as a form of contraception. In the UK, Norman Fowler, the Conservative Minister of Health at the time, proposed a radical public information campaign. It was particularly radical because the Conservative government had conservative attitudes towards sex, and sex education.
The campaign became known as the Tombstone campaign, or Don’t Die of Ignorance, because the most memorable images were a public information film with a huge tombstone, and adverts with the phrase ‘don’t die of ignorance.’ This phrase was on posters everywhere, and leaflets were sent to every house. It even became a postmark used by Royal Mail.
Much has been written and discussed about the campaign. Some argue it was impressively radical, and hugely effective. Others point to the fact that campaigning had already been underway by charities and some media for some years. The reason I was reminded of it recently is because it was a government campaign, and it is clearly missing today.
The government has failed to produce a well-designed public information campaign that explains how Covid spreads, how and why to wear a mask, that encourages everyone to keep windows open, and to avoid enclosed spaces. We need that mixture of clear information, and a direct call to action. ‘Don’t die of ignorance,’ could as easily apply today as it did back in 1987. The original lockdown tag line, ‘Stay home. Protect the NHS. Save lives,’ was as close as this government has come to ‘Don’t die of ignorance,’ but it has not become part of popular culture and is not nearly as impactful.
It was a good start, but any sense that this was becoming the defining phrase of the pandemic was undermined by the painfully vague ‘Stay alert, control the virus, save lives.’ This was then superseded by the disastrous advice to ‘eat out to help out,’ which will probably last longer in people’s memories both because it was so fun, and so calamitous. This was then followed by ‘Hands. Face. Space,’ a phrase so striking and memorable that I had completely forgotten about it until I started researching this essay. Ironically, this completely overlooks the main thing we should be doing, which is wearing masks. After the entirely predictable surge of infections after the misguided relaxation of rules over Christmas, we are full circle back into lockdown, and being told to ‘Stay Home. Protect the NHS. Save lives.’
None of these, with the exception of ‘save lives,’ even mentions death, and bizarely none of it has focussed on wearing masks. They feel like they were written by earnest scientists, and then considered by awkward political advisors afraid of offending anyone. They are a mixture of technically accurate information conveyed in a politely non-confrontational way.
The AIDS campaign worked because it focussed on death. It was shocking, frightening, and unambiguous: do this or die. On the news now, the daily briefings are getting harsher in that respect, the scientists and doctors are sounding desperate as the politicians continue to prevaricate. The politicians are finally starting to talk about how the minority who flout the laws are causing infections and deaths. But people no longer sit on the edge of their sofa watching these news briefings — people have become immune to them, just like we have to the numbers of infections and deaths.
This government’s response to the virus has been dogged by an underlying libertarian ideology that believes government should not tell people what to do, and should trust people to make the right decisions. This has been shown not to work in these circumstances. What we need now, even this late in the day, is a clear and decisive public health campaign on the scale of the Tombstone campaign, which explains how Covid spreads and makes a clear link between not wearing a mask or social distancing properly, and people we love dying.
Why has the government not worked more closely with Social Media and phone companies to flash public information directly onto people’s screens and devices? There are plenty of empty billboards and advertising spaces at the moment, and a short advert-like film could be circulated around streaming channels, and tagged onto podcasts, as well as being circulated by influencers. Much of this is happening, but not in a coordinated way, and not with a defining and jarring message. There are posters now telling us to ‘Stay Home. Save Lives,’ and reminding us to wear a mask on public transport, but it is too little too late. It is vague, uninformative, and sparse.
The government has done a bad job with so much of this pandemic, but in particular with communication and clarity of message. Now is the time to bring in the best minds to come up with a Covid version of the Tombstone campaign.