[quote ilovesooty]@RedToothBrush it's complicated isn't it? I've got one not very close friend who described herself as 'relaxed' about the restrictions. That meant she stayed overnight on several occasions at their houses with at least a couple of friends not in her household. I've certainly not made any attempt to contact her since I became aware of that and as she's a professional connection I'm not really sure how I feel about her now.[/quote]
Tell me about it. I have struggled with people I know who have been breaking the rules heavily and then explain it away with a strawman argument about how they can still do x, y and z and a pretty childish 'its not fair' reasoning rather than realising it was about priortising social contact for certain purposes.
I think it highlights how we have different priorities in life and assess risk in different ways more than anything though. Its not simple and the whole 'everyone should get vaccinated and anyone who doesn't is selfish mentality' helps precisely no one.
I would argue that understanding risk and putting that into context is one of the most difficult things to do - especially when the use of %s is frequently used - which particularly confuses people.
This isn't something that only the 'uneducated' or 'stupid' struggle with either.
Research has found that a scary number of doctors don't properly understand this and can't adequately explain risk to other people. To the point that I think it alarming and that I think everyone should do more to under this so they can challenge doctors if they think they are being told duff information or feel they are being unfairly pressured into doing something they aren't entirely comfortable with.
In terms of restrictions and people not following them, there was an element of 'you can't tell me what to do' combined with people just not really understanding risk profiling and combined collective risk of enough people breaking rules in a way that put people at more risk than they realised.
It does have to be said that presenting risk in a way which doesn't carry bias is also something which is notoriously difficult to do though. We tend to present risk in a way which pushes a particular 'preferred behaviour' and this can make people feel pushed into something or can mean that informed free choice is damaged slightly. And that can, in turn, damage trust in scientists and doctors.
I know that this is an area that there is work being done to try and improve the situation and I think its much needed.
I've plugged Margaret McCartney's book The Patient Paradox more times that I care to mention on MN but its such a good book for deconstructing some of this poor practice and counter intitutive outcomes. One of the things she highlights the need to not go for targets primarily but focus on building relationships with patients instead as thats far more likely to get people with hestiancy of various kinds to engage. If you have concerns about science / doctors / public health campaigns read it. This isn't about telling people to have the vaccine - but understanding that there are lots of people in medicine who understand there are problems with public health campaigns and are working to improve the ability of people to make informed choices and public health campaigns can sometimes be problematic and not hit the mark.
The friends I have who have broken the rules frustrate me, and the reason I've distanced myself from them is less to do with being angry at them and more to do with identifying them as a potential risk to myself which I'd not be prepared to take myself. I also feel like 'they should know better', given his occupation and what his responsibilities are. But you can't actually say this outloud.
I would also add there has been a bit of debate in the media this week about making vaccines compulsory in certain workplaces. A number of experts - not politicians - have argued whether this would be counter productive and actually alienate people meaning they become even more hostile to the idea of having the vaccine. This tends to happen when you have a power imbalance and you have top down rules imposed which removes power from individuals. Putting two fingers up at authority makes some people feel empowered - especially if they are from a group which may have lower 'social status' normally. Its a concept that I don't think really has been spoken about at all and perhaps should be.
I have to say, in terms of building trust with the public, I am very against this type of approach myself. Its somewhat lazy and doesn't engage with the reasons why people are hestitant and why they feel they don't trust the vaccine. The main thing here is that relationship building is time consuming and labour intensive (I actually think there are going to be long term consequences to GPs who have closed their doors particularly harshly and without flexibility for this reason - relationships will be broken and never restored which will have an impact on health further down the line - and this is quite apart and different from not getting appointments as it represents a breakdown in trust).
This is presented as a simple decision but I think for many its MUCH MUCH more complex than that and we should be encouraging greater understanding of disengagement across the board because the problem goes way beyond covid vaccinations.
Health anxieties, white coat syndrome and various other health related phobias are much more common than people realise. They also have usually been triggered by 'something' and thats ultimately what you need to start looking at. For me it started after a couple of experiences of doctors with really poor bedside manner and a condesending tone that made me feel like complete shit and not feel like I was either respected or taken seriously. It might sound minor but it had quite a significant impact on me, and continues to do so. I don't feel I have confidence to deal with deals on a equal level so feel I need support with this. And I'm educated and generally articulate. Imagine that magnified on a community level particularly in less well off areas and the impact that might have.
Its about people failing to acknowledge there is a problem, never mind engage with it and to try and find solutions to it.
I think the best thing we can do is emphasis the importance of making rational not emotional decisions on this and trying to equip people with the tools / skills best to do this and reexamining whether public health campaigns need work in certain ways to improve engagement with particular groups.
Its a very difficult, contenious subject which really doesn't attract enough of the thoughtful debate it needs - particularly from within medicine and public health itself - and its why Margaret McCartney is one of my heroes really.