In nearly every public appearance since March, Boulder County Public Health Executive Director Jeff Zayach has talked about personal responsibility.
The setting changes — city council meetings, University of Colorado Boulder briefings, school board meetings, public health community forums. But the message remains the same: People can stop the spread of coronavirus by not gathering, keeping distance from others, washing their hands and wearing a face covering.
As COVID-19 cases ebbed this summer and surged in the fall, officials at all levels of Colorado government, all the way up to Gov. Jared Polis, have repeatedly stressed the importance of people taking individual responsibility to stop the spread of the virus.
But does telling people to be personally responsible — to take it upon themselves to prevent a virus that’s claimed the lives of more than 2,700 Coloradans — actually work?
According to researchers and experts in public health policy, the benefits of telling the public to be personally responsible range from lukewarm to damaging.
“Public health measures that have tended to work throughout the years are things that individuals can’t affect,” said Stefanie Mollborn, sociology professor and interim director of the Institute of Behavioral Science at CU Boulder.
“When we’ve gotten cleaner water, cleaner air, safer food supplies and better trash removal — these things were very, very important 100 years ago for bringing us into these decades of growing good health, and these are all things that individuals couldn’t have done,” she said.
But Zayach said he thinks it’s important to keep talking about the importance of individual actions.
“Whether we think it’s an effective message or not, it really does come down to people taking responsibility for those precautions,” he said. “People are battling over strategies put in place across the country and world, but we know this is completely preventable without needing to put all of those mandated things into place.”
The mandates are necessary, Zayach said, because people aren’t following precautions.
There’s also the challenge of how people view responsibility through different filters of politics, culture and identity. How Weld and Boulder counties have interpreted and implemented personal responsibility as a public health policy represent different sides of the same coin. Boulder County’s enforcement of state and local public health orders stands in contrast to Weld County’s emphasis on citizens choosing what’s best for them.
“Talk about conflicting messages,” said Lori Peek, sociology professor and director of the Natural Hazards Center at CU Boulder. “When I’m in Weld County I’m receiving one message and cross into Boulder County and receive a different set of messages. It’s hard because we all have different factors that are influencing our sense of personal responsibility, and what does that really mean in the context of a pandemic?”
Clear messaging a struggle
The best case scenario for communicating with the public in a crisis, according to Peek, is a clear, consistent message from a trusted source that’s tailored in a way that it makes sense to the audience and is culturally appropriate.
Hitting all — or even some — of those marks in the coronavirus pandemic has been a struggle.
“We’re living in such a fractured media environment that figuring out who is the trusted messenger has become ever-more complicated,” Peek said. “Having a clear and consistent message as we’re grappling with a still-unfolding crisis, where there are still so many unanswered questions, is also complicated.”
The first example that comes to mind, Peek said, is when U.S. Surgeon General Jerome Adams in February exhorted people to stop buying face masks because they weren’t effective at slowing the spread of coronavirus. Studies subsequently showed that face coverings are effective at preventing the spread of the virus, and Adams reversed his position in the following months.
“The science has been moving at the speed of light, so getting that clear and consistent message out to the public in this time of turmoil and so much division and conflict has made adhering to those principles of effective communication really hard,” Peek said.
Personal responsibility as a public health policy has a mixed record of success, said professor Glen Mays, chair of the Department of Health Systems, Management and Policy at CU Anschutz’s Colorado School of Public Health.
It gets complicated when behaviors are more likely to protect others than the individual, Mays said.
“One of the problems with a purely personal responsibility message is that for most people, their individual risk for serious health consequences (of coronavirus) is pretty low,” he said. “When a lot of the benefit from being safe accrues to other people, we have to be really altruistic to engage in those behaviors, and that’s a tough message for people to really resonate with.”
Using shame or fear is also not an effective motivator, Mollborn said. So when Polis compared attending Thanksgiving dinner without quarantining first to putting a gun to grandma’s head? Not so helpful.
“Appealing to fear is only going to change people’s behavior if they feel empowered to deal with the threat,” she said. “With COVID, it just tends to freak people out.”
Mays, Peek and Mollborn said talking about personal responsibility can be more effective when it’s paired with examples of how those actions benefit society as a whole.
“The personal responsibility narrative can be quite dangerous because it’s not a viable solution to get through the pandemic with,” Mollborn said. “What worries me is when we only talk about what individuals can be doing, that’s not something that’s the kind of multilevel solution that’s going to get us through this thing.”
Researchers, scientists and policy experts have pointed to two things that will bring an end to the pandemic — widespread, rapid testing or a widespread, highly effective vaccine.
“When we think about those things, those are not things as an individual I can go out and acquire,” Mollborn said.
So if those large-scale solutions are currently out of reach for individuals — and in many cases, for local governments — what’s the next best option?
“If we were going to use messaging rooted in a sense of collective responsibility, this is the moment,” Peek said. “What you do has ramifications for other human beings and health care workers. What a moment for us to cultivate empathy and caring for one another.”
“All disasters, especially a catastrophe of this magnitude, provide an opportunity for us to revisit our collective responsibility to one another and how much we depend on one another for our very survival,” she continued.
Officials defend policy
Officials with city, county and state government provided statements to the Camera defending, to various degrees, the effectiveness of personal responsibility as a public health policy.
In an email, Polis spokesperson Conor Cahill said the governor has responded “swiftly and boldly” to the unique challenges of the pandemic.
“The governor believes personal responsibility is a critical component of defeating this deadly virus, but it’s also important it is coupled with clear and concise messaging from elected officials about how people can best protect themselves and their families,” Cahill wrote. “The state of Colorado throughout this pandemic has implemented policies to make clear to individuals the actions expected of them to protect themselves and their community like wearing a mask, social distancing, working remotely and avoiding personal gatherings.”
City of Boulder spokesperson Sarah Huntley said individual action and responsibility are driving forces in keeping the virus at bay.
“We can tell people over and over what steps they can take to decrease their risk, but we need each person to take this information to heart and act on it. Honestly, this has been a challenge,” Huntley wrote in an email. “Behavior change is hard to achieve even in the best of circumstances. And these are not the best of circumstances. We have had some wins, however, and we are grateful for community members who are changing their habits and traditions to protect themselves and their neighbors.”
Huntley added that the message of personal responsibility needs to be paired with effective public health policy during a health emergency.
“While the primary responsibility for this rests with the county, the city has — and will continue — to enact necessary regulations to protect our community,” she wrote.
Messages that focus on personal responsibility can be effective for some, but not others, said Boulder County Public Health spokesperson Chana Goussetis.
“In general, individual behavior changes that benefit public health are difficult changes for people to make — such as choosing water instead of a sugary drink, or wearing a helmet when riding a bike — so often a policy approach is more effective,” Goussetis wrote in an email. “As others have stated, when personal responsibility messaging is combined with how the behavior will benefit the larger community, it can be effective.”
More coordination needed
Throughout the coronavirus pandemic, Weld County Commissioners have held fast to a public health policy based in personal responsibility, that people and business owners can make their own decisions about what precautions to take.
County leaders have refused, by and large, to enforce coronavirus public health orders such as face coverings, capacity limits and restrictions on indoor dining.
That policy has led to tension with state officials and neighboring communities and to the state intervening at local businesses that are not complying with public health orders by suspending liquor licenses.
Weld County is also seeing a surge in coronavirus cases and is running low on critical care beds for sick patients — but Commissioner Scott Jones said that isn’t related to the county’s policies.
“I truly believe that voluntary compliance is working up here in Weld County,” Jones said. “We have high incidence rates, but I would argue that has less to do with policy and more to do with population and the essential nature of our workforce in Weld County.”
Jones said he thinks the right things to do to prevent the spread of coronavirus are the same things being promoted elsewhere — to keep distance from people, wash your hands and to wear face coverings.
last Two women wear masks while browsing the book exchange box on Main Street in Longmont last month.(Cliff Grassmick/Staff Photographer)“We do wear masks,” Jones said. “We simply don’t believe in the mandate. … It’s all hyperbole and politics and we encourage our citizens to do the right thing.”
That belief has caused friction with leaders in Longmont, where Mayor Brian Bagley proposed that sick people from Weld County should be denied medical care at the city’s hospitals because of Weld County’s policy.
Bagley later abandoned the idea, but not before starting a firestorm of support and condemnation. The Longmont City Council last week directed city staff to draft a resolution calling on Weld County Commissioners to enforce public health orders.
Patchwork public health enforcement in neighboring communities has made managing the pandemic “extremely difficult,” Zayach said.
“The only way we’re going to deal with this at a statewide level is when we have a coordinated and supported approach that is consistent across counties,” he said. “When we have a county that’s going to say, ‘I’m not going to do this or that’ … the political boundaries having nothing to do with holding this disease spread, so we have to be coordinated.”
There is “absolutely” room for improvement in the coordination between Weld and Boulder counties, Zayach added.
Jones said he will stand alongside other government leaders, including Polis, to communicate what the right things are to do in the pandemic.
“We are in a troubled time and we have a nation and state and counties that are unsettled, and people are frightened. The best thing we can do as citizens and leaders is to speak comfort to people and say we know how to defeat this, it’s the right thing to stand alongside each other and defeat this thing,” he said.
There is a light at the end of the pandemic tunnel, Zayach said. Boulder County officials expect to receive the first round of coronavirus vaccines in the coming weeks.
“I know it’s really difficult. I get calls every single day and every single week from people on all sides of this perspective on what this really means to individuals and how this impacts them,” he said. “We’ve got to get through a few more months, make sure we’re diligent and get the vaccine in the community.”
In the meantime, Peek said she’s urging people to cultivate empathy for others by listening and learning.
“If this pandemic teaches us anything, please let it be how deeply connected we are, how interwoven our lives are and how the actions of one can affect the lives of so many others. If that’s a personal responsibility message then I’ll get behind it,” she said. “I think empathy is the linchpin that can see us through this.”
