Communication from the government, epidemiologists, and health statisticians seem to rely on the belief that if people are shown enough graphs, models, and statistics, they will act rationally and do the right thing. Even when that is deeply at odds with the way people live, you can still close yourself at home, potentially alone, and stop all intimate contact with people outside.
This was successful in 2020 as a response to a disaster, but it isn't a realistic long-term strategy. The cultural, social and political history of the HIV epidemic taught us that the approach of trying to protect a population by focusing on ideal individual behavioural guidelines doesn't work.
I worry that we haven't yet learned the lessons from the "doomsday" epidemiologists, who seem to think that the only solution to the epidemic is to lock everyone in until we reach an idealised #zerocovid state.
I do not mean to question the work done by epidemiologists in understanding how disease spreads. There are other forces that inform how people decide to behave. Epidemiologists study people in social formations. Population-level data and models aren't the sole driving force of our actions.
In the case of HIV and other epidemics, epidemiological models have either been shown to be wrong or insufficient. Early in the Pandemic, data from the US wrongly made the virus a cause of concern only for already stigmatised populations, thus contributing to further social discrimination. The Mineshaft bar in New York was closed in 1985 in an attempt to curb the spread of the AIDS virus.
None of these things were enough. It was not until the 1990s that we were able to effectively contain the virus thanks to the use of antiretroviral treatments and prophylactics, not the behavioural changes advocated by epidemiologists and other public health specialists in the first decade of the epidemic.
We did not wait for treatments to arrive. The treatments arrived due to the political pressure from affected communities who realized that expecting people to change their behaviors and do the right thing at all times was not sustainable. We stopped privilege the statements of truth that were offered by a single scientific discipline and instead started drawing from knowledge produced across the humanities, medical sciences, social sciences, and patient groups.
The Gay Men's Health Crisis group in the US was the first to start promoting condom use among gay men when the state didn't want to do it. Act Up brought the voices of patient groups and communities to the forefront of political decision-making. We gained a better understanding of what matters to people and the lives they consider worth living from this.
We need to understand what drives people to behave in certain ways, why certain behaviors are important to them, and meet them where they are by acknowledging and respecting their value systems. There are a number of factors at play. The desire, pleasure, pull of intimacy, need for proximity and physical contact are some of the things that determine what people do.
Drawing conclusions and recommendations about individual behaviors from population-level data can be difficult, and the way this abstract approach can easily overlook the social complexity and differences in specific communities can be seen during Covid.
The ability to protect oneself is often unevenly distributed, with epidemiologists telling people to gather in their gardens, to use separate bathrooms at home if one person falls ill, or to spend a few hundred pounds on air purifiers for their homes. Government regulations have assumed since the start of the Pandemic that everyone lives in a detached single- family home with their loved ones, or that homes are safe places where we can lock ourselves in without being alone or fear of violence.
We see the same messaging brought forward. Gay men were recommended to stop having casual sex by the trust in the early months of the epidemic. The Gay Men's Health Crisis in the 1980s gave advice to queer men on how to manage Covid risk during hookups, which is a more realistic approach than abstinence-only.
The lessons of the Aids crisis are that public health messaging that doesn't take into account what different people value as being a life worth living, and that is directed at an abstract general public is insufficient, and that epidemiologists can make errors of both science and advice. We need to involve social scientists, cultural scholars and communities in order to get a better understanding of what matters to people, while also acknowledging that we don't always behave rationally.
The models assume that populations are made of agents who will act according to reason in response to information. The problem is that, for those of us who work on the medical, cultural and social histories of an older and still continuing global epidemic, such views fall short of capturing what happens every time we are faced with a choice. They are limited and counter productive.
Joo is the senior lecturer in history of modern and contemporary art and visual culture.
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