For months, scientists have been calling for mask mandates to control the spread of COVID-19, especially with the rise of the more contagious Delta variant. But some members of a pandemic-weary public have been pushing back on this idea.
This week, U.S. health officials met intense outcry when the Centers for Disease Control and Prevention shifted course and changed its recommendations for wearing masks. The CDC is now urging people who live in high-transmission areas to wear masks indoors—even if they are fully vaccinated. Similarly, public ire is rising after an increasing number of companies and local governments unveiled plans for sweeping vaccine mandates.
Some politicians say the decisions to vaccinate and wear masks should be left up to individuals. And the new guidance from the CDC is just that: guidance. States, schools, and private companies must now decide whether to require face coverings in certain circumstances. In the meantime, masking up—or risking infection—remains a choice for many Americans.
People have had to weigh risks throughout the pandemic, and they’ve often come to drastically different conclusions. As the Delta and Lambda variants rage against a backdrop of social activities resuming, borders reopening, and schools offering in-person learning, people will continue to be presented with risks, and they will have to make decisions about what to do and what to avoid.
But in a world riddled with both obvious and subtle threats, danger can easily be misjudged, ignored, or disagreed upon. “It’s not just that different people see risk differently, but that the same person will react very differently to one danger than to another,” says Paul Slovic, a psychologist who studies risk, and founder of the nonprofit Decision Science Research Institute, based in Oregon.
Deciding which actions are risky is a constant cognitive challenge, says Valerie Reyna, co-director of the Center for Behavioral Economics and Decision Research at Cornell University. “It’s uncertain, it hasn’t happened yet, and it’s based on our best estimate, which changes over time as conditions change. That’s really hard,” she says.
Here, experts explain why humans struggle to assess risk, how the brain responds to risk, and how our need to weigh risks has changed during the ongoing pandemic.
Responding with intuition
Some researchers believe people have two ways of assessing risk and making decisions: a knee-jerk, emotional process—often called experiential or intuitive thinking—and a slower, more analytic mode. “Most of the time, we respond [with] our experiential system,” says Slovic. He’s quick to add that people can use both, “but the human brain is lazy. If we think we can respond to complex situations the easy way—with our feelings—then we go that way.”
That’s not always a bad thing. The analytic mode of reasoning is clunkier and more time consuming, often exemplified by “reason, mathematics, and cost-benefit analysis,” says Slovic. That kind of thinking is “important and powerful, but hard to do.” So, people evolved to assess risk quickly: After all, you don’t want to deliberate too long whether to run from a prowling lion or try and fight it off.
“If you’ve ever tried to compute the square root of 285, then you have an idea of how it feels to deliberate,” explains Ralf Schmälzle, a communication neuroscientist at Michigan State University. Deliberation “consumes a lot of working memory resources,” while intuition lets people arrive at an answer instantaneously.
And it mostly works: By using intuition, “we manage, we survive, we make it to the next year or through the next two decades,” Slovic says. “In a complex world that is dangerous, we do OK.” But, he adds, “there are times when we do terribly.”
In 2013, Schmälzle studied people’s risk perceptions of another viral threat: the H1N1 pandemic, colloquially known as the swine flu. Along with colleagues at the University of Konstanz in Germany, he asked about 130 people a variety of risk-related questions and divided participants into two groups: those who saw H1N1 as a risk, and those who didn’t.
The participants then watched a fact-based documentary about the swine flu as Schmälzle scanned their brain activity, measuring it with magnetic resonance imaging. The team found that the anterior cingulate cortex—the part of the brain often associated with processing threats—fired synchronously in the participants who already believed H1N1 posed a risk.
“People are noticing some kind of intuitive alarm signal” driven by emotion, he says.
When it comes to COVID-19, “if you lack this sort of intuitive aspect to the risk perception, then you will not see a need to wear a mask or get vaccinated,” says Slovic.
Beyond gut instinct
The theory that people use this so-called dual-systems risk analysis is “an excellent theory supported by a lot of data,” says Cornell University’s Reyna. However, it leaves out other major drivers of decision-making, she notes.
One is called optimistic bias, says Dickinson College social psychologist Marie Helweg-Larsen. This type of bias makes an individual feel like they are somehow exempted from the potential consequences. “We recognize that things can happen to people,” she says, but “we think that we are special. We think that we’re less likely to experience the negative consequences.”
For example, smokers know that cigarettes can be harmful to their health, but some may think their risk of lung cancer is less than that of other smokers, Helweg-Larsen says. “They think if they eat more vegetables, if they puff less on the cigarette, if they smoke healthier cigarettes,” that they can avoid the consequences of smoking, says Helweg-Larsen. “But eating more vegetables doesn’t lead you to not get lung cancer.”
The same optimistic bias may have played into how people gauge their COVID-19 risks: People who refuse to wear masks likely understand there’s a chance they could catch the coronavirus and even die from it—but they also think their personal risk is less than others’, she says.
“It’s easy to think that people are delusional,” Helweg-Larsen says, but it’s more akin to wearing rose-colored glasses. “It’s what we in psychology call ‘motivated cognition,’ meaning that we draw the conclusions that we wish to draw because it brings us outcomes that we would like.”
Optimism can be helpful, because many things humans do carry some risk. If people thought they would die in an accident every time they got into a car, no one would ever drive. “It would be really hard to navigate our daily lives if we were afraid of possible-but-small risks,” she says.
Consequences that excite people—either in terms of hope or fear—can also motivate people to take or avoid risks, Slovic says. A $100 million jackpot might compel someone to risk wasting money on a ticket even though the chance of winning is miniscule. Similarly, news of a deadly plane crash can make people more afraid to fly, even though it’s statically safer than driving.
A sense of control—or lack thereof—affects people’s ability to assess risk as well, Helweg-Larsen says. “We overestimate the extent to which we can control our outcomes,” she says. In the example of being afraid to fly, someone might overestimate the risk of a crash because they’re not flying the plane.
“It’s not that people think they could fly the plane. But it feels uncertain because they are not in control,” she says. “But it’s all an illusion, of course, because lots of accidents are not caused by the driver in your car.”
During the pandemic, “a lot of people are feeling anxious about entering into the world and relying on other people’s willingness to do the right thing, which has been a problem throughout the pandemic and is still the case now,” Helweg-Larsen says. “We want to control outcomes—and that’s why it feels even scarier.”
What's more, people can be influenced by direct experience with a particular danger—including a COVID-19 infection. A new study from the University of Alabama shows that people who got COVID-19 and recovered may be less likely to support mitigation efforts such as mask wearing and social distancing. By contrast, those with a friend or family member who contracted the disease were more in favor of mitigation measures.
Study co-author Wanyun Shao, an assistant professor of geography at the University of Alabama, suspects “that hearing ‘horror stories’ from others can evoke concern, while directly experiencing COVID can lower the concern as if the suspense is over.”
Freedom of choice
Researchers say there are ways we can better assess risks as the pandemic drags on. The most important, they agreed, is to continue to follow the science from credible sources. “If you are a person who has said that we should trust the science, try to hold on to that idea now,” says Helweg-Larsen.
It’s also important to recognize that judgments based on intuition often happen in a fraction of a second—but not every situation requires an immediate reaction. Instead, “it’s wise not to react instantly, but to pause and to reflect on the information you’re hearing,” Slovic says.
But with the end of the pandemic hanging in the balance, some public health officials are making the case that society as a whole might not be able to rely on people’s ability to assess risk and make the safest, smartest choices.
In recent weeks, local governments and many companies—including Facebook, Google, Netflix, Morgan Stanley, the Washington Post, and some 600 universities—have announced vaccine mandates. In the past, such mandates have proved pivotal in stamping out pandemics. Between 1919 and 1928, 10 U.S. states introduced vaccine mandates for smallpox, while four states prohibited mandates—and a February 2021 study includes data showing that cases of smallpox were 20 times higher in states that banned mandates than in states that enacted them.
“The problem with people attempting to do a cost-benefit analysis for getting vaccinated is that it sounds logical but people get it wrong,” says Helweg-Larson. “It is overwhelmingly better for most people to get vaccinated. The personal [and societal] benefits outweigh the costs.”
But psychologically, Helweg-Larson says, giving people the freedom of choice is best. “We are willing to limit and restrict people’s choices when our behavior harms other people,” she says. “That’s why we encourage quitting smoking and limit and restrict where you can smoke—but we do not outlaw smoking.”
In the case of COVID-19, she says, the choice could be get vaccinated or “put up with the inconvenience of regular testing and masking.”