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north. I cannot believe that this government are as incompetent as they appear. I have to believe that the misinformation is deliberate. It doesn’t make sense otherwise.

7. THE TOOLS OF THE TRADE

‘I’m stunned by the weaponisation of behavioural psychology over the last five years.’

Anonymous scientific advisor deeply embedded in Whitehall

Covid-19 is not the first time the UK government has frightened us for public health reasons. A standout example is the ‘Don’t die of ignorance’ campaign about AIDS in 1986. It was a powerfully chilling television and leaflet campaign, and still haunts our memories.

According to the campaign, AIDS had an ‘explosive infection rate’ and it was predicted that millions of Britons would become infected.1 Sound familiar? In another parallel with Covid-19, the media coverage was a cacophony of doom. Fear and death sell.

The Chief Medical Officer, Donald Acheson, and the Health Minister, Norman Fowler, pushed to create a hard-hitting campaign that would convey that everyone was at risk, rather than particular groups being more at risk. Similarly, our government has done very little to explain that risk from Covid-19 varies according to age and co-morbidity, and as we know there was an intention to increase our ‘perceived level of threat’.

In the early days of the AIDS campaign, the message was given that anal sex carried the highest risk and should be avoided altogether, which was an unrealistic and overly-prescriptive expectation. That message was soon replaced by the advice to use condoms for safe sex. Advice which doesn’t take human nature into account is harder to follow.

The focus on death aimed to frighten people into changing their behaviour. People still remember the ad and the feelings it conjured. I know I do. As a 13-year-old the haunting campaign imprinted on me that ‘something’ was very, very dangerous. Three years earlier, I’d had to pretend to the cool kids in primary school that I understood the lyrics to the Frankie Goes to Hollywood song, Relax Don’t Do It. I didn’t quite understand this campaign either, but it was frightening.

Rather like the messaging on Covid, the AIDS advertising elevated fear but did not provide balance. People with HIV had to live with the disease, and still do, and the campaign did nothing to calm their fears. I imagine it must have been frightening to see the tombstone and loaded messages for those who were living with a positive diagnosis. Perhaps it drove the fear and social ostracism which people with HIV experienced. The British TV series It’s a Sin about the AIDS epidemic in the 1980s has provoked people to write about the terrible fear that they felt at the time. One nurse recalled the ‘fear, the isolation on the wards, gowns, masks and gloves to enter a patient’s room.’2

I spoke to doctor and public health expert Jackie Cassell about her recollections of the AIDS campaign. ‘The fear was controversial at the time,’ she told me ‘People in public health generally thought they were terrible adverts. But they seemed to have an impact and it changed what politicians would talk about, such as condoms and sex. There was a sense that it was a success, but we didn’t like the fear.’

Similarly, how many people have been terrified by the thought of Covid, even though for the vast majority it is not very dangerous? As a reminder, Patrick Vallance told the nation on 13 March 2020 that ‘the vast majority of people get a mild illness’,3 but just 10 days later, Boris Johnson warned of ‘the devastating impact of this invisible killer’.4 The messaging mutated faster than the virus or the scientific evidence.

Research showed that the AIDS campaign changed people’s behaviour and the government considered it a success. However, some critics felt that it created panic rather than a proper understanding of risk and that it was actually grassroots organisations, such as the Terence Higgins Trust, which did more to slow the spread of infection among the impacted groups of people. As Cassell told me, ‘What really made a difference to the people at highest risk was the gay community action and activism. The government’s big success was needle exchanges for drug users.’

Is it ethical to use fear if it is in our best interests? For the sake of our health? Some would say so. As the Behavioural Insights Team report, MINDSPACE Influencing behaviour through public policy,5 says, ‘If we can establish that the behaviours do reduce wellbeing, the case for nudges is compelling’, while also acknowledging that it is ‘controversial’. In other words, the ends justify the means, even if the public wouldn’t like it if they understood they were being hoodwinked. And does the government claim credit for its own campaigns rather than honestly attributing credit where it is due? Normal Fowler said of the AIDS campaign: ‘There was no time to think about whether it might offend one or two people. And history shows we were right – people took care and HIV cases went down.’6 What about the Terence Higgins Trust or other grassroots organisations? Might a different sort of campaign also have encouraged people to take care without scaring everyone witless?

Since the AIDS campaign, the use of behavioural psychology has become more formalised and deeply embedded in government. The Behavioural Insights team has a couple of handy acronyms to detail its methods: EAST (Easy, Attractive, Social and Timely) and MINDSPACE. I’m going to zoom in on the effects described in the MINDSPACE7 document, as it offers more detail.

MESSENGER

We are heavily influenced by who communicates information, including their perceived authority, our relationship to them and how we feel about them. If the messengers are perceived as possessing high levels of authority, or to be worthy of admiration, people will be more likely to believe them and follow their advice and directives. Think of NHS frontline medics relaying the importance of staying home to protect the NHS.

INCENTIVES

Our responses to incentives are shaped by predictable mental shortcuts such as strongly avoiding losses. Incentives are not just financial (although they can

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