Governments worldwide are grappling with the challenge of vaccinating millions of citizens against coronavirus.
But how can authorities enforce stay-at-home measures when Covid fatigue has set in?
Given that vaccination is not 100 per cent effective at stopping illness - and because it may still allow individuals to pass on the virus - social distancing, mask wearing and hand washing will still be needed while the pandemic rages.
But night-time riots in the Netherlands and protests in Denmark have highlighted the presence of anti-lockdown sentiment, which, coupled with simple lockdown fatigue, may lead increasing numbers of people to ignore rules.
Research has found that multiple factors influence compliance with lockdown rules. For example, certain groups are more likely than others to go against regulations, according to Prof Linda Bauld, professor of public health at the University of Edinburgh.
Young adults, men, people in urban areas and those with children are less likely to comply, although Prof Bauld cautioned that in some instances this was because compliance was harder than for, say, elderly people.
Research on people in 55 countries published last year found that another important influence on whether a person complied with lockdown rules was personality type.
Released in the journal American Psychologist, the study found that extroverts were less likely to follow stay-at-home orders, while people classed as neurotic were more likely to follow rules.
Individuals with open-minded personalities too tended to stay at home, possibly because they took a greater interest in what was happening with the pandemic and realised its gravity.
While the work was carried out early in the pandemic and so may not be as relevant to current circumstances, Friedrich Götz, a researcher at the University of Cambridge behind the study, said other research had found similar results.
“There is … converging evidence from multiple other studies that found very similar personality-pandemic behaviour associations at different time points and across diverse populations,” he said.
Prof Stephen Reicher, of the University of St Andrews in the UK and a member of the British government’s Scientific Advisory Group for Emergencies (SAGE), said a person’s ability – not just willingness – to comply with lockdown rules was also key.
For example, poorer individuals might find it harder to adhere to self-isolation rules because they cannot afford the loss of income if no compensation is available.
“The problem isn’t people following the rules, but the support so that people can follow them,” said Prof Reicher.
“Compliance is variable but it’s not so much due to motivation, but support and clarity of messaging.
“Where the messaging becomes poor and people don’t think there’s a problem, compliance is poor.”
Governments should, he said, ensure rules are clear, and provide assistance to people who might otherwise be unable to comply with rules.
With rules that people can easily follow, such as social distancing, compliance typically remains high, said Prof Reicher, and, if anything, higher than earlier in the pandemic. Signs of lockdown fatigue therefore appear to be limited.
“There’s this [view that] the public will be the weak link, but the evidence is not there,” he said.
Simpler messaging is thought to be one reason, suggested Prof Bauld, why compliance has improved in the UK as lockdown rules have become stricter with the emergence of the more easily transmissible British variant.
“Certainly from a behavioural science perspective … people are just as scared as they were in the spring.
"I think that’s to do with the news of the new variant. That’s caused genuine public concern,” she said.
Messaging – among other factors – may account for why compliance appears to have varied from country to country, with Prof Bauld suggesting that some parts of East and South East Asia, such as Taiwan, Thailand, Singapore, South Korea and Hong Kong, may have had more public adherence to rules.
“There are differences with these populations. The governments are very good at sending clear and consistent messaging,” she said.
“There’s perhaps more acceptance of government intervention in people’s lives, wider acceptance of face coverings and maybe more community cohesion. Maybe disinformation is something that’s not in play there.”
As well as in the United States, disinformation has, she said, been a major problem in countries such as Brazil and Argentina, not always helped by the leadership in Brazil, which has made “statements that were not evidence-based”.
In some countries, such as India, which has embarked on what has been described as the world’s biggest Covid vaccination drive, vaccine hesitancy is an acute problem, fuelled by disinformation and unwarranted concerns over vaccine safety.
Similar issues have affected some South Asian communities and some other ethnic minority communities elsewhere in the world.
“There’s less hesitancy around childhood vaccination in these countries. People are used to having their children vaccinated for polio and rubella,” said Prof Bauld.
Now that vaccines are being rolled out, Prof Bauld said governments should follow a two-pronged approach that encouraged people to get vaccinated while still emphasising the importance of preventing coronavirus spread.
“[Governments must] build confidence that these vaccines are effective and safe,” she said.
“That has to be done in parallel with an explanation that vaccination doesn’t protect people from passing the virus on. That means public health behaviours still need to be maintained.”
