Statement – Rising COVID-19 fatigue and a pan-regional response
Statement to the press by Dr Hans Henri P. Kluge, WHO Regional Director for Europe
06 October 2020
Countries across the Region are reporting rising levels of COVID-19 fatigue.
Since the virus arrived in the European Region eight months ago, citizens have made huge sacrifices to contain COVID-19. It has come at an extraordinary cost, which has exhausted all of us, regardless of where we live, or what we do. In such circumstances it is easy and natural to feel apathetic and demotivated, to experience fatigue.
Based on aggregated survey data from countries across the Region, we can see, not surprisingly, that fatigue among those surveyed is increasing. Although fatigue is measured in different ways, and levels vary per country, it is now estimated to have reached over 60% in some cases.
Amidst this protracted public health emergency, one that has forced people to live with uncertainty and disruption for many months, these levels of fatigue are to be expected. Although we are all weary, I believe it is possible to reinvigorate and revive efforts to tackle the evolving COVID-19 challenges that we face.
There are three strategies for doing this:
The first call to action: take the pulse of the community regularly, and use what you find.
From understanding the behavioural needs of young people returning to university to the emotional toll isolation has taken in elderly care homes, policy must be driven by the growing body of evidence we have on people’s behaviours and on fatigue.
By addressing individual experiences and cultural nuances, we can shape more effective response strategies. Here, WHO/Europe has worked with 27 countries to gather such data with a behavioural insights tool. The tool measures fatigue by looking at the degree to which individuals perceive risk of the disease, their protective behaviours and the degree to which they adhere to social policies and measures.
Many other countries are gathering information on cultural acceptance and adherence to measures, on knowledge, attitudes and practices. In Hertfordshire in the United Kingdom, the county health authority tracks the pulse of the community and uses what they find. Through an online platform they measure community feelings and comfort with indoor and outdoor settings, and health service provision is adjusted accordingly.
I also advocate for engaging expertise beyond the medical and public health sectors to discuss measures and restrictions. In Germany, the government has consulted philosophers, historians, theologians, and behavioural and social scientists, who provided valuable input on the educational progress of children from disadvantaged families, the legitimacy of restrictions, and the balance between public support and moral norms versus coercive state action.
Second call to action: co-create interventions with the community.
It is essential that we respond together and that communities own response policies with authorities. Consultation, participation and an acknowledgement of the hardships that people are facing are key if we are to have truly effective policies. The community should be considered a resource, as well as a recipient or beneficiary.
We have seen successful examples of this. In Denmark, one municipality invited young students to work with them to determine the most appropriate way to preserve the student experience while protecting communities as universities reopened.
In Turkey, social media polls are being used to connect with the community and better understand non-compliance with protective measures to inform and evolve COVID-19 policy and introduce supportive communication or services to reinvigorate positive public response.
In Norway, kindergarten staff were engaged to develop sustainable and reasonable guidance for re-opening kindergartens in a way that counteracts fatigue of staff, children and parents through flexible attendance – a good example of recognizing that people are experts in their own environment. We are seeing growing ingenuity, innovation and an emphasis on citizen participation, with great results.
Citizens are at the heart of a solution to the pandemic and policy-makers should treat them as such.
Third call to action: we need to meet our needs in new, safer ways.
As we enter the coming celebration season, we will need to combat fatigue by meeting the needs of citizens in new, innovative ways. We saw this during Ramadan across the Region, when community-based groups found safe solutions to breaking the fast, including doing so virtually or delivering meals to homes for distanced celebrations.
Creative approaches can restore social pleasure while protecting communities. We have seen the effectiveness of floating cinemas, new format cultural events and social bubbles. By balancing science, social and political needs we can develop precautionary measures that are culturally accepted. Every sector and every citizen has a role to play as we find a way to enjoy this important time of year while protecting our communities.
We do not yet have all the answers to navigate the season ahead. But, in response to this growing challenge, yesterday WHO/Europe convened a meeting of chief medical officers and director generals of health from over 30 countries in the European Region. The forum provided a chance to examine the behavioural trends and exchange innovative ideas and strategies.
We released a framework to support countries in tackling fatigue and reinvigorating the public response. WHO will establish an ongoing forum to drive action and inform local COVID-19 responses that engage communities and meet the needs of our populations, who continue to endure disruption and hardship.
The way forward is through collective commitment to these 3 strategies:
- Take the pulse of the community regularly, and use what you find.
- Co-create WITH the community. Recognize the community as a rich resource.
- We need to meet our needs in new, innovative ways. Let’s be creative and courageous in making that happen.
A courageous approach, with empathy at its core, will get us through this crisis. Despite the hardships, COVID-19 is urging us to move beyond biomedical science in our response. We have an opportunity to maximize our community insights into behaviour, to integrate real community participation into public health policy on a scale that has not been done before.
