What healthcare professionals can learn from the Covid-19 measures

The measures against the spread of the coronavirus have been around for about six months now. They have become part of our so-called ‘new reality’. And we might even have grown into some of them. Then again, we might not have.

An increasing number of people are starting to oppose these measures. Protests are being organised in large cities all over Europe. Tens of thousands of people are gathering in the streets to have their voices heard, to demonstrate against these measures. But even on a smaller scale, when talking to our friends over dinner for example, the discussion often turns to whether these measures are still absolutely necessary or not.

Now, I don’t want to get into the nature of these measures, and whether they were rightly put in place or not. I don’t want to argue in favour of or against them. Instead, I want to reflect on this recent attitude change. If we look back on the start of the Lockdown, in late March, people were rather obedient. Almost everybody carefully followed the coronavirus measures, right? Although we weren’t too pleased with them, we did comply and acted in the way that was expected from us. At the moment, however, people are – and I’m phrasing this carefully – ‘confused’ about the importance and the impact of these measures. Others simply want to see them lifted immediately.

What has happened? How did we go from simply following these rules to actually fighting against them? Finding the answer is, obviously, not that straightforward. You can approach this matter from several angles and there are many different reasons why we find ourselves in this situation. However, I’d like to point out two particular elements that might (in part) explain the recent change. Two elements, which – in my opinion – can even teach healthcare professionals a lot. Those two elements are “a system-centred approach” and “fear-based decision-making".

Let me start with the latter concept, i.e. fear-based decision-making. At the beginning of the national lockdown, we made decisions based on fear. Measures were decided upon, based on fear. We decided to comply with these measures, based on fear. That is who are as human beings. It is part of our logic. When somebody puts a gun to our heads, we will carefully listen to what they want from us and comply with their demands. Fear-based decision-making. But what if that gun continues to be pointed at us, for a very, very long time…? Well, at a certain point, we will no longer want to surrender to that fear. We will no longer want to give in to our attacker’s demands, because it’s not worth continuing life that way. At that point, our emotions take over.

Let’s now take a look at patients; they actually behave in that exact same way when they are confronted with a new disease. They fear it, will change their lifestyle because of it and comply with the suggested health measures. Take people who suffer from high cholesterol, for example. Right after the initial diagnosis, they might change their lifestyles, take their medication on a daily basis et cetera, because they were suddenly confronted with what can be a very deadly condition. They feared everything they heard about it and acted accordingly. Fear-based decision-making. But after a while, that fear could start to wear out. When it comes to high cholesterol, patients hardly have symptoms, if any. For that reason, fear-based decision-making fades away. As do the lifestyle changes or the medication adherence.

However, it is possible to have people adapt to a life with high cholesterol. For that to happen, we need to get rid of fear-based decision-making, because it is simply not sustainable. Just look at how people are tired of living with fear. They are tired of living with all these coronavirus measures. To be able to remove fear-based decision-making from our lives, we need to get rid of something else: "a system-centred approach”. Instead, we need to install a “people-centred approach”.

Instead of making people afraid, we need to inform them better and even differently than we currently are. But we also need to understand every person’s reality and take that into account. By ‘taking into account their reality’ I do not mean we should do this in the context of the decisions we will force upon them, but rather related to the additional information they should require. Personal trainers, health coaches, and dieticians have come to understand the power of this approach ages ago. Their approach often includes perfect examples of how to install a “people-centred approach”.

Dieticians, for example, have long understood that they should not make people afraid. Although I’m no dietician nor food expert, I have noticed a big change in the way they work. It’s not about pointing out what can and can’t be done. Instead, it is about food literacy, i.e. explaining the impact of things, and discovering – together with their client – what works for them. Exploring how several small changes can make a difference in their lives. It’s never about fear or pushing things down people’s throats. It’s a “people-centred approach”, based on what works for the patients.

You can notice that same evolution in the fitness world. Personal trainers are all about this “people-centred approach”. They are the experts. Therefore, they know a lot more than their clients and might want to force their clients to exercise when they simply aren’t exercising enough. But they have discovered that telling someone to do something – even if they are paid to do exactly that – won’t work in the long run. People will only keep on exercising, if it (1) fits their own life(styles) and if (2) it makes sense to them. They will not do so out of fear, but because they understand why and because they know they can make it work.

To me, this is – in part – what causes people to resist the Covid-19 measures today. But this is also why patients tend not to comply with their therapy, medication, or the necessary life style changes. It is a system-centred approach that gives rise to fear-based decision-making. And both are unsuccessful in the long term.