key: cord-1000772-9j8s4ul9
authors: Kantor, Jonathan
title: The power of narrative: Storytelling, fear, and the COVID-19 pandemic
date: 2021-07-29
journal: JAAD Int
DOI: 10.1016/j.jdin.2021.07.005
sha: 75f729bc266176b3bfdd917808cbf01317fea28c
doc_id: 1000772
cord_uid: 9j8s4ul9

nan

T he COVID-19 pandemic has become one of the defining features of our times, and the ways in which we responddand fail to responddto this crisis may haunt us for generations. The rapid development of vaccines heralded a historic opportunity while concomitantly exposing fault lines in the ways in which science is taught, transmitted, and toyed with. Moreover, while wealthy nations were able to both underwrite and preorder vaccines in record quantities, others were left to the mercy of the United Nations initiatives such as COVAX and the largesse of those practicing vaccine diplomacy. However, even in nations where vaccines are widely available, significant vaccine hesitancy remains, with heterogeneous swaths of the population decliningdor deridingdvaccination with responses ranging from hesitancy to fervor.

As the global health community increasingly appreciates the potential for vaccine hesitancy or refusal to impact public health, it is important to remember that things do not need to be this way. Indeed, although vaccine hesitancy has long been acknowledged as a major threat to public health, a culture of respect for knowledge, and one in which the population broadly feels an element of cultural and intellectual ownership, should serve to inoculate against extremism on all sides.

Scientists should welcome healthily reasoned and reasonable debate, as long as the goal for both sides is to (perhaps asymptotically) approach the truth, rather than simply win an argument. Public health education is an infinite game, and the rules of engagement are malleable. The vaccine hesitant are a heterogeneous group, driven by a wide range of concerns. Muzzling free speech, even with the best of intentions, has historically resulted in more pain than gain.

Although it may come as a shock to some, people are not wholly rational, and our decisions regarding our healthdparticularly when fear is the overriding emotiondare notoriously irrational. Traditional agent-based models assume that people will act rationally and that their decisions can be easily predicted and mapped. However, work in a range of fields, from network analysis to computer science and behavioral economics, suggests that this is precisely not how people make decisions. We are all social beings, and we are influenced not onlydor even primarilydby our own independent views honed over years of reading Plato, Aristotle, and Kant by the fireplace but also by the other people in our real and virtual networks. This is as (or more) true for vaccine attitudes as it is for smoking and obesity. 1, 2 This understanding parallels decades of work highlighting that when the general public fails to share the enthusiasm of scientists for controversial technologiesdfrom cloning to nanotechnologydsuch wariness is not simply the result of a knowledge gap. 3 Those with real and abiding concerns cannot be dismissed with a paternalistic pat on the head, and those with true concerns regarding the safety or efficacy of vaccines should be met with reason, not rancor. We must appreciate that reflexively and exclusively countering fear with factsdand attempting to neuter stories with numbersdwill fail. In a battle between a good story and real numbers, the story always wins. 

The collective dynamics of smoking in a large social network

The spread of obesity in a large social network over 32 years

Anticipating the perceived risk of nanotechnologies

None disclosed.