Typically held twice a summer on New York’s Governor’s Island, the Jazz Age Lawn Party has become a delightful tradition. Typically, for two weekends in June and August, it has live music, ballroom dancing, dance performances, and lots of gorgeous 1920s-style dresses and smart suits. This year it became an accidental example of why we need better health communication and policies on COVID-19.
Since it was canceled last year, many people at this year’s June event were especially keen to do the Charleston, the Peabody, and otherwise swing themselves into the 2020s, which eerily echoed the 1920s.
Unfortunately, it was not allowed to dance on the spacious lawn due to health authorities’ requirements. And although proof of vaccination or recent negative COVID tests were required, masks should be worn at all times except when sitting, eating, or drinking. While the music was actually great, I almost expected there would be a rule that the trumpets and trombones must use mutes.
Perhaps these restrictions can be seen as a repetition of the precautions associated with the 1918 flu. But to me they represented yet another public health failure. Despite the fact that we know much more about which situations pose a high risk of infection than we did last year, clear government guidance is still scarce.
But that is exactly what we need now more than ever. Rules that are too cautious, such as requiring vaccinated people to wear masks to an outdoor party, don’t make sense when almost everyone is affected by pandemic fatigue. Instead, we need to apply the principles of “harm reduction,” a public health philosophy that recognizes this reality and has grown in importance in recent years.
The idea of harm reduction was born in the fight against AIDS. By the mid-1980s it was already clear that combating drugs and needle possession would not prevent HIV infection. In fact, the places with the strictest laws and the greatest shortages of needles actually had the highest rates of AIDS.
Essentially, non-acceptance meant that the ban on needles did not eradicate intravenous drug use, that the scarcity of syringes guaranteed sharing – and with it the spread of HIV. (Unfortunately, some states are now rerunning this experiment by cutting off access to the syringes, and they can expect the same results seen in Edinburgh, New York, and Charleston, W. Virginia under such restrictions.)
And so, people who inject drugs came together with public health officials and researchers to develop an alternative. Instead of insisting that we must fight drug use at all costs, policies should focus on reducing injuries to individuals and public health in general, they argued. Saving lives was more important than trying to stop behavior that some consider immoral.
In other words, the best way to slow the spread of disease is not to make unrealistic demands for total abstinence, but to work to reduce the greatest harm. This idea was soon picked up by gay men who injected drugs and was carried over to sexual behavior as well.
In the mid-1980s, a drug advisor, Luis Palacios-Jimenez, realized that he sometimes saw the same behavior in his fellow gay men as he did in his addicts. They heroically tried to maintain abstinence or celibacy for months – and then they slipped and made no attempt to protect themselves while intoxicated or on a rampage. To counteract this, he co-founded the now highly regarded workshop Eroticizing Safer Sex and wrote an accompanying book.
Psychologist Alan Marlatt observed similar behavior among cigarette smokers and drinkers and described it as the “abstinence injury effect”. Basically, if the only acceptable goal is continuous abstinence, even a small slip can quickly turn into a snowball. When people think they have already “blown it”, they think they could do it just as well and throw any prior warning to the wind. This problem affects dieters too – and pretty much anyone trying to change their behavior. It can be fatal in extremely high-risk activities – and addiction research shows it can make relapses more likely and worse.
Today we also see it with COVID measures: If we have to be 100 percent 100 percent careful, if we fail at least for a short time, we will tend to give up further attempts to reduce risk.
But harm reduction – and the many papers now showing its effectiveness in everything from reducing the spread of HIV to moderating alcohol consumption – offers a better way to go. As new variants may make existing vaccines less effective, it is more important than ever to highlight preventive measures, especially when they can be of greatest benefit, so that they can have the greatest effect.
That means, no, at events where people have proven their vaccination status, no mask is required outdoors. However, recommend them to anyone in tight, crowded indoor spaces where air circulation is restricted, vaccination status is unknown, and distancing is not possible.
Don’t fall into the trap of the “hygiene theater” of constantly washing surfaces that show little evidence of driving transmission – but help people maintain better hand washing habits and avoid unnecessarily touching high-contact surfaces like lobby elevator buttons.
Instead of aiming never to take risks, instead you help people identify which situations are really risky – and critically explain why.
In the drug world, harm reduction advocates discovered that treating people as if they were confident and respectful helped reduce risk taking, likely by making people feel wanted and valuable.
The same applies here: Talking to people or assuming that they cannot or do not want to make good decisions about risks themselves only increases distrust. In contrast, if you provide accurate information – including data on uncertainties – people will be much more likely to pay attention to it.
In essence, when people feel that their decisions are important not only to themselves but also to their communities, they are more likely to be doing the right thing. And if they trust that the authorities will catch up with them, they are more likely to reduce risk behavior again. In fact, a study on reducing the risk of COVID-19 found that countries with the highest public confidence doubled compliance with the strictest restrictions.
If we leave the US pandemic behind, we need to learn from mistakes made early on, such as: B. Notices of masking intended to protect health care workers but instead discourage effective preventive action and increased suspicion.
On June 15, New York Governor Andrew Cuomo lifted most of the state’s remaining pandemic restrictions, citing that 70 percent of the state’s adults are now at least partially vaccinated. But people remain confused, and many fear losing their vigilance – especially over ominous reports of variants that regularly make headlines. Clear, honest, and accurate risk communication is vital.
Harm reduction research shows that even the most unlikely people – those actively dependent on drugs like methamphetamine and heroin – act to protect themselves and others when they are given accurate information and access to resources like clean needles and overdose antidotes receive.
We should respect the general public in order to cope with COVID at least as well. (And it seems the Lawn Party is back in full swing in August).
This is an opinion and analysis article; the views of the views Author or authors are not necessarily those of Scientific American.