AN OMICRON NUDGE — Last week, when my husband and I were sidelined with fatigue, headaches, runny noses and coughs, I panicked. Not about having Covid — we're both vaccinated and boosted and otherwise healthy — but about the prospect of having to keep our two toddlers, who are 3 and 2, home for two weeks under their day care guidelines for Covid exposures. So I thought about doing something that elicits sympathy from parents of young kids right now: I contemplated not getting tested at all. Two years into a pandemic whose spread depends on individual decision making — whether people choose to get vaccinated, to wear a mask or to get tested — political leaders, businesses, schools and day cares are struggling to find the right way to nudge people into making choices that benefit society broadly but sometimes come at steep personal cost. And as the Biden administration prepares to send Covid tests to millions of homes and schools and requires insurance companies to cover their cost, the country faces another hurdle: getting people to take the tests and, should they test positive, follow guidance that helps limit the spread of the virus. Covid cases have blown past previous peaks. Hospitalizations are as high as they were last winter and are set to rise further. About a quarter of the population has yet to receive a vaccine dose. But policymakers have given up on shutdowns. Instead they are relying more and more on Americans to navigate Covid guidance on their own by monitoring symptoms and testing and following quarantine guidance. "More people are saying things like, 'I am over it. I am calling it,'" said Elizabeth Levy Paluck, deputy director of the Kahneman-Treisman Center for Behavioral Science & Public Policy at Princeton. "It's relatable." Federal and local governments need to make testing, masking and getting a vaccine as easy as possible, said Raymond Niaura, a tobacco use expert at New York University. Ideally, people should be able to get tests and vaccines within a half mile of their homes with no waits or appointments, he said. "There is always going to be a group of people who won't budge," he said. "The goal should be to make that group as small as possible." Decades of behavioral science research shows that the first step to getting people to do something is to make it easy, said Paluck, who studies social psychology and behavior change in the U.S. as well as in post-conflict countries like Rwanda. "It is very hard to create motivation," Paluck said. "The simple thing is to remove a barrier." Yet under the Biden administration's testing plan, only a limited supply will actually be sent to people's homes. Federal health officials are also still weighing whether to send people high quality masks to their homes. Instead, a big part of the testing plan involves what Paluck describes as a barrier: requiring people to go to participating pharmacies to get tests covered by their insurance. Then there is a confusing patchwork of guidance from the CDC, schools and other businesses about when to test, what to do after being exposed or experiencing symptoms and how long to isolate. To nudge people to report potential exposures and to test if they have no or mild symptoms, federal and local governments and businesses need to think more creatively, Paluck said. In post-conflict zones, Paluck found that the stories people tell shift their behavior. She suggested getting people to see testing and masking as the antidote to isolation. "One thing we could try to do is brand these late-arriving measures as our ticket to more connection," she said. Businesses, she said, could create a feeling of interdependence by making visible the names and stories of specific employees — janitors or cafeteria workers — who would be most affected by a workplace outbreak. "We need to already have these mental maps," Paluck said, "showing us that there are so many people this would affect and I know their names." My husband and I did take PCR tests in the end. It helped that the barriers were low: We were able to skip the hourslong testing lines because I taught a class at the University of Texas at El Paso. We were also worried about his mom and co-workers and the other kids in our day care. When we finally got our results nearly six days later, they were negative for Covid — but positive for the flu. I had meant to get my flu shot when I got my Covid booster in December, but I worried about the side effects of getting both at once, even though the experts said it was safe. So I put it off. And then I never got around to going back to the pharmacy. Welcome to POLITICO Nightly. Reach out with news, tips and ideas at nightly@politico.com. Or contact tonight's author at rrayasam@politico.com, or on Twitter at @RenuRayasam.
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