Behavioral expert: Israelis will never stay at home, but the elderly might

Get most of the country back to normal, quarantine seniors, and take measures to prevent contact between them and younger people, says says Technion scientist

Nathan Jeffay is The Times of Israel's health and science correspondent

Illustrative: Elderly Israelis play cards at a coffeeshop in the Mahane Yehuda market in Jerusalem, January 10, 2012. (Miriam Alster/FLASH90/File)
Illustrative: Elderly Israelis play cards at a coffeeshop in the Mahane Yehuda market in Jerusalem, January 10, 2012. (Miriam Alster/FLASH90/File)

Israel should require those most susceptible to the coronavirus pandemic sweeping the world to remain at home, while letting everyone else go about their normal lives, a Haifa-based behavioral expert said Monday, arguing that a partial or even full lockdown is unrealistic.

Reports late Monday indicated that the government was set to enact drastic new restrictions, compelling people to remain at home, shutting public transportation, and closing all shops but groceries and pharmacies. The only people allowed to venture out would be those whose work is deemed vital.

But Ido Erev, a behavioral scientist at the Technion – Israel Institute of Technology, said any such measures will lead to a “big mess” and be “impossible to enforce.”

Erev, an expert on how people make their everyday decisions, said that Israelis simply will not stay home all day every day.

“My research suggests that to be successful with enforcement you need to be very specific, but what they are trying to do isn’t, and won’t be successful. People can always say they are going to shop or to work,” he said.

“I think it will be much more effective if, instead of locking down the entire population, you focus on the elderly,” he said.

Ido Erev, a behavioral scientist at the Technion – Israel Institute of Technology. (Courtesy)

Erev argued that as the coronavirus restrictions are largely aimed at protecting the elderly, who face disproportionate chances of death from the disease, confining them to their homes and letting those aged under 65 move around freely is the best solution.

“It’s about time to let the young people go back to work, so the economy doesn’t collapse,” he said.

An unconfirmed report on Channel 12 on Monday suggested that the government was considering a lockdown that would forbid all men aged 70 and up and women aged 65 and up from leaving their homes.

There was no suggestion in the report that the lockdown would quickly pave the way for a return to routine for the rest of the nation. But Erev, president of the European Association for Decision Making, said that there is little logic in keeping the younger and healthier subject to heavy restrictions if the elderly are isolated and safe from infection.

The World Health Organization has warned that while the elderly and those with preexisting medical conditions are disproportionately vulnerable to the virus, data from many countries shows people aged 50 and under make up a “significant proportion” of patients who need hospitalization. “Today I have a message for young people: You’re not invincible,” WHO Director-General Tedros Adhanom Ghebreyesus said on March 21. “This virus could put you in hospital for weeks or even kill you.”

Erev also said that if the government tries to keep far-reaching restrictions in force for everyone for months, adherence will wane. He noted that there is already a strong “it-won’t-happen-to-me effect” that sees Israelis break guidelines because they assume they will not play a part in spreading the virus.

Erev said that this effect is so strong that even those who fully understand the increased danger to the elderly will still visit them, thus exposing them to risk.

“It’s human nature,” he said, adding that he even slipped up himself, despite studying the statistical risks of coronavirus and despite 30 years of research in behavioral science, by entering his elderly mother’s home instead of leaving shopping by her door.

Illustrative: Elderly Israelis sitting on a bench in Ramat Gan, August 19, 2009. (Liron Almog/ Flash90)

Erev said the elderly were less likely to feel the invincibility of younger people who insist on continuing to go out, and argued that while the state could not provide for the needs of every housebound citizen for a month or more, it could afford to provide the elderly with a package that enables them to stay home relatively well-supplied.

“We could get back to normal and give the old people a very good life, including good food from restaurants,” he said, adding that the government should provide support staff — regularly tested for coronavirus — who take care of all their household needs and coach them to use technology like video-chat that reduces loneliness.

The government should also absorb the cost of uniting elderly friends and siblings who want to share a home, Erev said.

“If there are two 70-year-old sisters who want to live together, the state should invest money in testing them for the coronavirus, and then giving one a taxi to go to live with the other.” Under-65s could be cleared from the streets for an hour each day, he suggested, during which the elderly could go for walks.

Erev acknowledged that these steps would come with a high price tag, but said they were worth the cost to protect the elderly, and because relatives will only stay away if they are confident that their parents and grandparents are being cared for.

He said that the steps “will not only help save lives, but also help to get kids back to school, because if older people are actually staying at home and kids and grandkids aren’t feeling they should go and visit them, we can get back to normal more quickly.”

Ambulance workers wearing protective clothing, as a preventive measure against the coronavirus evacuating a woman with suspicion for COVID-19 at Hadassah Ein Kerem hospital, in Jerusalem, on March 22, 2020. (Flash90)

Erev stressed that he favors “gentle” methods to ensure that rules are followed, such as the measures to deliver good quality of life, but said that there should also be negative consequences if rules are broken, and made one radical suggestion: de-prioritizing rule-breakers if they are hospitalized with coronavirus.

“If you’re over 65 and you go outside, and we have 300 beds for patients and high demand, you should not get one of them,” he said. “It’s suicide.”

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