What health measures are the French prepared to accept?

New Year's Eve parties held in small groups or cancelled, families scattered and isolated, self-confinement, local, partial or generalized confinement, curfews, travel restrictions, border closures, uncertainty as to whether certain sectors will reopen: France, like many other countries around the world, has faced a series of restrictions in an attempt to contain the epidemic.

Thierry Blayac, University of MontpellierBruno Ventelou, Aix-Marseille University (AMU)Dimitri Dubois, University of MontpellierMarc Willinger, University of MontpellierPhu Nguyen-Van, University of Strasbourg and Sébastien Duchêne, University of Montpellier

While each type of measure/restriction has its own effectiveness in controlling the epidemiological dynamic, they must also be assessed in terms of their acceptability to the population.

At a time when decision-makers are wondering whether to re-evaluate restrictive measures to avoid a rebound in the epidemic, people's preferences should count in public decision-making.

This is particularly true after months of effort, followed by the introduction of new measures in many European countries in recent weeks.

Distinct attitudes

Our team of behavioral economics researchers quantified the degree of resistance or acceptability of a population to various strategies to combat the Covid-19 epidemic. Our results led to the publication of an article in the international scientific journal The Lancet Public Health.

The results of the study show that wearing a mask, transport limitations and digital monitoring are relatively well accepted.

On the other hand, closures of restaurants and recreational areas, and excessive restrictions on leisure travel are much less acceptable. Analyses of population subgroups (clinical vulnerability, age groups, gender) also show that the acceptability of certain strategies depends on personal characteristics.

In particular, the young population differs quite strongly from the others, in terms of anti-Covid-19 policy preferences and demands for monetary compensation, suggesting the need for an adapted "menu" of anti-Covid-19 policies, based on distinct attitudes.

Assessing people's preferences

The study uses a preference-revealing method, the " Discrete Choice Experiment ", to assess people's preferences for various combinations of public policies to control COVID-19 epidemics.

Between May 4 and May 16, 2020, at the end of the first containment in France, our team carried out an Internet survey on a representative sample of the French population.

One of the aims of the survey was to assess acceptance of the restriction measures among the main anti-COVID strategies discussed by the French government in early April for the period following containment.

The graph below gives a ranking of preferences for the population as a whole and for certain sub-groups, defined according to their clinical vulnerability, age or gender.

A necessary evil

Masks, restrictions on public transport and digital tracking (via an optional cell phone application) were deemed acceptable by the general population, provided the restrictions on each of these dimensions remained reasonable. For example, wearing a mask is much less acceptable when the word "everywhere" is associated with it.

Conversely, additional weeks of confinement, the closure of restaurants and bars, and excessive restrictions on leisure travel (less than 100 km) were not deemed acceptable.

On the whole, these results indicate that the French population was relatively accepting of the restrictive measures that followed the first confinement, seeing them as constraints, but also as a "necessary evil", to be set against the risk of further confinement, an eventuality that was perceived very negatively.

Rejection for additional weeks of confinement was more than proportional: the longer the duration of additional confinement, the greater the intensity with which it was rejected.

Vulnerable people more tolerant

Compared with the general population, clinically vulnerable people, i.e. those reporting chronic illness, showed greater tolerance of confinement, greater acceptance of mask wearing and less rejection of restaurant and bar closures.

However, these differences were small, indicating either a form of altruism on the part of the non-vulnerable towards the vulnerable, or a low degree of singularity on the part of the vulnerable in their attitudes to risk.

Young people (aged 18-24) were the most dissonant group, perhaps because they are less concerned by health risks than older age groups (although medical risk is not zero for young people, and remains significant for the elders with whom they come into contact).

In our survey, we proposed, among the various attributes, financial compensation to offset the burden of restrictive policies. Our analyses showed that young people were clearly in favor of this proposal, while other segments of the population clearly rejected it.

From this result, we can deduce that financial incentives could be an effective instrument when targeted at young people, and that they are likely to make young people more accepting of restrictive anti-COVID policy options.

This solution would involve applying a compensation mechanism, such as a Pigou transfer, which has already been applied in other fields of public economics. According to Arthur Pigou, an English economist of the early 20th century, the principles of "welfare economics" can lead to taxing - or compensating - individuals who exert negative - or positive - external effects, so as to bring them back to behaviors that are more optimal for society.

Thus, knowing how people in a population classify the various prophylactic measures related to COVID-19 is a prerequisite for designing appropriate programs and measures, a challenge that many countries in the northern hemisphere face every day until a vaccine becomes widely available.

Our survey therefore highlights the need for anti-COVID policies that are closer to people's sensibilities.

It suggests ways of improving the acceptability of control policies, particularly by compensating young people, taking into account the preferences of different segments of the population, and preventing some of them from refusing to adhere to the measures, thereby spreading the epidemic risk throughout society.

Thierry Blayac, Professor of Economics, Centre d'Economie de l'Environnement de Montpellier (CEE-M), University of MontpellierBruno Ventelou, CNRS-AMSE researcher, economics, public health,, Aix-Marseille University (AMU)Dimitri Dubois, Behavioral Economics, Environmental Economics, Experimental Economics, University of MontpellierMarc Willinger, Professor of Economics, Behavioral and Experimental Economics, University of MontpellierPhu Nguyen-Van, CNRS Research Director in Economics, University of Strasbourg and Sébastien Duchêne, Associate Professor of Economics, University of Montpellier

This article is republished from The Conversation under a Creative Commons license. Read theoriginal article.