Tag Archives: anti-vaxxers

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Fantasy and Denial: Our Public Health Challenges

Routine protocols for dealing with fast-spreading viral diseases have been reimagined as partisan ploys designed to destroy personal freedom.

In the last year my colleagues who specialize in health communication have had to face a landscape of public opinion fissures beyond what most could have imagined. Health communication explores how we can acquire information that will allow us to make better personal choices. One of the triggers for this area of study was the realization decades ago that it was costing much more to treat seriously ill smokers than to educate them about the risks. Public health practitioners realized that they needed the help of people trained in the arts of shaping public opinion.

Many who do this kind of research could be forgiven for thinking that the route to control of a treatable malady is a straight path involving the conversion of the best expert advice into coherent messages, producing high levels of compliance. But no. By nature, humans are fantasists more than critical thinkers. If vaccine resistance has taken many of us by surprise, it is perhaps because we thought we understood the power of credible medical advice. But ask members of our species about material causes for a particular result, and some will manage to weave together alternate narratives that have no bases in fact.

There is irony in living in an information-rich age that also supports bubbles of completely looney “truths.” We never need to look far. Many of us have seen folks look a reporter in the eye an assert that the seditious acts of January 6 against certifying a new Democratic president were the work of the Democratic Party. Where do you start with these people?

The eradication of polio is a representative case. In the mid-1950s, Americans anxiously lined up their children for the first vaccine against the highly infectious disease that left thousands of children paralyzed. As medical historian David Oshinsky has noted,

“If you had to pick a moment as the high point of respect for scientific discovery, it would have been then, After World War II, you had antibiotics rolling off the production line for the first time. People believed infectious disease was [being] conquered. And then this amazing vaccine is announced. People couldn’t get it fast enough.”

By early 1960, polio in the U.S. had been all but eliminated.

But this is not 1954. The pandemic has turned into an unforeseen world-wide experiment in how to manage the rapid transmission of a deadly virus while fighting off the dross of misleading messages. As it has turned out, and in spite of advances in immunology, helpful advice would have to outpace the lightning dissemination of misinformation, frequently with fantasies that a Hollywood screenwriter would have thought too outrageous. Perhaps eight to ten percent of the population is untethered to the ground, expressing phantom fears and wanting unobtainable guarantees of perfect safety.

Although many of us may owe our lives to the COVID vaccines that became available last March, widely expressed doubts about the helpfulness of masks, social distancing, and vaccines were triggered by this countermovement. It has expanded beyond the small core of anti-vaxxers and conspiracy-paranoids that have always been around. If we want to know how misguided public attitudes can be, we need look no further than many narratives that have turned treatment into a government plot. Routine protocols for dealing with fast-spreading viral diseases have been reimagined as partisan ploys designed to destroy freedom of action.

Thousands are going from hospital ICUs to their graves with the belief that COVID was a governmental plot

As this is written, only 48 percent of the residents of Alabama have gotten two doses of a COVID vaccine, with the predictable result of abnormally high per-capita death rates. Indeed, using the New York Times’ database derived from the CDC and other sources, some states like Idaho may not even know how many citizens have received vaccines. And the inequities of care within a single state can be vast. In Texas, 82 percent of the residents of Webb County are vaccinated, but only 21 percent in Gaines County.

Core public health best practices for the control of the spread of disease have been known for decades, granting some variations for local factors like weather, the mobility of the population, and the variability of medical care. Even so, it is settled science that immunization and wearing facemasks can reduce the spread of infectious disease in Burlington Vermont as well as Miami. But against the uniformity of guidelines lies the darker immutability of human conduct. Again, our dilemma is that prior beliefs and fantasies are difficult to dislodge even with sound evidence. Overlay this resistance to new fantasies that political treatments are surreptitious tools of thought control, and suddenly medical staffs have been forced to deal with wild speculation as well as disease. Indeed, a small percentage—but maybe thousands–are going from hospital ICUs to their graves with the belief that COVID was a governmental plot.

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Making Sense of Truth-Denial

Fantasy theme analysis helps us understand the contagion that happens when “information” combines with our hard-wired impulse to see the world in self-perpetuated stories.

There are many aspects of the ongoing pandemic that defy easy understanding. It’s not always clear why it has spread in some areas of  the world and remained more contained in other parts. But we do know proven ways to reduce the spread of COVID and its variants.  A simple list of public health precautions is available to anyone who cares to look: mask up especially indoors around other people; get tested if you have symptoms, and be sure to be vaccinated with one of the amazingly effective shots that will greatly increase immunity and lower the chances of death.  The science is clear: these precautions work. A person is more likely to get sick and die without a vaccine. As of this summer, 97 percent of the individuals in hospital ICUs for COVID were unvaccinated.  No wishful thinking can change these facts.

Even so, the denial of this most elemental of realities persists, and gives the virus a chance to change and infect new victims.  Meanwhile, alternate narratives circulate and gain credence mostly because they affirm what the deniers want to believe.  Hence COVID becomes a tool of control cleverly engineered by big-pharma, big government, or a host of other phantoms.

The Mechanism of Evidence Denial

Years ago, social scientist Robert Bales noted that groups of people put together in a room to solve a problem often reach a moment when there is a convergence of views around a preferred narrative. In many cases folks in the group didn’t have the facts or knowledge to make a judgement picked up bogus ideas from other like-minded people around them. Think of a jury reaching a judgment on a case based on a shared prejudice.

Later on theorist Ernest Boorman at the University of Minnesota refined Bales’ ideas into a convincing and solid theory called Fantasy Theme Analysis. Boorman acknowledged what  we all sense: that even in the presence of good information, we tend to rely on the views of our reference group and our natural compulsion to spin narratives that allow us to move from uncertainty to conviction.  This is more likely to happen with people who were never adequately trained in even the rudiments of fact-checking or assessing a source’s likely credibility. One result is the protective responses of fantasy themes that “chain out” to others with similar views and the same inabilities to process truth claims.

Such flawed thinking may well cost us our republic.

Fantasy theme analysis helps us understand the contagion that happens when incomplete information combines with our hard-wired impulses to see the world in sets of comfortable stories. Each one is filled in with actors, motivations, villains, and final outcomes. We hate incomplete narratives, as when there is an airplane accident caused by bad weather.  So we are happy to construct our own story, regardless of what solid evidence might oblige us to believe. We especially want to put human agents in the picture to be at least partly responsible.

Here’s another example I have used that suggests that none of us are immune from fantasy thinking. I was sitting in my office one day in the 80s with a copy of the New York Times opened up on my desk. A colleague dropped by and, at the same time, we both noticed the paper’s front-page picture of the new Soviet version of a space shuttle. The Buran space craft looked exactly like the American version. Same wing shape. Same color. Same size. And without missing a beat we both blurted out the view that “they must have stolen the American design.” End of story. We “knew” it and we were ready to fill in the blanks. The similarity of the shape was enough to accept the fantasy of a theft of our plans.  All the while, we pretty much ignored the physics of space flight, which mandates similar design parameters for any earth-to-space vehicle.

With group fantasies, the world is explained from existing beliefs. Without them, we would have to live with the continuous uncertainties mandated by the real world of incomplete information and awkward truths.

In my field the phrase homo narrans is sometimes used to describe the essence of our species. We tell stories to live. That is our priority, with Truth far down the list of imperatives. Truth is often too inconvenient. It feels better and it is much easier to bolster each other’s views with agreeable tales that put a disliked faction or renegade political group behind a particular phenomenon.  Such flawed thinking may well cost us our republic.

If we are looking for reasons for the current peril of the American experiment, we need to deal with the paradox of a society awash in “information” that makes it possible for frail minds to cherry-pick beliefs that fit with what they already “know.”