A story is told about an unprecedented public health menace that swept the whole town of Venice, Italy, in 14th-century Europe. The authorities, alarmed that the “Black Death” was fast spreading and ruthlessly consuming its people, resorted to what is now known as quarantine. It required ships to remain anchored for 40 days before landing to prevent the spread of the disease.
Apart from it ushering in the era of quarantine and similar disease prevention and control measures like immunization, this is viewed as one of the earliest examples of prosociality in recorded history.
Prosociality is the orientation of government and citizens to the needs of society as a whole, instead of being limited to narrow individual interests. Promoting prosociality can improve policymaking to uphold the common good and induce protective behavior among people.
This is the premise of the latest “The Lancet Commission on lessons for the future from the COVID-19 pandemic,” in which prosociality is touted as a major force influencing the five pillars of pandemic response: prevention, containment, health services continuity, equity, and global cooperation.
This becomes more relevant now that we have already opened our economy and resumed our routine activities—in business, work, school—and even relaxed some restrictions, like the wearing of masks outdoors, while still in the midst of a pandemic that can turn tragic and deadly in its next sly turn.
Aside from intensifying our efforts to improve health education for health promotion and exploring ways to better understand behavior and social sciences as they relate to compliance with minimum public health standards, we should learn to understand how government policies and people’s behavior are informed and determined by prosociality.
Like an adaptation of the Golden Rule, prosociality in public health requires that we act and behave according to what will work best for the health and well-being of the majority. Thus, we should do our best to make others safe because that’s also what we expect from them.
Prosocial behavior during the pandemic ranges from testing for possible infection, isolating upon getting a positive result, going on quarantine after exposure to a positive case, wearing masks, maintaining physical distancing, and getting vaccine shots, to meeting outdoors and working from home as much as practicable. These need to be reiterated, supported, and incentivized.
On the other hand, if there are deviations from prosociality, more than instilling fear and imposing penalties or sanctions—although these had been proven to work, according to some studies—we have to investigate further the attendant challenges to prosociality—self-serving interests, desire for autonomy in decision-making, and low trust of people and authorities. These need to be addressed on their own.
For instance, the “pasaway” rhetoric and the fear tactic can only go so far. Evidence has shown that for people who are innately selfish, fear will not work. Instead, building empathy and using moral suasion might be the appropriate strategies for those with these tendencies and personalities. This will require a more tailored and scientific approach to pull off.
On the same note, decentralized governance structures are inclined to make grounded decisions on their own; however, it should be argued that prosocial pandemic policies should always be national in terms of scope of implementation in a country context. After all, Philippines will not be safe unless all local government units are safe.
Moreover, with trust being a major determinant of prosociality, some progress has to be made in several areas: standards for leadership and governance have to be set higher; public vigilance for prosocial actions has to be significantly heightened; misinformation and disinformation have to be dealt with more strategically; and working relationships and mechanisms of engagement between the government and its citizens must be enhanced.
Ultimately, to create a sea change when it comes to prosociality, we need to put a high premium on social cohesion and improve mutual aid, which means the spirit of bayanihan must be kept alive in the new normal.
Prosociality starts with every Filipino. All of us tread and share a single path toward recovery and sustainable development. There is only one way to combat a crisis—by moving as one nation. This is one hard lesson we’ve learned from the pandemic, but going forward should be easy if we are prosocial enough.
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Ronald Law is a medical doctor and public health practitioner with expertise in health emergency and disaster management. He is also an academic, a scholar, and an advocate of future-ready health systems.