The U.S. is battling an early spike in the flu season, with the number of people suffering from the flu thus far almost 10 times higher than last year. Yet less than half of the American population has gotten a flu shot.
Researchers at Wake Forest University sought to understand this behavior using an online computer game that simulates the spread of an infectious disease among its players.
The study, the first in the economics of disease control using virtual diseases, was conducted by economists Drs. Fred Chen, Allin Cottrell and Amanda Griffith, and computer scientist Dr. Yue-Ling Wong.
“When it comes to policies for disease control, one size does not fit all. Some people are very risk-tolerant and some are super risk-averse. Our research shows that to prevent an epidemic, there is a need to tailor a menu of options for different kinds of people,” said Chen, who studies economic epidemiology.
When studying how best to contain epidemics, scientists and policy makers often must make assumptions in mathematical models about how many people will or will not take preventive measures to keep from getting sick. The virtual epidemic experiment allowed firsthand observation about how people really behave when faced with choices about whether or not to self-protect during a widespread occurrence of infection in a community.
Researchers say the online computer model game simulates an epidemic among the players over several weeks.
At the beginning of each day of the game, healthy players have the option to choose, at a cost, a protective action that reduces the likelihood of getting infected.
“We can’t do in real life what we can do in the game,” said Griffith. “We can’t give some people treatment and others not. The game gave us a way to conduct an experiment on behavior that could never be done in real life.”
Because self-protecting involves a cost, players earned the highest number of points by staying healthy and not choosing the preventative measures.
At the end of the game, players knew they would receive a gift card with a value equal to the total number of points earned in the game — an incentive to play honestly.
The experiment was conducted twice. In one game, the cost for players to self-protect was low, in the other it was higher. Players in the low-cost condition were significantly more likely to make the choice to protect themselves from infection.
“Players were rolling the dice to see if they could stay healthy without paying the costs of protection. But even those players who were more inclined to take risks chose to self-protect the more often they got sick,” Chen said.
Researchers believe the findings can be applied to many illnesses from the common cold to sexually transmitted diseases, where there are costs, financial or otherwise, to taking a preventative measure.
For example, in the face of an outbreak of flu, preventative costs might include a fear of negative side effects from taking a vaccination, a fear of needles, lost pay for time away from work, the gas cost of driving to a flu shot center and the time spent waiting in line for a vaccination as well as, for some, the cost of the vaccination itself.
The study shows that to reduce disease prevalence, policies that reduce the cost of self-protection can be helpful, such as offering paid time off for employees who get flu shots or providing free flu shots onsite.
Investigators learned that as the number of players infected increased, so, too, did the number of players who chose to protect themselves from infection.
“At the start of each day, participants could see how many players in the game were infected. As the number of sick players increased, more healthy players chose to take the preventative measure.
During a bad cold and flu season like the one we are in this winter, more people may may be willing to take extra precautions if they know how many people in their community are sick,” Chen said.
Researchers also confirmed that having the flu in the past (and the memory of the horrible, helpless feeling attached to the illness) corresponded with individuals elevated willingness to take precautionary action ie receive the vaccination.
And, that people willingness to engage in safe behavior increases or decreases over time depending on the seriousness of the epidemic.
Source: Wake Forest University