Prof Edgar Jones, in The Lancet, offers a historical review of government policies and the behaviour of civilians during times of great threat, in this case, the World War in the past and the pandemic in the present. August 2020.
The COVID-19 pandemic and the World War 2 aerial bombing campaign against the UK between 1939 and 1945 both exposed the civilian population to a sustained threat. Risk, whether from exposure to viral load or the density of the bombing, led to a range of protective measures and behavioural regulations being implemented. The V1 and V2 missiles used in summer and autumn, 1944, functioned as a second wave of bombing, arriving after people believed the danger had passed. Adherence to lockdown and a reluctance to return to work after the lifting of lockdown during the COVID-19 pandemic in the UK were mirrored in the preference for using home-based bomb shelters during the air raids. Heightened sensitivity to risk, or a so-called deep shelter mentality, did not materialise even during the second wave of bomb attacks and some deep bomb shelters were closed because of low occupancy. The most popular protective measures were those that reflected people’s preferences, and not necessarily those that provided the greatest safety. As with the COVID-19 pandemic, the public drove government policy as much as they followed it.
Unprecedented is a term commonly used about the COVID-19 pandemic. Yet there are substantial parallels with earlier threats to people’s lives, not least the 1918 and 2009 influenza outbreaks. However, this Historical Review compares the current COVID-19 health crisis in the UK with the aerial bombing of its towns and cities (known as the Blitz) during World War 2. The response to the Blitz is one of the earliest examples of a government seeking to protect people from harm and maintain national production, informed by behavioural science and psychological understanding. An emerging interdisciplinary scholarship has begun to address the parallels between these events that have been drawn by commentators and politicians.1, 2 People’s occupation of air raid shelters offers a comparison with people remaining at home during the lockdown.3The threat of a second wave of COVID-19 infection was mirrored by the V1 and V2 missiles launched in summer and autumn, 1944, when Londoners who had survived the Blitz of 1940–41, and the Baby Blitz of spring, 1944, believed that the war was effectively over. Then, as now, the government commissioned studies into the new types of threat faced by the nation, to inform the character of protective measures and information campaigns to sustain resilience. Parallels exist between the COVID-19 pandemic and the aerial bombing campaign in terms of the planning, preparation, and exposure phases. This Historical Review compares the psychological responses and behaviour of the UK people during periods of threat to identify common patterns to inform understanding for future health emergencies.
In the prewar planning phase, the Committee of Imperial Defence identified stoicism (mental resilience) as the core defence against the stress of aerial bombardment,4 and sought ways to strengthen people’s inherent resolve to withstand bomb attacks.5 If shelters deep underground were provided as the only guarantee of safety from air raids for people living in towns and cities, it was thought that the shelter occupants would rapidly become risk averse when presented with the contrasting sight of destruction once back on the surface. Such risk aversion was considered to be contagious and likely to foster a so-called shelter mentality, which could undermine national production as workers became increasingly anxious.6 A series of air raids on Helsinki by Soviet planes in November, 1939, appeared to confirm these predictions: “persons in raided areas would go and sit in shelters at times when no raid was in progress to recover from an attack”.7 In February, 1939, the UK Government rejected proposals to construct deep underground shelters, not only to protect inherent resilience but also to maintain a sense of unity in adversity.8 Shared standards of protection were provided across areas of equivalent risk of bombing to prevent any social or occupational group from feeling disadvantaged, and the cost of a nationwide network of deep shelters was considered prohibitive.To predict behaviour and to design protective measures, the prewar government drew on reports from other nations, notably Spain, Ethiopia, and China, all of which had been subjected to air raids.9, 10Although this intelligence revealed adaptability and an absence of panic, this valuable evidence was discounted by planners on grounds of national differences. Claude Pelly, the UK air attaché in Shanghai, expressed prejudices common to Europe and North America in this period, when he argued that the observed resilience was a racial characteristic: “the Chinese are more fatalistic and possibly less imaginative than the Western races”.11 In the present day the UK, late in the chain of countries to be infected by COVID-19, could have accessed data from China, South Korea, and Italy, but failed to do so.12 Italian mortality rates were discounted on the grounds that these were a function of particular demographics, notably a high proportion of elderly people living in close proximity with their younger relatives. Furthermore, the Scientific Pandemic Influenza Group on Behaviour and Communication urged caution about using behavioural science from other nations “because there is evidence to show that how people respond to infectious disease outbreaks differs between countries”.13
Phoney war and pre-lockdown
The declaration of war in September, 1939, was followed by a burst of activity, in which civilians filled sandbags, stockpiled food, and joined voluntary organisations.14 Yet, when the expected air raids failed to materialise, much of daily life returned to normal. A poll in October, 1939, suggested that 50% of the working population thought there would be no air raids.15 In December, 1939, John Anderson, the UK Home Secretary, warned, “public opinion is only too ready to discount the risks of a large-scale attack, merely because no such attack has yet to be delivered”. He urged that active steps be taken to “counter this spirit of false optimism”.16 Without the anxiety created by nightly bombing, many people had little motivation to prepare for the bombing.17 A survey in June, 1940, found that 38% of London households had taken no air raid precautions beyond observing the compulsory blackout (ie, extinguishing sources of light that could help enemy aircraft to identify urban and industrial targets).18The dissipation of anxiety similar to that in the phoney war was also apparent during the 3 months between the first reports of a deadly virus in China and the spread of cases within the UK early in March, 2020. On Dec 31, 2019, Chinese authorities notified WHO of an outbreak of pneumonia in Wuhan City, later classified as COVID-1919At the end of January, Britain entered the contain phase, designed to detect and isolate the first cases of COVID-19.19 Despite widespread media coverage, by March 1, a YouGov poll found that only 24% of UK adults feared catching the virus.20 On March 12, as the number of confirmed cases in the UK rose to 596, with eight deaths, a policy of delay was introduced, designed to flatten the peak incidence of infection. Although the wisdom of holding large public events was questioned, in the week of March 8, the Cheltenham Festival (4 days of horseracing) went ahead, and attracted daily crowds in excess of 60 000 people. However, fear of catching the virus gradually increased, being expressed by 38% of adults on March 13. 3 days later, the prime minister urged people to avoid non-essential travel and to work from home if possible.21 In the week of March 16, as some schools and workplaces closed voluntarily, concern was expressed that the government was following rather than leading on preventative measures, prompting its announcement that schools would close from March 20. Lockdown was introduced on March 23, and not eased until 7 weeks later, on May 11.