Tuesday, September 28, 2021
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The nudgers are still hard at work

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Mitesh Patel is an accomplished fellow: a professor of health care management at the Wharton School of the University of Pennsylvania and former director of the university’s Penn Medicine Nudge Unit, the ‘world’s first behavioural design team embedded in a health care system’. He is a professional ‘nudger’.

Professor Patel and scientists from Harvard, Yale and several other US universities recently collaborated on a ‘mega-study’ of more than 47,000 patients to establish how to boost the uptake of the flu vaccine. The team are eager that their findings be used to ‘encourage the uptake of Covid -19 jabs’.

The researchers wanted to discover which methods were most effective at ‘nudging people to get their shots. They used jokes, short videos, and ‘allowing participants to dedicate their shots with a loved one’s initials’. The most effective was ‘a reservation reminder’.

Patel said that participants were sent a text 72 hours before their appointment warning them ‘it’s flu season,’ followed by another reminder 24 hours before their appointment, stating that ‘a flu vaccine has been reserved for your appointment’.  Apparently, using ‘reserved for you’ boosted vaccination rates by 11 per cent.

In their efforts to find out how to nudge more people into taking flu jabs, the researchers overlooked a basic question of whether such jabs are ‘either effective or efficient’ in preventing influenza. They were unaware of, or chose to ignore, evidence  from a major meta- analysis first published in 2010, and updated again in 2018, of international health data bases,  including the Cochrane Central Register of Controlled Trials (the gold standard), and the WHO International Clinical Trials Registry Platform, that suggested there was little statistical benefit to be had, especially in the ‘elderly’ (those over 65) .

During the 2019–2020 flu season, fewer than half the US population took the flu vaccine, with an estimated 35,000 deaths from the virus. Covid-19 is reported to have killed more than 635,000 Americans and 155,465 people in the UK, though other numbers and causes of death are available.

According to ourworldindata, 39.6 per cent of the world population had received one Covid jab by August 29, 2021. The US Centers for Disease Control and Prevention (CDC) report that 74 per cent of Americans have taken at least one dose and, in the UK, over 72 per cent have had one, and 64.1 per cent two.

But these figures are not enough. The dominant ‘scientific narrative’ is that ending the Covid-19 ‘crisis’ requires vaccinating the entire world, not once, not twice, but three times. We are told that enormous efforts from Big Pharma, financed by ‘public investments’, have ensured the development, authorisation and mass-production of safe and effective SARS-CoV-2 vaccines in record time.

Yet, there are still people reluctant to accept this bounty. Their numbers are unclear, but likely to be a substantial minority. Their failure to fall into line threatens to undermine efforts to manage the Great Reset and frustrates global elites. Much more is needed to ensure Total Compliance.

Though our governments are becoming more overt in their drive to mass-vaccinate, some scientists still consider that nudges, i.e. interventions that rely on behavioural science insights and manipulation, are more subtle, less likely to be resisted, and perhaps more easily defended in a Nuremberg 2 scenario.

In an interview with Wharton Business Daily  Professor Patel said: ‘Now that we have the evidence on what works and what doesn’t, we can actually leverage this to help motivate more people to get vaccinated quickly.

‘The most important takeaway is that the way that we communicate the vaccine to people is going to have a huge impact on whether or not they’re going to be motivated to get it, and that really subtle changes can have a big impact.’

Patel’s language is interesting; he describes the top-performing text message as having ‘packed a one-two punch’. Fear, monitoring, and personalisation – the Chinese Communist Party approach to public health. 

Patel commented on how the pandemic had accelerated the adoption of digital tools for many health care systems and welcomed text messaging as an ‘efficient and inexpensive way to reach patients wherever they are’. Patients’ contrary views are clearly not his concern.

He describes a world of drones where ‘Individuals every day are glued to their phones; they don’t leave home without them. This gives us insight into what they’re doing because we can actually track how they’re engaging with their health care portals or platforms’ – a frightening reality.

Patel goes on: ‘It also gives us an opportunity to be able to then change the interface, the architecture, the communications through those digital platforms in ways that are aligned with the patient’s goals.’

He reports that scientists from the University of California-Los Angeles have undertaken similar trials around ‘psychological ownership’ of the vaccine.  

He considers this to be important because it indicates that there are ‘still plenty of opportunities to nudge that last cohort of vaccine holdouts – people who are hesitant or apathetic’. Any notion of individual agency, confidentiality, freedom of choice, or bodily integrity has clearly passed him by.

Patel says that behavioural and health care scientists are ‘hard at work during this pandemic, designing experiments and digging into the data to learn as much as they can about nudging people into behaviour that benefits everyone’. And there is not a hint of irony.

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Kate Dunlop
Kate Dunlop is a mediator.

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