In late March, Deborah Birx, the nation’s Coronavirus Response Coordinator, famously stated that “There is no magic bullet, no magic vaccine or therapy. It's just behaviors.”

Teachers College’s John Allegrante, Professor of Health Education, agrees -- but in a recent article in The American Journal of Preventive Medicine, he and coauthors M. Elaine Auld, Chief Executive Officer of the Society for Public Health Education, and Sundar Natarajan of NYU Langone Health argue that thus far the United States has fallen far short in its prevention strategies. 

“If ‘it's just behaviors,’ preventing further viral spread will require strengthening evidence-based behavioral change and implementation of science strategies to effectively reach the large numbers of at-risk Americans who are anxiously navigating the difficult social terrain to keep themselves and their families safe from COVID-19 and its long-term sequela,” the three write in in a piece titled Preventing COVID-19 and Its Sequela: There Is No Magic Bullet... It’s Just Behaviors.” “In other wars, the U.S. committed resources, technology, and expertise to achieve overwhelming superiority and overcome the enemy. The strategy for winning this contemporary war will demand nothing less.”

Preventing further viral spread will require strengthening evidence-based behavioral change and implementation of science strategies to effectively reach the large numbers of at-risk Americans who are anxiously navigating the difficult social terrain to keep themselves and their families safe.

[Read the full article by Allegrante, Auld and Natarajan.]

Currently, argue Allegrante, Auld and Natarajan, the prevention “narrative” being delivered to the public is “missing the behavioral science expertise that is central to achieving protective behaviors.” The three call for “a national historic commitment…in which behavior change methodology is a dominant weapon in the nation’s public health arsenal.” They underscore an urgent need for “accurate data about the public understanding of COVID-19 risk and preferred sources for obtaining information about how to stay safe.”

At hotspots or areas of impending risk, push notifications to reinforce social distancing, hand washing, and use of masks could be sent to every mobile phone there until government leaders and public health authorities believe the risk has been lowered substantially.   

The three authors also urge better utilization of digital technology to enable more efficient targeting of at-risk individuals and tailoring of behavioral interventions. For that to happen, they argue that pandemic behavioral science, methodology, and evidence need to be updated and expanded.

“At hotspots or areas of impending risk, push notifications to reinforce social distancing, hand washing, and use of masks could be sent to every mobile phone there until government leaders and public health authorities believe the risk has been lowered substantially,” the authors write. “Such notifications could be sent by the National Emergency Broadcast System, AMBER Alert (the Department of Justice's Nationwide System of Emergency Response), or even by active alerts through the National Weather Service or other emergency mass text alert systems to provide the cues and nudges to activate behavioral change.”

In other wars, the U.S. committed resources, technology, and expertise to achieve overwhelming superiority and overcome the enemy. The strategy for winning this contemporary war will demand nothing less.

The authors also praise work by former New York City Mayor and presidential candidate Michael Bloomberg to develop smartphone apps for tracing COVID contacts as an “example of how clever strategic use of digital technology could strengthen the national response.”