Reducing the Spread of COVID-19: A Social Marketing Perspective (by Nancy Lee)

Reducing the Spread of COVID-19
A Social Marketing Perspective

Nancy R. Lee, MBA
Teaching Associate, University of Washington
Adjunct Faculty, Boise State University
President, Social Marketing Services, Inc.
Strategic Advisor, C+C: All About the Good

This article presents perspectives on what Social Marketing principles, strategies and best practices appear to have been applied to reducing the spread of the coronavirus Disease 2019 (COVID-19), even if they were not labeled as such. In addition, it discusses which ones were not apparent in this campaign to date (as of April 30, 2020), and might have helped. The following components of a strategic social marketing campaign, and related principles for success, are considered:

Priority Audience Segments
Desired Behaviors
Audience Insights: Barriers, Desired Benefits
Marketing Intervention Tools to Help Citizen Behavior Change:
- Product Strategies
- Price Strategies
- Place Strategies
- Promotional Strategies

It should be noted that this article does not address the pros and cons of other efforts undertaken, primarily upstream, to reduce the spread of the virus including ensuring adequate supplies of test kits and masks, and supporting healthcare workers, businesses and their employees during this time of crisis.

The focus of this article, instead, is downstream, on activities, both voluntary and involuntary, to influence public behavior change to reduce the spread of the virus.

BACKGROUND

On March 11, 2020, the World Health Organization (WHO) declared the 2019 coronavirus outbreak a pandemic. Several behavior-related facts were emphasized at the time of the announcement. The virus is spread mainly through close contact, and by small droplets produced when people cough, sneeze, or talk. People may also catch COVID-19 by touching a contaminated surface and then their face. Of additional relevance to potential preventive behaviors, it was noted that the virus can survive on surfaces up to 72 hours, and that it is most contagious during the first 3 days after onset of symptoms. It was noted, however, that spread may be possible before symptoms appear and in the later stages of the disease.

PRIORITY AUDIENCE SEGMENTS

In addition to the General Population, the following is a list of major audience segments that appear to have been “singled out” at times for specific, relevant, desired behaviors that would reduce the chances of their contracting the virus, and/or spreading it:

Most vulnerable (homeless, immigrants, refugees, adults over 60, pregnant women, people with autoimmune diseases, people living at or below poverty line, people with underlying health conditions like heart or lung disease, and prison populations)
Helpers (healthcare professionals, first responders, workers in public health, nursing homes and long-term care facilities)
Essential businesses (grocery stores, pharmacies, gas stations, hardware stores)
Directly or indirectly affected by COVID-19 (test positive, have symptoms, household member tests positive, exposed in other ways, etc.)
Community (faith-based organizations, community-based organizations/non-profits, average citizens doing extraordinary deeds, etc.)
Families (kids of all ages, parents, grandparents, guardians, other caregivers)

DESIRED BEHAVIORS

One of the more impressive Social Marketing principles that seemed to be followed in developing and recommending desired behaviors was that many of them were very singular, concrete and consistently worded. Behaviors that were emphasized the most appear to be those applicable to the General Population:

Major Behaviors Promoted Most Frequently and Consistently by Public Health Institutions:

Practice Social Distancing at least 6 feet
Stay at Home
Avoid touching your eyes, nose, and mouth with unwashed hands
Wash your hands for 20 seconds several times a day
Cover your cough and sneezes with your elbow
Wear a homemade cloth face mask when in situations with higher volume of people (e.g., shopping, in certain workplaces, on mass transit, etc.)

Other Behaviors also Encouraged for the General Population, With Some Contradicted and/or Not Verified by Public Health Institutions:

Wipe down grocery packages before putting them on your counters or in cupboards
If you have symptoms, call your healthcare provider before going to the emergency room
Quarantine yourself for 14 days if you have tested positive for the virus or have symptoms or have traveled from an area of high breakouts
Use disinfectant wipes on surfaces in your home and car
Leave packages delivered to your door outside
If you wear plastic gloves, such as when shopping, remove them carefully and dispose of them so as not to spread any viruses picked up by them
Only call 911 for emergencies
Avoid high touch surfaces
Interact electronically (e.g. FaceTime and Zoom)
Postpone elective surgeries
Limit your shopping trips
Take your shoes off at the door
When out shopping, put your phone in a clear plastic bag to avoid touching the screen
Stay healthy
Take care of your mental health
Get plenty of sleep
Exercise
Do not play on playground equipment, basketball courts, or tennis courts in parks
Order meals to go
Order groceries to be delivered or picked up
Request retail businesses put purchases outside for pickup
Stay hydrated
Ask for/seek help if you need it

AUDIENCE INSIGHTS: BARRIERS, BENEFITS

Barriers to Behaviors the Marketing Intervention Mix Apparently Focused on Addressing:

Need to make frequent trips to groceries
Difficult to get groceries since not able to take public transit
Need for prescription medications
Need to interact/work with coworkers
Need to take care of a family member so must go to their home
Mental health concerns with social isolation
Desire to enjoy my nights out to restaurants and bars
Belong to groups I care about that meet regularly in person (e.g., church, gym, community groups)
My work can only be done in my place of business (e.g., hair salons, tattoo artists)
Many students don’t have laptops that enable distance learning (grade school and university)
Need to travel for my business
Have vacations planned
Have ceremonies like a wedding or graduation or memorial service planned
Need to vote in person
Lack of internet access, computer or smart phone to order groceries, download book, etc.
Lack of a car to use the drive-thru, get to food bank, visit a testing site, or just get out of the house for a change of scenery
Lack of a safe outdoor space for exercise
Feeling of isolation/need to get out
Believing there is a lot of misinformation and exaggeration

Desired Benefits from Behaviors that Strategies Apparently Highlighted:

Save lives
Keep from getting the Virus
Keep from spreading the Virus, especially to family and friends and vulnerable populations
Collectively assist society in “flattening the curve” which saves lives and assists the medical community from becoming overwhelmed by high patient volumes
Learn new skills (e.g., Zoom for virtual gatherings)
Spend more time, even remotely, with people you love

MARKETING INTERVENTION TOOLS: PRODUCT, PRICE, PLACE, PROMOTION

PRODUCT STRATEGIES NOTICED:

Tangible Goods

Services

Hand sanitizers
Soap
Disinfectant wipes
Masks, face coverings, face cloths
Gloves
Gowns for healthcare providers
Test kits
Face cloths
Phones that tell how good doing with distancing
Plexiglas shields in grocery stores
Personal Protective Equipment (PPE) for workers and service providers
Plexiglas shields at checkout counters
Single use pens and pencils for signing at banks and restaurants
Wristbands (like Fitbits) that buzz when closer than 6 feet

Local Call Centers
Locations for isolation when can’t do at home (e.g., sports stadiums converted to temporary shelters)
Employers organizing and supporting Zoom meetings
Volunteer healthcare workers
Testing sites
Universities and School Districts offering remote and online activities
Childcare for children who are already in close contact
Drive-by testing
Videos on how to make a face covering

PRICE STRATEGIES NOTICED:

Monetary Incentives and Disincentives for Desired Behaviors	Non-monetary Incentives
Fines like in NYC for not social distancing Employees receiving increased days for Paid Time Off Suspension of library late fees Restaurants giving discounts for pick-up Employers offering sick leave so essential workers are able to stay home	Recognition for healthcare workers (e.g., crowd applause) City mayors and State Governors acknowledging communities for social distancing Local radio and TV stations telling many of the goodwill/heartwarming stories of companies helping others

PLACE STRATEGIES NOTICED: Making Access Convenient or Inconvenient

Reducing # of people in stores at any given time
Marking 6ft distances in stores
Use of face covering by retail workers
School closures
Non-essential businesses closed or moved to remote work options
Encouraging takeout orders
Blocked off playgrounds and parks
Blocked off parking in parks
Shared streets, accommodating cars, pedestrians and bicycles
One-way lanes in grocery stores
Widening sidewalks
Placing purchased items outside business door for pickup
Special hours for seniors and other vulnerable populations

POSITIONING TACTICS NOTICED:

Introducing Social Distancing vs. Physical Distancing
Distinguishing Face Cloths vs. Face Masks vs. Face Coverings
Fight Fear and Stigma as well as the Virus
Overstocking vs. Realistic Purchasing
Distinguishing Essential Businesses from Non-essential Businesses

PROMOTIONAL STRATEGIES NOTICED:

Messages: Ones that Messengers, Creative Elements/Slogans Focused On:

Daily reports of new cases & deaths
Specific behaviors to do, how and why
What staying home will do to shorten and contain the spread
We will get through this together
Driven by the science narratives
Need for mass community action
Highlighting well known people with the virus (Cuomo, British Prime Minister, Tom Hanks)
Emphasizing it will take all of us to make a difference

Messengers:

Elected officials
Newscasters
Professors at University Medical Centers
Physicians
Health Agencies: CDC, State and County Public Health Departments
School Superintendents
Police & Fire Chiefs
People on nextdoor and Facebook sharing how to make a mask easily
General Public clapping for healthcare workers and first responders
Corporations and Foundations promoting desired behaviors:
- Auto manufacturer showing cleaning steering wheel
- Grocery stores
- Bill & Melinda Gates Foundation emphasizing importance of making testing more available and vaccines on a fast track
- Major League Baseball making PPE out of uniforms
Late night hosts (Stephen Cobert, Fallon, Kimmel, Trevor Noah, Seth Myers, etc.) hosting shows from home and promoting positive behaviors
Social influencers/celebrities leading by example (demonstrating their struggles/successes with homeschooling kids, promoting charities, showing how to make masks, featuring ways to stay connected while apart, providing entertainment, etc.)

Creative Elements: Graphics, Images, Slogans

We Will Get Through This Together
Spread the Facts
Be Kind
“April Distance Brings May Existence”
Stay Home. Stay Healthy.
Stay Home. Stay Safe.
Stand Together. Stay Apart.
Icons for behaviors: Stay home, Washing hands, 6 feet apart, Meditation
One-way directional signs on aisles in grocery stores
Cartoons
Songs (e.g., “Need a Little Help from My Friends” and “Won’t You Be My Neighbor”)

Media Channels

Press conferences
Radio and TV news/programs, and paid and unpaid ads
Town Halls (Remote)
Social Media
Emails to customers
Posters
Zoom
Neighborhood email groups
Retail store signage
Electronic signs on roadways
Billboards
Coverage of special events (e.g., neighbors on balconies singing, parades honoring local heroes)
Newspaper stories//Editorials

SUMMARY THOUGHTS

Done Well: Followed Social Marketing Principles

Consistent emphasis on major specific, doable behaviors
Focus on personal desired benefits
Focus on at risk populations and locations
Making norms visible
Featuring credible messengers
Recognizing that a mandatory behavior (quarantining) was necessary and engaging communities to “help” get through it
Reducing barriers (e.g., businesses shifting to home deliveries, employees working from home)

Could Have Been Better/More

Key behaviors and associated messages needed to be more consistent throughout the states
Some behaviors needed clarity and detail:
- Use of masks and gloves
- Sanitizing mail and takeout packages
- Gatherings among families and friends not living together
- What to do if you think you may have been exposed to the virus
Products that would have helped reduce the spread:
- More and sooner testing availability
- More mask availability
- Contact Tracing mechanisms
- Immunizations
More multicultural and multilingual tailored messaging
Better and earlier funded public health and healthcare systems
Time and resources for more audience research throughout the process to make better informed decisions
Elected Officials: Although they frequently served as messengers to their constituents, it may have been beneficial for them to have been more strongly advised to engage in and make more visible specific behaviors that the general public was being encouraged to perform, primarily to help create a norm for desired behaviors. For example, I noticed press conferences where elected officials and their staff stood less than 6 feet apart; did not wear cloth masks, and even a few who shook hands.

In summary, I am happy (even thrilled) that many of Social Marketing’s best practices were implemented to help reduce the spread. In some ways, this felt like “our moment” to demonstrate Behavior Change for Social Good, one I hope we can refer to for future “wicked problems” that Social Marketing can help alleviate.

1. Retrieved April 13, 2020: https://en.wikipedia.org/wiki/Coronavirus_disease_2019

2. ESMA Coronavirus Disease 2019 (COVID-19) Pandemic. A Statement from the ESMA

3. ESMA Coronavirus Disease 2019 (COVID-19) Pandemic. A Statement from the ESMA