A Socio-Psychological Perspective on Flattening the COVID-19 Curve.

Download Full Article Article Brief


Umar Ruhi, PhD, MBA, CIPS-ISP 

Canadian Health Policy, April 2020. ISSN 2562-9492


In the fight against the COVID-19 outbreak, slowing the spread of the virus (flattening the curve) ultimately depends on citizen participation and community engagement in public health measures such as social distancing and self-isolation. To ensure effective citizen participation in such measures, countries need to adopt public health policies and protocols that are aligned with their culture and underlying societal values. Using Hofstede’s cultural dimensions framework as a basis of comparison with other countries, Canada constitutes a low power-distance and short-term orientation culture, and Canadians exhibit high individualism and indulgence attitudes. These cultural traits can help explain various types of unscrupulous public behaviours such as panic buying and hoarding, and nonconformity with social distancing guidelines. This paper highlights the implications of socio-psychological cultural traits for community engagement and public health practice, and outlines examples of non-pharmaceutical public health measures that are relevant in the Canadian context. Some of these measures include improving specificity of situational information in public health messaging, developing a public health strategy that combines compassion and competence, implementing stringent social distancing measures with penalties for non-abidance, applying enhanced and longer-lasting restrictions over entertainment and recreational venues, expanding the use of e-Public health interventions including mobile applications and social media for tailored public health education and advisories, and using innovative infodemiology and infoveillance tools and best practices.


1. Hofstede, G.: Culture’s Consequences: Comparing Values, Behaviors, Institutions and Organizations Across Nations. Sage Publications Inc, Thousand Oaks, CA (1984).

2. Hofstede, G., Hofstede, G.J., Minkov, M.: Cultures and Organizations: Software of the Mind. McGraw Hill Professional, New York, NY, USA (2010).

3. Hofstede, G.: Culture’s Consequences: Comparing Values, Behaviors, Institutions and Organizations Across Nations. Sage Publications Inc, Thousand Oaks, CA (2001).

4. Deschepper, R., Grigoryan, L., Lundborg, C.S., Hofstede, G., Cohen, J., Kelen, G. Van Der, Deliens, L., Haaijer-Ruskamp, F.M.: Are cultural dimensions relevant for explaining cross-national differences in antibiotic use in Europe? BMC Health Serv. Res. 8, 123 (2008). https://doi.org/10.1186/1472-6963-8-123. 

5. Meeuwesen, L., van den Brink-Muinen, A., Hofstede, G.: Can dimensions of national culture predict cross-national differences in medical communication? Patient Educ. Couns. 75, 58–66 (2009). https://doi.org/10.1016/j.pec.2008.09.015. 

6. LeRouge, C.M., Gupta, M., Corpart, G., Arrieta, A.: Health system approaches are needed to expand telemedicine use across nine latin american nations. Health Aff. 38, 212–221 (2019). https://doi.org/10.1377/hlthaff.2018.05274. 

7. Chandratilake, M., Mcaleer, S., Gibson, J.: Cultural similarities and differences in medical professionalism: A multi-region study. Med. Educ. 46, 257–266 (2012). https://doi.org/10.1111/j.1365-2923.2011.04153.x. 

8. Morrow, G., Rothwell, C., Burford, B., Illing, J.: Cultural dimensions in the transition of overseas medical graduates to the UK workplace. Med. Teach. 35, e1537–e1545 (2013). https://doi.org/10.3109/0142159X.2013.802298. 

9. Mackenbach, J.P.: Cultural values and population health: a quantitative analysis of variations in cultural values, health behaviours and health outcomes among 42 European countries. Health Place. 28, 116–132 (2014). https://doi.org/https://doi.org/10.1016/j.healthplace.2014.04.004. 

10. World Health Organization: Managing Epidemics: Key Facts about Major Deadly Diseases. , Luxembourg (2018).

11. Reynolds, B., W. Seeger, M.: Crisis and Emergency Risk Communication as an Integrative Model. J. Health Commun. 10, 43–55 (2005). https://doi.org/10.1080/10810730590904571. 

12. Giuffrida, A.: Italy struggled to convince citizens of coronavirus crisis. What can Europe learn? https://www.theguardian.com/world/2020/mar/23/a-warning-to-europe-italy-struggle-to-convince-citizens-of-coronavirus-crisis, last accessed 2020/03/26.

13. Reuters: Covid-19 outbreak in Italy and S Korea a tale of two states, https://www.irishtimes.com/news/world/europe/covid-19-outbreak-in-italy-and-s-korea-a-tale-of-two-states-1.4202546. 

14. Cyranoski, D.: What China’s coronavirus response can teach the rest of the world, https://www.nature.com/articles/d41586-020-00741-xNS-, last accessed 2020/03/26. https://doi.org/10.1038/d41586-020-00741-x. 

15. Outbreak Observatory: The Success of South Korea. , Baltimore, MD, USA (2020).

16. Normile, D.: Coronavirus cases have dropped sharply in South Korea. What’s the secret to its success? https://www.sciencemag.org/news/2020/03/coronavirus-cases-have-dropped-sharply-south-korea-whats-secret-its-successNS-, last accessed 2020/03/26. https://doi.org/10.1126/science.abb7566.

17. Centers for Disease Control & Prevention (CDC): Testing for COVID-19, https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html, last accessed 2020/03/28.

18. Microsoft Inc.: Microsoft Health Bot Service Overview, https://docs.microsoft.com/en-us/healthbot/, last accessed 2020/03/28.

19. Eysenbach, G.: Infodemiology and Infoveillance: Framework for an Emerging Set of Public Health Informatics Methods to Analyze Search, Communication and Publication Behavior on the Internet. J. Med. Internet Res. 11, e11 (2009). https://doi.org/10.2196/jmir.1157. 

20. Eysenbach, G.: Infodemiology and infoveillance: Tracking online health information and cyberbehavior for public health, (2011). https://doi.org/10.1016/j.amepre.2011.02.006. 

21. Wong, J.C.: As the coronavirus spreads, misinformation is spreading even faster, https://www.theguardian.com/commentisfree/2020/jan/31/coronavirus-misinformation-spread-facebook-conspiracy-theories, last accessed 2020/03/26.

22. Druckman, J.N.: The Implications of Framing Effects for Citizen Competence. Polit. Behav. 23, 225–256 (2001). https://doi.org/10.1023/A:1015006907312. 

23. Wiles, S., Morris, T.: You’re waking up in lockdown New Zealand. Here’s how it works, https://thespinoff.co.nz/politics/26-03-2020/siouxsie-wiles-toby-morris-youre-waking-up-in-lockdown-nz-heres-how-it-works/, last accessed 2020/03/27.

24. Tumilty, R.: COVID-19: Trudeau to Canadians: “Enough is enough. Go home and stay home,” https://nationalpost.com/news/canada/covid-19-ontario-reports-78-new-cases-the-most-in-one-day-so-far, last accessed 2020/03/28.

25. Dong, L., Bouey, J.: Public Mental Health Crisis during COVID-19 Pandemic, China. Emerg. Infect. Dis. J. 26, (2020). https://doi.org/10.3201/eid2607.200407. 

26. Canadian Mental Health Association: CMHA offers tips to support mental health amid concerns of COVID-19 pandemic, http://ontario.cmha.ca/news/cmha-offers-tips-to-support-mental-health-amid-concerns-of-covid-19-pandemic/, last accessed 2020/03/27.

Subscribe image

CHP blogazine