Opinion Articles

To Repair the Whole, We Must Understand its Parts

On January 16, Novak Djokovic, the top-seed men’s Tennis player in the world, was deported from Australia after a legal saga that ultimately resulted in the cancelation of his visa on the basis of “health and good order” on the eve of the Australian Open.

Although Djokovic is not vaccinated against Covid-19, he has not actively promoted anti-vax disinformation. A lengthy BBC article attempted to document what he had actually said about vaccination, but the only important clue  uncovered was a Facebook live clip in which he explained that he “wouldn’t want to be forced by someone to take a vaccine” to travel or compete in tournaments.

Djokovic was not the first. A few weeks earlier, the sports world was rocked into turmoil by the decision of some NBA players not to get vaccinated, just before the start of the season.

The lack of legal measures obligating the refuseniks, combined with the concerns of their bench mates, team managers, other team officials, and opposition host cities, fanned the flames and created a real crisis that threatened the opening of the basketball season and the integrity of the league. LeBron James, the Los Angeles Lakers star, who had declined to comment on the issue in the past, issued a press release saying that he had been skeptical about the vaccine at first, but after doing his research, changed his mind and was vaccinated. For a long time, James, like other vaccine refuseniks, was labeled by many as an “anti-vaxxer.”

An important question to consider is whether he can be considered in the same group as his fellow NBA player, Kyrie Irving, who has expressed support for conspiracy theories suggesting that chips are implanted via vaccines to spy on people. Most of us would probably answer no, but the public mood after two pandemic years and the policy measures in place indicate that the tendency is nonetheless to tie them together under a single heading – anti-vaxxers.

Studies in the field of behavioral economics and decision-making call this tendency the Binary Bias. This bias refers to the inclination to attempt to obtain clarity in the complex world around us, by consigning complex sequences into two categories: black or white (or in our discussion – anti-vaxxers and those who are not), in which only one party can be right since there is only one truth.

The Binary Bias is not unique to the world of sports or vaccines, and we see it in many of the policy challenges that lie ahead. Psychologist Adam Grant writes in his 2021 book Think Again that a good starting point for someone who wants to deal with Binary Bias is to look at a range of positions as a spectrum and not as two distinct polar opposites. He examines the climate crisis as an example, but the method can also be applied to the vaccine challenge:

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Grant mainly emphasizes the distinction that emerges when looking at the spectrum between skeptics and deniers. Skeptics exercise judgment and act according to the principles of the scientific method when making decisions – they tend not to blindly follow everything they see, read, or hear, but rather ask challenging questions, constantly updating their position based on access to new information. Deniers, on the other hand, dismiss those who think differently, they tend to follow charismatic figures who represent the positions they hold and often ignore or distort information that contradicts those positions.

To change reality, and propose policies that will ultimately benefit society as a whole, policymakers need to start at the point proposed by Grant. To outline the spectrum, and dismantle the large group that comprises the “them,” those who at this stage choose not to be vaccinated, into its different constituent parts in order to identify the complexity created by this reality. Only then can we understand the specific challenges and reasons behind what each sub-group thinks, and then tailor unique solutions to them.

Reality teaches us that the black or white binary approach (no matter what the policy challenge), without deep examination of the data across different population segments (not just different attitudes – groups can be distinguished by age, religion, ethnic origin, geographic location, and more), and without identifying the unique characteristics of each group, is likely to produce a policy that in the best case will succeed in helping very few people, in a worse case will fail to achieve any goal, and in the worst case actually cause harm.

In a world where the Covid pandemic rages and the vaccination rate is not reaching the desired target, classifying skeptics as deniers lessens the chances of getting through to them and often damages their good name and, sometimes, diminishes the opportunities before them.

Distinguishing between groups may help us reach those people who, like LeBron James, fear the vaccine and its consequences, and give them the tools and knowledge to thoroughly examine the risks versus the benefits, and make an informed decision.

The benefit of distinguishing between population groups can be seen, for example, in the data we have from Israel’s Arab sector. In August 2020, a Covid headquarters for Arab society was established, headed by Ayman Saif, against the background of worrying data on morbidity in the Arab population. Together with the ultra-Orthodox population, these were the two sectors with the highest morbidity levels. On August 25, 2020, Professor Ronni Gamzu, the Covid czar at the time, noted the high rate of morbidity in Arab society, which was approaching 28% of all morbidity in Israel (with Arabs making up about 21% of the population). Soon after the establishment of the Covid headquarters, from the beginning of September of that year until mid-October 2020, there was already a decrease in the scale of morbidity.

In the first week of October, only 13% of new patients were from the Arab sector. And the number of Arab localities designated as “red zones” decreased from 32 to four (a decrease of 87%). Lifting the lockdown in October led to a further upward trend in Arab society, but not to the levels previously recorded. While it is true that even after the establishment of the Covid headquarters, morbidity in Arab society continues to fluctuate, and the vaccination rate is lower than that of the general population, the data indicate that the specific, tailored approach to the Arab population and its needs has curbed the spread and led to greater cooperation. For example, in October 2021, the number of young people who had been vaccinated jumped from 11% of those aged 16 – 39 who had received one jab to almost 77%. Even in the older age group, an increase was noted (from 75% to 82% in the 40 – 59 age cohort, and from 82% to 86% for those 60-plus). It is by adapting the policy to the needs and challenges of the Arab public, as well as tailoring the messaging and how it is delivered, that this change was made possible.

The data we have today, two years into the Covid crisis, point to the vaccine’s effectiveness in reducing the incidence of the disease and decreasing the severity of illness in cases of infection.

The Israeli government, which is interested in expanding vaccine take-up and protecting the citizens of the state, must break down the group known as “anti-vaxxers” into its component constituencies and stop treating it as a monolith. By doing so we will be able to propose a tailored policy for each of the groups, and achieve the overall goal – to increase the numbers of the vaccinated.