CDC Works For You 24/7 Blog

(Welcome to CDC Works for You 24/7, a blog highlighting CDC’s work to save lives and protect people like you from health threats. For our inaugural blog, we welcome Dr.  Barbara Reynolds, crises communication senior advisor in the Office of the Director at CDC.)

Can fear be a contagion?

No one is immune to fear, but what causes fear can be different for each person. Fear is a negative sensation or feeling that arises when someone becomes aware of a threat.  How much fear a person feels depends on whether the threat seems directed at them personally or not, how bad the threat seems, and how soon or likely it is. 

Emotions and behaviors are not the same. Emotions are feelings and behaviors are actions that can be, and often are, influenced by our emotions. That’s why I consider both when exploring what occurs before and during a life-threatening crisis, such as a severe contagious disease outbreak.

Fear alerts a person’s fight or flight in the body.  It’s important for our survival.  How we respond to fear depends on many things such as our previous experience with the threat, our belief in our ability to confront the threat or escape from it and our personality traits.  Fear is personal. Fear can be protective or harmful. Fear, itself, is not bad.  However, how we cope with fear can be negative if it makes a person fail to take protective actions.

A question I’m often asked is: “is fear contagious?” It can be but it does not have to be. There are many theories about whether fear is a contagion.  There is even some biological basis for believing that a person can “smell” fear and may react to it.  The body releases pheromones under stress. It is uncertain that others around the fearful person will feel dread too.

More likely, fear is contagious because people pick up on nonverbal cues from others.  In fact, fear is one of only a handful of emotions that all cultures perceive the same way. When any human shows fear on their face we know that it is, indeed, fear. 

Can mass fear lead to public panic?

Panic is a loaded word.  In our society we often use the word panic as a substitute for explaining our strong feelings of fear, terror or dread.  From a psychological point of view, panic is best used to explain a behavior that is irrational or counter to a person’s survival.  We speak in terms of panic behavior more often than panic feelings.  But, panic behavior is actually quite rare.  Researchers can find instances of panic behavior but seldom in high numbers even in horribly threatening situations. 

More often than not, a person’s fight or flight response will kick in and the person does something that will help protect them from the threat.  There are times, though, when people seem incapable of helping themselves because they do not believe they can. When that happens they may put themselves, and perhaps others, at risk. That’s unfortunate and may be prevented.

Fearful people need to believe they can take an action that will reduce the threat or allow them to escape from the threat.  In a major crisis situation, the best way to avoid panic behavior is to offer concrete steps people can take to protect themselves. The key is to make sure people are capable of taking the recommended steps.  For example, don’t tell people to “go to the basement” when a tornado threatens because they may not have a basement to go to.  Or, don’t tell people to remain at home and away from people if the quarantined person does not have the necessities of life available at home.   

We also should make sure people have the emotional and social support to take the actions recommended.  That is why I emphasize how important it is for leaders in a crisis to model the behavior they wish others to take. 

Great uncertainty without guidance and support increases unhelpful behavior in a crisis. People dislike uncertainty.  Uncertainty causes anxiety. People want to reduce that feeling by taking action. If all options seem equally possible, people may choose an option that harms them because it seems like a good idea, or other people are doing it, or it’s easy to do and they know they can do it too.

People are most vulnerable when uncertainty is high and trusted advice is absent.  Here are the four things I recommend officials should communicate to help people manage their fear and avoid panic:

1. Acknowledge the uncertainty of the situation. That alone helps people emotionally. Let them know you: “get it” in terms of what they are feeling. They need to know you understand the stress, fear, anxiety, or dread they are feeling.
2. Quickly tell people what you know to be true and what you don’t know. That increases trust.
3. Involve people in the process of finding answers. Let them know what is being done and why.  This is respectful. 
4. Give people things to do.  Having a purpose is important. Direct people to do helpful things at the same time officials search for the answers that will reduce uncertainty.  Don’t underestimate the public’s hardiness. Engage them respectfully in the response to the crisis.

CDC has created a model on how best to talk to people when a crisis happens. Learn more about crisis and emergency-risk communication or CERC.

I wonder, how do you think your friends or community would behave in a deadly contagious outbreak? What would you recommend to help your friends or your entire community handle fear and uncertainty in a crisis? Please leave your comments below.

Barbara Reynolds, Ph.D., is Crises Communication Senior Advisor in the Office of the Director at CDC. Dr. Reynolds’ communication expertise has been used in the planning or response to pandemic influenza, vaccine safety, emerging disease outbreaks, and bioterrorism. Internationally, she has acted as a crisis communication consultant on health issues for France, Hong Kong, Australia, Canada, former Soviet Union nations, NATO, and the World Health Organization. She is the author of Crisis and Emergency Risk Communication and CDC’s Crisis and Emergency Risk Communication course, which is now taught in universities and other settings nationwide and internationally. You can reach Barbara at Bsr0@cdc.gov.