Interview with Jonathon Crystal about reducing face touches to reduce COVID-19 spread

Jonathon Crystal and I met online to talk about the first set of recommendations – to reduce face touching – made by the Behavioral Science Response to COVID-19 Working Group. Our hands are disease vectors, so by reducing the times we touch our faces, we reduce the chances of transferring the virus from our hands to our respiratory systems.

The audio from our interview was used for the podcast. But we also had video, which gave me the perfect opportunity to count the number of times both of us touched our faces. Over the course of our 20-minute chat, Jonathon touched his face a respectable 3 times. I, on the other hand, touched my face a whopping 22 times!

In 20 minutes, Mickes touched her face 22 times and Crystal touched his face 3 times. Crystal is the victor!

In the interview, Jonathon makes an excellent point that should resonate with everyone. And that point is while we’re waiting for effective medical interventions, we need to turn to effective behavioral interventions to reduce the spread of the coronavirus. After all, all of the recommendations made are behavioral in nature, including:

  • washing your hands
  • maintaining social distancing
  • practicing good respiratory hygiene
  • avoiding touching your face

The first set of recommendations is ways to reduce face touches. We should all take heed.

 

Transcription

Intro

Myers: You’re listening to All Things Cognition, a Psychonomic Society podcast.

Now, here is your host, Laura Mickes.

Preface

Mickes: In the upcoming interview I speak with Professor Jonathon Crystal, the Editor-in-Chief of the Psychonomic Society journal Learning & Behavior. Here, he discusses recommendations to reduce the number of times we touch our faces. The recommendations are based on empirical evidence from behavioral research and made with the expressed goal of informing the public about ways to change their behavior to slow the spread of coronavirus. [The infographic is available in different languages here.]

Reduce Face Touching Infographic

Interview

Mickes: Hi Jon! Thanks for talking to me today.

Crystal: It’s a pleasure.

Mickes: One of the really neat things that you’ve done is mobilized people.

Crystal: So I have a working group. It consists of experts who are in the general field of learning and behavior modification. And I got started by inviting basically all the editors-in-chief of learning journals and they were all very positive and responded that they wanted to engage and have a conversation. And fortunately, a couple of them are in the domain of behavior modification and so they knew who are the people who’ve done research on how you get persistent habits to be reversed.

And just telling someone don’t touch your face is not an effective thing.

We touch our faces a huge number of times. It seems to be automatic and outside of our awareness or control. And so 20 times an hour or more, we’re touching our faces and if you do it in the vicinity of your eyes, your nose, and your mouth, there’s a risk of the virus transmission.

Mickes: The working group is called the Behavioral Science Response to COVID-19 Working Group. And you’ve already mentioned touching faces and that it’s so common, but that is the first behavior that you decided to set recommendations for?

Crystal: So we started with some brainstorming on what, what we were really searching for was what are the things that behavioral science can uniquely contribute based on evidence-based recommendations. And there’s a lot of folk psychology and we weren’t looking for that, we weren’t looking for things – although some of them may look like common sense, we tried to restrict ourselves to things that had evidence behind it.

And the idea is that COVID-19 is a behavioral problem. How does it get transmitted? It’s from contact between people.

And who are the people who study human behavior? Uh, it’s going to be behavioral scientists.

Mickes: Right.

When did you start the group? Because it’s, it’s moved fast, it seems.

Crystal: Yeah, it’s moved fast. Not as fast as I was hoping when we started, I had outlined what could we do in 24 to 48 hours and it took us a couple of weeks,

Mickes: Wow.

Crystal: Well not quite, not quite two weeks, but it certainly took over a week to have a product ready to widely disseminate.

Mickes: And what are the recommendations?

Crystal: Yeah. So as I said, it’s not effective to just tell people don’t touch your face. We have all of these instructions, maintain social distance, wash your hands, don’t touch your face. And of course, it’s good to tell people that. But what are the types of recommendations that behavioral science could offer to help us be more successful with that instruction?

PS Reduce Face Touching Increase Awareness
Increase awareness

One of them is just to increase awareness. So I touch my face all the time. I’m largely not aware of it. We’re all in isolation in our homes with our families and so one can enlist family members who are around us and ask them to tell us when you’ve just touched your face.

Mickes: The face touching police.

Crystal: Yeah. But you know, it can be done in a lighthearted way. So you know, the kids could have it as something of a game and compare scores, sort of like, you know, you’re motivated with your Fitbit or your Apple watch.

Mickes: Do you have kids and are you playing the game with them and have you been keeping track?

Crystal: Well, I’m not such a good example. My kids are 13 and 18 so they’re a little mortified when I try to share this. [laugh]

PS Reduce Face Touching Help Others
Help others

Mickes: [laugh] So there’s that: You get somebody to tell you when you’re touching your face and you help other people, let them know.

What are the other recommendations?

Crystal: Yeah, so once we’re aware, it’s good to have empathy and perspective-taking because one of the problems that contributes to the pandemic is so many people are young and healthy. If they experience symptoms, many of the reports are that people are experiencing quite mild symptoms. And so that leads to a mindset, I’m going to be okay, we’ll be okay.

And of course, by the time all the transmission occurs, it’s everywhere. And I fear we’re on the path to that. And then, of course, all the vulnerable people are at serious risk and even young healthy people are actually at risk too.

So this amounts to trying to imagine an individual who you care about, who you know about perhaps your grandmother who has health issues, who would be more vulnerable and to try to use that as a way to motivate your own behavior.

PS Reduce Face Touching Do Other Things
Do other things

Mickes: And what’s another one?

Crystal: Yeah, so some of the things come from behavior modification research that tries to reverse habits.

So some of them actually include face touching because sometimes very maladaptive behaviors happen with self-injuries and so on. So trying to take the tricks of the trade that people have used in those types of practice settings based on high-quality research.

So one of them is to have other things to do with your hands. If your hands are occupied then they’ve got something to do and you are less likely to do some of those face touches.

 

PS Reduce Face Touching Change Posture
Change postures

And another is to change your posture. So if you’re seated at a table and you’ve got your elbows on the table, well we often put our hands on our face and give our back a little bit of a break. But if you sit in the middle of a couch, you’re not by an armrest, you’re less likely to adopt those postures.

Mickes: Was there one more?

Crystal: There was one more and it was focused on relaxation. So some of the work that’s been done on behavior modification has found that stress is a factor that promotes these maladaptive behaviors. And so some effort to practice relaxation.

And here, I will say we’re, we’re not experts on relaxation, but the types of things on paying attention to your breathing and trying to relax your muscles instead of being tense, not focusing your attention on future events, things that you might be stressed about coming down the road, just outdoors for me seems to be a nice way to deal with some of the stress that we’re now increasingly facing.

PS Reduce Face Touching Stress Reduce
Practice relaxation techniques

Mickes: Is that because you get away from your teenage children?

Crystal: [laughs] I walk my dog and she’s very therapeutic.

Mickes: Ah. [laughs]

Okay, so which of these recommendations, if any, are the most effective at reducing face touching behavior or do it all?

Crystal: I would say all of them. It’s a focus on reducing face touching. So are we going to completely eliminate it? Are you never going to touch your face? This is probably not realistic.

Mickes: Why should people listen to these recommendations?

Crystal: The problem with a pandemic is the risk that there’s widespread transmission of the virus. So there’s going to be lots of medical science that have harnessed to try to develop a vaccine to develop a treatment, and of course, those would be outstanding developments. But even if those are successful, it takes well over a year of clinical trials, the types of steps that are done to ensure safety and effectiveness before that type of product reaches people. And the problem we have is for many parts of the world, right now, every single day, and in the United States that it seems like we’re two or three weeks behind Europe and so there’s, there’s very little time and this, of course, is the place where behavioral science can make a difference because the types of things that we’re talking about are interventions.

The ones we’re trying to identify, they don’t require equipment, they don’t require needles. There are things that everyday people can engage in to try to stem the rapid growth of coronavirus.

Mickes: And they’re based on scientific evidence that you and your working group members know a lot about. What is the next set of recommendations?

Crystal: We took a little breather [laughs] after this went out and actually what I plan to do later today is to send an email to all the people in our group and try to take stock of what were the other directions that we left on the table that we could with a little more work, maybe by recruiting some people with other domains of expertise, to come out with a second round.

It’s just so easy for us to think about this as a medical science problem.

Mickes: Right.

Crystal: In the United States, there are CDC recommendations, if you look at what are those recommendations, they’re all about your behavior.

Mickes: Same with the World Health Organization and NHS recommendations – all behavior.

Oh gosh! Why are we talking?! You’ve got to get to work! You have many more recommendations to give. [laughs]

Crystal: [laughs] We’ll try.

Mickes: Okay. Thank you so much for doing this.

Crystal: It’s my pleasure.

Concluding statement

Myers: Thank you for listening to All Things Cognition, a Psychonomic Society podcast.

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