Where Were the Nudges?

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We all know that flu is a killer and that every year we are advised to “get your flu shot.”  A February 26, 2020 Centers for Disease Control report indicated 45 million flu cases in the United States during the 2017-2018 influenza season, including about 810,000 flu-associated hospitalizations and about 61,000 flu-associated deaths.  The flu strains almost never are exactly the same as in the previous year, so the shots are never reliable.  For 2017-2018 the overall vaccine effectiveness against influenza A and B viruses was 40%.

Before continuing with this blog, I need a preface for those who did not read my book, Justifiably Paranoid: Resisting Intrusive and Malicious Influences.  In it I described “nudging” which is the government practice of trying to manipulate the environment to cause people to do what officials believe is “good for them.”  The practice began in England and the United States.  Now there are more than 60 government and international agencies trying to nudge their often unsuspecting citizens.  You probably would agree with some of the nudges, such as ones to “encourage” you to save for retirement.  But you might recoil from others, such as one that imposes an excessive tax on your favorite alcoholic beverage.

Because 2017 motor vehicle accidents in the United States were responsible for about 20,000 less deaths than influenza, one would think that nudging would have focused more vigorously on flu than it has.  Before the current pandemic, never in my life did I hear of any government program that advised hand washing or social distancing during flu season.  That government failure is especially disturbing not only because of the relative ineffectiveness of influenza inoculations, but also because flu onslaughts are inevitable, have occurred every year for centuries, and are significantly mitigated by simple behavioral changes.  Maybe, going forward, governments will do more yearly than ask us to get a questionably useful flu shot.  Perhaps comprehensive, creative healthful anti-flu government nudging will be on the agendas of at least 60 plus governments.

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