title: Skip the trip: air travelers' behavioral responses to pandemic influenza.
abstract: Theory suggests that human behavior has implications for disease spread. We examine the hypothesis that individuals engage in voluntary defensive behavior during an epidemic. We estimate the number of passengers missing previously purchased flights as a function of concern for swine flu or A/H1N1 influenza using 1.7 million detailed flight records, Google Trends, and the World Health Organization's FluNet data. We estimate that concern over "swine flu," as measured by Google Trends, accounted for 0.34% of missed flights during the epidemic. The Google Trends data correlates strongly with media attention, but poorly (at times negatively) with reported cases in FluNet. Passengers show no response to reported cases. Passengers skipping their purchased trips forwent at least $50 M in travel related benefits. Responding to actual cases would have cut this estimate in half. Thus, people appear to respond to an epidemic by voluntarily engaging in self-protection behavior, but this behavior may not be responsive to objective measures of risk. Clearer risk communication could substantially reduce epidemic costs. People undertaking costly risk reduction behavior, for example, forgoing nonrefundable flights, suggests they may also make less costly behavior adjustments to avoid infection. Accounting for defensive behaviors may be important for forecasting epidemics, but linking behavior with epidemics likely requires consideration of risk communication.
authors.affiliation: Yale School of Forestry and Environmental Studies, New Haven, Connecticut, United States of America. eli.fenichel@yale.edu
authors.forename: Eli P
authors.initials: EP
authors.lastname: Fenichel
authors.forename: Nicolai V
authors.initials: NV
authors.lastname: Kuminoff
authors.forename: Gerardo
authors.initials: G
authors.lastname: Chowell
mesh_terms: D001519:Behavior; D003142:Communication; D003365:Costs and Cost Analysis; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology*; D008960:Models, Psychological; D058873:Pandemics; D014195:Travel / Q000191:economics; D014481:United States / Q000453:epidemiology