title: Spontaneous social distancing in response to a simulated epidemic: a virtual experiment.
abstract: BACKGROUND
  Studies of social distancing during epidemics have found that the strength of the response can have a decisive impact on the outcome. In previous work we developed a model of social distancing driven by individuals' risk attitude, a parameter which determines the extent to which social contacts are reduced in response to a given infection level. We showed by simulation that a strong response, driven by a highly cautious risk attitude, can quickly suppress an epidemic. However, a moderately cautious risk attitude gives weak control and, by prolonging the epidemic without reducing its impact, may yield a worse outcome than doing nothing. In real societies, social distancing may arise spontaneously from individual choices rather than being imposed centrally. There is little data available about this as opportunistic data collection during epidemics is difficult. Our study uses a simulated epidemic in a computer game setting to measure the social distancing response.
  
  
  METHODS
  Two hundred thirty participants played a computer game simulating an epidemic on a spatial network. The player controls one individual in a population of 2500 (with others controlled by computer) and decides how many others to contact each day. To mimic real-world trade-offs, the player is motivated to make contact by being rewarded with points, while simultaneously being deterred by the threat of infection. Participants completed a questionnaire regarding psychological measures of health protection motivation. Finally, simulations were used to compare the experimentally-observed response to epidemics with no response.
  
  
  RESULTS
  Participants reduced contacts in response to infection in a manner consistent with our model of social distancing. The experimentally observed response was too weak to halt epidemics quickly, resulting in a somewhat reduced attack rate and a substantially reduced peak attack rate, but longer duration and fewer social contacts, compared to no response. Little correlation was observed between participants' risk attitudes and the psychological measures.
  
  
  CONCLUSIONS
  Our cognitive model of social distancing matches responses to a simulated epidemic. If these responses indicate real world behaviour, spontaneous social distancing can be expected to reduce peak attack rates. However, additional measures are needed if it is important to stop an epidemic quickly.
authors.affiliation: Computing Science and Mathematics, School of Natural Sciences, University of Stirling, Stirling, UK. ak@cs.stir.ac.uk.
authors.forename: Adam
authors.initials: A
authors.lastname: Kleczkowski
authors.affiliation: Computing Science and Mathematics, School of Natural Sciences, University of Stirling, Stirling, UK. savi@cs.stir.ac.uk.
authors.forename: Savi
authors.initials: S
authors.lastname: Maharaj
authors.affiliation: School of Psychological Sciences and Health; University of Strathclyde, Glasgow, UK. s.a.rasmussen@strath.ac.uk.
authors.forename: Susan
authors.initials: S
authors.lastname: Rasmussen
authors.affiliation: School of Social Sciences, University of the West of Scotland, Paisley, UK. lynn.williams@uws.ac.uk.
authors.forename: Lynn
authors.initials: L
authors.lastname: Williams
authors.affiliation: School of Psychological Sciences and Health; University of Strathclyde, Glasgow, UK. nicole.cairns.2013@uni.strath.ac.uk.
authors.forename: Nicole
authors.initials: N
authors.lastname: Cairns
mesh_terms: D003198:Computer Simulation; D058872:Epidemics / Q000517:prevention & control*; D006801:Humans; D008960:Models, Psychological; D008962:Models, Theoretical; D012309:Risk-Taking; D012919:Social Behavior; D012934:Social Isolation / Q000523:psychology*