Jenny Baker / Wednesday, December 30, 2020 / Categories: TIP, 2021, 583 Beyond Organizations: Contributing to COVID-19 on a Larger Stage Sylvia J. Hysong, Baylor College of Medicine and Michael E. DeBakey VA Medical Center The COVID-19 pandemic has transformed the way we live, in a way no act of terrorism, natural disaster, war, economic catastrophe, or other public health crisis has done. As public officials at all levels in the patchwork of governments that comprise our country struggle to make decisions that balance the conflicting demands of public health and economic well-being for their constituents, COVID-19 cases, hospitalizations, and deaths continue to skyrocket; states that had initially begun to bend the curve are seeing resurgences. In short, our country seems to be playing a game of cat and mouse with the coronavirus, and at the time of this writing, the mouse is clearly winning. In the October issue of TIP, Randall and Solberg (2020) called on SIOP to leverage our expertise to respond to COVID-19 in our respective organizations. In some cases, the contributions we can make are evident; we are the go-to experts for work–life integration, training, and e-learning. In other cases, such as assessment and selection, the connection to COVID may not be as immediately obvious, but the topic is clearly still in our wheelhouse. Given the impact we could make in our respective organizations, what kind of impact could we make outside of our traditional organizational roles? For me, a trip home earlier this year inspired me to contemplate the possibility of how we as I-O psychologists could contribute to controlling the COVID-19 pandemic on a larger stage. Containing the Spread of COVID-19 in Puerto Rico Earlier this summer I needed to fly to Puerto Rico during the midst of the COVID-19 pandemic to check on my elderly mother, who lives by herself on the island. The prevalence of COVID-19 numbers in Puerto Rico as of the time of the trip were substantially lower than in Houston, where I currently live—one third as many cases and deaths, to be exact, even after accounting for differences in population size. I found these numbers reassuring, though puzzling, given that Puerto Rico is not nearly as well resourced as Texas, especially in the wake of multiple major natural disasters in Puerto Rico over the last 3 years. Upon visiting the island, I experienced a glimpse of what they were doing right. Puerto Rico required proof of a negative COVID-19 test sampled within 72 hours of flight time; failure to do so meant getting tested on the island and quarantining for 14 days or the duration of one’s trip (whichever was shorter) at one’s own expense—a reasonable request of visitors to the island and highlighting the importance of increased, fast-turnaround testing. All entrants were required to provide contact information for symptom-monitoring and contact-tracing purposes and report their symptom status daily via text messages to the Sara Alert system, an automated, open-source, public-health monitoring tool for reporting and tracking of individuals exposed to or infected with an infectious disease. Island-wide curfews were in effect from 10 pm to 5 am, a fact of which you were reminded frequently through the emergency alert text notifications system. Alcohol sales and public consumption thereof were prohibited after 7 pm—at one restaurant, we were asked by the owner to ensure all semblance of alcohol be off the table by the 7 pm cutoff. Upon entry to every business I was greeted by a staff member who took my temperature and spritzed my hands with sanitizer (no, they did not trust the public to do it themselves). Masks were mandatory at all times in public. In malls, physical distancing measures were in place, including the now ubiquitous 6-foot floor markings and signs to direct the flow of traffic in a single direction, like lanes in a two-way road, complete with mall personnel to enforce compliance. I was very impressed by all the hard work the Puerto Rico health officials had put in to keeping the virus at bay. Conversations with family members, neighbors, and shop owners, however, told a different and unexpected story: one of frustration. Unlike the frustrations of mainland U.S. residents aired repeatedly in the news—conflicts over the need to wear masks or the inability to gather in groups—Puerto Ricans were frustrated with the large numbers of tourists arriving from the mainland US without tests in hand (80% according to the Puerto Rico National Guard), refusing to wear masks or to follow the island’s public health regulations. Local residents as well as public officials believed these tourists were ruining the hard work of the locals and using up the precious few treatment resources intended for the island’s residents (Acevedo, 2020). Indeed, I worried about not being able to return home amidst protests at the airport the day before my departure, calling for the island to close the airport to incoming flights (a power the governor does not have; all U.S. airports are under the jurisdiction of the Federal Aviation Administration). The locals’ frustrations were certainly understandable; yet, despite the observed increase in cases, the place of my birth was nevertheless having far greater success at controlling the spread of the coronavirus with far less political friction than the place of my residence. This sparked a question in my mind: given that Puerto Rico is a U.S. territory with a fraction of the financial resources of most states (Puerto Rico has the third lowest state/territory GDP per capita according to the Bureau of Economic Analysis), how had it managed to maintain among the lowest confirmed COVID-19 case counts in the country despite a recent rise in cases attributable primarily to tourists? As a faculty member at a school of medicine, some obvious public health possibilities came to mind, such as the fact that Puerto Rico is an island and thus harder to travel to than the continental US. This would certainly be consistent with the low case counts in Hawaii, for example, which is twice as far away by air from the nearest mainland U.S. airport as Puerto Rico is from its nearest airport (and twice as expensive to travel to). Another public health answer laid in Puerto Rico’s swift and stringent public safety measures—like Hawaii and certain states on the mainland such as Colorado, Puerto Rico shut down early and sent its residents a consistent message of masking, quarantining, and sheltering in place. This, however, did not fully explain the observed differences in prevalence given available resources, nor did it explain the frustrations I heard from the locals—for that, I needed my I-O psychology superpowers. Through the lens of I-O, two explanations offered potential answers: a shared mental model of adversity and key cultural differences between Puerto Rico and the rest of the United States. Overcoming Adversity Together: A Shared Mental Model In the last 3 years, Puerto Rico has suffered a devastating volley of natural disasters and public health emergencies in rapid succession (hurricanes Irma and Maria, and the wave of earthquakes in early 2020) that have wrought devastation on the entire population. With nearly the entire island losing power after hurricane Maria for weeks to months, no one on the island escaped these disasters unscathed. Therefore, everyone on the island has a shared vision of adversity and suffering, providing a strong common goal for the community: to overcome a common source of adversity and devastation—hence the slogan, “Puerto Rico se levanta” (Puerto Rico lifts itself up) commonly heard throughout the island after hurricane Maria. In contrast, though the mainland US has certainly suffered no shortage of natural disasters and emergencies, no single recent event, not even 9/11, has affected the psyche of the entire country as a whole at once. Thus, there is no recent unifying event or set of events over which Americans can come together to create a shared mental model of unity over adversity. Individualism and Power Distance in the Face of COVID-19 Before becoming a U.S. territory, Puerto Rico was a Spanish colony for over 400 years, and thus retains many cultural features and traditions from Spain that contrast with U.S. culture. When seen through the lens of Hofstede’s cultural dimensions theory (Hofstede, 1984), the contrast becomes far clearer. Puerto Rico and the mainland US differ markedly on two dimensions in particular: individualism–collectivism (the extent to which members of a society are supposed to look after themselves versus belonging to groups and active for the good of the collective) and power distance (the extent to which the less powerful members of society accept the idea that power is distributed unequally). The US is the most individualistic country in the world according to Hofstede’s dimensions, whereas Puerto Rico (treated as a country instead of a territory from a cultural perspective) is in the second lowest quintile, making it far more collectivist. Conversely, Puerto Rico is far stronger in power distance compared to the US, making it a much more hierarchical, centralized society with greater deference to authority; in contrast, mainland US is a much more decentralized patchwork of governments whose residents are far quicker to question authority. This combination of hierarchy, centralization, and deference to authority makes it far easier to implement a comprehensive public health strategy than what seems to be happening in the tapestry that is the 50 states of the Union. A Call to Action: I-O Psychologists on the National Stage As I write this article the US is seeing its worst levels of daily cases since the beginning of the pandemic; and despite a vaccine being close at hand, 49% of the population say they would not get a COVID-19 vaccine once it becomes available (Tyson et al., 2020). The US will have an uphill climb relative to other countries in controlling the COVID-19 pandemic in part due to its relative lack of prior adversity and highly individualistic culture with low power distance. To overcome such challenges, a coordinated, centralized strategy to implement a common vision throughout the country with consistent messaging is critical. These challenges are psychological at their core, and SIOP members are, first and foremost, psychologists: experts in human behavior. How can we leverage our decades of expertise in fundamental areas of human behavior, areas like personality, influence tactics, leadership, and culture? How can we use what we know about behavioral change and organizational change management to overcome these challenges strategically rather than in a reactionary manner? Those of us working in the government sector (7% of our membership, according to SIOP’s latest income and employment report) are ideally positioned for such a challenge. For example, I recently served on a national committee in the Department of Veterans Affairs to design a survey assessing VA employees’ attitudes to vaccine acceptance so that the agency could make evidence-based policy decisions about how much vaccine to procure and how best to distribute it to its nearly 400,000 employees nationwide. Similar efforts are also underway to make similar assessments and decisions about the nearly 10 million veterans served by the Veterans Health Administration. I-O psychologists in other industries, such as the tech sector, could make an impact of equal magnitude through other means. I invite the membership to think creatively and act boldly to help the country out of these interesting times. References Acevedo, N. (2020, July 22). Puerto Rico wanted tourists, but with coronavirus spiking, it has changed plans. NBC News. Retrieved August 5, 2020, from https://www.nbcnews.com/news/latino/puerto-rico-wanted-tourists-coronavirus-cases-spiking-they-ve-changed-n1234624 Hofstede, G. (1984). Culture's consequences: International differences in work-related values (2nd ed.). SAGE Publications. Randall, J. G., & Solberg, E. (2020). I-O psychology and the response to COVID-19: A call to action. The Industrial-Organizational Psychologist, 58(2). https://www.siop.org/Research-Publications/Items-of-Interest/ArticleID/4747/ArtMID/19366 Tyson, A., Johnson, C., & Funk, C. (2020, September 17). U.S. public now divided over whether to get COVID-19 vaccine. Pew Research Center. 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