**5. Conclusion**

In controlling and managing infectious diseases through social isolation, distancing or vaccination, the role of individual choice is becoming an increasingly important driver that subsequently affects underlying disease burden among the population. In particular, human behavior and social interactions played a significant role affecting the magnitude of the COVID-19 pandemic. Major factors behind such behavioral interactions are losing jobs and forgoing daily income from social distancing, fatigue from social isolation, and/or conscious or unconscious exploitation of uncertainty due to lack of awareness and knowledge. Thus, the dynamics of controlling infection through social isolation is a potentially complex interplay between individual behaviors and disease dynamics, informed by the perceived cost of being socially isolated and infection risks [69]. This complex interplay can be seen as a strategic game and is conveniently modeled and analyzed using the mathematical framework provided by Game Theory [70, 71]. Such behaviorprevalence game theoretical models have already explored vaccine exemption behavior for endemic diseases [72] but there is less emphasis on behavioral interactions like social distancing, especially analysis from the perspective of cultural dimensions of populations and also their socioeconomic conditions. The current study opens up a forum for further research on how individual choice, especially at the population level, is of utmost concern for public health policymakers to curb a pandemic.

Our model scenario highlights the interplay between economic impact and human choice in social distancing measures. Individuals with limited resources must choose between complying with public health guidance (a collectivist approach where personal actions can help the population) at the expense of losing income that is necessary for basic sustenance (an individualist approach). Changes in public policy are essential to combat the long-standing problems associated with health and economic inequities since these are more pronounced during a health care crisis, such as the COVID-19 pandemic.

To address these inequities there needs to be changes in public policy during inter-pandemic phases to ensure planning in place that is activated at the beginning of an outbreak. Policies should act to provide increased resilience and capacity at the beginning of an outbreak to minimize economic losses. Both the public and private sectors can put planning in place to reduce the magnitude of the economic disruption from NPI compliance in the workforce, supply chains, and healthcare system to prevent unforeseen economic crises.

It was suggested that sharing or pooling of available resources and networking can occur at several different levels including: the individual, household, local community, city, state or province, regional and national scale as a strategy to increase resilience and avoid negative mental health and economic outcomes [73].

Pandemic crises such as COVID-19 have particular characteristics within a complex system requiring a number of different types of resilience be addressed including population health resilience (the population recovering from the disease), healthcare system resilience (the recovery of the healthcare system), economic resilience (recovery from the economic consequences) and psychological resilience (individual recovery from fear, anxiety, depression) [74].

In the context of the COVID-19 pandemic drawing on the different types of resilience can reduce psychosocial effects such as depression, anxiety, stress and non-compliance to public health NPIs during curfew, self-isolation and lockdowns. Indeed, previous studies have shown that resilience decreases the negative effects of stress both at the individual and regional levels [75, 76].

*Human Cultural Dimensions and Behavior during COVID-19 Can Lead to Policy Resistance… DOI: http://dx.doi.org/10.5772/intechopen.96689*

The city, regional and country-level attention and support for designated essential workers is important to ensure that they are adequately equipped and compensated for vital services performed to maintain public health standards [74, 75, 77].
