>"Keywords: mass hysteria; nocebo effects; contagion; mass media; social media; public health; law
and economics; political economy; groupthink; culture of fear; emotional contagion; anxiety; policy
error; COVID-19"

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In a multidisciplinary analysis (beyond Law and Economics or Sociological Economics), we show that the size of the state exacerbates the negative consequences of mass hysteria.

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>"In a mass hysteria, people of a group start to believe that they might be exposed to something dangerous, such as a virus or a poison. They believe a threat to be real because someone says so, or because it fits their experience. Due to the threatening delusion, a large group of people gets collectively very upset. In other words, a threat, whether real or imaginary [17], causes collective anxiety [18]. The group members may even start to feel sick. Group members might also get symptoms of sickness including weakness, headaches, or a choking feeling, which are propagated to other persons. When a mass hysteria causes physical symptoms, it is called mass psychogenic illness or epidemic hysteria. The symptoms are caused by the stress and anxiety people experience due to the perceived threat [19].

Mass hysteria is infectious [20] and may be a contributing and amplifying factor in real epidemics. While there is—to our knowledge—no literature on the political economy of mass hysteria, the literature on mass psychogenic illness is rich and focuses on empirical analyses of specific cases. Kerckhoff [21] analyzed the case of sickness that spread among workers of a plant due to the belief in a poisonous insect. McGrath [22], reviewing cases of mass hysteria, found that persons of low status in high stress situations after a triggering dramatic event are most responsive to mass psychogenic illness. Schmitt and Fitzgerald [23] analyzed eight cases of mass psychogenic illness among workers. They found that low income, dissatisfaction with superiors, lack of support, and unclear work assignments led to a higher average number of reported symptoms. Singer [24] points out that victims of mass psychogenic illness are really sick even though there is no toxin. Singer believes that mass
psychogenic illness occurs more often than we recognize as it may appear simultaneously with physical progenitors of illness and we only count “pure” cases of mass psychogenic
illness."

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>"It is well known that in addition to placebo effects, so-called “nocebo” effects also exist [39]. Due to the placebo effect, a person recovers from an illness because they expect to recover. When a person suffers from a nocebo effect, on the contrary, they get ill just because they expect to become ill. An intriguing and famous case of a nocebo effect is the case of a man who tried to commit suicide [40]. The man was involved in a clinical study taking an experimental drug. In order to kill himself, he swallowed twenty-nine capsules of the drug, believing he would not survive. However, the capsules that he was taking were placebos, as he was a member of the control group in the clinical study. Believing that he was going to die, he developed serious symptoms and arrived at the hospital with extremely low blood pressure. When, finally, the doctor directing the medical trial arrived, the doctor told the patient that he had swallowed placebos. As a consequence, the man recovered within fifteen minutes."

Due to the nocebo effect, the expectation to become ill can cause real symptoms in a self-fulfilling prophecy. In this way, a mass hysteria may develop when people believe they will become ill. Anxiety and fear contribute to this process [41]. Indeed, during the Spanish flu in the wake of World War I, panic contributed to a mass hysteria and deaths that otherwise would not have occurred, because panic can have adverse health effects on ill persons [42]. Once some people develop a hysteria, it can easily spread to other people because fear and anxiety are contagious [43]."

(PDS: Winston Churchill: "The only thing we have to fear is fear itself...")

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>"Another indicator of overestimation of the threat is the number of deaths. As of 22 January 2021, 2.1 million deaths have been classified as COVID-19-related [53]. However, other diseases are equally or even far more deadly and do not trigger panic or unprecedented government intervention. In other words, the probability to die from COVID-19 is not only very low in absolute terms, but it is also lower than the probability to die from other diseases. It is true that the majority of these other diseases are not as infectious as SARS-CoV-2. This fact has contributed to the panic and led to government interventions that do not occur with other diseases that are even more deadly than COVID-19.
The ten leading causes of death worldwide can be seen in Table 2.

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Self-interested politicians [119,120] face an asymmetric pay-off. Underestimating a threat and failing to act has great political cost, as politicians will be held responsible for the disaster caused by the threat they underestimated. By contrast, an exaggeration or even invention of a threat and bold state intervention are politically more attractive. If the existential threat claimed by politicians really turns out to be such a great danger, they can be celebrated as heroes if they enacted bold measures. If the costs of these measures ultimately turn out to be excessive compared to the actual danger, then the politicians do not have to bear the cost of the wrong decision but can pass it on to the rest of the population. Politicians enjoying a guaranteed income therefore have an incentive to exaggerate a danger
and to impose exaggerated measures, also called policy overreaction [121,122], which is conducive to the emergence and growth of mass hysteria."

PDS: My all-time favorite paper on Covid-19, thus far...