The Psychology of Being 'Over' Covid

The human body was not designed to endure this level of stress for this length of time. Many people are simply giving out. JL

Jane Hu reports in Slate:

Why does it suddenly feel hard to keep going? If that’s you right now, it might help to know you’re not alone. We are fighting an uphill battle; our brains simply were not built for a pandemic scenario. This year has also seen wildfires, civil unrest, an election cycle that has threatened our country’s democracy, and a tanking economy. That’s leading to burnout, which has physical, emotional, and cognitive effects: It increases heart disease risk, spurs depression and anxiety, induces trouble concentrating, and affects decision-making.“We’re not meant to sustain this level of overload to our nervous system.”By any metric you look at, COVID-19 is surging across the U.S. right now. Cases are at an all-time high, as are COVID-19 hospitalizations. States are reenacting stricter policies—and the Centers for Disease Control and Prevention has even recommended against Thanksgiving get-togethers. There are now more cases than the initial outbreak of the virus in March and April, yet, people appear less concerned about the virus. According to polling from FiveThirtyEight, COVID-19 concern hit peaks in mid-April and again in July, but has remained fairly steady over the past few months despite the huge rise in cases. Anti-maskers and others have long been saying, “We’re all going to get it anyway” and “it’s not worse than the flu,” but anecdotally, it seems that as the pandemic drags on, we’re now seeing that attitude from people who were previously cautious but are just really, really tired.

Pandemic fatigue is not new—and it’s certainly understandable. Doctors, nurses, public health officials, epidemiologists, and others fighting to treat COVID-19 and control its spread have been worked to the bone. Working parents are juggling full-time jobs alongside their new gigs as their children’s teachers. Business owners have been struggling to stay afloat, adhere to local policies, and politely deal with aggressive customers, all while exposing themselves to virus risk daily.

But a spate of new stories from folks who say they’ve been careful but got it anyway makes it feel inevitable that COVID-19 could be around any corner, and we just don’t have any vigilance left. Why does it suddenly feel hard to keep going? If that’s you right now, it might help to know you’re not alone. We are fighting an uphill battle; our brains simply were not built for a pandemic scenario.

Bad stuff has always happened to people, of course, and like other animals, our bodies mount physiological stress responses to improve our odds of survival. “Think about an animal, like a gazelle, on the African savannah, being hunted by a cheetah,” says Adrienne Heinz, a psychologist at the Stanford School of Medicine. If that gazelle is going to survive, it’s going to activate its fight-or-flight response, dilating its pupils and sending its heart rate and blood pressure sky-high, giving the nervous system a little jolt to quickly escape. If the gazelle makes it to safety, it will relax—but in a scenario with a prolonged threat, the gazelle will stay stressed. “If we continue to stay keyed up with high levels of cortisol and adrenaline, then we’re like the gazelle all the time,” says Heinz. “We’re not meant to sustain this level of overload to our nervous system.”

And it’s not just the constant stress of the pandemic—this year has also seen unprecedented wildfires, civil unrest as America grapples with the injustice of police murdering Black people, an election cycle that has threatened our country’s democracy, and a tanking economy. That’s leading to burnout, which has real physical, emotional, and cognitive effects: It increases heart disease risk, spurs depression and anxiety, induces brain fog or trouble concentrating, and—most crucially for our pandemic response—affects our decision-making.

In a variety of lab studies, researchers have manufactured stressful situations, like giving a speech, and observed its effect on people’s decisions about moral dilemmas. In general, it seems that stress decreases people’s likelihood to choose utilitarian options in favor of deontological ones; that is, stressed-out people seem more likely to make decisions on the basis of whether they personally think something is right or wrong, rather than considering whether that decision benefits the largest number of people.

Take these results with a grain of salt—studies that manufacture stress and ask participants to fill out surveys about what they would do in hypothetical situations may have no relationship to people’s behavior in real life. But I can’t help but see a parallel to COVID-19 here, as many people are making decisions about their behavior based on their personal moral compasses and not necessarily based on whether those decisions will hurt other people. Sure, you may believe it’s most moral to see your family for Thanksgiving, or to agree to see friends for a meal inside a restaurant. (You may also believe it’s your right.) But ultimately, that decision will likely affect other people, too.

Which leads us to another problem: It often doesn’t feel like our decisions are affecting people outside our circles. If you’re staying at home and not giving people COVID-19, nothing happens, so it can feel like you’re giving up things you love for no reason. I’ve had countless conversations with friends who say they feel gaslit by the mismatch between their actions and those of their friends vacationing with their 16 closest friends in Tulum, or the couple that decided to have a “small” wedding with 100 guests. Even worse, the longer we go without our usual interaction, the worse it will feel. “All the outlets we used to have to support each other through difficult times have been really disrupted,” says Heinz. “We’re neurobiologically wired for connection, and to chronically go without that is a huge risk factor for burnout.”

Observing others’ behavior might also break down our will to continue trying. “Cooperation is fragile,” says John Clithero, a decision-making researcher at the University of Oregon. “As soon as one person is observed breaking the rules, the incentives to cooperate—wear a mask, distance, stay home, don’t gather in large groups—it’s harder for people to persevere with cooperative behavior.” In psychology and decision-making, the prisoner’s dilemma is a classic example of how rational actors might choose not to cooperate, even when it behooves them to do so. The scenario is that two prisoners, A and B, are separated, and each given the choice of remaining silent and both serving some time in prison, or tattling on the other, in which case they’d go free. But if they both tattle on each other, they’ll serve more time than if they remained silent. Our current world is not a perfect parallel to the prisoner’s dilemma, but there are some similarities: Essentially, our friends vacationing in Tulum are choosing the option where they go free and imprison us suckers staying home, and that makes the folks at home want to stop cooperating, just out of spite.

We may soon be facing down another psychological challenge to taking proper public health precautions: the promise of vaccines. Recently, both Pfizer and Moderna announced that their vaccines are about 90 percent effective, and FDA approval and vaccine distribution are expected to follow in the next couple months. This is exciting news; as one Atlantic headline put it, “The End of the Pandemic Is Now in Sight.” The flip side of that is a silly thing our brains do, which researchers call moral hazard. In short, the idea is that people are more willing to take risks if there’s some change in incentives that protect them from risk. “The vaccine is presumably still a ways off, but if [people] assign that to sooner in time, as if the vaccine is already here, then that would be problematic,” says Clithero. Knowing that we could be protected by a vaccine might lure us into a false sense of security. But even once the vaccine becomes available, it will take months to roll out across the country, and it will not be 100 percent effective, meaning people will still need to take precautions for some time yet.

There are no easy solutions to pandemic fatigue and burnout. I can tell you to get more sleep, exercise regularly in whatever way you can, and keep in touch with friends and family, but that won’t fix the systemic issues driving many people’s stress: unemployment, illness, feeling overburdened by responsibilities, racism. But know that if you are struggling, you are not alone, and it’s not a personal failure to feel this way. And if you feel like giving up, take it from this Japanese fisherman: You just have to try.