Covid Caution Fatigue - You Probably Have It; Don’t Let It Cause Your Death
What is Covid-induced caution fatigue? Let’s get started by remembering that this pandemic began back in March so it has been March, April, May, June, July, August, September, October, November, and now December and it will continue beyond. That is a long time to be frustrated, to be tired, to be bored, to be scared, and even a bit angry. These are all emotions that are building up inside of us, and as they keep layering some new stressor means an additional layer. It’s like a layer cake with more and more layers and the layers seem to be getting bigger and bigger. The problem with that analogy is that the cake tastes good and this does not. None of us like it. None of us want another slice. We want to push it aside. We have been cautious for months but now we are tired. Caution fatigue has set in.
The retirement community where my wife and I live is a good example of people developing caution fatigue. There are about 2,000 people and among us are about 1,800 who live in independent living — our own apartments. The other 200 are in buildings for continuing care. There are six restaurants, two gyms, an Olympic size indoor swimming pool, multiple venues for meetings, conferences, games, and so forth. There is a large gallery where residents can hang their art. We have a well-staffed medical center and our own pharmacy. Other than a grocery store, and that is literally next door, Charlestown is a rather self-contained community although most everyone likes to go beyond the gate for shopping, museum trips, and restaurants.
In March came the beginning of the pandemic. The management is to be commended for instituting measures that made good sense. They started restricting visitors. They closed the restaurants. They started bringing meals right to our door. They brought packages from UPS, FedEx, and the US mail directly to our door. So, in a sense, we didn’t have to go out. Many of us did go out, just for a nice walk every day for both our mental health and our physical health but otherwise, we didn’t have to leave our apartments. The staff was terrific. Many of them changed roles — waiters and waitresses in the restaurants did the home deliveries. The staff of the gym did concierge functions. Residents for the most part accepted the new reality and all pulled together. It worked. In March, April, May, June, and the first part of July, there were no COVID-19 infections among those of us in independent living. We were all pleased, very happy, and very grateful. I did an informal survey and just about everybody said the same thing, “I feel safer here than I would if I was still on the outside in my old home.” That’s a compliment to what was done. But then something happened.
Over a few weeks beginning in late July, five residents tested positive for the coronavirus. Four were people who had gone off-campus, separately, and met with a friend or a relative. In each case, they were thinking essentially, “I know Charlie. Charlie is fine, he’s my close friend of many years. I know he doesn’t go out bar hopping. I know he is careful. He couldn’t possibly be infected; besides he feels fine, so I’m just going to go visit with him. I can take my mask off. I don’t have to sit six feet away from him. We can have a meal together.”
The problem of course is that Charlie did have a Covid-19 infection but he did not know it. He did feel well but then developed symptoms a few days after that visit. Despite no symptoms, he could and did breathe out the virus in the aerosol from his nose and his mouth. This was how four residents became infected during those few weeks in the summer. The fifth resident became infected when a home aide, feeling well, and not knowing she was infected, spent time in the resident’s apartment.
Now, in late October and through November, four additional residents have become infected, each with a similar explanation. The latest is worth further comment. This is a person who frequently had the mask not over the nose and sometimes down around the neck and was more than once observed like this on the elevator. And a few days before becoming ill, this person was observed in an area with seven or eight others around a table, none with masks on.
You might say that only nine out of 1800 residents is pretty good and I would agree. But these are all older more vulnerable people; one died; and, in each case, it was preventable.
Why did it happen? And what does that have to do with Caution Fatigue? Everything.
Caution fatigue is well known to develop after disasters. At first, everybody comes together and helps each other and does whatever is necessary. But only for a while. Once there is a sense that the threat is gone or less of a threat, that need to be careful goes down. That’s caution fatigue. You’ve become willing to take greater risks than before. It’s like “the straw that broke the camel’s back,” the apparently minor event that on top of the cumulative effect of many small events leads to an unanticipated reaction. As we become more, and more and more frustrated, more and more even a little bit angry, caution fatigue slips in.
So, what can you do about caution fatigue? There are some basics. None of them should be a surprise. The first is to recognize you’ve got it. Talk about it. Talk about it to your friends. Talk about it to your spouse. Talk about it to your family. Talk about it to anybody. It’s important to “let it out.” We need to talk about these things. It only gets worse if you hold it in, so, talk about it.
The second, and it relates to the first, is you need social interaction. Humans require social engagement for good emotional health. A Zoom call, a phone call, emails, a letter even — the old-fashioned way. Meet outside with others in warmer weather but keep your masks on and sit six feet apart. But do have people interactions. It’s critically important to maintain resiliency.
Third, make a point of finding events, things, or people for which you are grateful today. It can be something apparently minor like a bird singing in the tree or an email from a friend. We all have reasons to be grateful. Think about them. Better yet, write them down each evening before bed. Expressing gratitude has many positive effects on your brain including overall emotional well-being. It is another way to improve your resilience while reducing stress. Gratitude practice will help you ward off caution fatigue and thereby wad off the coronavirus.
Caution fatigue means being less cautious about your lifestyles such as what you eat, how you exercise, how much sleep you get, and your stress levels. That macaroni and cheese — “that’s my comfort food. Maybe I shouldn’t have it. Well, maybe just a little bit.” That chocolate layer cake. A little slice perhaps but consider — did you previously have dessert every day of the week? Or was it just on Saturday night? Now it’s every day and it’s not just one slice but a big slice and not just one scoop of ice cream but two scoops of ice cream. And so it goes. You are likely not eating healthy.
You likely are not be getting adequate exercise. It’s harder to exercise with gyms closed or limited but exercise is very important. At a minimum, get out for a 30-minute walk every day. It will also assist your body and your mind’s health to do some resistance exercises such as squats, pushups, the plank, crunches — each of which you can do right at home.
Many people are not sleeping well. You need a good night’s sleep and there are some things you can do to help. Stick to a sleep schedule. Don’t watch something excitatory on TV or look at Facebook right before bed. Have a very dark room. Have a very quiet room. Make sure all the lights are out. Turn your smartphone off. Turn the TV off. It’s best not to have a TV in the bedroom anyway.
Everyone is under stress even if it is not recognized, some people more than others. This pandemic has led to major stresses for nearly everyone. If you focus on a healthy diet, get some exercise and a good night’s sleep, your stress levels will be reduced. But you almost certainly need some specific stress reduction techniques like meditation, yoga, or Tai Chi. If that seems too complicated, then start with just some deep breathing. Breathe deeply to a count of four, hold it for two and then exhale slowly to a count of six to eight. Repeat for a minute or two, preferably more. With the exhale being longer than the inhale, a message will go to your brain to relax and that will, in turn, send a message back via the vagus nerve to let the tension in your body subside.
Remember that the media does all it can to get your attention largely with excitatory or negative news. Keep your media time to a minimum. Read only a well-edited newspaper. Avoid most TV news and limit your time on social media with all its sensationalism.
These are some of what you can do to overcome caution fatigue and maintain good health.
Remember that even young people that get infected can have a serious illness. Many with rather minimal symptoms still get strange long-term sequelae such as fatigue, shortness of breath, inability to smell, and a sort of “brain fog.” Don’t listen to those that say it’s OK to mingle unprotected.
Most importantly just recognize that caution fatigue is present. Pay attention; you probably have it. Do not let it do you harm. You’ve weathered this storm for nine months. With vaccines coming and monoclonal antibodies becoming available, the light at the end of the tunnel is getting closer. Stick with it. This is not the time to make a decision that leads you to Covid-19 infection, possibly severe, possibly with long-term sequelae, or possibly even your death.
The essence of this article is also available as a video.
Note — You can learn more about protecting your health with BOOM — Boost Our Own Metabolism by Dr. Harry Oken and myself.