Covid 19 Fatigue

“We’re over it”: Pandemic fatigue is a rational response, not a weakness

 Gabrielle Bauer

Gabrielle Bauer

Gabrielle is a freelance science & medical writer based in Toronto. She has won six national awards for her magazine articles and is the author of two creative nonfiction books. She is currently working on a book about the Covid-19 pandemic called 2020 BLINDSIGHT, slated to be published in 2023 by the Brownstone Institute.

Pandemic fatigue is often described as a human weakness — an obstacle that experts must help people overcome so they can continue to “follow the science.” Here, I argue that pandemic fatigue is part of the science. Rather than a sign of weakness, it’s a mature and rational response — an adaptive mechanism that allows us to get on with the business of living. Instead of deriding people for getting tired, public health experts and politicians need to understand the psychology of pandemic fatigue and factor it into their policies, during this pandemic and the next one.
 
“I’m done with Covid.” Earlier this year, journalist Bari Weiss spoke those words on the Real Time with Bill Maher TV show. Predictably, her statement triggered a spasm of outrage that shot through the Twitterverse. Some people chided Weiss for disrespecting the people who died of COVID-19. Others hit back with some version of the “you may be done with Covid, but Covid isn’t done with you” trope, which they evidently saw as a gotcha.

It isn’t. When people say they’re done with Covid, they’re not denying that the virus still exists or that it carries a risk. Nor are they disrespecting the dead. They’re simply stating that they’re done with living in crisis mode. In essence, they’re saying: “COVID-19 has ruled our lives for over two years. That’s long enough. Even if the virus still lurks among us, we need to put it on the back burner, where we place the other risks in our midst.”

Some people call this pandemic fatigue, and it’s a perfectly reasonable response to a threat that won’t go away. Fatigue from COVID-19 also helps explain why the more recent Monkeypox scare has largely failed to elicit mass panic. There’s only so much crisis the human brain can take.
As COVID-19 grumbles through its third year, the emergency phase largely behind us, we have the opportunity to assess how well our experts have understood public fatigue and accommodated it in their policies. The short answer: not very.
 

Early start

Signs of fatigue showed up early on in the pandemic. As revealed in the Understanding America study, adherence to the COVID-19 restrictions started slipping in May 2020 (1). People of all ages began socializing again, sometimes on the sly, despite remonstrations from public health advisors and Twitter warriors. While a change in perceived COVID-19 risk and waning trust in public institutions may have contributed to the slippage, the World Health Organization also suspected pandemic fatigue as a factor (2).

In the fall of 2020, having noted the creeping pandemic fatigue in its member states, the WHO’s European Office published a paper called “Pandemic fatigue: reinvigorating the public to prevent COVID-19”. The architects of the document, to their credit, showed a welcome sensitivity to human psychology. They recommended acknowledging people’s hardships, striving for the highest level of fairness in restrictions, transparently sharing the rationale for restrictions, understanding which restrictions may be “unbearable” (their word) in the long term, and conceding the limits of science and government.

Too bad nobody got the memo. Over the course of the pandemic, governments continued to impose and reimpose restrictions with scant logic beyond “cases up, masks on” and “we need to keep slowing the spread.” When people complained of unfair or illogical rules, politicians responded with knee-jerk platitudes like “we continue to consult with our scientific advisors.”
 

A feature, not a bug

Most experts have made it clear they view pandemic fatigue as no more than a loose brick in the edifice of pandemic management — a hole to patch up. To offset pandemic fatigue, an August 2021 article in Nature magazine encouraged policymakers to figure out “how to motivate steady physical distance adherence, with additional focus on groups [that have] shown the largest drop-off” (3). A few months later, an Italian paper proposed combatting pandemic fatigue through “fear of the disease’s consequences modelled with the death rate in mind” — a polite way of saying “striking terror in people’s hearts” (4). Speaking directly to the Covid-fatigued public, the American Medical Association offered a set of trite recommendations: seek mental health care, focus on what you can control, practice positive affirmation.
The underlying premise is always the same: if people can get past their fatigue, they will keep following the science and all will be well.

But here’s the thing: pandemic fatigue is part of the science. It’s a feature of pandemic management, not a bug — a predictable human response that decision makers must factor into their policies if they want public buy-in. Researchers have even developed instruments to measure it, such as the aptly named Pandemic Fatigue Scale (5) and Covid Burnout Scale (6).
 

Covid 19 Fatigue
Covid 19 Fatigue. Photo @Liza Pooor for Unsplash.

The logic of pandemic fatigue

Pandemic fatigue falls under the umbrella of habituation (7), defined by psychologists as a “decrease in response to a stimulus after being repeatedly exposed to it”. Habituation is an adaptive mechanism — a form of learning. It allows people to disregard repeated, non-essential stimuli and focus on things that demand their attention. If you’re hammering out a report in your home office and your teenager is noodling on the guitar in the next room, you’ll work more effectively if you can tune out the twanging.

While often presented as a manifestation of childish impatience, pandemic fatigue denotes sophisticated adult reasoning. It’s an intuitive recalibration of risk tolerance in response to a persistent threat. It makes sense to endure pandemic restrictions if we see an off-ramp ahead, but when the off-ramp keeps receding, the cost/benefit changes. A rational person may conclude: “I must accept either indefinite restrictions or an extra increment of risk. On balance, option B gives me a better shot at a good life. What time does that jazz festival begin already?”

A guy called Jeff echoed this view in a response to an article about battling fatigue through the Omicron wave. “Fatigue?” he wrote. “Perhaps we have looked around and done a very reasonable risk assessment for ourselves and made a conscious and calculated decision.”

Life is all about calculated decisions, and the calculus naturally shifts over time. Imagine, for a moment, that you wake up to a raging blizzard. The thermometer reads minus ten. You’re out of fresh pasta and tomato sauce, but there’s no way you’re going to the grocery store. Next day, same weather and same decision. Ditto for the day after that. After a week of howling winds and sub-zero temperatures, however, you’re tired enough of canned tuna that you’ll happily brave the elements for some linguine marinara. Like pandemic fatigue, this reasoning makes perfect sense under the evolving circumstances.

If we kept responding to a recurring stimulus at peak intensity, we could never get on with the business of living. That’s why people’s willingness to follow public health mandates erodes over time: they reach a point where avoiding disease becomes less important than making a new friend or putting on a theater production. There’s nothing unscientific about that.

A pair of academics from Griffiths university understood this dynamic when they wrote, in an article for The Conversation, that “gradual exhaustion and inability to engage with government public health messaging is not unusual and is part of a complex interplay of factors, including those relating to risk and control”. The article’s takeaway: if governments and expert advisors want the public’s cooperation, they need to assess the public mood (through regular surveys, for example) and tailor their messaging accordingly.
 

Reading the room

Instead of showing such understanding, many experts deride people for losing their focus — for “capitulating to Covid”,  to borrow cardiologist Eric Topol’s ill-tempered locution. Or they insist that we all double down. “Very simply, we need judiciously targeted mask and vaccine mandates and widespread testing to, once again, flatten the curve of infections”, public policy researcher Henry Miller wrote in a June 2022 opinion pieceSeriously? The “flatten the curve” meme got the public’s attention in March 2020. Coming in mid-2022, it falls, well, flat. As for vaccines and masks, the time for knee-jerk, one-size-fits-all mandates has come and gone. As the past two years have made abundantly clear, blanket mandates pose a threat to the social fabric, and this needs to be weighed against their putative benefits.

That said, vaccines should certainly play a role in ongoing COVID-19 strategy. High vaccination rates strengthen the case against restrictions on social and commercial activity, thus offering a relatively painless escape from pandemic fatigue. Perhaps an annual vaccine, mandated as a default but subject to reasonable exemptions, could help balance the tension between public safety and personal autonomy in a fatigued public.
To understand pandemic fatigue, one has only to enter an online discussion forum. Under cover of anonymity, people will tell the world what they really think, as they did in this recent Reddit thread about rising cases:

“Vaxxed/boosted. Not going to worry about it or live in fear. Done all I could. C’est la vie.”

“There will always be another variant around the corner. At this point I’m willing to take my chances and live my life.”

These statements do not signal denial, laziness, or capitulation. They simply reveal a shift in people’s priorities, which experts would do well to respect — in this pandemic and the next one. It’s called reading the room. If they don’t, they shouldn’t be surprised if the public responds with a yawn.

My wish list going forward? Updated and readily available vaccines, clear guidance on managing risk, transparent data sharing, and allowance for pandemic fatigue — more or less what the above-mentioned European WHO document lays out. Perhaps our decision makers will get the memo this time.

 

Gabrielle Bauer

 

References:

  1. Kim, J.K., Crimmins, E.M., “How does age affect personal and social reactions to COVID-19: Results from the national Understanding America Study”, PLOS One, 2021.
  2. Lilleholt, L. et al. “Pandemic fatigue: measurement, correlates, and consequences”, PsyArXiv, 2020.
  3. Petherick A, et al. A worldwide assessment of changes in adherence to COVID-19 protective behaviours and hypothesized pandemic fatigue. Nature Human Behavior 2021.
  4. Meacci, L., Primicerio, M., “Pandemic fatigue impact on COVID-19 spread: A mathematical modelling answer to the Italian scenario,” Results in Physics, 2021.
  5. Cuadrado, E., et al. “Construction and validation of a brief pandemic fatigue scale in the context of the coronavirus-19 public health crisis”, International Journal of Public Health, 2021.
  6. Haktanir, A., et al. “Do we experience pandemic fatigue? current state, predictors, and prevention”, Current Psychology, 2021.
  7. Dan,V., Brosius, H.B., “The onset of habituation effects: predicting fluctuations in news use during the COVID-19 pandemic by disease occurrence”, European Journal of Health Communication, 2021.
Received: 14.06.22, Ready: 30.06.22,. Editors: Federico Germani, Robert Ganley

The views and opinions expressed are those of the authors and do not necessarily reflect the official position of Culturico, its editorial team and of the editors who revised the article.

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