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Canada COVID-19 quarantine fatigue: The arrival of summer will test our resolve to social distance

22:37  23 may  2020
22:37  23 may  2020 Source:   nationalpost.com

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As a boy growing up in Fox Creek, northern Alberta, Jay Van Bavel learned how to give a firm handshake. Guys would be teased if they had a flimsy grip. It was that masculine, alpha-male thing.

That small-town boy grew up to become a social neuroscience professor at New York University who, back near the end of February, before the virus that causes COVID-19 began spreading in North America in any serious way, was at a conference in New Orleans when he started watching data come in from around the world. He read how the adoption of fist bump greetings over a strong handshake might substantially reduce the spread of this new coronavirus.

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Back at the conference, “everybody is shaking hands.” Four thousand people. He tweeted out the article , declaring he would be doing more fist bumps until the #coronavirus passes. “Please RT if you want to make this a social norm.” “I shared the article, and then I started fist bumping, everybody. But even people who saw the article, friends, instinctively kept reaching out for my hands,” Van Bavel remembers.

“It’s that habit we built our entire life in our culture. Shaking hands is the way you connect with somebody.”

We don’t shake hands anymore. Van Bavel also spent his childhood summers playing baseball and bunking at summer camps, typical glorious “Canadian stuff” that, this pandemic summer, like handshakes, have been scuttled in most parts of the country.

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Humans are social animals. We seek physical closeness and, in the response to a collective threat, we reach out for even more. “Contact seeking”, Ophelia Deroy and colleagues write in a paper in Current Biology, is ingrained in our physiology. We crave it the way we crave food. “Asking people to renounce social contact is not just asking them to abstain from pleasurable activities; it is asking them to diverge from a point of equilibrium, toward which they normally all gravitate. “

Extending social distancing, Deroy says in an email, is one of the biggest bets on human resilience governments are taking.

How long can we cope?

As the days grow warmer, as the brain grows weary of being on high alert, we run the risk of becoming de-sensitized. As lockdowns begin to lift, some basic activities of life — shopping, exercising — no longer seem so scary. Things feel safe, even though they’re not necessarily any safer now than they were eight weeks ago. Would it really be so awful to gather with neighbours over drinks on the deck? Hug our grandkids? Blissfully bag out on a shared beach blanket with someone?

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Canada’s chief public health officer, Dr. Theresa Tam, warned this week Canadians must remain vigilant, for months to come, or risk losing what we gained by staying locked inside for umpteen weeks. Perseverance, she says, is the best shot we have at avoiding exponential spread of the virus over the spring and summer, and preparing for whatever fall and winter might bring.

a group of people sitting at a park:  People relax in designated circles marked on the grass at Brooklyn’s Domino Park on May 18, 2020, in New York. The circles were added after the park became severely overcrowded during a patch of unseasonably warm weather about a week earlier. © Kathy Willens/AP People relax in designated circles marked on the grass at Brooklyn’s Domino Park on May 18, 2020, in New York. The circles were added after the park became severely overcrowded during a patch of unseasonably warm weather about a week earlier.

Certainly, many Canadians seem antsy about taking steps toward something approaching normal: in a survey of 2,000 Canadians released this week by Carleton University researchers, 79 per cent agreed it’s more important “to minimize avoidable illness and death” than restart the economy prematurely, while 21 per cent expressed a preference for “getting the economy going again,” even if it means more sickness and death.

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While we can now shop for patio furniture and perennials, this will be a frozen summer. No carnivals or festivals. No proms. No stampede in Calgary. Canada Day on Parliament Hill will be a virtual party only.

People have taken the shelter-in-place and physical distancing advice, for the most part, seriously, says Josh Greenberg, a professor of communication and media studies at Carleton. We’ve listened to and have done what was asked of us. “I think people have established, as unpleasant as it is, a routine in their lives. I think there is a sense of collective responsibility that everybody is still in this, and doing it,” he says.

But we can’t be in shutdown mode forever. Suddenly, there is talk of “quarantine fatigue,” what Harvard Medical School infectious diseases epidemiologist Julia Marcus describes in The Atlantic as the “profound burden of extreme physical and social distancing.”

a man standing in front of a tree posing for the camera:  Carleton University professor Josh Greenberg: “Everybody’s guard will slowly start to go down.” © Supplied Carleton University professor Josh Greenberg: “Everybody’s guard will slowly start to go down.”

People are becoming tired of the constraints on their freedoms. “Over time, it decreases the probability that we’ll be able to comply,” Van Bavel says.

In the U.S., demonstrators, some armed, have protested shelter-in-place orders, hoisting signs reading “Give me liberty or give me COVID-19.” Many are what Brad J. Bushman, professor of communication and psychology at Ohio State University describes in Psychology Today as “astroturfing activism” — “the practice of masking the sponsors of a message or organization to make it appear as though it is a grassroots protest.” The Operation Gridlock protest staged outside Michigan’s state capitol was organized by the Michigan Conservative Coalition, which has accused government officials of panicking based on expert predictions that “were wrong, way wrong!”

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Conspiracy theories have taken root in Canada: in the Carleton University survey, 26 per cent believed the virus was engineered as a bioweapon in a Chinese lab; 11 per cent agreed with the statement that COVID-19 isn’t a serious illness but a cover up for the effects of 5G mobile networks. A fifth falsely believed antimalarial pills evangelized by U.S. President Donald Trump can treat COVID-19; 17 per cent believe a myth that rinsing your nose with a saline solution can neutralize the virus.

a group of people standing next to a tree:  People take advantage of a warm spring day to look at cherry blossoms in Toronto during the COVID-19 pandemic. © Jack Boland/Postmedia/File People take advantage of a warm spring day to look at cherry blossoms in Toronto during the COVID-19 pandemic.

“Some of the conspiracy theories (such as 5G) go against the proven fact that COVID-19 is caused by a virus. And if you don’t think (COVID-19) is caused by a virus then it follows that you might engage in riskier, not-socially distanced behaviour,” says co-researcher Sarah Everts, who worries the spread of myths and misinformation could lead to a “lackadaisical or cavalier disregard of social distancing, which could then lead to a resurgence of the virus.”

So could dwindling motivation or energy. Jacqueline Gollan has coined it “caution fatigue” — we become more impatient with the warnings; we don’t believe them to be relevant or real.

“I do hear people saying that they’re tired of this narrow routine, the expectation that they abide by these new safety guidelines,” says Gollan, an associate professor of psychiatry and behavioural sciences at Northwestern University Feinberg School of Medicine.

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There are a couple of things going on, she says.

Caution fatigue happens when we become desensitized to a warning or risk. Initially, when we hear “pandemic,” we get scared. We become fearful and take action. But over time, “we adjust, psychologically, to reduce the fear, and then we de-sensitize the pandemic information.”

Jay Van Bavel wearing glasses and smiling at the camera:  Professor Jay Van Bavel of New York University: “You have a thousand different little reasons why any individual might be experiencing fatigue with all of these things.” © Outlier Professor Jay Van Bavel of New York University: “You have a thousand different little reasons why any individual might be experiencing fatigue with all of these things.”

What follows is malaise, Gollan says, a sense of boredom, a lack of a vital routine. “People start to regain an interest in resuming a routine, trying to maintain their mental, emotional and spiritual health. We want to resume our prior habits,” Gollan says.

Health leaders have reason to worry about caution fatigue, she says, because the dangers are  real. “There are harsh consequences to the community if caution fatigue drives some of your choices.” Not maintaining safe distances, ignoring public health announcements, pulling down fences put up to keep the public out. If we address our caution fatigue, we can reduce sickness and death.

Already, “People feel fatigued from this highly taxing experience,” Gollan says. But the messaging shouldn’t be total abstinence from public life, but a  harm-reduction, low-risk approach — a shift from the early #StayHome message to a #BeSafe message.

Gollan explains it this way: “Do what you can, when you can, to reduce your risk to yourself and others. So, if you’re still going to socialize, put on the mask and stand six feet away.” At her briefings this week, Tam said small bubbles of core contacts are better than big, outdoor spaces, better than indoor.

In fact, some studies suggest the transmission of the SARS-CoV-2 virus is a largely indoor phenomenon. One study analyzed 318 outbreaks in 120 cities in China (outside Hubei province, where the virus emerged) involving 1,245 infected people. Researchers looked at the enclosed spaces and environments where the outbreaks were reported, including apartments, villas, trains, cars, high-speed rail, planes, cruise ships, restaurants, gyms, teahouses, barbershops and thermal-power plants. They could identify only a single, outdoor outbreak involving two cases — a 27-year-old man who had a conversation, outdoors, with someone who had recently returned from Wuhan, the epicentre of the pandemic.

Mariachis delight quarantined Colombians with jolts of street music

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Some have asked, if the findings are correct, if the virus spreads near exclusively in tightly confined quarters, why enforce social distancing in unconfined spaces?

Think of risk on a sliding scale, says infectious diseases specialist Dr. Isaac Bogoch, from greatest risk— indoor, enclosed spaces, lots of people close together unable to practice physical distancing — to lowest risk, meaning outside, where people can physically distance, keeping two metres away from others. In that setting, “the risk is getting pretty close to zero,” Bogoch says. The same isn’t true for an outdoor concert, where people are tightly packed together. Crowded public beaches are also a different story. “There is only so much sand and a lot of people who want to get into it,” says Dr. Ali S. Raja, executive vice-chair of the department of emergency medicine at Massachusetts General Hospital.

Yet, we still seek physical contact, with friends, family, loved ones, and there’s little chance our “social capacities and needs” will change, even in the face of an invisible threat, says Deroy, of the faculty of philosophy of mind at Ludwig Maximilian University Munich. They are deeply rooted in our brains and behaviours, she says.

“When we can be in the same physical space, or even more, when we touch and are in direct physical contact with each other, we have this immediate feeling of reciprocity: I touch your hand, you touch mine. This is very precious, and we know that joint presence, joint attention, play a crucial role in our lives.” Grandparents want to read books with their grandkids on their laps, not via Zoom, she says, and the same is true for the grandchildren. “Joint presence and joint attention are not transferrable to online platforms — not now, and if you ask me, not for a long time.”

So we need to muddle through. In New York City, “it’s going to be really hot soon,” Van Bavel says over the phone from Manhattan. People are going to want to go to a beach, to a pool. “They’re irritated their life is disrupted — you have a thousand different little reasons why any individual might be experiencing fatigue with all of these things.”

Like the handshake, we can get past it, he says. There’s no intrinsic part of human nature that requires our Western greeting to be a handshake, he says. We could wave, we could bow. Until we have a vaccine, “we’ll learn new norms about how to socially interact, in small groups, spaced out, with masks on, in ways that allow us to get our basic human and social and mental health needs met, while reducing the infection risks.”

As the lockdowns ease, it’s not clear how people will respond, socially, culturally, psychologically. “Everybody’s guard will slowly start to go down,” says Greenberg. “And I think that’s where there is so much uncertainty now: what are the implications of that happening?”

• Email: skirkey@postmedia.com | Twitter: sharon_kirkey

Mariachis delight quarantined Colombians with jolts of street music .
Mariachis delight quarantined Colombians with jolts of street musicAs the Andean country waits out two months of a national coronavirus quarantine, musicians playing the traditionally Mexican genre are lugging guitars, trumpets, violins, speakers and microphones to street corners, accepting tips from delighted residents who dance on their balconies.

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