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Why People Have Trouble Making Sense of the Coronavirus

Some people minimize the threat while others go stir crazy and take risks. Why?

Over this past weekend, hundreds of bars and restaurants were packed, despite coronavirus warnings, and many people continue to minimize the threat. Over the next few weeks and months, many of us will go stir crazy, locked in our apartments all day and want to go out, and have to decide whether to be 100% safe or take some gambles and if so, which. Churches, universities, and other institutions have canceled events. Governments in Italy and parts of China have restricted all movement, forcing millions of people to stay home. Many Americans can still roam to certain degrees, but we will increasingly each face many dilemmas. Millions of people are having difficulty making sense of the pandemic.

We can protect ourselves by washing our hands with soap and water for 20 seconds or using sanitizer before touching our faces. Clorox, Lysol, and Purell also kill the virus. But many people wonder whether they should try to avoid all grocery stores, pharmacies, and public transportation, if these remain open, and always wear gloves outside, and to get together with even small groups of family or friends. Stores are supposed to disinfect all surfaces daily. Numerous people remain wary, however, and worry whether their own protective efforts suffice.

Psychologists have shown how humans have difficulty processing complex risks for several reasons. We frequently fail to perceive risks rationally, and commonly under- or overestimate them, biased by our own personal experiences.

People are facing challenges responding to this pandemic partly because the overall number of current US cases may seem relatively low thus far compared to the country’s total population. At the moment, the US has around 15,000 cases—roughly 1 in 28,000 people or about .004% of the population. But since the curves have risen exponentially in China and Italy, epidemiologists estimate the tens or hundreds of millions of Americans will get infected.

Daniel Kahneman received the Nobel Prize for his work with Amos Tversky, examining biases or heuristics people use in gauging the likelihood of a particular event occurring. According to the “availability” bias, individuals see an event as more likely if they can more easily bring it to mind. If we have personal familiarity with an event, we tend to see it as more common.

Studies have shown, for instance, that men and women who know someone with HIV are more worried about the possibility of acquiring it themselves and protect themselves more. Conversely, individuals who know no one with the disease are less concerned about getting it and engage in riskier behaviors. The coronavirus is invisible to the naked eye, and very few of us personally know anyone who has it, at least thus far. Hence, many people discount any danger to themselves.

Risks themselves are also inherently complex to assess—figuring out how to weigh the likelihood of a risk (which may be small) against the magnitude of the risk (which can be high—possible death to ourselves and our loved ones).

Unfortunately, infected people who lack symptoms can nonetheless spread the disease to others, and we regularly touch our faces, unconsciously. We itch, sweat, and scratch. In a study, medical students each touched their faces an average of 23 times per hour! As in Rodin’s famous sculpture, The Thinker, resting your chin on your fist can help you concentrate. These days, it can also, however, increase your risk.

The question you confront before touching a surface is how many other hands have done so since it was last disinfected and whether you can adequately clean your hands before then touching your face.

Only 10 people may be in a grocery store or pharmacy, but hundreds of people may have passed through earlier in the day. The odds of getting exposed are relatively small, but risks persist. When did the staff last disinfect the establishment—what if someone has since coughed on the Tylenol bottle I buy? Unfortunately, to clean all cardboard in a grocery store—every box of crackers and cereal—with Clorox is impossible.

What about a dinner party of 10? Or six? Friends have asked me if they should visit their elderly parents. A problem is that we don’t know whom they have each been exposed to over the past two weeks.

The dangers and public precautions may seem surreal, since in recent decades the US has been unusually lucky, and been spared such a pandemic. However, for most of human history, infections have devasted human populations. The Black Plague killed 30-60% of the entire population of medieval Europe. In the 20th Century, smallpox killed about 400 million people worldwide. The 1918 H1N1 flu pandemic killed 50 million people worldwide, including 675,000 Americans. Modern medical research has yielded powerful antibiotics and other weapons. In the late 1960s, several leading physicians even declared that the era of infectious disease was over. The field lost prestige. Yet, AIDS, SARS, Ebola, treatment-resistant TB, and other diseases remain.

Alas, many key facts of COVID-19 remain unknown: how infectious are people who harbor the virus but lack symptoms. The viral test used by the Chinese has a 30-60% false-negative rate — about half the people who actually have the microbe will test negative. The CDC has not released data on its’ test’s accuracy.

Such uncertainty makes us anxious. When humans face danger, our autonomic nervous systems kick in. Our heart pounds. We feel agitated, on-edge, and can’t concentrate on other tasks. In response, we look for information and control — or try to deny the threat.

In general, individuals differ in how they respond to any particular dangers: how much risk they feel comfortable taking in return for how much gain. Even before the coronavirus, some people refused to fly, afraid of possible crashes. Others of us readily boarded aircraft, feeling safe enough and wanting to save time. Still others went hang gliding and parachute jumping. Our automatic nervous systems react differently — when threatened, some people want to fight, while others feel fright and take flight.

Fortunately, researchers have learned ways of identifying and containing COVID-19. By comparison, we did not know what caused the plague, and no test existed for the 1918 flu. Hopefully, an effective vaccine and treatment will soon be developed, but that could take many months or even years. Scientists have failed to develop an HIV vaccine, despite 30 years of attempts.

In the interim, people will respond differently, as we struggle to cope, and we may each have varying comfort levels.

On Saturday, I attended a family birthday dinner. We were all careful, as we had never been before, not to share any cups or utensils. I was glad to see them, and venturing out refreshed me. I've gone walking or running and have shopped in the grocery store, though wearing gloves and a mask. I wondered though, as the cashier handed my credit card back to me, whether I should disinfect it — along with the milk, cheese, apples, and other items I bought. When I got home, I did so, just in case. I've been unsure when I would next go out.

In the upcoming months, many of us will have to make multiple tough decisions, and live with the consequences. Importantly, we must each manage these risks as rationally as we can, based on scientific evidence as it becomes available, and encourage others around us to do so as well. Alas, that might not always be easy, but anticipating these challenges can perhaps make them at least a bit easier. Our health, and that of our loved ones, neighbors, and others depend on our all doing so as best we can.