Coping With Corona
How to skillfully cope with a pandemic, and thread the need of safety and risk?
Posted Apr 15, 2020
How can we best cope with the uniquely contagious and deadly virus known as the coronavirus (aka COVID-19)?
As a clinical psychologist and psychotherapist, I’m used to more abstract and perceived threats, such as helping agoraphobics calculate the tradeoff of going out into the world on a daily basis. I advise that the dilemma is a no-brainer; the importance of a successful work and social life is so high, and the non-zero percent chance of suffering a fatal traffic accident on any given day are so low, that it's critically healthy and adaptive to take the risk!
Unfortunately, preliminary findings on the coronavirus suggest we’re dealing with a much more dangerous and prevalent threat; as a result, the world has been flipped upside down, and an agoraphobic strategy has actually become the necessary and national solution.
The first step to healthy coping is an objective and bravely unblinking view of the threat.
The coronavirus appears to spread like wildfire (keep in mind that the overall infection rate is actually much higher than the formal counts because there is a sizable subgroup of the population that is infected, asymptomatic, untested, and, therefore, uncounted). This societal medical threat not only seriously wounds 5 to 20 percent of those infected/tested with severe and hospitalization-required symptoms, but proves fatal in 1 to 2 percent of cases (a death clip 10 to 20 times that of the garden-variety flu). Further, this pandemic could still end up being worse than predicted, and we are still many months and infection spikes from a sufficiently safe and effective vaccine.
The societal threat is even worse; a catastrophic scenario of flooded hospitals and, in turn, significant spikes in not just coronavirus deaths but also general medical emergency deaths that go unaddressed. The risk of such a temporary but nightmarish scenario has risen from “seemingly impossible” to “plausible, if not predictable without major intervention” in mere months.
In short, the threat of the coronavirus is so dire that this highly disruptive, months-long societal quarantine we’re now in is, at the very least, a justified, necessary, and proportionate adaptation to circumstances.
Realizing this rationale can help us to stay motivated and disciplined with healthy coping step number two - safety vigilance or a disciplined approach to social distancing and life quarantining (to as much of a degree as is personally workable). It is a civic duty, a highly effective safety and interpersonal strategy (when we reintegrate with our social networks, our friends, family, and colleagues will surely want to know how quarantined we've been), and a healthy outlet for channeling our pandemic anxiety.
Having said all that, we also have to be dialectical about the threat.
Meaning, as we seek to limit our overall coronavirus exposure, healthy coping step number three consists of taking reasonably calculated risks to preserve our quality of life. Further, we want to frame the threat in as reassuring terms as possible, if for no other reason than keeping anxiety low helps our immune systems to stay sturdy against potential infection.
So, let’s take a deep, collective, calming breath, and remind ourselves of the equally objective notion that the odds of a coronavirus infection remain low to medium, but not high; and, if infected, the vast majority of cases will be mild and fully recoverable (with the true percentage of severe and fatal cases being lower than the formal 1-2% given the official projection's failure to account for the asymptomatic and untested subgroup). In this current peak/surge phase of the pandemic's fluctuating trajectory, safety vigilance and discipline should, of course, remain at the front of our minds. But, in the back of our minds, we should presume optimistically that virus infection will either be avoided or, at worst, severe but not fatal (e.g. it is adaptively optimistic to presume that each and every day we will fully avoid injuries and calamities). This will help us navigate necessary societal errands and tasks, as we touch store shelves and overthink whether we've just gotten infected. In this vein of anxiety-relief and reassurance, such presumed optimism - the bedrock to peace of mind - can perhaps over time begin to regrow and expand to include normal and healthy positive illusions (e.g. happy people presume excellent longevity up until there are compelling medical reasons not to).
In the coming months, as our selective and incremental return to normalcy unfolds (and, in turn, a proportionately increased risk of coronavirus exposure), we'll need our threat detectors to be fluid and flexible. There will be quality of life tradeoffs and a diminishing-returns to safety discipline that will make calculated risk-taking ever more important.
For instance, social distancing is a proven and effective safety strategy, which makes it worth the sacrifice of self-consciousness and social frustration, at least for now, but what about smaller safety measures like sanitizing groceries? Surely there’s an incremental increase to short-term safety and peace of mind - but how much, precisely? - and does the benefit outweigh the inherent costs (e.g. lost time and energy, and increased anxiety due to threat-salience)? If so, for how long?
We don’t want to overwork with safeguards, because even the most cautious among us could get still get infected during a careful and infrequent public excursion. Also, we can never reduce our coronavirus exposure risk to zero, and convenience will soon become necessity (e.g. employees will need to return to work, students to school, and children to daycare). At the same time, just because we could contract the coronavirus through no fault of our own, or in spite of highly cautious living, doesn’t mean we should throw caution to the wind. How we get infected matters. We wouldn’t want to suffer and pass on coronavirus symptoms because we were infected from an easily avoidable, high-exposure, predictably risky activity (e.g. hugging everyone at a large-group gathering), as this would add a painful emotional layer of ruminative regret and justified guilt to the uncertain health consequences.
What else can we do during this pandemic - behaviorally, emotionally, and socially - to stay in the psychological “sweet spot” of minimized anxiety and optimized safety?
We should keep a thermometer handy, but only use it if we actually feel feverish. We should wash our hands aggressively, but not crazily. We should refrain from touching strangers, and probably seek explicit consent before touching loved ones. We should stay informed with the news, but embargo scary anecdotal stories and sensationalistic sources. We should maintain bare minimum consistency with daily routines (e.g. sleep schedule) and compassionately lower our personal standards for daily productivity and happiness. As we endure the unnatural effects of social isolation, we should tune in to the underlying sense of societal unity/connection around this pandemic fight, and optimize video chat to maintain ties. And, because it helps to hold heavy ideas as lightly as possible in our minds, we should heretofore refer to the coronavirus as “corona,” because the associations to beer and beaches will make a topic that is very necessary for thought and discussion, just a little more palatable.
To sum up, in order to skillfully cope with corona, and promote an effective and efficient return to normalcy, all we have to do is grieve major loss (e.g. daily routines, peace of mind, jobs, even loved ones), patiently tolerate perpetual angst and life restrictions, summon amplified discipline, and mindfully approach calculated risks.
Pandemics, clinically speaking, really suck. I wish us all the best.