Quarantine Fatigue: How Will You Decide to Rejoin the World?

If you’ve been self-isolated for the last several weeks or months, you may be feeling like you want out. Making this decision will be challenging because we don’t have all the information we might want or need.

I want to note that not everyone has been under self-isolation. Essential workers have not been able to follow stay-at-home recommendations.

But many of you may now be deciding when to end your self-isolation. We often make decisions without all the relevant information. We have some information. And some of what we know is likely incorrect. Maybe we’ve been exposed to misinformation or conspiracy theories on a particular topic. Nonetheless, we have to make a decision about when to end our self-isolation.

And we can be sure certain of one thing in the COVID-19 pandemic: We are making decisions under uncertainty. There are so many things we just don’t know. How widespread is the disease? How many people will die? Will someone I know die? How many people will be saved by various actions? Will I be exposed if I go out? Will I inadvertently expose others to the virus? How high is my risk if I maintain distance, if I wear a mask, if other people wear masks? We don’t know the answers to all these questions.

We are also looking at uncertain economic conditions. How many people will become unemployed or risk losing their homes? How rough will these economic times be and how long will they last? Will I or someone I know lose a job or their income? When will the recovery start? I don’t know that I would trust any predictions for what the economy will be like in 6 months.

So many things we don’t know and can’t know right now.

Fortunately, we know a lot about how people make decisions under uncertainty. Understanding decisionmaking processes can help you make better, although probably not perfect, decisions.

The most important point is how we frame a decision. Framing means how we understand a situation. Framing often concerns how the possible outcomes are presented. The original research of framing and decision making was developed by Daniel Kahneman and Amos Tversky. Their work is so important that it was awarded a Nobel Prize in Economics.

First, when considering a decision, are you focused on losses or gains? Are you thinking about people dying or saving people? The same information, the same decision, can be framed as a loss or a gain. You can present a situation as potentially saving the lives of 35,000 people or as 35,000 people possibly dying. When we present the outcomes of a decision as saving people (or money), we become more careful. We prefer options that definitely save people. We don’t want to take any risks. If we instead focus on losing money or people dying, then we are more likely to consider riskier choices. We become more willing to gamble, even take a low probability bet, when the choice involves people at risk of dying. Importantly, the same decision can be presented as saving people or people dying. Doing so dramatically changes the way people make decisions, making us more or less likely to take risks (Tversky & Kahneman, 1981).

Here’s another interesting aspect about framing something as gains or losses: Losses are stronger. Losing 10 dollars feels bad and gaining 10 dollars feels good, sure. But the 10 dollar loss hurts more than that 10 dollar gain feels good. Being concerned about 1,000 people dying in your community will feel awful. Thinking about saving 1,000 lives, while important, just won’t have the same power.

In decision making about COVID-19 how are your decisions being framed? If you are focused on lost money, you might be more willing to take the risk of going back to work. If you are focused on people potentially dying, then you may be willing to try untested drugs. If instead you are focused on saving what you have and saving lives, then you may be more risk averse. You may hope that you can wait before going back to work. You may want to avoid drugs with a high risk of side-effects. So that’s the first part of framing – presenting a decision in terms of losing or saving, dying or living.

We should also consider another critical aspect of framing: Something is really different from nothing. For example, Kahneman and Tversky noted that gaining (or losing) 10 dollars is powerful when you start with nothing, at zero. The first 10 dollars really matters. But getting another 10 dollars when you’ve already gained 110, just isn’t the same. It doesn’t impact your decision in the same way. And what you consider as your baseline, as your zero point, matters a lot here.

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Consider your response in February to the possibility that 35,000 people may die in the US because of Covid19. What would you have been willing to do to prevent those deaths? Would you have been willing to stay home for a month to save 35,000 lives? Now consider that 65,000 people have already died to this point (as I am writing this). We could be at 100,000 people lost by the end of this month. Are you willing to stay home for another month to save 35,000 lives now? The first 35,000 hits harder. That many people will be tragic. But the impact of the first set is stronger than going from 65 to 100 thousand. Of course, you can frame this situation differently. Ignore the lives already lost. Present this only as 35,000 people dying this month. A new anchor of zero can make the number more powerful again.

I want to consider one more important way of framing a decision. Who are you focused on? Are you thinking about yourself or other people? For example, how do you convince people to wash their hands to prevent the spread of disease?

Grant and Hofmann (2011) placed different types of hand hygiene reminder signs in a hospital to conduct a field experiment on framing effects. The signs were placed above sinks and hand sanitizer stations. In one condition, people were reminded that “Hand hygiene prevents you from catching diseases.” And in the other, the signs noted that “Hand hygiene prevents patients from catching diseases.” A simple change from self to other-focused. Being focused on helping others increased compliance with hand hygiene, even in a hospital. Maybe this is something about doctors and nurses. But I don’t think so. Instead, I think we can all make better decisions when concerned with helping others, when the same behavior is framed that way.

I will admit that I have been horrified by the self-focus I have seen of the anti-shutdown protests. Many people have signs reading: “I need a haircut.” These people are focused on themselves, focused on something they have lost. I wonder how their view would change if they were focused instead on saving the lives of others.

Many people making decisions during COVID-19 are facing more complex decisions than staying home or going out for a haircut. There are conflicts about money, about the need to pay bills, and the risks of losing one’s income. These concerns are sometimes juxtaposed against the risks of catching and spreading COVID-19. We worry about saving lives and our own economic situation. These are not easy decisions. How much should we stay home, when is it safe to go out, should we wear masks?

In making decisions, framing matters. Two people can consider the exact same situation and know the exact same facts. But they may be framing the problem and outcomes differently. We will be more likely to choose risky options if focused on ourselves, on losing money, and on people dying. The deaths will also matter less as they accumulate. But we can present the same situation by focusing on helping others and on saving lives. We are more likely to emphasize safety when focused on saving people.