Jordan: I’ll start today’s episode by being honest. I get anxious sometimes about my health and about the health of my loved ones. I worry about people getting sick. A lot of us do that and a lot of us don’t often talk about it. Then a scary virus takes the world by storm kind of all of a sudden, almost everyone is at least a little worried. It might not be enough to make us panic, but it is a constant low level hum of bad news rattling around in our heads. And the people who worry anyway, well as you know, if you’re one of them, or as you might imagine, if you’re not, it can be a lot tougher on them. CoVid-19 may be a respiratory disease, but before it even gains a foothold in Canada, it’s messing with some of our minds. And I’ll be honest with you again, I think the best way to fight that is with knowledge. Not knowledge of who has the disease and where they are and how many more cases today, but with some information about what all those headlines and numbers are doing inside our heads. So what is the psychology of a pandemic? What happens in our brains when we absorb all of this? And how can we prepare ourselves to keep calm when it seems like much of the world is close to panicking? I’m Jordan Heath Rawlings. This is The Big Story. Dr. Steven Taylor is a professor of clinical psychology at UBC. He is also the author of a book, The Psychology of a Pandemic. Thanks for joining us, Dr. Taylor.
Dr. Steven: You’re welcome.
Jordan: Can you first just, uh, start by answering the question that I think, uh, I’ve been worried about a lot lately, which is how well is my brain working in the middle of all of this news about CoVid-19, and how outbreaks are inevitable? Cause I feel off-kilter.
Dr. Steven: It’s interesting. It’s a rapidly evolving situation with a lot of uncertainties and we have vivid media depictions, just recently, of stores depleted of groceries and so forth. And we need to ask ourselves, how accurate is that depiction of the reality of the situation? So how well is your brain working? Well, it’s difficult to say because we have a whole lot of information being delivered to us, but yet on the other hand, a great deal of uncertainty about what the situation is and how best to respond.
Jordan: What happens on a macro level within a community when a fears like this start spreading?
Dr. Steven: If you’re on the Titanic and everyone starts running to the lifeboats, you’re probably not going to think too much about it. You’re just going to start running as well. And that’s the sort of situation here where people have started panic buying and other people have heard about this, and without giving it too much thought and started to copy that same behaviour. So on a macro level, that’s what has been happening. Um, and so I think what’s important is for people to consider the impact of their own behaviour on other people. Fear is contagious. If people see you acting in a frightened way, they might become frightened as well.
Jordan: What am I missing there? When something like that happens and I see, you know, people running to the store or I see images of people buying bottles and bottles of water, and then I do it too, what process am I just somehow not getting?
Dr. Steven: It’s the classic marketing strategy where you create a sense of scarcity and urgency, and that’s been used in marketing to sell us goods, but it’s also happening here naturally with this panic-buying. So that’s what’s happening. The people are getting the idea that food stuff, toiletries, medicines are scarce and they need to get out urgently. And then the situation becomes snowballed by vivid images on social media and other media of depleted shelves, which amplifies the sense of scarcity. And then people hear news reports of price gouging, or there’ve been rare, uh, reports of looting of things like, of all things toilet paper. And that further amplifies the sense of scarcity and urgency and all of those things can amplify purchasing related anxiety.
Jordan: So tell me about some of the mistakes that we do know about and that we’ve worked to correct. And maybe just start even with the name of this virus. Why did we settle on CoVid-19?
Dr. Steven: We learned the mistakes of the past. Previous pandemics had been called things like Russian Flu or Hong Kong Flu or Swine Flu, Avian Flu. You need to be really careful about naming diseases after people, places or things because of the fallout it can have. In the case of naming outbreaks after regions, it can create problems with discrimination. You name an outbreak after animals, that can lead to the needless killing of, of livestock and so forth. So you need a name that on the one hand, conveys the urgency, if you call this thing, CoVid-19, if you called it “a little bit like a really bad flu,” that is not going to convey the level of urgency. So the public needs to know that this is something to be taken seriously, but it can’t have any of the fear-mongering that leads to discrimination or harm of animals. So that was the thinking. And I think the label CoVid-19 I think it was a good decision.
Jordan: Is there a similar line of thinking behind whether or not to use the term pandemic? Because that’s been hotly debated recently.
Dr. Steven: I believe so, yes. Pandemic the word pandemic, casts up scary images of the Spanish flu with, uh, hearses hauling off bodies with hospitals stacked with sick people. So I’m assuming the WHO are being very careful about whether or when to use the word pandemic. The problem there is there’s no firm definition of a pandemic, it’s a little fuzzy and vague, and health authorities like the WHO, they need to have the trust of the public. Because if the public staff do not trust the health authorities, they’re not going to follow the guidelines. And so people like the WHO, they walk a fine line between understating a problem versus overstating it. It’s very difficult. And for some people, I think it might seem that the WHO is dragging their feet with regard to whether or not to announce this as a pandemic. So it’s a, it’s a tricky situation, but many people are saying that for all intents and purposes, this is a pandemic right now.
Jordan: Well, one of the reasons we wanted to talk to you about the psychology behind this is, as I kind of mentioned off the top, I’m one of those people that it doesn’t take much to get me worried about my health and the health of those around me. So when something like this happens, obviously my brain goes into overdrive and one of the things you discuss is the, the term “worried-well,” which I’m interested in.
Dr. Steven: Right. That, interestingly, I heard today that in some cities are having news announcements on the radio that if you’re feeling sick, do not go to the hospital. Do not go to the ER unless you have severe symptoms. And this was a problem in the 2009 H1N1 flu pandemic where there were reports of hospital ERs being overwhelmed with “worried-well” patients thinking they had pandemic flu when in fact they had minor coughs or sniffles. And there’s a concern that this will happen this time around with CoVid-19. So someone has a cough or a fever, a parent who has a child who has a cough or a fever, they might misinterpret that thinking that there’s an infection with CoVid-19, and take themselves or their child to the ER. And it’s, everyone did that for every mild ailment, it would overwhelm the healthcare system. So that’s a big concern. Now that’s not to trivialize anxiety about one’s health. That’s an important issue. Um, but it’s important that people get educated about the tendency to misinterpret bodily signs or sensations. And this is going to happen with CoVid-19, people will be misinterpreting coughs or fevers is signs of possible infection. So they need to be mindful of that.
Jordan: What is it about a virus like this that makes us do that? Because again, you know, uh, I get sniffles and colds and people around me get them all winter and they could easily be misinterpreted as signs of the flu or whatever, but it doesn’t bother me to the same extent. And I think a lot of people feel that way.
Dr. Steven: So what it is here is it’s unknown. There’s no vaccine. It’s not even– there are a lot of uncertainties. It’s not know how far it’ll spread. There have been many, many infections and many deaths. And the other thing is the sheer exposure to news that people have received about this. So if I develop a fever, because I’ve heard so much about CoVid-19, the first thing that’s going to pop into my mind is, Oh, what if I’m infected with the Coronavirus? It’s partly, it’s called the availability heuristic. It’s partly due to the amount of exposure you’ve had to something.
Jordan: Right. What about the other end of the spectrum? People who, cause we all know, some of them who are just convinced that they won’t get it, right? Or if they do, they’ll be fine.
Dr. Steven: They are equally worrying for different reasons. The people who think that what happened to them, or if it does, they’ll be fine, they’re the people who won’t wash their hands, who won’t self-isolate if they’re infected. They’re actually the people who will spread infection to other people. And there’s been research from previous outbreaks showing that indeed that does happen. And unfortunately, these individuals don’t understand that although they might not be worried about infection, they could be giving infection to people who could become seriously ill as a result.
Jordan: How do you find the proper level of, well, maybe not the proper level of anxiety, but the proper level of care to sort of walk that line between, uh, overreacting to symptoms, but also being aware that you could be infecting others?
Dr. Steven: It’s a complex issue. It depends in part on your situation, your own health status, um, the health status of loved ones. If you’re elderly or medically frail, then it would be reasonable to be worried about getting infected. So it depends on that background situation. But you also need to ask yourself, well, am I following what the healthcare authorities are recommending, or am I going overboard? Or am I over responding? Or am I under responding? And people need to ask themselves, well, how is that affecting your life? Are family members commenting that you seem excessively anxious or irritable about the outbreak, and that would suggest an excessive amount of anxiety, for example.
Jordan: How much of these thoughts, uh, and this worry can or maybe can’t, uh, be mitigated by the way governments and public health officials choose to communicate around this?
Dr. Steven: It’s a really tricky situation because we live in an era where there’s two way communication. It’s not just governments delivering messages to us, but it’s us feeding back messages through social media to other people in our community. So the challenge the governments face is one of understating versus overstating. Each one is associated with problems. So it’s very difficult, particularly when there’s a lot of uncertainty about things. So warning people, encouraging people to engage in protective measures, without leading them to become overly anxious. That’s great if you can do that. But on the other hand, governments need to be seen as transparent. They need to acknowledge uncertainties. And then indeed, there are many uncertainties around CoVid-19, so it may be the case that we, the people need to learn to accept that there are uncertainties in their lives. And also learn to recognize that when there are important uncertainties in people’s lives, rumours will flourish. And the health authorities have done well to address the major rumours, but the general community need to be mindful that they will be rumours circulating about CoVid-19 and we need to take them with a grain of salt.
Jordan: You know, I wanted to ask you a little bit about things that ordinary people can do to kind of work with their worry about this. And I know a little bit about cognitive behavioural therapy and things around that and sort of examining the thoughts that your instinctual impulses come from, and I wonder how much of that applies here? Is there ways that people who are concerned about that can work with themselves?
Dr. Steven: Well, there are workbooks in fact around managing health anxiety that you can find. In fact, we wrote one some years ago. But more specifically for CoVid-19 it’s important to try and and understand your own thoughts and reactions. Are you just automatically going along with what what everyone else is saying? Or are you stopping to think, what are the realistic risks? What realistically do I need to do in terms of stockpiling? What degree of risk am I able to tolerate in my life? And getting on that issue involves something called the intolerance of uncertainty, and people who have a particular difficulty tolerating uncertainties, they are likely to worry excessively. They are likely to go into panic buying and buy face mask and so forth. In that case, it can be helpful for people to remind themselves that every single day of their lives they deal with things that are far more dangerous at this point than CoVid-19. Crossing the street or driving in your car is probably the most dangerous thing people do, and people accept that. So the point here is people need to accept that life is full of uncertainties and people do tolerate many uncertainties in their lives and that people will tolerate and learn to cope with the current outbreak.
Jordan: How much of this is exacerbated by the way social media seems to reward the worst news? Cause I know I’ve been seeing– the majority of the coverage that I’ve been seeing of this virus comes from the hardest hit places and the places where hospital beds are stacked up by the dozens, etc.
Dr. Steven: Right? That’s going to skew people’s perception of reality. If all we see are all these dramatic images of sick people, scarcities and so forth, that is going to distort the way we see our own environment, in which say, in Vancouver or Canada right now, the risk is extremely low, but if all we see are these dramatic images, that’s gonna distort our perception and lead people to overestimate the degree of threat.
Jordan: Is it perhaps worth, for people who might be battling, uh, with this kind of anxiety to take a social media break and sort of rely more on the official news coming from the government or the, the mainstream outlets?
Dr. Steven: Yes, if it’s getting too much or if your anxiety is being ramped up, often people who are anxious about their health will engage in checking behaviour. They will check the media or check social media with an attempt to reassure themselves, or to find ways of keeping themselves safe, but that backfires and they end up feeling more anxious. So in those cases, it would be a good idea to give yourself a break from health-related social media and to look more to what health authorities like the WHO or Health Canada are recommending. And you can go to their website, say WHO, for example, has press briefings every day or two in which they provide authoritative information.
Jordan: If there was one thing that you could maybe have governments or health authorities take into account in their communications, uh, that you’re not seeing enough of right now, is there anything?
Dr. Steven: There is, but it’s a timing issue. When a vaccine is developed for CoVid-19 there’s the big concern that many people, and perhaps most people will not get vaccinated, and this has happened in previous pandemics, the 2009 pandemic in Canada and elsewhere, fewer than half of the population decided to get vaccinated. Yeah, it was worse than other countries, and clearly you can’t contain an outbreak if people aren’t going to adhere to vaccination. And this is something that’s been called, it’s a bit of a euphemistic term, it’s called vaccination hesitancy. And in 2019 the WHO declared that of the top 10 health threats, vaccination hesitancy was one of them. So this is going to be a big, big problem that’s going to come up maybe later this year. And so governments, I would recommend that they get onto this problem early, and start talking, having a discussion in public forum about a vaccine, theCoVid-19, and the importance, and start addressing or discussing the issues of vaccination hesitancy. And often people decline to get vaccinated because they don’t have correct information or they’ve heard about the debunked link between vaccines and autism, for example. Yeah. So I think we need to be proactive and address that problem earlier rather than wait till we have a vaccine and have the problem with vaccination hesitancy.
Jordan: And finally, I guess for somebody who’s been listening to this podcast and, uh, is now about to go on with the rest of their day, but is worried about the stuff in the, and the mounting, uh, uncertainty of when it’s coming in Canada, what’s one thing that they should be doing or thinking about as they go forward?
Dr. Steven: Um, as they go forward, well, I guess carrying on as usual, as best as you can, as usual. Think about this information as something you can dose. You don’t want a too big a dose of scary information about CoVid-19, although you want to stay informed. So it’s dosing that, but doing your best to carry on with your life and keep your routine, uh, the same as you would normally do, including doing whatever stress management activities that you would usually do.
Jordan: Thanks for joining us today, Dr. Taylor. That was very helpful.
Dr. Steven: Thank you very much. You’re very welcome.
Jordan: Dr. Steven Taylor, author and professor of clinical psychology at UBC. That was The Big Story. If you’d like more from us, including lots of episodes that won’t induce panic, you can head to thebigstorypodcast.ca. You can also talk to us on Twitter if you are not taking a break from bad news on social media at @thebigstoryFPN. You can find us in your podcast feed on your favourite player, Apple or Google or Stitcher or Spotify. Pick your favourite. Leave us a rating. Leave us a review. Thanks for listening. I’m Jordan Heath Rawlings. Wash your hands and we’ll talk tomorrow.
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