As a third surge of COVID-19 cases lurches through the United States, public-health experts warn that the pandemic is only likely to worsen as chilly weather sends people indoors and so-called pandemic fatigue wears on them.
Dire signs are already showing: The U.S. total case count topped 11 million on Sunday, adding 1 million new cases over the previous six days alone. The country averaged 150,265 cases per day over the last week, according to a New York Times tracker, an 81% jump from the average two weeks prior. Hospitalizations are climbing, with some states readying for bed or staff shortages.
“It’s really hard for me to be optimistic about the next three months,” Emily Landon, the executive medical director of infection prevention and control at University of Chicago Medicine, told MarketWatch. “It looks awful. The numbers are terrible.”
With that said, “we don’t have to give up. We can totally do this,” Landon said in the same interview. While most health professionals agree this winter is likely to be difficult for everyone — particularly those who are living alone, struggling financially, or experiencing poor mental or physical health — they also see reasons for hope, and acknowledge that the COVID-19 crisis will not last forever.
Here is your guide to maintaining your health, making smart choices and managing your vaccine expectations this season:
Understand ‘COVID fatigue‘
COVID-19 fatigue is “like being in a prolonged state of fight or flight,” said Alison Buttenheim, a behavioral epidemiologist at the University of Pennsylvania. “This can cause a stress-like reaction, which eventually leads to behavioral fatigue,” explains a post on Dear Pandemic, a science-communication project that Buttenheim co-founded.
While many people were afraid of the novel virus and complied with public-health recommendations early on, their acclimation to all the restrictions has gradually made the virus feel less threatening, and people have grown tired of not being able to partake in normal activities, the post says. “Abiding by COVID-19 prevention strategies has become more and more difficult.”
‘If you’re going to take a risk about COVID, then decide that’s worth it to you and to everyone else. But don’t do it because you’re fatigued and you just don’t care.’
If you find yourself making arguments that sound like, “Well, we can’t eliminate the risk, so there’s no use in trying,” acknowledge that your decision making may be influenced by pandemic fatigue, Landon said. Take a moment to accept “that what you’re being asked to do is really hard, that it’s not fair — but that that doesn’t mean that you don’t have to do it,” she said.
Then decide how much you actually want COVID-19 fatigue to play a role in your life, Landon said. Maybe you do want to take calculated risks to go to the gym or out to dinner one night — just think it through first.
“Don’t let COVID fatigue trick you into taking risks you don’t want to take,” Landon said. “If you’re going to take a risk about COVID, then decide that’s worth it to you and to everyone else. But don’t do it because you’re fatigued and you just don’t care.”
Take charge of your mental and physical health
Get your flu shot. Practice basic self-care such as getting enough sleep and eating healthy food. Get some kind of exercise, “even if it’s just walking around your apartment,” Landon said. Even if it’s cold, wear appropriate clothing and go outside every day if you can, she added: There is no shortage of research extolling the benefits of outdoor time.
If you struggle with dim winter days, consider a light-therapy device, Landon suggested. “It really does make you feel brighter and better in the darker days of winter.”
Plan a little “me” time, added Georges Benjamin, the executive director of the American Public Health Association. Turn off the TV and try giving yourself some quiet time to think. “Nobody’s so busy they can’t carve out a few minutes for themselves, whether it’s their morning meditation or before you go to bed,” he said.
Take advantage of tools like FaceTime and Zoom, particularly on occasions like Thanksgiving, winter holidays, New Year’s Eve, birthdays and anniversaries, when people might be feeling sad.
Tap into online support groups, added Rossi Hassad, an epidemiologist and psychology professor at Mercy College in New York. And if you’re really struggling with your mental health, reach out to your city or state mental-health hotline and consider virtual therapy, Landon said. The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Disaster Distress Helpline also offers crisis counseling for people affected by the pandemic.
“Make use of the resources that are available to you — they are out there and they are good,” Landon said. “This is not something that you need to grit your teeth and bear.”
Now is not the time to use alcohol, tobacco, marijuana or other substances as coping mechanisms, Benjamin added.
Stay connected to friends, family and neighbors
Connect with friends and family in a safe way, Hassad said, as “social support is critical at this time.” Know a neighbor, friend or family member who lives alone? Reach out to them and stay engaged, Benjamin said. Call someone you haven’t spoken to in a while, like your college roommate or bridesmaid. Wave to your neighbors from the porch. Check in on coworkers who are single and might feel lonely.
“We do want people to physically separate, but that doesn’t mean social isolation,” Benjamin said. “Loneliness and depression and sadness [are] a real problem in normal times, and we should all recognize that every one of us are stressed.”
Take advantage of tools like FaceTime
particularly on occasions like Thanksgiving, winter holidays, New Year’s Eve, birthdays and anniversaries, when people might be feeling sad, he added.
If you take risks, take appropriate precautions
As winter drags on, it’s possible that you’ll decide to engage in certain behaviors that bring your COVID-19 risk above zero. Benjamin, a fellow of the American College of Physicians, said he was accustomed to people not always taking his medical advice, whether it was because they didn’t want to listen, didn’t trust him or had conflicting family or work obligations. “Life gets in the way of doing some of the advice,” he said.
But you should still take steps to reduce your risk to the extent possible. Wear a mask to protect yourself and others, wash your hands frequently, and maintain physical distance as much as possible, Benjamin said. If you feel sick, stay home.
‘We are susceptible to both optimism bias (“I am less susceptible to bad things than other people”) and halo effects (“I love someone, therefore I also ascribe other positive qualities to them, like they’ve been playing it safe and aren’t likely to have been infected”).’
Be mindful of the limitations of testing without taking other protective measures, especially in the context of a rapidly expanding epidemic, Buttenheim said. Testing too early can produce false negatives.
“You can’t rely on testing the week before or the day before to have a transmission-free holiday gathering,” she said. “There’s a good chance that a lot of people have gotten sick recently enough that the testing they did didn’t catch it, and now they’ve shown up at your house” with an asymptomatic infection.
Be aware of the biases that might be influencing your actions, Buttenheim added. “We are susceptible to both optimism bias (‘I am less susceptible to bad things than other people’) and halo effects (‘I love someone, therefore I also ascribe other positive qualities to them, like they’ve been playing it safe and aren’t likely to have been infected’),” she said.
“So, even if we acknowledge that community transmission is really high and going up, and even if we acknowledge that generally everyone should cancel travel plans and not host large gatherings, we cut ourselves slack and license our own behavior because we’ve convinced ourselves that it’s less risky or we have a special exception,” she added.
Be hopeful for a vaccine, but manage your expectations
The stock market surged last week on the news of a surprisingly effective vaccine candidate from BioNTech
and partner Pfizer
prompted a market rally Monday after announcing its own vaccine candidate had achieved 94.5% efficacy in a late-stage trial. (The companies have yet to publish their findings in peer-reviewed or preprint format.)
By and large, public-health experts have suggested there is reason to be hopeful for an eventual return to some normalcy.
Be clear-eyed about ‘how many doses [will be] available when, for whom, and who’s first in line,’ as well as about ‘how quickly enough people [will] be willing to get it that we can reach coverage rates that are meaningful epidemiologically.’
At the same time, it’s important to consider a vaccine’s potential logistical concerns around ultra-cold storage and distribution across the country, as well as behavioral concerns regarding people actually getting vaccinated, Buttenheim said.
Be clear-eyed about “how many doses [will be] available when, for whom, and who’s first in line,” Buttenheim said, as well as about “how quickly enough people [will] be willing to get it that we can reach coverage rates that are meaningful epidemiologically.”
“Historically, and for vaccine trials in general, we have had disproportionately more failures than successes, even after earlier positive reports,” Hassad added. “While the recent report of a potentially highly effective COVID-19 vaccine is indeed cause for optimism, this should be tempered.” Vaccines for ebola and polio both took decades to develop, he noted, and there are still no vaccines to prevent herpes or HIV.
Frontline workers and high-risk populations are expected to be prioritized in the event a vaccine is rolled out, and many experts say it’s unlikely to be widely available to the general public before spring or summer of 2021. “The pediatric doses are further down the line,” Buttenheim noted. A vaccine will not be a silver bullet, Benjamin added; even after people start getting vaccinated, masking and physical distancing will still be necessary for some time.
Help is on the way, but “we’re not going to get back to anything close to the way we lived a year ago for easily another year and a half — and we should plan for that eventuality,” Benjamin said. “If it turns out things work better, that’s wonderful. But we should plan for a longer slog than we would like to get this done.”
Prepare to hunker down
Stock up on winter supplies like you normally would, Benjamin said, though there’s no need to panic-buy toilet paper. Plan to spend more time than usual at home: Make a list of the books you want to read, the crafts you want to make and the home-improvement or cleaning projects you want to tackle. Embrace a new hobby.
Turn winter into a time of productivity by carving out one or two small, realistic goals for yourself to accomplish every day or week, Benjamin added. “It will give you a sense of accomplishment,” he said.
Stay informed, but avoid information overload
It’s more important than ever to stay informed, Hassad said: Be sure to vet your media sources and make sure you’re getting information from local health authorities, the U.S. Centers for Disease Control and Prevention and other trusted entities. “There’s a lot of misinformation in terms of what’s happening with COVID, vaccines and treatment,” he said.
At the same time, strike a balance between staying informed and overloading yourself with information, he added. Manage and limit your media consumption, perhaps reading the news at specific times of day for a specific duration of time.
Read these encouraging words
“We will get there,” Benjamin said, pointing to the trajectory of the 1918 influenza pandemic, which came in three waves and lasted around two years. “Even though we didn’t have many of the tools we have today, the world was able to handle it,” he said. “It was terrible, but we got through it.”
Buttenheim, meanwhile, pointed out that spring will eventually come. “There’s a lot of good news on the vaccine front. We will have, I hope, a better national response in place soon,” she said. “And we are a crazily innovative and resilient nation.”
“This is part of what it means to be human: to have to sacrifice for each other,” Landon added. “Any time you have to delay gratification, you have to just remind yourself of the goal.”