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COVID-19 Crisis: The Psychology of Defiance

Cedars-Sinai Mental Health Expert Explains Why We Find COVID-19 Guidelines So Hard to Follow and Why Young People Are Especially Prone to Pandemic Fatigue

Wear a mask. Wash your hands frequently. Don't get together with people outside your own household. After more than 10 months of the COVID-19 pandemic, these messages are starting to sound like background noise.

"People definitely have pandemic fatigue," said Olusinmi Bamgbose, MD, a mental health expert and a psychiatrist on the Cedars-Sinai Reproductive Psychology team. "I think people miss their families and miss doing what they want to do. I think they want their life to feel normal again, so they're looking for ways to go and do that."

Unfortunately, the data support that theory. In the last few weeks, hospitals in Los Angeles County and across the state have seen an unprecedented increase in COVID-19 cases, likely the result of Thanksgiving get-togethers, despite healthcare leaders' pleas to avoid gatherings, especially indoors.

In response, state and local authorities are cracking down, and that causes the general public to become even more frustrated.

"It can be hard for people to understand the medical decision-making that goes into these guidelines," Bamgbose said. "It's hard to reconcile the current restrictions­–for example, the fact that outdoor dining at restaurants is now prohibited–with those we had in the not-so-distant past, just a week or two ago."

While the changes in guidelines are based on the most up-to-date public health information, like prevalence rates of the virus in the community, Bamgbose said it can lead to people becoming confused as to which guidelines to follow.

And Bamgbose said there's another culprit: confirmation bias.

"People tend to give more weight to their own experiences than they do to the experiences of others," she said, which means that someone who engages in risky behavior, like attending a party, and doesn't get sick, is likely to do that same behavior again.

"It also means that if you have, for example, a friend who gets a mild case of COVID-19, you're more likely to think along the lines of, 'My friend had COVID-19 and she's fine. I'm going to be fine, too,'" Bamgbose said.

Peer pressure plays a role, too.

"You might be faced with people around you who are pressuring you to push your boundaries, like a mother who wants you to come over for a holiday dinner where several people are coming over and getting together inside," Bamgbose said. "It can be very difficult to stick to your guns and say, 'I don't feel comfortable doing that.'"

If confirmation bias and pressure from friends and family are leading people to make risky decisions, and those risky decisions are leading to an increase in COVID-19 cases, is there a way to "hack" our own brains and break the cycle?

"One of the best things you can do is sit down and do a personal risk assessment and a personal inventory of what you feel comfortable with and what your boundaries are," Bamgbose said. "Remind yourself of the reasons why you should be following the public health guidelines."

Those reasons, she said, could range from the very personal, like, "I don't want to get sick," and, "I don't want to get my partner or child sick," to more distant, like, "I don't want to sicken someone else's grandmother, who I may not even know."

"Try to remember why we're doing this," Bamgbose said. "Even if you don't get sick, if the hospitals are overloaded, think about the health system as a whole, and the consequences if the virus is spread."

While it helps to itemize reasons for staying safe, another factor may be subconsciously sabotaging our decision-making: age.

"Younger people are inherently more reckless," Bamgbose said. "Their frontal lobe, which controls judgment, doesn't develop fully until about the age of 25, so even without COVID-19, they tend to engage in riskier behaviors and are therefore at a higher risk of death from accidents, for example."

With younger people generally at a lower risk of severe disease or death from COVID-19, Bamgbose said it can be hard to convince them not to gather in large groups.

"They feel kind of invincible," she said. "That's not unique to COVID-19, it's just kind of a young person's mindset."

Bamgbose said striking a balance between mental health and physical health all comes back to one question: "Who am I protecting?"

"Is that your mother? Is it your grandmother? Go back to your personal reasons for staying safe, and try to connect with a community of like-minded people to keep yourself in a good-behavior echo chamber," she said.

Bamgbose, like other health professionals, recommends finding ways to safely connect with loved ones until the pandemic is over. That means connecting primarily over video chat or phone call.

If you do visit, like to drop off food for a loved one, "make sure you are chatting from across the yard, at a safe physical distance, and with masks on," Bamgbose said. "When you see a loved one, even from a distance, it can be easy to let your guard down. So set a time limit and stick to it."

"I recognize that sometimes, we do need to make a connection," she said. "It's about making sure we're able to feel that in the safest way possible."

Read more on the Cedars-Sinai Blog: Stop the Spread of COVID-19: Stay Home This New Year's