What Can We Learn From The Covid-19 Pandemic?

It's week six (or seven?!) of the covid-19 pandemic lockdown here in the UK and as the rate of infections and daily deaths begin a slow, gradual decline, much of the commentary and coverage has turned to the next steps. 

There's no doubt that the pandemic has fuelled anxiety levels and worry. People are worried about money, jobs, health, education and a whole load more. Everyone has been affected in many ways. Survey data from the Office of National Statistics (ONS) has suggested that over 80% of people in the UK are worried about the effect that covid-19 is having on their life and around half of adults reported high levels of anxiety. 

I've written recently about some ways to manage anxiety and mental health during the pandemic and one of the things I suggested is supported by the survey findings showing that staying in touch with friends and family remotely was the most common action helping people to cope with staying at home.

I've also written recently about our future predictions are often wrong and how that relates to coping after lockdown. You have more resilience than you may give yourself credit for.

And in this article I cover three things that the research and evidence is telling us and that we can all learn and do and consider as we move through and beyond the pandemic. 

Many people have kindly asked how I'm doing under lockdown (thanks for caring!). Like most of us the start of lockdown was a bumpy affair of adaptation and uncertainty. Since then I've been continuing to study, work with clients remotely, get some outstanding jobs done (like my tax return and the gardening) whilst learning guitar and pushing the kids outside for some exercise each day. I'm definitely not being as productive as usual, but I think in this climate you've got to take the small wins and roll with them as a positive. 

And as much as I miss working with clients face to face, in the meantime, these two certainly keep me busy! This was taken during one of their daily PE lessons (I'd have made a mean PE teacher!):

covid19 anxiety hypnotherapy ely 

Echoes Of The 1918 Pandemic 

Many people have referred to the Spanish Flu pandemic of 1918 when discussing the current covid-19 pandemic.  The Spanish Flu pandemic, the deadliest in history, swept around the globe and is thought to have infected about a third of the entire population of the world. 

Johnson & Mueller (Updating the accounts: global mortality of the 1918-1920" Spanish" influenza pandemic, 2002), estimate that the 1918 Spanish Flu pandemic killed around fifty million people worldwide, although this may be much lower than the true figure due to the level of recording and information available from that time.

"Global mortality from the influenza pandemic appears to have been of the order of 50 million. However, even this vast figure may be substantially lower than the real toll, perhaps as much as 100 percent understated. There are vast areas of the world for which we have no or little information, and often what information we do have is of dubious quality and contradictory...The lack of precision notwithstanding, the scale of mortality undoubtedly makes it one of the largest outbreaks of disease in recorded history, particularly as these deaths occurred in a very short time, from early 1918 through to, in some cases, 1920" (Johnson & Mueller)

In 1918, Science magazine published a paper on lessons from the Spanish Flu pandemic (Soper, 1919. The lessons of the pandemic). A number of the factors discussed in that paper have strong echoes with the covid-19 issues of today. Soper talks about the barriers to prevention of the spread being, firstly, public indifference because people do not appreciate the risks they run (more on this below), secondly, that it goes against human nature to isolate yourself to protect others and, thridly, people may pass on the disease before they are symptomatic and so people can unconsciously act as a continuing danger to themselves and others.  

All of which sound pretty similar to many of the things being discussed, debated and argued over since the Covid-19 pandemic hit these shores.

Many people through the covid-19 pandemic have considered themselves 'immune' from the health impacts, perhaps because they are young or have no underlying health issues or have no symptoms. And many hundreds of people have been reported to and sometimes fined by the police for breaking the lockdown rules. 

Interestingly many of the preventative actions cited in 1918 are those that are still applicable today such as avoiding needless crowds, covering your coughs and sneezes, and hand washing before eating (although Soper does also advise avoiding tight clothing!).

Whilst more than one hundred years later we have access to more knowledge, science and technology in the battle against disease, it does seem that one of the main learnings (or reminders) of this pandemic is that many of the basics of self-protection and protecting others continue to be applicable today. 

The Ongoing Allure of Conspiracy Theories

In the same way they exist for the moon landing, the death of Princess Diana, the assassination of JFK, alien landings, global warming and many other areas of international interest and focus, throughout the covid-19 pandemic, conspiracy theories have continued to appear. Many of the ones I've seen have involved China deliberately creating and releasing the virus, Governments covering up true figures of deaths (or conversely inflating them) or the blame upon 5G waves and the destruction of masts. I'm sure there are many others circulating out there too.

Conspiracy theories involve explaining important events through the involvement of secret plots and malevolent groups. 

Douglas et al (The psychology of conspiracy theories, 2017), describe how the, "research suggests that people may be drawn to conspiracy theories when—compared with nonconspiracy explanations—they promise to satisfy important social psychological motives that can be characterized as epistemic (e.g., the desire for understanding, accuracy, and subjective certainty), existential (e.g., the desire for control and security), and social (e.g., the desire to maintain a positive image of the self or group)."

They can help people to cope and find understanding when information is unavailable or to finding meaning in uncertainty or when events seem random and they foster someone's own self image.. And of course, these type of thinking becomes almost self supporting in that if others don't agree with it then that suggests they may be part of the conspiracy. And of course, by their very nature of secrecy and things being hidden they become almost impossible to logically challenge. Belief in conspiracy theories tends to be stronger when events are significant and people are dissatisfied with mundane explanations or where people experience distress as a result of feeling uncertain and anxious.

Conspiracy theories seem to fulfil some psychological needs for the person who believes in them. Yet there can be wider impacts of these theories.

Findings by Swami et al (Analytic Thinking, Rejection of Coronavirus (COVID-19) Conspiracy Theories, and Compliance with Mandated Social-Distancing: Direct and Indirect Relationships in a Nationally Representative Sample of Adults in the United Kingdom, 2020) suggest that people who believe in conspiracy theories about covid-19 may be less likely to comply with social distancing measures.

They found that, in a nationally representative sample of adults in the United Kingdom, anlytical thinking was diretly associated with compliance with social distancing requirements and that the rejection of Covid-19 conspiracy theories led to greater compliance. "The present results suggest that individual differences in the disposition to think analytically may help shape compliance with mandates to stop the spread of COVID-19 both directly and via rejection of conspiracy theories."

So it's not just about whether someone believes in a conspiracy or not, their belief can have impacts on a much wider scale if they ignore disease preventative measures.

So how do you protect yourself from adopting conspiracy theories or falling prey to fake news?

The answer lies in deliberate critical, logical and fact based analytical thinking ,for example by replying on trusted sources of information, seeking out the evidence and facts through investigating the research and adopting a healthy scepticism so you are not just replying on social media or unsubstantiated claims.

"Analytic thinking prompts careful and deliberate processing of information (Chaiken et al., 1989), which increases attention to the logical fallacies and factual inaccuracies inherent in most conspiracy theories. That is, analytic processing of information may inhibit intuitions and biases that support the assimilation and acceptance of conspiracy theories" (Swami et al, Analytic thinking reduces belief in conspiracy theories, 2014).

And if you want some help in understanding medical research to help you think logically and analytically about the claims and theories out there then do take a look at this free course on the Coursera website:  Understanding Medical Research: Your Facebook Friend is Wrong

 What Can We Learn From The COVID 19 Pandemic

So the next thing I think we can learn from the covid-19 pandemic is that, when it comes to understanding, facts are king and we need to be alert to any tendency to accept beliefs that have no substance. 

Belief in conspiracy theories is one reason people may not have complied with social distancing, another is something called the 'optimism bias.

Why Some People Break The Rules

One thing that has been highlighted time and time again is just how many people have ignored or broken the lockdown guidance. Recently I saw figures suggesting the police have imposed over nine thousand fines for breaches in the UK and many hundreds of people have reported others who have broken the rules. 

There may be many reasons why someone ignores the rules that are in place to protect us all. There may be financial reasons and a need to earn money to pay the bills. Some people will rebel against rules imposed upon them out of principal (just look at some state protests in America for evidence of that). And for others it may be that a certain psychological principle is at play.

The fact is that our brains and our perceptions and thinking are often wrong, or at least skewed. I've written about this before with regards to happiness and how we think and predict that more money and stuff will bring us happiness, only to find we adapt and get used to it and then we want something more (hedonistic adaptation). We also think that spending money on ourselves will make us happier, only to find that being kind and spending ot on others has that effect. I've written about how we predict that we will feel worse that we actually turn out to with regards to a relationship break up, not getting the job you want and even getting a positive Aids test result.

I've also written a lot about the spotlight effect and how we over estimate how much attention other people give to what we say and do and how we look, as well as the transparency illusion that leads us to predict hat people can tell how we feel much more readily that is the case. And certainly with anxiety itself, our brains are often wrong and forecasts all kinds of worst case scenarios that either don'tt happen or that you can cope with much better than you imagined you would.

Our brains just aren't that good at anticipating and predicting the future, despite the importance of planning and thinkng ahead in our lives.

"Given the importance of these future projections, one might expect the brain to possess accurate, unbiased foresight. Humans, however, exhibit a pervasive and surprising bias: when it comes to predicting what will happen to us tomorrow, next week, or fifty years from now, we overestimate the likelihood of positive events, and underestimate the likelihood of negative events" (Sharot,  2011. The optimism bias). 

This phenomenon is known as the 'optimism bias' and has been found to be a consistent, prevalent and robust bias in our thinking. It means that in general you under-predict your chances of being involved in a car accident or suffering from cancer and you will likely overestimate how long you will live and how successful you will be. It all comes down to what you predict will happen and then what the outcome turns out to be in reality.

It's estimated that about 80% of people display this optimism bias whereby they expect things (e.g. expecting a holiday to be better that it turn out to be or underestimating how long a task will take to do) although people with depression do not exhibit this bias (and may tend towards a pessimistic bias).

Now, personally, I find it fascinating how our brains can overestimate and mis-predict in so many ways that we are so often blind towards. Yet, what does the optimism bias have to do with covid-19?

Relatively early in the pandemic (mid March 2020), Kuper-Smith et al (Optimistic beliefs about the personal impact of COVID-19, 2020) tested individuals’ beliefs about infection probabilities and abilities to practice social distancing in UK, USA and Germany.

Now whilst it may, or may not, have evolved over recent weeks, they found that at the early stage of the pandemic and lockdown that "individuals show an optimism bias: they estimate the probability of getting infected with the virus, and of infecting others if infected themselves as lower for themselves than for someone similar to them."

People considered that they were less likely to contract the disease or, if infected to spread it to others, than someone similar to them. As Kuper-Smith et al point out, this may be because they believed they could easily reduce social interactions and follow hygiene best practices but, it could also mean that "optimistic people will be more likely to spread COVID-19, simply because they naïvely think they’re less likely to contract and transmit it compared to others."

And that sort of optimistic thinking could easily lead to people breaking the lockdown rules and, potentially, adding to the spread of the coronavirus. Further support from this comes from research involving Americans in the early stages of the pandemic.

Wise et al (Changes in risk perception and protective behavior during the first week of the COVID-19 pandemic in the United States, 2020) investigated the risk perception and engagement in preventative measures in 1591 United States based individuals over the first week of the pandemic.

They found that over five days, people demonstrated growing awareness of the risk posed by the virus and largely reported engaging in protective beahviours. "However, they underestimated their personal risk of infection relative to the average person in the country. We found that engagement in social distancing and handwashing was most strongly predicted by the perceived likelihood of personally being infected, rather than likelihood of transmission or severity of potential transmitted infections."

Once gain the optimism bias means that people underestimate the likelihood that they will contract covid-19 and that thinking bias can then lead to less compliance with preventative measures such as social distancing.

"Our analyses indicate that although most individuals are aware of the risk caused by the pandemic to some extent, they typically underestimate their personal risk relative to that of others, an example of optimism bias. In turn, higher perceived personal risk predicts engagement in protective behaviors such as hand washing and social distancing."

All of which suggests that one reason that people do not follow the lockdown rules is because they underestimate the likelihood they will get covid-19 or that they will pass it on. Their thinking is affected by the optimism bias. Some might argue that the UK press has been fuelling fear in their coverage of the pandemic, although on the flip side that fear may be the thing that drives people to consider their personal risk and to therefore comply with the social restrictions. The issue will be when the lockdown unwinds because that fear, which may have been useful for compliance, may stop people getting back to work and school even if those things are suggested to be safe.

Which brings us to an additional learning form the pandemic, and that is that people don't necessarily blatantly disregard the imposed limitations on life (although some will) do), their thinking bias may be at play. And that means we should all pay attention to our predictions and better understand how our thinking can be erroneous so that we can better plan and make better decisions to protect ourselves and others.

I'll be back with more mental health and psychology articles very soon and in the meantime please do heed the lessons of 1918 and wash your hands regularly, check up on the facts when faced with fake news and conspiracy theories, and be certain to remind yourself that sometimes your thinking may be biased and you may underestimate your chances of getting or passing on disease (so be sure to maintain sociai distancing and again, wash your hands!)

Stay healthy and safe,

Dan Regan

Hypnotherapy in Ely & Newmarket 

 

References:

Douglas, K.M., Sutton, R.M. and Cichocka, A., 2017. The psychology of conspiracy theories. Current directions in psychological science, 26(6), pp.538-542.

The History Channel: https://www.history.co.uk/

Johnson, N.P. and Mueller, J., 2002. Updating the accounts: global mortality of the 1918-1920" Spanish" influenza pandemic. Bulletin of the History of Medicine, pp.105-115.

Kuper-Smith, B.J., Doppelhofer, L.M., Oganian, Y., Rosenblau, G. and Korn, C., 2020. Optimistic beliefs about the personal impact of COVID-19.

Office For National Statistics, Opinions and Lifestyle Survey. https://www.ons.gov.uk/

Sharot, T., 2011. The optimism bias. Current biology, 21(23), pp.R941-R945.

Soper, G.A., 1919. The lessons of the pandemic. Science, 49(1274), pp.501-506.

Swami, V., Voracek, M., Stieger, S., Tran, U.S. and Furnham, A., 2014. Analytic thinking reduces belief in conspiracy theories. Cognition, 133(3), pp.572-585.

Swami, V. and Barron, D., 2020. Analytic Thinking, Rejection of Coronavirus (COVID-19) Conspiracy Theories, and Compliance with Mandated Social-Distancing: Direct and Indirect Relationships in a Nationally Representative Sample of Adults in the United Kingdom.

Van Bavel, J.J., Boggio, P., Capraro, V., Cichocka, A., Cikara, M., Crockett, M., Crum, A., Douglas, K., Druckman, J., Drury, J. and Ellemers, N., 2020. Using social and behavioural science to support COVID-19 pandemic response.

Wise, T., Zbozinek, T.D., Michelini, G. and Hagan, C.C., 2020. Changes in risk perception and protective behavior during the first week of the COVID-19 pandemic in the United States.