Contents
- COVID
COVID
Psychological Defense Mechanisms
I have been thinking about the psychology of the COVID response in the context of Elisabeth Kübler-Ross and her stages of grief, but it didn’t seem to fit well. I came across a Tweet thread that provided some good examples of what is going on with people pushing back against being cautious. I’m copying the text of the entire thread here, particularly for those who don’t use Twitter with the permission of the author, Mike Hoerger, PhD MSCR MBA (@michael_hoerger).
As a clinical health psychologist, I notice that many people are using psychological defense mechanisms to downplay the risk of COVID. These are my Top 7 examples:
#1 – Denial – Pretending a problem does not exist to provide artificial relief from anxiety.
- “During COVID” or “During the pandemic” (past tense)
- “The pandemic is over”
- “Covid is mild”
- “It’s gotten milder”
- “Covid is now like a cold or the flu”
- “Masks don’t work anyway”
- “Covid is NOT airborne”
- “Pandemic of the unvaccinated”
- “Schools are safe”
- “Children don’t transmit COVID”
- “Covid is mild in young people”
- “Summer flu”
- “I’m sick but it’s not Covid”
- Taking a rapid test only once
- Using self-reported case estimates (25x underestimate) rather than wastewater-derived case estimation
- Using hospitalization capacity estimates to enact public health precautions (lagging indicator)
- Citing mortality estimates rather than excess mortality estimates.
- Citing excess mortality without adjusting for survivorship bias.
#2 – Projection – When someone takes what they are feeling and attempts to put it on someone else to artificially reduce their own anxiety.
- “Stop living in fear.” (the attacker is living in fear)
- “You can take your mask off.” (they are insecure about being unmasked themselves)
- “When are you going to stop masking?”
- “You can’t live in fear forever.”
#3 – Displacement – When someone takes their pandemic anxiety and redirects their discomfort toward someone or something else.
- Angry, seemingly inexplicable outbursts by co-workers, strangers, or family
- White affluent people caring less about the pandemic after learning that it disproportionately affects lower-socioeconomic status people of color
- Scapegoating based on vaccination status, masking behavior, etc.
- “Pandemic of the unvaccinated”
- Vax and relax
- “How many of them were vaccinated?” (troll comment on Covid deaths or long Covid)
- Redirecting anxiety about mitigating a highly-contagious airborne virus by encouraging people to do simple ineffective mitigation like handwashing
- “You do you” (complainers are the problem, not Covid)
- Telling people to get vaccinated or take other precautions against the flu or RSV but not mentioning Covid
- Parents artificially reducing their own anxiety by placing children in poorly mitigated environments
- Clinicians artificially reducing their own anxiety by placing patients in poorly mitigated environments
- Housework to distract from stress
- Peer pressure not to mask
#4 – Compartmentalization – Holding two conflicting ideas or behaviors, such as caution and incaution, rather than dealing with the anxiety evoked by considering the incautious behaviors more deeply (hypocrisy)
- Hospitals and clinicians claim to value health/safety but then don’t require universal precautions
- Public health officials claim to value evidence but then give non-evidence based advice (handwashing over masking), obscure or use low-value data over high-quality data (self-reported case counts over wastewater), etc.
- Getting a flu vaccine but not a Covid vaccine
- Interviewing long Covid experts who recommend masking in indoor public spaces but then going to Applebee’s
- Masking in one potentially risky setting (grocery store) but not masking in another similar or more-risky setting (classroom)
- Infectious disease conference where people are unmasked
- Long Covid and other patient-advocacy meetings where only half the people mask In-person only
- EDI events
- Not testing because it’s just family
- Mask breaks
#5 – Reaction formation – expressing artificial positive feelings when actually experiencing anxiety
- “It’s good I got my infection out of the way before the holidays”
- “I had Covid but it was mild”
- Anything quoted in Dr. Jonathan Howard’s book, “We Want Them Infected: How the Failed Quest for Herd Immunity Led Doctors to Embrace Anti-Vaccine Movement”
- Herd immunity (infections help)
- Hybrid immunity (infections help)
- “It’s okay because I was recently vaccinated”
- “Omicron is milder”
- “Textbook virus”
- “Building immunity”
#6 – Rationalization – Artificially reducing Covid anxiety through a weak justification.
- “I didn’t mask but I used nasal spray”
- “I don’t need to mask because I was recently vaccinated”
- “It finally got me.”
- “You’re going to get Covid again and again and again over your life.”
- “It’s not Covid because I don’t have a sore throat.”
- “It’s not Covid because I took a rapid test 3 days ago.”
- “It’s not Covid because I’m vaccinated.”
- “Airplanes have excellent ventilation.”
- “I’ve had Covid three times. It’s mild.”
- “Verily was cheaper.”
- “Nobody else is masking.”
- “Nobody else is testing.”
- “My roommates don’t take any precautions, so there’s no point in me either.”
- “I have a large family, so there’s no point in taking precautions.”
- Surgical masks (they are actual “procedure masks,” by the way)
- Various pseudo-scientific treatments used by the left and right
- Handwashing as the primary Covid public health recommendation
- Droplet transmission as a thing
- Public health guidance that begins with “data shows” (sic)
- Risk maps that never turn deep red
- 5 expired rapid tests
- “Masks recommended” instead of universal precautions
- “Seasonal”
#7 – Intellectualization – using extensive cognitive arguments to artificially circumvent Covid anxiety
- Unending threads to justify indoor dining
- Data-rich public health dashboards that use low-quality metrics and/or don’t change public health recommendations as risk increases
- The entire justification for “off-ramps”
- Oster, Wen, Prasad Schools denying air cleaners because it “could make children anxious”
- Schools not rapid testing this surge because it “could make children anxious”
- The mental gymnastics underlying the rationales for who can get vaccinated, how frequently, or with what brand
- Service workers told not to mask because it could make clients uncomfortable
- “What comorbidities did they have?”
- “The vulnerable will fall by the wayside”
- Musicians and others holding large indoor events
- 5-day isolation periods
Here’s a link to the full book, a newer edition than what I own. The information on defense mechanisms begins on textbook page 100. Please let me know if there’s a more accessible alt-text solution that you would prefer so I can do better next time.
Studies
Studies out of Sweden are particularly interesting because of the way that the minimizers tried to push the laissez-faire approach taken by the country. It hasn’t worked out so well. About 1/3 of the 11,935 people who had to take sick leave responded to a survey that was given 18 months after their first day of sick leave. The distribution is telling of the damage that was caused by the disease. “The reported prevalence of problems with daily life activities was 46%; 9.5% reported a small problem, 26% reported some problem and 10.3% reported a big problem.” Maybe letting it rip as suggested by those who signed the Great Barrington Declaration wasn’t such a good idea.
Changes in memory and cognition during the SARS-CoV-2 human challenge study
First, I will state that I do not think that this is an ethical study. Intentionally infecting young adult (18–30-year-old) volunteers is madness. I truly doubt that the volunteers who participated in this study really gave “informed” consent. I don’t think any rational person who is fully informed about this disease would consent to be infected.
“The main cognitive endpoint was a baseline-corrected global cognitive composite score (bcGCCS), defined as the baseline-corrected, standardised mean across all 11 tasks…
- Motor Control–Measures visuomotor accuracy and reaction time
- Object Memory (Immediate)–Measures short term precision recognition memory
- Simple Reaction Time–Measures reaction time
- Choice Reaction Time–Measures complex reaction time
- 2D Manipulations–Measures mental manipulation of 2D visuospatial information
- Four Towers–Measures mental manipulation of 3D visuospatial information
- Spatial Span–Measures spatial working memory capacity
- Target Detection–Measures attention and distractibility
- Tower of London–Measures spatial planning
- Verbal Analogies–Measures semantic reasoning
- Object Memory (Delayed)–Measures medium term precision recognition memory”
There was a very important statement made in the middle of the study. “Notably, none of the volunteers reported subjective cognitive deficits.” This is a bit alarming in that people are not recognizing that they are impaired. It seems similar to how someone who has “only had a few drinks” may not realize that they are a danger driving on the road.
“In conclusion, this study confirmed that prospectively controlled infection with Wildtype SARS-CoV-2 is followed by objectively measurable reductions in cognitive task performance that can persist for at least a year. Immediate and delayed memory, and executive function were the most sensitive cognitive domains.”
