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The Critical Importance Of Human Behavior In Our Response To COVID-19

Discussion in 'Psychiatry' started by Mahmoud Abudeif, Nov 30, 2020.

  1. Mahmoud Abudeif

    Mahmoud Abudeif Golden Member

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    Early in the pandemic, Dr. Deborah Birx, the Coronavirus Response Coordinator for the White House Coronavirus Task Force, reminded the public of the critical importance of individual and collective human behaviors to change the course of the COVID-19 pandemic. She said,

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    “It’s communities that will do this. There’s no magic bullet. There’s no magic vaccine or therapy. It’s just behaviors. Each of our behaviors translating into something that changes the course of this viral pandemic over the next 30 days.”

    The pandemic continues to profoundly change our “normal” lives many months later. And to compound the impact, we are now facing the possibility of a devastating third wave of new cases.

    This once again reminds us of the importance of human behavior in combatting the pandemic. Despite tireless, ongoing efforts, there is still no magic vaccine although we keep being told that one is on the horizon.

    There has been some good news on the therapy front. Clinicians have gotten much better at treating hospitalized COVID patients leading to a drop in the death rate. Further, remedesivir, an antiviral drug that stops the spread of the virus in the body, was just approved by the FDA.

    Despite these advances, we continue to depend on human behavior to contain the spread of the virus. And, according to experts, we will do so for the coming months (or longer) until a vaccine has been tested, approved, disseminated, and administered.

    The challenge of depending on human behavior to combat the COVID-19 pandemic

    The challenge of employing human behavior to combat a crisis of this magnitude is that behavior is often unreliable and unsustainable. We’ve already seen this play out in some of our impulsive behaviors like hoarding toilet paper or shopping online for items we don’t need.

    It is also playing a role in our paradoxical behavior when it comes to adhering to certain health guidelines, such as wearing a mask or staying at home.

    Because of these challenges, and the fact that a medical solution is still somewhere in the future, many are asking, “how do we move forward?”

    A good place to start is to gain a deeper understanding of why people act the way they do during times of immense stress and uncertainty. Behavioral science can help inform our country of the next steps we need to take to enact real, meaningful change in our country’s overall response to the coronavirus.

    In this piece, we’ll explain how stress can influence our behavior. And, we will share actionable insights that can be used to inform both our individual and collective responses to the coronavirus pandemic.

    The impact of stress on thinking and decision-making

    In times of crisis, most of us are exposed to increases in both acute (in-the-moment) and chronic (consistent over time) stress. Stress can impact us in a variety of different ways, including how we process and perceive information in the world around us.

    As a function of evolution, we’re wired to preferentially notice, process, and remember emotional information over non-emotional information. For example, many of us can vividly remember that embarrassing moment from middle school. However, we might be hard-pressed to recall what we had for breakfast three days ago.

    Stress has many physiological and psychological effects. One is the heightening of our awareness of negative, rather than positive information.

    Again, this is an evolutionary response. Humans become stressed because there is a threat in our environment. Heightened awareness of negative information increases our chances of identifying and dealing with the source of our stress.

    There is a large amount of emotionally negative stimuli related to the COVID-19 pandemic

    Today, we are seeing, hearing, and experiencing a large amount of negative and fear-inducing information. And, we are more likely to retain that negative information, and have it be top of mind.

    That chronic exposure to emotionally-negative stimuli can lead to increased stress. It can also provoke neurobiological changes that predispose us to be more likely to notice other negative stimuli.

    One classic example is the phenomenon of many experiences after breaking up with a romantic partner. To them, it seems like every song they hear on the radio is about breaking up or falling out of love.

    While this is helpful for survival in some cases (being hyper-aware of animal noises while walking in the woods at night, for example), it can be very cognitively taxing for us in situations like the one we are in right now.

    The impact of chronic stress on decision-making

    Chronic stress impacts our decision-making. In fact, even in “normal” circumstances, much of our behavior, including buying, is driven by a balance between two motivations:
    • The desire to regulate how we feel right now
    • The need to regulate ourselves from doing something impulsive.
    Those two cognitive “needs” operate more or less in balance with one another. This balance is disrupted by negative emotions, such as:
    • stress
    • fear
    • uncertainty
    Under those conditions, our desire to make ourselves feel better gets amplified. And, we put much less effort into controlling our impulses. That is why many of us went out and stocked up on toilet paper and other essentials when the pandemic first began. We did it even though we knew we didn’t necessarily need it or could have saved it for someone else.

    The importance of human behavior in our response to the COVID-19 pandemic

    With a deeper understanding of how stress impacts human behavior, we can start to make informed decisions about the most effective ways to move forward.

    There are steps we can take both individually and collectively that can enact meaningful change and help change the course of the coronavirus pandemic for the better.

    Individual behaviors

    Individually, we can work to reduce our negative exposure and protect ourselves from becoming overly stressed by:

    • Physical activity
    Physical activity, even around the home, can mitigate the production of stress hormones like cortisol. It also reduces anxiety-like symptoms. Physical activity also promotes oxygenated blood flow to the brain. This can both reduce cognitive load and promote long-term brain health.
    • Social support
    Social interaction provides myriad mental health benefits. Even virtual interactions, via webcam or even text-based communication, promote the release of oxytocin. Oxytocin is a reproductive hormone that can increase feelings of bonding and closeness. It also drives prosocial behaviors.

    Although these responses are mitigated for virtual, rather than in-person, interactions, maintaining social relationships has obvious benefits over social isolation.
    • Emotion regulation
    Effortful regulation of our emotions can be challenging. But it is very effective for our well-being. We may be tempted to turn off the news, close our laptop, and avoid as much negative information as possible. However, this strategy of emotion suppression – ignoring or pushing away our negative thoughts and feelings – only delays (and, sometimes, amplifies) negative emotional states.
    • Reappraisal
    Reappraisal is a method of thinking critically and re-framing the negative information we are exposed to and reframing how it relates to us. This way of thinking is much more beneficial to our long-term emotional health. Further, it can have protective effects when we encounter new, negative stimuli. Reappraisal often takes cognitive effort, but the long-term effects are worth it.

    Strategies we implement to help the collective
    • Highlight and communicate the positives when possible
    As a society, we choose to focus on and highlight the positives as much as possible. We do this both for our emotional health and also for effectiveness in our communication.

    Emotionally, there is a lot to feel negatively about right now. Many of us have lost loved ones, our livelihoods, and social relationships. Those things, of course, are incredibly difficult to deal with.

    Acknowledging those negative stressors is important. However, ruminating on them is harmful to ourselves and to others around us.
    • Try to not highlight negative information
    Highlighting negative information is a less-effective communication strategy. For example, there has been ample research over the last three decades on anti-smoking PSAs. It shows that a focus on the negative health outcomes of smoking are often ineffective at promoting smoking cessation.

    This is because our default response is to shut out that information. We think, “This can’t happen to me” or “I don’t want to see that.” In some cases, those PSAs may actually prime smoking behavior because they cue smokers to think about nicotine.

    More effective messaging focuses on the positive consequences of behavior change:
    • Leading a long and healthy life,
    • protecting your loved ones, and so on.
    Whether you are a manager, a health official, or even a parent, understand that negative information can get peoples’ attention. However positive information can be more effective at promoting behavioral change.
    • Mentalize on behalf of others
    We are all the main characters in our own story. However, getting through a crisis is a collective and social experience.

    It can be difficult to be vigilant to the needs of others. But, putting in the effort to do so is critically important.

    Try not to become frustrated or hurt if your partner wants to take a few hours to read a book quietly. Or jump to conclusions about work ethic if a team member needs to take an afternoon off to decompress.

    Do something, even if it is small, like reminding yourself, “That’s what they need to do for themselves right now.”

    It can be an effective way to reappraise the situation. And, it helps you put yourself in the shoes of someone else.

    Our behaviors are the best weapons to fight COVID-19 right now

    As we await a medical treatment, our behaviors are all we have in the fight against coronavirus. Despite its unpredictable nature, especially in times of crisis, we must find ways for human behavior to help, not hurt or hinder, our response to the pandemic.

    We must take what we know about human behavior during times of chronic stress, and apply it to how we move forward as individuals and a collective. It will help us shape a response that is better suited for human behavior. One that can, ultimately, change the course of coronavirus.

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