Video Transcript

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JOHN WHYTE: Hi, everyone. I'm Dr. John Whyte, Chief Medical Officer at WebMD, and you're watching "Coronavirus in Context." Are you getting tired of washing your hands? Wearing those masks? Now is not the time to-- to pull back on caution. I've invited Dr. Jacqueline Gollan, Associate Professor of Psychiatry and Behavioral Science at Northwestern University Feinberg School of Medicine to join me to talk about this caution fatigue many of us are experiencing.

Dr. Gollan, thanks for joining me.

JACQUELINE GOLLAN: Thank you for having me.

JOHN WHYTE: Let's start off with, what do you mean by this term caution fatigue?

JACQUELINE GOLLAN: Well, as people are striving to keep up with safety guidelines and keeping themselves safe, they may find it difficult to stay on high at-risk alert, and caution fatigue may emerge. And it's really the low motivation or interest in taking safety precautions. Uh, it occurs because the constant state of being alert, uh, for threat can activate a stress hormone called cortisol, and that can affect our health and our brain function.

So when we're subjected to high levels of stress, we start to desensitize to that stress. And then we begin to, uh, pay less attention to risky situations. So caution fatigue is really the sense of depletion, or low motivation, or tiredness in following, uh, safety behavior.

JOHN WHYTE: So we know how important wearing masks, physical distancing, hand washing are. So how do we help listeners overcome this caution fatigue?

JACQUELINE GOLLAN: Well, initially, you might consider that when you first inf-- heard this information that you might have been energized to follow some of the safety behavior. And now with time and with new information, uh, you may be less interested. You may feel, uh, negative or depleted. So I think those things we want to try to do is to ensure that we're integrating new healthy habits into our routines. We still can seek exercise, uh, pleasure, connection with others, but we have to integrate these new habits, as best we can, to ensure that we stay safe.

JOHN WHYTE: Do we need to stay on some type of a schedule?

JACQUELINE GOLLAN: We need to stay on a normal routine, as best we can, staying-- um, you know, carefully monitoring our-- our nutrition, sleep schedules, our level of activity, maybe even boosting it, if possible, to seek out goals of enjoyment of mastery. Um, in general, though, it is important to now consider risk and reward as a trade-off. So what you may be gaining from, uh, resorting back to your normal-- normal routine, you may now be introducing new risks, uh, for your safety, or for your health, or for others. So now we need to be thoughtful about revising those routines so as to integrate that trade-off.

JOHN WHYTE: Give us some more examples. What-- what are you doing, actually, in-- in your practice and in your daily activities that we could learn from?

JACQUELINE GOLLAN: Yeah. So what I'm trying to do is think about, uh, how to mitigate risks, so trying to think a little bit about should I try to, uh, maintain a safe home environment, a safe social environment or social activities, whereby I'm really considering the health and well-being of others around me. Um, I may be healthy, and I may not have symptoms, or may not get subjected to, uh, a severe course of COVID, but I'm very aware that others may. And so my focus is really on staying respectful of the health of others, trying to maintain a social responsibility for that.

JOHN WHYTE: But Dr. Gollan, what do you say to people, who know-- you know what, I see a lot of people not doing the things that you're asking me to do. I'm just tired of it. And-- and you know what? I'm not sure sometimes that it really matters. That's not what I'm saying, but that that's what we're hearing. How do--

JACQUELINE GOLLAN: Yeah.

JOHN WHYTE: --you address that?

JACQUELINE GOLLAN: It's an interesting point you make. Essentially, there's a couple of things going on when people are making that determination. I mean, they may be right. They don't see people who are being, uh, affected by COVID in any way around them, and they wonder whether, in fact, this is actually a true thing to care about. But there-- there are some important things to remember.

One is that there is a decreased sensitivity to repeated warnings. So our brains adjust to alarms to reduce our stress. This is something that naturally we all do so that we start to ignore those warnings, or we may take longer to respond to them. Um, and we may assume them not really to be relevant to us. So we think other people are subjected to this, but this really isn't going to happen to us.

Um, there's also a sense of dissonance, which is, you know, we-- we can't tell which risks are true risks and which aren't. We don't have a Geiger counter out there to tell us, uh, where the risks are. And I think that's where it speaks to trying to track and trace people who are having COVID symptoms so that we understand, um, you know, who-- who around us may actually be suffering from COVID so that we can take some precautions there.

You know, the other thing is that we initially may have been fearful. We have some sense of trying to balance fear and control. So some of us are, um, more comfortable assuming risk versus others, and there's variance in the population.

So some of us all may have been quite fearful at the beginning. But then as you start to gain control over your situations around you, you may become more confident to confront situations or be out there, uh, particularly of those things that initially may have scared us. And so as a result, some of us may underestimate the actual threat, because we're, um, really much more comfortable with uncertainty.

JOHN WHYTE: Are we telling people too often wash your hands, wear the masks? Are-- are we contributing to that fatigue? Or do we continue with those, you know, recommendations, um, and best expert advice?

JACQUELINE GOLLAN: It is always a good strategy to go with best expert advice, as well as to, um, remind yourself, as much as you can, to instigate these in your daily routine. So hanging a mask on the doorknob of your front door would remind you to wear the mask when you go outside. Um, putting up little Post-it notes in your home to remind you to wash your hands as you, uh, come in and out of your home environment, um, and so forth. So no, I don't think that we are bombarding people with too many messages about how to take precautions. Um, in public health, being reminded is a good thing.

JOHN WHYTE: Now, last question I'm going to have to ask, I know everyone's wondering, tell us about that Empire Strikes Back poster behind you.

JACQUELINE GOLLAN: This is a, uh, a-- a collection, actually, of four posters in this room, um, that reflects, um, a true belief in seeking out and fighting for the well-being of the-- of other people. Uh, essentially, this is a poster that's part of a collector's edition and, uh, really just reflects my, um, motivation to, uh, keep up the good fight.

JOHN WHYTE: What's your favorite episode of the series?

JACQUELINE GOLLAN: Actually, I think this is my best-- this is the one that I like the most. Yeah.

JOHN WHYTE: Dr. Gollan, I want to thank you for taking the time for sharing your insights and helping us recognize that some of us might be experiencing this caution fatigue, and then the strategies of how do we overcome that.

JACQUELINE GOLLAN: Thank you.

JOHN WHYTE: And thank you for watching "Coronavirus in Context."

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