Coping With the Crisis: Fighting COVID caution fatigue

It’s been nearly a year. People have found ways to cope, although some ways better than others.

The fear and confinement of last spring gave way to a looser summer and fall, with stores and restaurants cautiously opening and Shelter Island’s successful school rollout. Then came the dark winter with cases peaking, and staggering daily death counts. We had the excitement of the vaccine production, only now to discover that the distribution has been spotty at best and even non-existent in some places. 

So, a year and 400,000 deaths later, where are we?

Some people have received a vaccination (or two if they are really lucky). Others see a continuing long road of isolation. We knew from the outset that it would be a long haul — remember they kept telling us it would be a marathon and not a sprint?

But actually living through it all is a challenge. “Caution fatigue,” the decreasing motivation to comply with safety guidelines, is a normal response to the call for never-ending vigilance. It can also be deadly.

On Shelter Island, some people who were carefully wearing masks are no longer bothering. At the IGA, social-distancing of at least 6 feet and the green and red lanes are now being ignored. Social gatherings are more common and, with the cold weather, are being held indoors. Over the holidays, there were several large gatherings since so many of us wanted to see our families together in one place.

Therefore, it’s not surprising that the number of positive Shelter Island COVID-19 cases that had held steady for many months began increasing this winter. In fact, Suffolk County’s numbers have been among the worst in the state.

Trish Gallagher, a clinical psychologist on Shelter Island, has seen increasing numbers of people suffering from anxiety disorders during the past year, especially post-traumatic stress disorder and suicidal thoughts among her patients at the New York Presbyterian Hospital. Clearly, this virus has taken a psychological as well as physical toll on adults and children alike. Addressing the mental health issues is a challenge, especially as the numbers of those afflicted grow.

So how do we all stay safe and emotionally healthy as we limp to that long-awaited vaccine? President Biden’s 100-day mask mandate is a no-brainer. But other prohibitions are not necessarily all-or-nothing. Dr. Julia Marcus of Harvard Medical School has written about the “Harm Reduction Model.”

She learned from her HIV research that a complete preventive approach was often unsustainable. For example, she learned that asking at-risk populations to abstain from sexual activity altogether was less successful than educating them about safe sex methods. A harm reduction approach allows for sensible risk reduction as opposed to complete risk avoidance.

Using the Harm Reduction Model gives people an opportunity to find a balance between safety and risk. Maskless indoor gatherings are foolhardy.

But complete isolation is not too great either. Perhaps a socially-distanced walk with a friend to watch the sunset is a good middle ground. Or check the library’s calendar of events and sign up for a few exciting online programs. Their offerings during the pandemic have been lifesavers for many Islanders.

Maggie Mulqueen, a psychologist in the Boston area, offers another strategy called “chunking.” Her theory is similar to the “one day at a time” credo of 12-step programs. By reducing difficult long-term events into “chunks,” we are better able to digest and confront them.

For example, patients facing a year of chemotherapy will find it easier to focus on one chemo treatment at a time. Similarly, with the virus, as we are now close to the finish line, we may need to take it one month at a time. No one wants to get sick right before vaccination. We have come too far.

A vaccination plan will be coming. But in the meantime it will require patience.  We can get there by behaving responsibly. 

Hopefully, the summer of 2021 on Shelter Island will be safe and glorious.

Nancy Green is a member of The Shelter Island Health and Wellness Alliance, which also consists  of Lucille Buergers, Jim Colligan, Jessica Colas, Laurie Fanelli, Trish Gallagher, Bonnie Stockwell, and Ryan Sultan, MD.