Gonzalo Bacigalupe, EdD, MPH
It seems to me as if everyone is trying to understand what is happening, making decisions in the context of a crisis that affects all of us, but that few of us comprehend. There are people in self-imposed quarantine, while others remain skeptical without appreciating the importance of the situation, trying to live their lives as if this reality – a pandemic that is sickening and killing people in other countries – didn’t exist. No small proportion of people are obliged to and stressed out by having to travel across town to work, with a fear of contagion that grows day by day.
Understanding the mathematics of an epidemic is complicated because our cognitive framework allows us to intuitively grasp linear equations but not logarithmic ones. It is difficult to grasp exponential growth compounded by a series of uncertainties that don’t fit into a linear model. Epidemiological training such as the simulation of a tsunami alert entails continuous changes in information and the associated difficulties in appropriate decision making. This virus forces us to reexamine everything we think we know. Fear, anxiety and denial are common psychological reactions to these circumstances, reactions that can arise simultaneously or sequentially. Also, fatigue, symptoms of depression or dissociation, all interfere with the ability to think clearly, to act effectively, or to absorb information about the pandemic.
Trying to replace human contact with telework is not easy while at the same time dealing with all the tasks of home life. For the mothers of our country this scenario generates even more stress. For those who have to care for aging family members the stress is tremendous. We therefore not only have to create asynchronous spaces (such as email, Whatsapp, Facebook) but also real-time ones to share our concerns and ideas about how to manage things going forward. These conversations with the community, family members, co-workers and others allow us to share strategies for simultaneously maintaining a physical distance and staying connected.
Preventing contagion should be our central focus. Right now there is nothing of greater importance. It is like a tsunami warning, where what is most urgent is evacuation to a safe location. The evidence regarding physical distancing from others is irrefutable and as of now is the only thing of which we are certain. In that sense, focusing conversation on treatment of the illness is relatively unproductive. We know that fear doesn’t necessarily lead to the best decisions. “Flattening the curve” is what is critical. Over and above the extent of the region affected by the disease, the crisis is fueled by the astronomical number of people requiring information, assistance, diagnosis, treatment and end of life care. Making the distinction between what is sensible and what is not is paramount. The mission of public health is to save lives and avoid having naturally occurring threats turn into disasters; this virus does not have to become a disaster.
Gonzalo Bacigalupe, EdD, MPH, is a professor of Counseling Psychology, at the College of Education and Human Development, University of Massachusetts Boston, and is an associated researcher at CIGIDEN in Chile where he leads research on disaster risk reduction governance and education, and he finds himself in quarantine