Psychology of the COVID-19 pandemic: Social Distancing, Mental Health, Hypocognition

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Summary: Social distancing and mental health have a number of interactions (loneliness, uncertainty) that people need to address during a pandemic. Psychological adjustment is hard but there are things we can do: acceptance, following rules, acting as a community, and quality engagement.

“Now what?” is one of the hardest questions to deal with when something new and dramatic affects the world. In December 2019, a coronavirus evolved and began transmitting in humans. Within 3 months, it managed to capture human attention unlike anything before. The virus is called SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) and causes a disease named COVID-19 (coronavirus disease 2019). It has killed over 25,000 people across 190 countries and infected over 500,000 people as of March 27th, 2020[1]. It spreads via droplets from coughing and sneezing. We can also pick it up by touching surfaces contaminated with the virus. Latest updates from the CDC.[2]

The international public health goal is straightforward – reduce the spread of the infection, reduce the number of outbreaks in healthy populations, reduce the burden on healthcare systems that have to treat patients, enable quick testing & quarantine, and create more time to develop a long-term solution like vaccines, treating it seasonally, and approved medication. There is a time to be serious without panicking and that time is now. Selfish behavior like roaming around meeting people during a quarantine will unnecessarily put others in danger and cost the healthcare system limited resources.

COVID-19 has symptoms like shortness of breath, fever, and cough. The CDC[3] also outlines emergency warning signs such as difficulty breathing or shortness of breath, persistent pain or pressure in the chest, new confusion or inability to arouse, bluish lips or face. It may take up to 12 days for 97.5%[4] of the people to show symptoms.

These are scary and uncertain times, we don’t know how bad it can get and how long we’ll have to wait before we have a standardized way to treat it – tests, vaccines, medicines. Perhaps the virus will circulate in the population like an endemic disease. Perhaps every second person will be exposed in a year. We can’t know for sure. What we can do is reduce the burden on health-care services by reducing the speed at which it spreads. Effectively, slow the exponential growth and let it infect across a long period instead of within weeks – by then, treatments will probably be easily available.

There are 4 paths people can take to defend against the virus:

  1. Detect, quarantine, and medically treat.
  2. Gather data, conduct research, and understand the virus. This is the advancement of the science involved.
  3. Take precautions at the personal level – Avoid touching the face, sanitize your hands and body regularly and after touching potentially infected surfaces, wear clean clothes, bathe.
  4. Take precautions at the social level – Dramatically reduce human contact, stay at home, and add physical distance between people (social distancing). This will flatten the curve.

And, follow all government and official emergency rules sincerely.

Most of us who are not scientists or health care professionals need to focus on points 3 & 4. Let’s look at why.

In short – Stay at home and avoid meeting people as much as you can to prevent the spread of the disease. Don’t let people die and struggle for breath because you do not take the disease seriously.

Basic hygiene precautions to reduce the chances of getting infected

  1. Wash your hands with soap for 20 seconds thoroughly. Don’t forget areas like the crevices between your fingers, fingertips, and wrists. Dry them with a clean cloth. Do this after you touch unknown surfaces or even pick-up parcels or cash.
  2. Sanitize your hands thoroughly with an alcohol-based sanitizer containing at least 60% alcohol. Do this after you touch unknown surfaces or even pick up parcels or cash.
  3. Avoid touching ATM buttons, use a toothpick or gloves. If you are using gloves, sanitize them or throw them away.
  4. Cab doors and public transport contraptions are risky surfaces, so sanitize your hands after touching them.
  5. Cover your face while sneezing and coughing, wash-up thoroughly. Use a tissue when you can and throw it away. Cough and sneeze into your elbow like a vampire.
  6. Have thorough baths with soap and wear clean clothes. Change clothes if you have been out for too long.

What is social distancing and how to make it effective

Social distancing is literally adding more distance between you and other people. The goal of social distancing is to reduce the average number of human interactions and how physically close people are to each other during a period. This happens when we restrict our movement and maintain physical distance. That means we stay at home when we can, reduce going out, avoid meeting people, completely avoid crowded places, expose yourself to other people only when necessary, avoid traveling, reduce using any public service, and work from home.

In the context of the COVID-19 pandemic, social distancing has one mission: Reduce the physical opportunities the virus has to spread in a population. This will slow down the spread of the virus enough for the medical professionals to manage the patients without a major burst in the number of cases. That is, essentially, called flattening the cure. Slower spread means there is more time to treat existing patients. The pure number of patients who need treatment on a particular day will reduce because fewer people would’ve contracted the virus 2-14 days before – thanks to social distancing.

The SARS-CoV-2 spreads through breathing virus-carriers like droplets in a sneeze and contaminated surfaces. Social distancing reduces the opportunities a single person has to come in contact with a contaminated surface or touch virus carriers like droplets. Does social distancing really work? Yes, published scientific studies by epidemiologists and many other types of scientists have strongly demonstrated that it works, has worked in the past, and will work in the future (source[5], source[6], source[7], source[8], source[9]). It is now an official public health recommendation to slow down the spread of an infectious disease and reduce the burden on the health-care systems, and possibly, make it an endemic disease. Social distancing is our number 1 weapon against the coronavirus. It reduces everyone else’s risk of getting the disease.

Not everyone can implement social distancing. Daily-wage workers, healthcare professionals, the police, public transport drivers, etc. Them using social distancing means the ones who need care won’t get the needed care.

Social distancing works by making decisions at 2 levels – individual and population. When governments impose a lockdown and ask bars, restaurants, gyms, and offices to stay shut, they are effectively preventing hot-spots of human-to-human infection and surface-to-human infection. Social distancing is not just a precaution, it is a big part of the solution.

The guidelines below are general and a government’s directive based on new developments should be considered first, and with higher priority.

Guidelines for effective social distancing:

  1. Maintain 6 feet between you and others when outside. When at home, this may not be possible so just maintain personal hygiene.
  2. Stay at home. Avoid going to any public place and avoid as many human interactions as possible.
  3. While outside, try to minimize touching anything unnecessary and do as much as possible in one go.
  4. Don’t hoard, don’t panic-buy, there are people who cannot stock-up, who cannot pay for large quantities, and who will need resources urgently. They will need supplies in an emergency and you don’t want to kill their opportunity to buy them.
  5. Assess the risk of what you are doing when you are going outside. Ask yourself – Am I isolated from others? Am I increasing someone else’s risk of infection? Is it necessary for me to be outside? Am I allowed to be outside?
  6. Avoid all physical contact with strangers, don’t take children to play with friends.
  7. Use digital forms of payment instead of cash.
  8. If you are ill, stay at home, isolate yourself and take proper care. Reach out to a doctor and if suspicious of COVID-19 follow your local authority’s guidelines.
  9. Disinfect things you bring from the outside world into your home.
  10. Persuade uncooperative family members and friends to practice social distancing by telling them the damage they can do.

Here is a simulation of how social distancing flattens the curve[10]

Psychological adjustments for social distancing and the coronavirus pandemic

It is hard. Everyone doing it is going to face some issues. For some, there is no real change in lifestyle. For some, it’s a dramatic change in lifestyle. Adjusting with social distancing is a big task, psychologically speaking; and it will test many of us in many circumstances. People are dealing with uncertainty and a massive lack of control. Humans find it difficult to deal with uncertainty and that induces a lot of worrying, overthinking, anger, frustration, meaninglessness, irrational behavior, and even boredom. Some are going to be more scared and anxious than others. People with existing mental health conditions, diseases, disabilities, as well as older people and those with compromised immunity might be more anxious, stressed, and scared.

The virus has threatened our physical and psychological safety, regardless of privilege. Some people are going to die, some are going to recover, many are going to suffer. It is not unreasonable to believe that someone you know gets infected. That is the reality most of us are facing and/or fearing. Many of us are worried about our health and our family’s health, especially the older members. Our goal as a species is to ride this through and lower the intensity of spread as much as possible until there are sustainable treatments and logistics. Panic will not help. Social distancing will, personal hygiene will, staying at home will, and psychologically supporting those at risk will.

It is extremely important to unwind, relax, and take breaks from coronavirus related content. Regular doses of it can be upsetting and mind-numbing. Limit your coronavirus news-time. Share on X If you are a decision-maker and responsible for others, it is vital that you remain calm and act rationally. That way you can lead & care effectively during the pandemic. Follow official protocols. Share on X

Social distancing, loneliness, uncertainty, frustration, anger, anxiety

Humans are so innately social that forcing them into isolation can have severe consequences on their well-being. Psychological research has repeatedly shown that social isolation affects our chances of survival and psychological well-being. One meta-analysis[11] of 148 studies shows that your chances of survival are 50% higher when you have strong social relationships than when you have no or weak social relationships. Another study[12] shows being removed from society (social isolation) increases the mortality rate (likelihood of dying) by 29%, loneliness increases it by 26%, and living alone increases it by 32%. These studies have averaged out survival across all genders, age groups, cause of death, etc. Loneliness increases the risk of virtually all mental-health conditions ranging from anxiety, depression, Alzheimer’s, and addictions. It is the feeling that you are lonely that causes[13] the most damage, not the number of people you have around you. Many are going through the same thing – reach out and talk to others.

A crisis like the SARS-COV-2 pandemic will force many people into a position that worsens their mental health, and makes them very uncomfortable. Some people would celebrate how social distancing changes nothing for them and some would hate it because their routine and social needs are frustrated. What we know from research is that choosing alone-time can improve mental health and being forced to stay alone induces loneliness and worsens mental health. Having control over how we spend our time is linked to well-being and having little control isn’t. Follow the tips in the next section to reduce loneliness. Talk with people regularly, especially if you are living alone. Research on Chinese students[14] facing the CoVID-19 pandemic shows that high social support buffers against anxiety created by the pandemic.

Anxiety and stress compromise your physical immunity and increase the likelihood of health issues. Even if you don’t get COVID-19, high bursts of anxiety and stress, as well as continuous anxiety and stress, isn’t physically or psychologically healthy. Use the techniques mentioned below to reduce your anxiety. Anxiety emerges from perceived and real threats. It’s closely tied to how your brain simulates the future and becomes aware of the possible danger. Preoccupation with these worst-case scenarios isn’t healthy and only create more anxiety. However, a mild amount of worry can motivate us to take reasonable precautions. Obsessing over impending doom won’t help the community, won’t improve your well-being, and won’t help you make the best decisions. A moderate level of anxiety will help the community and improve your well-being through careful behavior.

Social distancing takes away your control over your social life just to help unknown people heal. It helps the people you have no knowledge about, have no feelings about, and have no relationship with. All you really know is that those people who benefit from it exist somewhere as a member of your community. The lifestyle sacrifices you make convert into good fortune for others tomorrow. When people recklessly put their self-interest first by socializing during a pandemic, they worsen the situation and cost people their health. Don’t just feel empathy, act on it.

Research shows[15] that people are willing to make social decisions like staying at home for the greater good when they realize that their actions actually have a significant impact on global health. People will strive to prevent the worst-case scenario when they realize how much others would suffer.

There are random people who won't get infected because you will break the chain of spreading the disease by staying indoors. #socialdistancing Share on X Many High-risk people will get sufficient medical care only when the amount of new incoming patients is low and hospitals are not overwhelmed – ensure it by staying at home & socially distancing. #flattenthecurve Share on X

For those of you who feel you can’t be of help to the world during such a crisis but want to help: Know that you have a positive influence on global health if you practice social distancing & personal hygiene, not hoard, and engage with others who are in a difficult spot.

People like control and a sense of meaning in life. A crisis can disrupt our existing control and sense of meaning. This makes us angry, helpless, and frustrated. Quarantines, social distancing, self-quarantines, etc. force people to adjust their lives for the benefit of the greater good. However, this adjustment needs to happen quickly because there is no time for taking small steps to make incremental lifestyle changes. Perhaps going to the gym is your favorite time of the day and you no longer have the opportunity to claim that moment. Perhaps reading for hours or binge-watching campy sci-fi is your ideal way to spend a day and now you have all the time to act on it.

Many are stuck with their families for longer hours due to social distancing. Many are going to have lots of free time to spare. This creates an opportunity to get on each other’s nerves and bring-up conflicts. Interpersonal dynamics have thresholds where one thing is cute/pleasant/fun/tolerable for a small duration but not when it goes on for too long. The psychological distance between family members is often maintained at an equilibrium because of work and social hangouts. Work-from-home situations create newer opportunities to fight and have conflicts. It’s important to find a new way to manage close-proximity relationships that have received this bonus time. If you are irritated with someone, understand that they might be irritated at you too and find a mutual solution.

Caring for children and older people can be extra stressful because of the amount of attention they require. Children, older people, and teenagers may act-out in odd ways and show unusual behavior. They may also rebel and not cooperate. While this can become a source of additional stress, understand that people of different ages cope with stress in different ways. Tell children that it’s ok to feel upset and assure them that they are safe. Share your feelings with them too and explain facts about the spread of the disease in simple ways instead of keeping them in the dark. Children might interpret the news differently than you do and it’s important for you to remain calm and respond to them.

Boredom is a powerful negative mental state that can make people ignore risks and act irrationally just to feel some excitement. Keep yourself entertained and engaged, follow what your friends are doing, and talk to people to figure things out. Boredom won’t kill but a virus will.

Uncertainty and a lack of meaning are also at the core of why people believe in pseudoscience.

Be grateful for all the medical store owners, grocery shop owners, supermarket staff, delivery people, scientists, public health workers, police, etc. because their work keeps us safe and functioning. They work so we are comfortable.

How to relax and overcome stress/anxiety during social-distancing/quarantine?

There are a number of ways to reduce worry, relax, calm down, and not panic.

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Deep breathing

  1. Breathe in deep from your nose slowly and gently.
  2. Breathe out deep from your mouth slowly and gently.
  3. Count 1 to 5 while breathing in and out if it helps.
  4. Close your eyes and focus your undivided attention on your breathing for a few minutes.

Deep breathing works with a number of pathways[16]. It offers psychological distance from the anxiety-inducing context. It also counteracts the physiological responses of anxiety – increased heart rate, sweaty palms, freeze response, muscular tension, etc. Use this breathing technique when you are panicking and your anxiety is rising.

Progressive muscular relaxation

  • Sit in a comfortable chair or lie down on your bed.
  • Slowly breathe in and breathe out 5 times.
  • Choose a muscle group like your hands and forearms. Let them rest loosely.
  • While breathing in, begin tensing them up as much as you can till you feel you are tightened up.
  • Breathe in and breathe out 5 times.
  • While breathing out, release the tension slowly and steadily.
  • Acknowledge the feeling of muscles releasing all the tension and relaxing

Do this for each of your 9 nine main muscle groups: (a) hands and forearms; (b) upper arms; (c) forehead; (d) eyes, nose, and cheeks; (e) jaw, chin, front of neck; (f) back of neck; (g) upper body; (h) legs up with toes pointed down; and (I) legs up with toes pointed up.

With this technique, your body is forced to relax. It is also the best time to assure yourself that you will get through the pandemic, you will adjust, and you will figure things out.

This technique is also effective in reducing anxiety in already infected people[17].

Listen to music

Music is, without a doubt, one of the most powerful ways to relax, enjoy, and distract yourself. Music can regulate all aspects of your mind/body-system – thoughts, anxiety, anger, fear, sleep, mood, and even loneliness. It puts us in a favorable mental state. If you like music, use it. You can read more about how music affects us here. If you are worrying a lot, listen to something you like.

Work and introspect

Spend your day productively. Do something useful, work on your skills and learning. Complete things you’ve procrastinated. Not only will this be a great distraction, but it will also reduce boredom and make you feel like you’ve spent your time well. It’s a great time to introspect and work on your mental space. Learn to be humble and ok with uncertainty but don’t get consumed by the virus. Your mental space can be used for a lot of other valuable things.

Do things you like and spend time constructively. Meaningful and stimulating work is a reward in itself. Give yourself that. Stay grounded in a productive reality.

Tips on how to be productive, overcome loneliness, and kill boredom while social distancing in a pandemic

  1. Catch up on your sleep, reading, movies, music, and other indoor hobbies.
  2. Focus on your inner-self. This is a golden opportunity to work on your mind.
  3. Don’t stop working and try to be on top of everything you wanted to do.
  4. Prepare a rough schedule to keep your day interesting and lay down your options. Create some structure for your time for a sense of stability.
  5. Connect with people via social media and phone. Loneliness and social isolation can take a toll on people, especially when forced; so maximize connecting with people. Many would be in the same boat and willing to connect.
  6. Clean, organize, and develop new habits for personal hygiene.
  7. Share your feelings with others, ask them about theirs. Talk with the high-risk worried people.
  8. Reach out to people who you’ve not had the time for before.
  9. Make yourself available to others who might need you.
  10. Exercise, stretch, meditate, do yoga.
  11. Learn new things and study for what you need to prepare for
  12. Use the time to reduce your knowledge and skill gaps.
  13. Give new things a fair shot.
  14. Learn to keep yourself calm in a stressful situation.
  15. You can have a Netflix party with a chrome extension, try that[18].
  16. Pick-up a course on Coursera.
  17. Call your friend up and stay on the phone without really talking and do individual activities.
  18. Eat healthy food.
  19. Unwind and take breaks from everything coronavirus -news, speculations, discussions.
  20. Do things you enjoy.
  21. If you are very lonely, have a warm bath and use a heavy blanket. Wear clothes that embrace you.
  22. Organize your digital files and clear the clutter.
Worried about how too much of social media will affect your mental health? Here is a detailed research-based account.

Tips on how to psychologically adjust to the COVID-19 pandemic for better mental health

  1. Fully accept that life has temporarily changed and you will see suffering.
  2. Follow the precautions and protocols recommended by the authorities properly. Don’t be reckless and think of the community.
  3. Accept that the inconveniences you will face are necessary for the greater good.
  4. Connect with people every day to lower loneliness.
  5. Panic will not help. Social distancing will, personal hygiene will, staying at home will, and psychologically supporting others will.
  6. It is ok to feel frustrated and overwhelmed but make an attempt to calm down. Long-lasting anxiety and stress is always detrimental to health.
  7. Accept that there will be uncertainty regarding the spread of the disease.
  8. Accept that you cannot cling-on to a possible best-case scenario or a worst-case scenario.
  9. Understand that you will need to update your point-of-view and make changes in life as soon new information is published by the authorities.
  10. Overthinking or underthinking about anything will not lead to any extra useful outcome in your life, following official guidelines will help you deal with it without thinking much.
  11. Remember, the hardest part of thinking about all of this is already being done by scientists and public health workers who are working on it 24/7. They have technically offloaded the burden of figuring things out from most of us.
  12. Accept that almost every human around you is affected in some capacity. Almost everyone around you is sad, frustrated, angry, helpless, and worried about something new. Show kindness and compassion.
  13. Find a way to make your day rewarding, fun, and meaningful. The lack of work and socializing can create an existential crisis so find things that you are motivated to do and try feeling a sense of accomplishment and control.
  14. Be grateful for the things and support you have during the crisis.
  15. Take solace in the fact that this too shall pass. We have in the past, and we will in the future. Our collective job is to get through it better and more effectively every single time.

Humans bounce-back quickly. Psychologists call it the “Hedonic Treadmill.” The hedonic treadmill describes how humans quickly return to “normal” and “stable” after a high-stress event. People have a set-point for their well-being and normal functioning. When an extreme event changes their circumstance, they are temporarily disrupted but they return to their normal, adjusted selves. The coronavirus will strain us right now but we will return to our set-point – like we always do. Assure yourself that you can get through this responsibly. Don’t lose hope. Remember the healthcare workers, think of what you can do after this is over. A meme eloquently said – If this is hell and hell is so bad, why wait in hell? Keep moving through it.

When social distancing starts taking a toll on your mental health via boredom, worry, or unmet needs, place your mindset in an altered context – a pandemic is an altered context which demands different behavior and constant reality checks. Talk to other people. Call up a mental health professional or seek online counseling. But most importantly, follow official guidelines.

Special note for healthcare workers and people who have to do their job for the rest of the world to function:

Doctors, pharmacists, store-owners, commercial business staff, delivery people, drivers, police, housekeeping, etc. – The world owes you tonnes of gratitude.

Hypocognition and the burst of new thoughts and emotions about the world

Most of us have been exposed to new types of information and types of thoughts because of the pandemic. Many of the words and processes we’ve come across in recent times are new in our awareness. Words like pandemic, endemic, propagation, DNA, RNA, death rate, incubation, etc. are not our typical words. These ideas exposed many of us to a lot of the other diseases that have spread. A lot of posts have shown us information about death rates from different diseases. All that new information comes with new emotions. That information removes our initial state of hypocognition[19]. (hypo = under/below, cognition = mental representations & thoughts)

When we lack the words and mental representations (visuals, processes, connections) to describe something, we are in a state of “hypocognition.” Hypocognition reduces our ability to comprehend novel things and experiences. Labels and words, even trivial ones, ground our knowledge concretely. Without them, information is poorly processed. Hypocognition also suppresses the experience of feelings, thoughts, and suppresses their expression. Social media shares, news channels, influencer posts, authority websites, etc. reduce the hypocognitive state and amplify the associated emotions tied to the newly gained knowledge. We are now able to express our worry with details, we are now specifically angry at the irresponsibility of others, we are now looking for things to blame, we are now engaged in making predictions because we learned something new. Some of this is to reduce uncertainty. Some of it is just because we are no longer suffering from hypocognition. It’s easy to overthink and freak-out about the new information because it is new, fresh, and emotionally loaded. It is easy and reasonable to feel scared and anxious about the spread of CoVID-19.

On the other hand, too much exposure to news that scares you might actually reduce the perceived intensity of the virus instead of amplifying it. This is the mere-exposure effect[20] – familiarity increases positive feelings toward something and reduces the initial negative feelings. Some people might become passive and act casually about the threat due to the power of exposure. The mere exposure effect might reduce our sense of threat but it’ll also reduce hypocognition which increases our knowledge of the threat. Perhaps now some of us will empathize with germophobes and meticulous doctors.

Taking a risk can induce a lot of guilt and worry. Focus on what you can do next to improve your decisions about risks. Be mindful and rational in such situations.

One reason why knowledge about COVID-19 has spread so quickly is that it managed to tap into our emotional contagion – looking at emotional behaviors and thought patterns trigger similar behaviors and thoughts in us. The spread of emotional contagion is accelerated by how interlinked we are via social media, bite-sized tweetable conversations, and how our concerns are aligned with global phenomena.

Couple social distancing with the all-time densest social media network with 3 billion people and you have a recipe for viral memes, not viral… viruses.

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