As the pandemic wears on, many people are beginning to relax their safety practices and return to old routines and activities they used to enjoy. But letting down your guard can be dangerous, particularly for people with medical conditions — including cancer — that put them at risk of becoming seriously ill from COVID-19.
One reason people are becoming lax about coronavirus safety is what psychologists call “caution fatigue,” which can lower your motivation to continue following safety recommendations.
Caution fatigue “occurs when we become desensitized to stress and warnings, and we outweigh the valid risk of injury or infection with the benefits of seeking a reward like human connection, exercise, or being in the outdoors,” said Jackie Gollan, Ph.D., associate professor of psychiatry and behavioral science and a clinical psychologist at Northwestern University’s Feinberg School of Medicine in Chicago, during an interview on the Breastcancer.org podcast.
When we receive repeated warnings or alarms, our brains work to reduce the stress caused by these warnings.
“Initially, fear is registered in the brain,” Dr. Gollan said. “But over time, another part of our brain is going to dampen down the fear response to lower the stress level.”
As we continue to receive warnings that make us feel fear, our brains work to assess whether the threats we feel are real or perceived.
“Fear is registered in the brain, and over time we start to use another part of our brain to understand the context of the threat to understand whether it’s real or not,” said Dr. Gollan. “And that context helps us dampen the fear response.”
And Dr. Gollan said it’s hard to adopt new routines, like wearing masks and social distancing, particularly when we often don’t have a strong sense of the actual consequence we’re trying to avoid.
“When we set ourselves new goals that require extra effort and attention, it’s hard to do, and it’s hard to remind yourself to do it when nothing bad happened to you,” she said. “Because there was no actual consequence you feel you have removed, it’s hard to stay motivated when everything is going OK.”
It’s also important to know that caution fatigue can cause you to believe you are safer because other people are following safety recommendations.
“If we know that others are taking safety precautions, we might do things that are more risky, like not wearing a mask and assuming we are safe because everyone else has taken those safety precautions,” she said. “That concept is called ‘risk compensation,’ which is saying, ‘I don’t need to do these things because the world out there is safer because others are engaged in safety behaviors.’”
And as the holidays approach, there’s even greater temptation to ignore social distancing rules to see family and friends. But according to Elizabeth Robilotti, M.D., assistant attending physician and associate medical epidemiologist at the Memorial Sloan Kettering Cancer Center, keeping holiday gatherings virtual is the safest way to celebrate, particularly for those at high risk due to medical conditions, such as breast cancer.
“I think it's important for breast cancer patients to consider where they are in the course of their treatments before engaging in that type of in-person visit with friends and family,” said Dr. Robilotti during a recent appearance on the Breastcancer.org podcast. “And they should discuss this with their oncologist, in terms of their plans.”
For people receiving treatment for breast cancer, it’s important to be aware of caution fatigue and continue to protect yourself from COVID-19. According to the Centers for Disease Control (CDC), being diagnosed with cancer increases your risk of severe illness from COVID-19. And being in active treatment, particularly chemotherapy, can weaken the immune system and increase your risk of infection.
Dr. Gollan said there are several ways you can fight caution fatigue and stay vigilant about your safety.
1. Return to your safety routines from the early days of the pandemic.
Revisiting the higher levels of vigilance many of us had about staying safe during the first months of the pandemic — like staying home as much as possible — can help you maintain safety routines to fight caution fatigue.
“If you can adhere to and comply with the schedules you had in the first month of this, that might be useful,” said Dr. Gollan. “Remind yourself there are basic rules you want to follow about social distancing, disinfecting things in your home, washing your hands, and wearing a mask.”
2. Set goals for safety and reminders to follow through.
Dr. Gollan said setting goals like always wearing a mask or washing your hands frequently can help you to maintain a safety routine. And the key to achieving those goals is to make it easier through thoughtful preparation.
“Put your mask where the door handle is, or put notes up like ‘wash your hands’ to remind you to get to this new goal,” she said.
3. Take small steps.
Creating and maintaining a safety routine can be overwhelming, particularly for those already dealing with the cancer treatments. Dr. Gollan suggests taking it one step at a time.
“Start with a small goal,” she said. “Deal with the routine you have this morning — don’t worry about this afternoon. And once this afternoon comes, reset your focus on that.”
4. Think about others.
Dr. Gollan said it’s important to remember that COVID-19 safety protocols aren’t just about protecting yourself — they’re meant to keep everyone safe.
“Focus on the risks that may be created for others,” she said. “You know how important it was for yourself to get through treatment — it’s really thinking about a behavior having a value, a ‘we’ think and not a ‘me’ think. Commit to keeping others safe.”
5. Seek information from a variety of sources.
Hearing repetitive messages is one of the things that can give us caution fatigue. Dr. Gollan said watching or reading news from the same source can intensify this effect. She suggests getting news from a variety of sources to increase your sensitivity to risk.
“Change up where you get your news about COVID and the pandemic so you start paying more attention to it,” she said. “When it’s different, we start to look at that information as new and start to think about it. Read across different newspapers and non-dramatic news shows to keep yourself alert.”
6. Take care of yourself.
Dr. Gollan said engaging in acts of self-care and doing everything to strengthen your mind and body can help you avoid caution fatigue.
“Set up a schedule of daily activities that build your physical and emotional strength,” she said. “When we think about fatigue, it’s a depleting, draining kind of experience. We want you to think about exercising safely, eating properly, setting achievable goals, so you feel emotionally and physically stronger as you’re getting through this.”
It’s important to remember that COVID will not last forever. But sticking to new habits that reduce your risk of being exposed to this infection is so important during this challenging time.
“There’s going to be an end to this,” Dr. Gollan said. “And hopefully we’ll be able to return to a new routine that is safe and about taking care of each other.”
Written by: Jennifer Bringle, contributing writer
This content was developed with contributions from the following experts:
Jackie Gollan, Ph.D., associate professor of psychiatry and behavioral science and a clinical psychologist at Northwestern University’s Feinberg School of Medicine in Chicago
Elizabeth Robilotti, M.D., assistant attending physician and associate medical epidemiologist at the Memorial Sloan Kettering Cancer Center
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