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How To Deal With Renewed COVID Anxiety

Aug 12, 2021
Originally published on August 14, 2021 9:58 am

Updated August 14, 2021 at 10:58 AM ET

Many people were calling this the "hot vax summer," as growing vaccination numbers against the coronavirus meant a rebound in travel, and early summer CDC guidance said it was safe to return to eating indoors at restaurants and bars.

"I think people were starting to think that there's a light at the end of the tunnel in the spring," Dr. Lucy McBride, a primary care physician in Washington, D.C, says. "People were getting vaccinated. Case rates and hospitalization rates from COVID-19 were dropping. And we knew at that moment in the spring, through accumulated evidence, that kids are protected at least in part by being surrounded by immune-vaccinated or naturally immune adults."

Things look starkly different now. The highly contagious delta variant is driving a new surge of COVID-19 cases throughout the country. Masks mandates are back, and instead of experiencing nerves over relearning how to socialize with people in person, many are dealing with feelings of anxiety, frustration and grief, knowing that this pandemic is far from over.

"Does anyone have an antidote for emotional whiplash? My vaccinated patients are asking," Dr. McBride tweeted last month. Her own advice is that anxiety is a justified emotional response: "It's how we run from danger," she says. But it's also important to remember "to calibrate it to our particular reality," otherwise we risk running our bodies and minds into the ground.

Dr. McBride spoke with All Things Considered's Ari Shapiro about creating coping strategies for anxiety, the effects of decision fatigue — a deteriorating quality of decision-making when faced with serious questions like whether to cancel trips home or taking kids out of in-person school — and how the path forward rests on a careful line between hope and realistic expectations. Listen in the audio player above, and read on for highlights of the conversation.

This interview has been edited for length and clarity.


Interview Highlights

On accepting feelings of anxiety, grief and frustration

The first step is acknowledging the trauma that we've experienced, the stacked stressors we've all been through over the last 17 months. That is real: It takes a toll on our bodies and minds. And once we allow ourselves to feel those complicated feelings, then we can unlock some coping strategies like making sure we exercise, prioritize sleep, connect with our loved ones and follow the facts. Make sure that you are looking to experts, including your trusted primary care provider, for nuanced advice to help marry broad public health advice with your unique situation. There is no one-size-fits-all prescription for human behavior in a pandemic. So, we really need to drill down into what it is that gives us a sense of safety and security, what it is we need to feel protected from disease and despair in tandem, and that is going to look different for each person.

On how to deal with decision fatigue

There is no one-size-fits-all prescription for human behavior in a pandemic. -

We're wired, we're hypervigilant and we're tired; so many decisions, so much information. We need to realize that this is normal and that we need to give ourselves a little latitude and grace as we navigate these complex times. When we're exhausted, when our guard is down, that's when we're more prone to excess anxiety that's out of proportion to reality. That then drives behaviors that may not be appropriate for that particular situation. At the same time, we need to make sure we are protecting ourselves and our families and our communities from disease and despair. So I'm not saying I have the answer for everybody on this program; I'm saying let's recognize it, let's name it, and then let's navigate it with facts in the driver's seat and fear out of the driver's seat.

On maintaining hope while managing expectations for the future

It's justified to be mourning the loss of life as we knew it. It's justified to be emotionally exhausted watching the ongoing death and destruction. We also need to realize that amidst loss, there is reason for hope. We know that these vaccines against COVID-19 are extraordinarily effective, even against delta, at preventing the worst consequences. And we know exactly how to protect kids in school. We need, really, for everybody in this country to get vaccinated and to protect each other so we can move on in a healthy way.

At the same time, we also need to realize that COVID is here for the duration. It's not about eliminating risk; that's just not on the menu. But what we need to do is, just as we have to modulate fears so that we protect ourselves without driving ourselves crazy, we need to manage expectations for what life is going to look like once we have this virus under better control.

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ARI SHAPIRO, HOST:

This was supposed to be our hot vax summer. Growing vaccination numbers meant a rebound in travel, restaurants and bars. Instead, we're experiencing something like a whiplash summer with new mask mandates and growing numbers of cases and hospitalizations. Of course, this is tied to the delta variant and new scientific research about how contagious it is. Even though vaccines are still very effective, we can no longer describe this summer with a tidy back-to-normal narrative. Dr. Lucy McBride is a primary care physician in Washington, D.C., who also writes a COVID newsletter with medical and mental health advice. Good to have you back here.

LUCY MCBRIDE: Ari, thanks for having me.

SHAPIRO: You tweeted a couple of weeks ago, does anyone have an antidote for emotional whiplash? My vaccinated patients are asking. And I think a lot of people can identify with that tweet. Tell us what you were hearing from your patients as you wrote that.

MCBRIDE: Well, I think people were starting to think that there's a light at the end of the tunnel in the spring. People were getting vaccinated. Case rates and hospitalization rates from COVID-19 were dropping. And we knew at that moment in the spring, through accumulated evidence, that kids are protected at least in part by being surrounded by immune - vaccinated or naturally immune adults. So then when delta comes on the scene, it really dimmed the light at the end of the tunnel.

SHAPIRO: And yet, if you pull the camera back, compared to a year ago when we all lived in acute fear of catching a deadly disease that could send us to the hospital, today hospitalizations are overwhelmingly - deaths are overwhelmingly among unvaccinated people. And so is that fear, that grief, the despair, anxiety - whatever you want to call it - justified?

MCBRIDE: I mean, I think it's justified to be mourning the loss of life as we knew it. It's justified to be emotionally exhausted watching the ongoing death and destruction. We also need to realize that amidst loss, there is reason for hope. We know that these vaccines against COVID-19 are extraordinarily effective, even against delta, at preventing the worst consequences. And we know exactly how to protect kids in school. We need, really, for everybody in this country to get vaccinated and to protect each other so we can move on in a healthy way.

At the same time, we also need to realize that COVID is here for the duration. It's not about eliminating risk. That's just not on the menu. But what we need to do is, just as we have to modulate fear so that we protect ourselves without driving ourselves crazy, we need to manage expectations for what life is going to look like once we have this virus under better control.

SHAPIRO: So can you talk about how people are dealing with decision fatigue? After a year and a half of trying to make difficult decisions in the face of risk and partial information, now we're once again faced with - do I go to that crowded restaurant? Do I visit my vaccinated parents and spend time indoors with them without a mask? Like, how do we deal with the ongoing decision fatigue?

MCBRIDE: I think you're exactly right. We're exhausted. We're wired. We're hypervigilant. And we're tired. So many decisions, so much information. I think we need to realize that this is normal and that we need to give ourselves a little latitude and grace as we navigate these complex times. When we're exhausted, when our guard is down, that's when we're more prone to excess anxiety that's out of proportion to reality, that then drives behaviors that may not be appropriate for that particular situation. At the same time, we need to make sure we are protecting ourselves and our families and our communities from disease and despair. So I'm not saying I have the answer for everybody on this program; I'm saying let's recognize it, let's name it, and then let's navigate it with facts in the driver's seat and fear out of the driver's seat.

SHAPIRO: I'm laughing 'cause you refer to excess anxiety, and I think of that expression - just because you're paranoid doesn't mean they're not out to get you.

MCBRIDE: Absolutely (laughter).

SHAPIRO: A lot of anxious people right now are thinking, like, there is every reason to be anxious about the circumstances (laughter).

MCBRIDE: One hundred percent. Anxiety - remember - is our constant companion. It's how we run from danger. It's not to say that anxiety isn't justified; it's to say that we need to calibrate it to our particular reality because when we let anxiety run roughshod through our bodies and minds, that's when we are really exhausted and make decisions that aren't appropriate necessarily for that moment or for that particular decision.

SHAPIRO: So you've talked about how we're feeling right now and why. Let's end on what we do about it, especially when there is so much that is beyond our control, so much that is uncertain. What's your advice to your patients given that, as we said at the start of the conversation, there is no pill or shot that you can take for emotional whiplash?

MCBRIDE: I think the first step is acknowledging the trauma that we've experienced, the stacked stressors we've all been through over the last 17 months. I mean, that is real. It takes a toll on our bodies and minds. And once we allow ourselves to feel those complicated feelings, then we can unlock some coping strategies - like, you know, making sure we exercise, prioritize sleep, connect with our loved ones. And follow the facts. Make sure that you are looking to experts, including your trusted primary care provider, for nuanced advice to help marry broad public health advice with your unique situation. There is no one-size-fits-all prescription, Ari, for human behavior in a pandemic. So we really need to drill down into what it is that gives us a sense of safety and security, what it is we need to feel protected from disease and despair in tandem. And that is going to look different for each person.

SHAPIRO: Dr. Lucy McBride, primary care physician in Washington, D.C. Thank you so much.

MCBRIDE: Thanks, Ari.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.