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Bothered and Bewildered, No More

Confusing, inconsistent guidelines and ever-changing, baffling recommendations seem to have left many of us not quite bewitched, but certainly bothered and bewildered.

Confusing, inconsistent guidelines from medical professionals, ever-changing baffling government recommendations, huge plot-twists, muddying daily news flashes, flawed research, gut-wrenching headlines, all seem to have left many of us not quite bewitched, but certainly “bothered and bewildered.” Like Ella Fitzgerald and Frank Sinatra in their famed song, Bewitched, many of us have become “a simpering, whimpering child again.” 

Is it “safe” to go to shopping malls, grocery stores, bars, gyms, movie theaters, churches and synagogues, attend gatherings at private homes, or travel in commercial airplanes? Yes? No? May we safely get haircuts? And oh my goodness, those masks. Should we wear them? Yes, we should? No, we don’t have to wear them? Who really knows? It seems the answer is, nobody. 

There are surely many puzzling risk factors we face during this pandemic of COVID19, with its associated anxiety, depression, stress and loneliness. The famed quote of Mark Twain comes to mind, “Be careful about reading health books. You may die of a misprint.” 

Jacqueline Gollan, the associate professor of psychiatry and behavioral sciences at the Northwestern University Feinberg School of Medicine who coined the term, “caution fatigue,” referring to low motivation or energy to observe safety information. “We outweigh the risks of our situation for other goals, health benefits of connection and normal routine. It can make people vulnerable to suggestions to bend COVID-19 safety guidelines,” she said in a recent interview. And Dr. Collin Reiff, a psychiatrist and clinical assistant professor in the Department of Psychiatry at NYU Langone Health observed, “People are tired of COVID. A lot of people at the beginning of this experience had an adjustment disorder because of acute stress. But now that the stressor is being removed, there’s less anxiety around this, which is dangerous in a way because it’s still very much alive and real,” he continued. “We all want to believe things are getting better, but that’s not necessarily consistent with reality. People don’t want to believe the numbers because it’s an inconvenient truth.” 

Confusion overflowing. Muddle in abundance. Uncertainty always. Hazards galore.

The CDC tells us that “it is important to learn about risk factors for severe COVID-19 illness because it can help you:

  • Take precautions as you go about your daily life and attend events.
  • Better understand how a medical condition could affect your own health if you get sick with COVID-19.
  • Anticipate medical treatment that you might need if you get sick.
  • Reduce your risk for severe COVID-19 illness by managing any conditions you have that are risk factors.”

If it were only so easy to take just the right safeguard, correctly understand this medical condition, anticipate proper medical treatment and appropriately and safely reduce all risk of this illness. But it’s not. In the end, like all of life with its daily jeopardy and hazards it is up to us, individually, to make our own calculated decisions, improvise and fumble through. If you’re looking for certainty, the only certainty is death.

Robert H. Shmerling, MD, Senior Faculty Editor for Harvard Health Publishing notes that when you are about to, “relax restrictions in your work or social life, consider these three important steps: 

And the CDC weighs in with more specific suggestions to best protect ourselves when it comes to personal and social activities:

  • Stay home if sick.
  • Wear a cloth face covering when less than 6 feet apart from other people or indoors.
  • Use social distancing (stay at least 6 feet away from others).
  • Before you go, call and ask what extra prevention strategies they are using, like requiring staff to wear cloth face coverings.
  • Wash your hands with soap and water for at least 20 seconds when you get home.

These recommendations, from so many sources, are enough to add to the anxiety that many feel during this pandemic.  From changes in eating and sleeping patterns, fear and worry about your own health and the health of loved ones, concerns about your financial situation or job, increased use of tobacco and alcohol or other substances, these are some indications that dealing with the current situation is taking its emotional toll. 

Then, of course, there are the numbers that float in, and trouble, our mind. Public health officials in San Diego County, where I live, reported this past weekend a single-day record of 497 new positive COVID-19 cases and one additional death, bringing our county’s totals to 13,334 cases and 361 fatalities. 

So how do we deal with all of this to reduce risk without becoming more bothered and bewildered than we already are? I find Dr. Shmerling’s “5 Ps” to offer an especially helpful structure in wisely assessing the risks we face.

  • “Personal risk tolerance. Is your mantra “better safe than sorry”? Or is it closer to “you only live once”?
  • Personality. If you’re an extrovert, you may be willing to dial down your restrictions (and accept more risk) because the alternative feels like torture. For introverts, limiting social interactions may not seem so bad.
  • Priorities. If you put a high priority on dining out, getting your hair done, or getting a tattoo, it’s a bigger sacrifice to put these off than it is for someone who doesn’t care about these things.
  • Pocketbook. Although the pandemic affects everyone, it does not affect everyone equally: some can weather the economic impact better than others. As a result, keeping one’s business closed or staying home from work are less appealing for some than others.
  • Politics. One’s preferred sources of information and political affiliation have a dramatic effect on views about restrictions related to the pandemic.”

With these “5 Ps” guiding your decisions and being better able to put COVID19 into a rational perspective, you may find you’re a bit more like Frank and Ella

“Wise at last, my eyes at last
Are cutting you down to your size at last
Bewitched, bothered, and bewildered…no more”

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