Dr. Mike shares tips for balancing risk while staying informed
In our latest Community Conversation, we spoke with Dr. Mikhail Varshavski – known to his 6.1 million YouTube subscribers as Dr. Mike – to talk about this trend, how to most effectively respond to it, and other frequently asked questions about navigating a constant state of COVID-19 preparedness.
The point that Dr. Mike most wants to stress is that people should stay alert, not anxious, because most people with this virus suffer mild symptoms, especially if they’re younger and have low risk factors. But the virus spreads two to three times faster than influenza, quick enough that even a low percentage of severe symptoms can still overwhelm health care systems.
At the same time, being constantly hypervigilant can cause emotional fatigue and poor decision-making. To help combat “caution fatigue,” he recommends:
- look for news from reliable sources
- consider information before allowing emotions to dictate behavior, and
- carefully weigh a decision’s pros and cons as it relates to your particular needs.
A five-second rule for social media
One problem Dr. Mike notes with the response to COVID-19 has been the mixed guidance over time.
For example, initially the surgeon general recommended that people shouldn’t buy masks. In part, this was due to a shortage of personal protective equipment (PPE) for health care professionals. But it was also because there wasn’t enough evidence that masks would protect the general public.
However, evidence has since shown that infected people can be asymptomatic or pre-symptomatic virus spreaders. This means that our response must change. The surgeon general now recommends that people wear a face covering when in public.
Such changes in guidance can be as confusing as they are frustrating. Which is why Dr. Mike recommends staying up-to-date with news from reliable sources such as the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and your local hospitals.
“If you happen to come across a claim on social media that triggers you emotionally,” Dr. Mike warns, “before you share it, pause to give your brain a little five-second break.” We’re all susceptible to emotional thinking, and that five seconds is enough to allow us to think more critically and decrease the spread of misinformation.
Lately, social and traditional media relate that younger people are now more susceptible to the disease, while children are returning to school. However, there’s confusion about just what is meant by ‘young people.’ “When we say young people,” Dr. Mike explains, “we generally mean those under the age of 40,” because in the early months of the pandemic, the hardest hit community was over the age of 40.
The media tends to portray ‘young people’ contracting the virus by making risky decisions like going to parties. And sometimes that’s true. “But, many times, they’re doing essential work that exposes them to the disease. We take for granted that we have Amazon delivery workers, the USPS is still working, and gas stations still have attendants. Those are generally not 60+ individuals working, because they’re at high risk,” he explained.
Younger people need to understand that, whether they are exposed through work or personal decisions, it isn’t only about how the virus will affect them, it’s about how they can affect others. Dr. Mike makes it clear that people can be asymptomatic and still spread the virus to their grandparents, or to friends who then expose their grandparents, or to people at work who may not have a great immune system.
It’s also important to note that hospitals’ intensive care units (ICUs) in many parts of the country are functioning at near capacity. Which means, Dr. Mike stresses, “that even if a small percentage of young folks start getting sick, they can overload the ICUs.” Suddenly, those systems become unable to deliver trauma care, cancer care, or infusions … and the situation with COVID-19 will worsen to the point that local hospitals can simply no longer deliver critical care to their communities.
The danger of caution fatigue
We need to return to normal, but we must be smart about it. “Six feet of social distancing,” says Dr. Mike, “is a great first step. Wearing a mask and washing your hands thoroughly are more great steps.” And, this guidance continues to evolve as we learn more about the virus. That in itself is problematic, because of a phenomenon known as caution fatigue.
In medicine, when an alarm is constantly going off, explains Dr. Mike, “eventually, our brains stop paying attention to it – and that’s a danger.” This alarm fatigue is what many of us might be experiencing with all the warnings and updates of the guidelines regarding COVID-19.
“The purpose of an alarm,” Dr. Mike says, “is to make sure you catch things early enough to step in. But with COVID-19, we’ve been getting so much guidance.” To the point that it’s hard to stay motivated to follow it all. Especially in the face of other needs – such as the need to pay bills, buy groceries, or return to campus.
“People want their doctors to have all the answers,” Dr. Mike worries. “But the truth is we don’t. We will continue to learn, and the guidance might change, and I don’t want that to frustrate folks!”
The costs and benefits of returning to social life
When Dr. Mike thinks about returning to social activities, he comes back to the aim of medicine: balancing risks and benefits.
In his practice, patients ask specific questions – if they can play a musical instrument around others, go to a bar or restaurant, or engage in sports. The answer depends on the relative value the person places on engaging in those activities, versus the risks those activities place on the patient and on those around him or her.
Dr. Mike recommends considering three factors:
- The environment: Outdoor activities are better than indoor activities, because wind, humidity, and sunlight lower the spread of the virus.
- The number of people: There’s less risk in having one person visit you at home than going to a party with 50 people.
- The amount of time: More time spent exposed to the virus increases the chance of getting ill; a slow walk browsing through a department store is riskier than a quick trip to the grocery.
Going back to school
For New Jersey, and much of America, schools are about to reopen. Many parents are asking themselves is if they should opt for in-person or all-remote learning.
One challenge Dr. Mike sees in making this decision is in the number of people involved: “employees at the school, the teachers and custodians; then you have the students; and then you have this other group of people, the families of the students.” All of these parties have legitimate concerns that need to be addressed.
In Dr. Mike’s view, isolation is toxic for the human mind and, in most cases, he feels that “schools need to reopen. Kids need to get back to school.” But, just like other aspects of society, schools need to reopen safely and intelligently.
“Does that mean there’s a one-size-fits-all solution?” Dr. Mike asks rhetorically. “Absolutely not.” Every state, every municipality is going to have a different set of challenges – differences in funding, in resources, in cases of COVID in their community – and so they’re all going to have a different set of guidelines on how to return safely.
One thing they’re all going to have to do is remind kids, especially younger kids, who sometimes need a layer of discipline, to wear masks, wash their hands, and stay physically distant.
“And then,” Dr. Mike considers, “the next part is that we have to be adaptable and ready to pivot.” We must be prepared to reassess the situation, to look at the number of cases in teachers, students, and staff, he says. And we must ask ourselves if the benefits of reopening outweigh the costs, and what remedies are needed to best satisfy the different needs of all of the stakeholders in the children’s lives.
Remember to stay alert – not anxious!
All interventions have risks and benefits, whether it’s taking medication or, in the time of a pandemic, returning to school, work, or the grocery store. The value we place on these activities must be weighed against our personal costs and the costs we bring to those around us.
Guidance about COVID-19 will continue to change as information emerges from research, and it’s important that we all stay informed. But even that need must be balanced against the real threat of caution fatigue.
Keeping up with guidance from dependable sources will help us stay alert – not anxious!