NPR's Audie Cornish talks with neuroscientist Gaurav Suri and emergency physician Leana Wen about why it's hard to understand the risks involved with the coronavirus.
AUDIE CORNISH, HOST:
When it comes to COVID-19, there's no shortage of messages guiding you on how to navigate risk.
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UNIDENTIFIED PERSON #1: We all have a role to play in preventing person-to-person spread of this disease, which can be deadly for vulnerable groups.
UNIDENTIFIED PERSON #2: Don't crunch the numbers and work inside the box. If you're sick, stay home from work.
TONY GONZALEZ: Hi, everybody. Tony Gonzalez here, urging you to stay at home, take care of your family, protect yourself.
CORNISH: And if that doesn't get you, then there's the data - charts with jagged lines, maps - so many maps - with the states shaded yellow, orange, and, these days, mostly red; tips on how to wash your cloth mask - yes to putting it in the dryer, no to putting it in the oven. But we still take risks and not always smart ones.
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LEANA WEN: There's this misunderstanding that if I'm doing one thing that's risky, I might as well do other things that are risky as well. But actually, it's the opposite.
CORNISH: People like Leana Wen think about this a lot.
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WEN: I had a patient who was so careful about everything. She was not going to the grocery store. She was not taking buses, not even having dinner with her grandchildren. But for some reason, she really trusted her neighbors and a few group of friends and would invite these neighbors and friends into her home without necessarily asking, what were the risks that they were then exposed to?
CORNISH: Wen is a doctor and the former public health commissioner for the city of Baltimore, where I met her a few years back. Back then, she was convincing opioid users to carry anti-overdose kits. Since the pandemic, she's been talking about the idea of a risk budget, not to be confused with the other suggestions out there, the risk calculator or the protective layers of a safety lasagna - you know, masks, social distancing outdoors and so on. The risk budget works like this. Just as every family has a different pool of money to budget with, the same goes for risk.
WEN: If you have underlying medical conditions, you're older, maybe you live in an area also where coronavirus is really surging, you have a more limited budget than someone who is otherwise pretty healthy and in an area where coronavirus is well-controlled.
CORNISH: Then, Wen says, you have to figure out how you want to spend that risk.
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WEN: The idea is that we might want a lot of things, but we know that we have to decide at some point, what are those things that are the most important? And set a budget accordingly. We have to keep in mind that with coronavirus, that risk is cumulative. So if you are doing one thing that's risky, you should be trying to cut down the risk in other ways. Let's say that you say, as I think a lot of parents will, my kid being in school for learning is the most important. Well, if that's the case, you should not also be doing the play date and the extracurricular activities. You should also not be going to that restaurant to be eating inside.
CORNISH: But part of the problem is we really let our guard down when it comes to friends and family.
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WEN: There is a magical thinking that we often have that somehow, those that we love and trust - we love them. They can't possibly be giving us coronavirus. Well, they're not intending to do so, but people we love and trust could just as well have coronavirus and not know it as strangers.
CORNISH: And there's another factor contributing to our blindness to risk. It's the way our brains are built to process the world. For that, we go to Gaurav Suri, a computational neuroscientist at San Francisco State University.
GAURAV SURI: Audie, I'm informal. I usually go by Gaurav.
CORNISH: Basically, he studies how we make decisions.
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SURI: There is a myth that we take in data. We compute it, and we come out with the right decision. That's not how humans actually decide. We have multiple decision-making systems. In the context of the pandemic, what's happening is that one system - the associative, effortless system - is telling us that things are OK. We go outside. The streets look the same. We look in the mirror. We look the same. Our family often looks the same. All of these cues in the environment are lending weight to normal actions.
CORNISH: Right. It's a weird consequence of also a disease in which you die in isolation, and your family can't even necessarily mourn you. It means that we aren't seeing other people who are affected by this.
SURI: Exactly. We aren't seeing these other people who are affected by this. And often, that information is more abstract. It's something we've read about, or it's something that we've heard statistics about. And that kind of representation engages this second goal-directed way of thinking. And that way is more resource-intensive. It takes more effort, and it's slower.
And when we have these two systems in conflict, one is saying, things are the same. We should go about our business as usual. And the other is saying, no, things are profoundly not the same. There is this tension between these systems. And the second system is slower and weaker in humans. That's why we falter. We sometimes will proceed in ways that are too risky because that first automatic system is taking hold of our behavior.
CORNISH: Most of us feel overwhelmed. We are listening to the news too much. I hear the term doomscrolling for, like, reading through social media feeds and just taking in bad news and bad news. How do we make this a little easier on ourselves, if at all? Maybe that's the wrong question.
SURI: I think it can be made easier on ourselves. I think it's important not to doomscroll. It's also important not to completely ignore the information because the information is a reminder for our goal-directed system to come online and stay online and be our friend. But there are other nudges that we can do. Many habits come about slowly, and they can be nudged into place. So one thing we could do is have masks visibly around the place where we leave our house. Make it easy on ourselves. Have masks in the car. These themselves become nudges and reminders to change our situation in a way that it enables us to do the right thing.
Another thing we could do is to use our social nature. For example, if we tell people around us that we are really, really into protecting ourselves and them and want to, over these next three or four high-risk months, be really careful about wearing our masks - if we actually tell that to our friends and family, we're more likely to do it.
CORNISH: The other thing is - I don't know about you, but I'm exhausted. I mean, if you're just every day trying to figure out, did I clean off all the doorknobs? Or should I use hand sanitizer this particular time? Or I'm outside, but am I actually standing six feet away? Or someone asked for a play date, and I don't know how to get into a conversation with them to say effectively, I don't trust your family (laughter), so I don't plan on having a play date with you and my kids. It's just like we're wiped, no?
SURI: Absolutely. We're wiped. And this is exhausting. The good news is that all actions eventually become easier with repetition. And I don't know how long this state of affairs is going to last, but I think the more we do it, the easier it will become. There are cultures in which people routinely wear masks, and they're not going through all the effort that we have to because it's new for us. We have to engage our goal-directed system to do that. Learning to drive is a lot more effortful than driving, and that's kind of where we are.
CORNISH: That's Gaurav Suri, a computational neuroscientist at San Francisco State.
Tomorrow, we'll continue our series on how we're processing and understanding the pandemic with a conversation about how TV writers are showing us the toll of this disease on screen.
UNIDENTIFIED PERSON #3: It's really interesting living inside the pandemic while depicting the pandemic.
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