Author(s): Lila Thulin

# Why it’s so hard to make risk decisions in the pandemic

Source(s):

Our brains weren’t built to do public health calculus like this, but following a few pieces of advice from the experts will help as you weigh your options.

Over the past two years, I like to think I’ve gotten practiced at a type of wretched multivariable calculus: pandemic decision-making. The process starts with the blue bubble of a texted invitation or a date flagged on the calendar—a party Saturday, a sibling’s high-school basketball game, a second cousin’s middle-school Quidditch match, a cross-country flight for a grandparent’s 90th birthday. Then other factors pile on like dog hair accumulates on a white couch.

What’s the transmission rate right now and is that number even reliable, if it’s reported at all? If I get sick, what’s the likeliest outcome, given how long it’s been since my last jab, age and other risk factors? How many attendees will be at an event? What do we know about the newest entry in our ever-expanding alphabet of variants? What is the CDC even advising about masks these days? Would I miss anything important if I caught Covid? How badly do I want to go?

A once-simple decision can morph into the kind of thorny equation that honors algebra didn’t prepare me for. If I am going to see Person X in four days, and they occasionally see their great-aunt on Sundays, and the test positivity rate is Y, and the event was supposed to be outdoors but it’s looking rainy, and someone was sniffling in the office yesterday but they swore it was allergies—what’s the hazard to myself and others, and is it worth it to attend? It is, of course, a privilege to be able to work remotely and make choices about what risks I am or am not willing to take with my health; but figuring it out feels exhausting.

Regardless of whether you’re a cut-and-dried decisionmaker or an overthinker like me, a solid chunk of Americans have found navigating the personal-responsibility era of the constantly evolving Covid-19 pandemic to be a choose-your-own-adventure exercise with the fun sapped out. An October 2021 study conducted by the American Psychological Association revealed that more than a third of Americans said the pandemic had made both simple and major decisions more stressful. Black and Hispanic respondents, parents and younger generations, in particular, experienced more of this pressure. As the BA.2 variant drives an upswing of cases in the Northeast and precautionary measures like mask mandates on travel end, Americans are, for the umpteenth time, faced with changed circumstances and the new choices that come with them. And unfortunately, our brains were not built for this.

More than a third of Americans surveyed said making simple and major decisions during the pandemic was more stressful than before it. 2021 American Psychological Association

“We’re built for simplification. We’re built for making fast decisions,” explains Kevin da Silva-Castanheira, a graduate student who studies the psychology of decision-making at McGill University. The human mind, he says—the wrinkly pink endpoint of millions of years of evolution—is “built to be cognitively lazy.”

The fact that our brains struggle with speedy risk assessment isn’t necessarily a bad thing. “[Humans’ decision-making process] does not always lead to inferior decisions…” points out Janet Yang, an expert in risk communication at SUNY Buffalo. “When a spider is crawling at you, for instance, you don't just sit there and calculate; you jump away immediately.” But those split-second or gut-reaction decisions can sacrifice weighing very real risks and benefits. If you learn about the gaps that might crop up in your logic, then you can take steps to make more reasoned decisions in the future.

As far back as at least the 18th century, economists seeking to understand decision-making proposed that, given enough information, individuals would behave logically and in whatever way maximized their own self-interest. Then, more recently, this “rational choice theory,” mostly gave way to a point of view that positions decision-making as a psychic war between emotions and rationality, with gut reactions holding significant sway. “The answer to an easy question (How do I feel about it?) serves as an answer to a much harder question (What do I think about it?),” writes Nobel Prize–winner Daniel Kahneman in the hallmark book on the subject, Thinking, Fast and Slow.

And even this framework continues to evolve. One corollary, proposed by Cornell University psychologists Valerie Reyna and Charles Brainerd, suggests a mental tug-of-war happens between more detail-focused and broader, concept-based thinking. Imagine you’re running late and tempted to speed. Nearsighted “verbatim” thinking would be calculating that there’s a low probability that a cop will see you speeding in this particular window and that you personally have never been in a car accident. Its opposite—what’s called “gist thinking”—would be realizing that as a rule, if you always choose to speed, you’ll probably eventually get ticketed or end up in an accident. Other emotion-influenced factors, like how tantalizing a reward is or your level of inhibition, join in to steer our actions.

As our brains are making a complex choice, we must keep multiple factors in mind at once, using mental storage space psychologists call “working memory.” Both someone’s personal working memory capacity and other outside limitations, such as a date by which you haveto book a flight or swirling emotions, set limits on our ability to clearheadedly analyze our options.

Not all risks are, in our minds’ eye, created equal. Individuals tend to avoid risks they consider unknown or dreadful, such as those that come with dramatically bad outcomes, like a hurricane. The level of autonomy you have in taking a risk matters, too: People tend to consider voluntary activities, like bungee jumping, as less dangerous.

Over the course of the Covid-19 pandemic, the hazard posed by infection has mutated. Some risks have changed quantitatively: for example, vaccines and boosters lower one’s risk of hospitalization and death. And the odds of getting infected have fluctuated along with the rise and fall of community case rates. Beyond the raw numbers, we also understand so much more about the virus than we did in March 2020, and the average person probably knows friends or family members who have recovered from Covid. That context means the chance of a positive test might feel less world-ending.

In May 2021, soon after vaccines became available for all adults, Yang and a graduate student, Jody Chin Sing Wong, surveyed Americans on how they perceived the risk of the coronavirus. People who found the pandemic more dreadful, they found, were more likely to keep up mitigation measures like washing hands or not socializing in a friend’s home. Now, she says, the popular attitude is moving from viewing the pandemic as a catastrophic event to a more chronic threat. But this balance is in flux: “Every time a new variant pops up, [the unknown dimension of the threat] shoots up again.”

If your community is among the two-thirds of U.S. counties where Covid rates are rising, you might find yourself reassessing the safety of various activities once again. Unfortunately, Yang says, “we are not rational beings most of the time.” So instead of carefully tallying the variables, you’ll be swayed by the context in which you’re making the decision, and you’ll probably default to heuristics, or rules of thumb.

Humans take dozens of cognitive shortcuts. There’s optimism bias. When asked to rate their own chances of getting Covid instead of their peers, people irrationally predicted that they were less likely to get sick. If have you just read a gripping article about someone experiencing long Covid, you might mask up more ardently, because vividly rendered risk is easy for your neurons to conjure. Factors like politics play in too; Gallup found that Republicans and Democrats differ in their estimates of the percent of Covid cases that result in hospitalization. And how far in the future consequences might crop up might influence pandemic risk perception. We’re shortsighted and often spring for an immediate small reward rather than the longer-term prize. Perhaps, for instance, someone would accept a free indoor dinner at a favorite restaurant this weekend instead of opting for a free dinner-and-dessert combo in a month or two, when case rates might fall. Our minds tend to either dismiss or overinflate small risks, with no middle ground.

The way risk is presented, or framed, matters too. In a 2006 study in Science, researchers gave students £50 and asked them to choose between a gamble (hold onto or return all £50) and a certain outcome (either “keep £20” or “lose £30”). The phrasing of the question affected their calls. The group selecting between “lose £30” and gamble proved substantially more likely to gamble than their peers, who were given the choice to “keep £20” or gamble.

Another fallacy we’re prone to: Once our minds latch onto a starting point, people don’t update their beliefs enough. For example, individuals asked to quickly multiply 1x2x3x4x5x6x7x8 estimated a far lower value than people asked to multiple the same exact numbers in reverse order—even though the answer is mathematically identical. And humans can be slow to incorporate new information into their guiding principles, particularly if the change in a variable is slight. Other times, we’ll update our beliefs faster in response to a positive development—Omicron BA.1 is less severe than Delta—than a negative one—it’s also more transmissible.

“Our decisions, unfortunately, are not necessarily based on rationality, or scientific information, or probability or statistics,” Yang says. Instead, “gut-level reactions tend to influence our behavior much more readily and automatically as compared to our calculated risk perception or analysis.”

Complex decisions don’t just boggle our brains; they exhaust them too. If you give someone a choice between doing a difficult or easy math problem, most people prefer the easier mental lift, da Silva-Castanheira explains. His thesis investigates the effort behind decision-making, and, he says, “There's a lot of evidence behaviorally that suggests that people don't like making [preference or risk-based] decisions…So, for example, when a decision is really hard, people tend to do things like stick to the status quo, or not even choose at all.”

A famous illustration of this decision avoidance took place in a gourmet grocery store. Customers shown a display of six flavors of jam purchased a jar ten times more often than the people shown 24 varieties.

A different series of experiments hinted that decision-making takes a mental toll. For example, participants asked to plan their course load showed depleted self-control as compared to others who were asked merely to contemplate undergrad classes. The decision-makers tended to stop studying faster. In other tests, people who’d had to make choices gave up on basic addition problems more easily and pulled their hands out of ice water faster.

Cognitive fatigue also seems to impact our ability to make deeply thought-through choices. One study found that as Scottish nurses’ shifts wore on, they played it increasingly safe when deciding on whether or not to refer a patient to another medical provider. Another discovered that approval rates for credit loan applications sagged as reviewers approached their lunch breaks.

The Covid pandemic has stressed Americans out. Since 2020, self-reported stress levels have remained higher than they’d been since 2015. Fretting over who will take care of a child who has to quarantine due to a Covid exposure or budgeting for rising inflation only increases the baggage on our brains. During the spring of 2020, da Silva-Castanheira surveyed adults across the U.S. about their level of pandemic-related worry. Faced with a simple matching task, worrywarts were thinking slower than their more Covid-unconcerned peers; the psychologists theorized that their stress was, essentially, hogging background brainpower.

Making decisions about what is or isn’t safe in a protean pandemic is a mental workout, essentially asking your brain to do burpees in a funhouse of distorted logic. Is there any way to make all of this easier for our poor minds? The experts Smithsonian interviewed offered a few tips:

First, make sure the information you’re basing a risk assessment on is accurate. Covid misinformation abounds, so double-check the source of the fact and make sure you understand its context. You don’t need to memorize every statistic, but make sure your core takeaways—what Reyna would call the “gist”—pass scientific muster. “You get [to a logical decision] much easier once you have intuitions that are rooted in correct scientific knowledge,” Reyna says.

Don’t overweigh anecdotal evidence, Yang advises. Just because a neighbor dined indoors in packed restaurants during the Omicron surge and didn’t get sick doesn’t mean you won’t if case counts shoot up. Instead, the communications professor recommends leaning on information from official sources, like the CDC or your local health department. (Admittedly, reliance on uncounted rapid tests and reduced government reporting can muddy the data; this website will point you to wastewater virus surveillance near you, and you can access CDC community-level reports here.)

Finally, sit tight when emotions are high. “Even though we might feel an urge to go out and have dinner for Valentine’s Day, for instance, it’s important to realize that emotions come in waves…they do dissipate. As much as possible, delay decisions, even if for an hour or two,” Yang suggests.

Personally, I’d call the past 25 months (and counting) wearying, especially as someone whose mind slicks over with a sheen of anxiety and indecision when confronted with a health risk. The science says that no matter how hard I try to weigh the pros and cons of going to a crowded concert, my conclusion will be messy instead of mathematically calibrated. So I’ll keep fumbling along, comforted a bit by the knowledge that I’m not alone in the exhaustion that takes hold every time another variant appears and disrupts our newest version of the “new normal.” Risky decision-making is a tall and taxing order, psychologically speaking. But by taking some simple steps and arming yourself with solid information about both outside circumstances and your own mental biases, you can have more faith in your judgments.