Last summer, we began seeing articles on COVID-19 fatigue. But these articles weren’t about the well-known side effect of the virus; these were all about “caution fatigue.” Caution fatigue is the state of desensitization after a long period of hyper-vigilance. Imagine there is a bear clawing at your front door: at first you might be very afraid, but after hours of listening to the bear at the door, you might stop worrying so much – even though the danger hasn’t gone away. The same thing has happened with the pandemic, and it’s putting us all at risk.
We recently passed the [one-year anniversary] (https://www.ajmc.com/view/a-timeline-of-covid19-developments-in-2020) of the first recorded COVID-19 case in the United States. After so many months of health-related stress, it’s no surprise that people are finding it more and more difficult to stick to the CDC guidelines. According to [psychologist Dr. Susan Albers] (https://health.clevelandclinic.org/how-to-fight-coronavirus-caution-fatigue/) of the Cleveland Clinic, at first the news of the pandemic shocked us all into a fight-or-flight state. But as time wore on, we became exhausted by that highly stressed state. People who weren’t directly affected by COVID-19 stopped feeling like there was a clear and present danger.
But the pandemic is not over. The bear is still at the door. The vaccine isn’t a silver bullet, and researchers have identified several new variants of the virus which appear to be highly contagious.
First, keep in mind that most viruses mutate rapidly. Every time they replicate, there is a good chance that there will be errors in the genetic material, causing a mutation. Not all of those mutations become permanent, because not all of those genetic changes are useful to the virus. But a high rate of mutation does mean that viruses can evolve quickly.
That said, coronaviruses are one of the few classes of RNA viruses that have “proofreading ability.” They have an enzyme that fixes errors in the viral genome, so they mutate less frequently than other viruses. (This proofreading enzyme makes COVID-19 more difficult to treat.)
Despite its built-in spell-check, COVID-19 has had enough time and hosts to mutate. So far, the following variants have been identified:
- B.1.1.7: Detected in the UK in September, this highly transmissible strain has spread to other countries around the world, including the United States and Canada.
- B1.351: Found in South Africa in October, this variant shares some of the same mutations as the UK variant.
- P1: Identified in four travelers from Brazil in December, this variant has several mutations that also seem to make it more infectious.
- [COH.20G/501Y] (https://wexnermedical.osu.edu/mediaroom/pressreleaselisting/new-sars-cov2-variant): Discovered in December, this strain is one of two variants detected by Ohio State University researchers in Columbus, Ohio. This variant has mutations which make it different from the B.1.1.7, B1.351, and P1 strains.
All of these strains have mutations that affect the spike proteins and make the virus more contagious. While this doesn’t mean the variants are more deadly, a higher rate of infection is still dangerous. As more people get sick, the chances of severe illness and hospitalization increase – as do the chances that the virus will continue to mutate. These variants could also lead to reinfections for patients who have already recovered from a different strain of the virus. That’s why we must continue to take the pandemic seriously, no matter how much caution fatigue we feel.
The good news: the current vaccines will still work against the new strains. That said, Moderna has found that their vaccine is slightly less effective against the B1.351 variant. An additional booster shot may be added to the existing two-dose regimen.
Keep in mind that while the vaccines protect people from severe illness, vaccinated people may still be able to transmit the virus to others. Even after receiving a second dose, we need to continue following pandemic protocol to protect the people around us.
Continue wearing masks
Double-masking may help keep you and others safe, but it depends on the situation (and the masks you’re using). Layering a cloth mask over a surgical mask can improve filtration considerably, but even improving the fit of a single mask can make a difference.
Keep your hands clean
By now, sanitizing your hands after being in a store and washing your hands when you return home are probably second-nature. But if you haven’t got into the habit of keeping your hands extra-clean, start today! Keep hand sanitizer in your car, purse, coat pocket, or wherever you’ll remember to grab it. Although the chance of contracting COVID-19 from contaminated surfaces is low, wash your hands after you grab the mail or bring in your latest food delivery.
Make the most of delivery and curbside pickup
Speaking of food delivery: take advantage of the now-ubiquitous contactless options. Grocery stores and restaurants all over the country have added delivery or curbside options. Many pharmacies have invested in delivery options. Patients can also request same-day home delivery with ScriptDrop.
The risk presented by the pandemic is real. [Over 400,000 Americans have died] (https://covid.cdc.gov/covid-data-tracker/#cases_casesper100klast7days) from COVID-19. We are seeing mutations in a virus that is comparatively less likely to mutate because it has had so much time to spread and so many hosts. It’s more important than ever to stay vigilant and fight caution fatigue.
Dr. Jacqueline Gollan of Northwestern Medicine says, “It’s hard to assess peril and risk… when the risk is invisible.” We all need to actively fight against the temptation to do things that will bring us joy in the moment but could spread COVID-19. Seek safe ways to connect with others, like virtual game nights or becoming pen-pals. For those struggling with loneliness, seasonal depression, and mental health concerns, don’t keep your pain to yourself. Talk to loved ones and ask for help.
We all must continue to take this seriously. Don’t put your loved ones at risk. Don’t put your employees at risk. Don’t put strangers at risk! Wear your mask correctly, keep your hands clean, use delivery and pickup whenever possible, and get the vaccine when it is available to you. Together we can scare the bear from the door.