As restrictions ease, why people struggle with the COVID fear factor
For two years, Ontarians were told to keep at least six feet apart from others, wear a mask in public spaces, get vaccinated and wash their hands vigorously to protect themselves and loved ones from catching COVID-19.
But as the latest Omicron wave dips, the province is now making the boldest moves toward reopening yet. On March 1, all vaccine mandates in Ontario will be lifted, meaning people no longer have to provide proof of vaccination to eat at a restaurant or watch a movie. Later in the month, Ontario's top doctors hinted at a review of mask mandates, which have been in place since May 2020.
Other provinces and countries are moving in a similar direction, and at a much faster pace. In the United Kingdom, all COVID-19 measures have been lifted, including the need to isolate for 10 days after testing positive with the virus. In Alberta, mask mandates have already been eliminated for school-aged children.
By and large, many governments are signalling a transition toward a post-pandemic life. But experts in psychology say people's views on reopening will vary widely, based on both their lived experience and their attitude toward risky behaviours. Some have developed a stress response to the possibility of exposure to the virus, while others have tuned out any fears related to COVID-19.
Pandemics don't end at the same time for everyone," said Steven Taylor, a professor and clinical psychologist at the University of British Columbia, who has written a book on the psychology of pandemics.
There are big reasons to be wary for some: the World Health Organization has been monitoring a more infectious subvariant of Omicron that has been detected in 52 countries, including Canada. Those who are immunocompromised continue to worry about the risk of falling ill, while parents of children too young to be vaccinated say they feel like they are being left behind.
Some who are triple-vaccinated and not immunocompromised may also be apprehensive toward reopening for different reasons. Taylor said for a few, this fear is rooted in a stress response that grew as a result of the pandemic.
Some psychology literature in the past two years has even explored the idea of coronaphobia, describing an excessive triggered response of fear of contracting the virus causing COVID-19," a December 2020 study in the Asian Journal of Psychiatry said, to the point that it begins impacting a person's daily life.
Coronaphobia" isn't an official medical term or a diagnosable illness, Taylor said, and emerged as part of other terms like cave syndrome," referring to the anxiety of leaving the house, that researchers have used to describe current phenomena in society. Still, through his own research during COVID-19, Taylor said he's observed a small but significant minority of people who developed what he calls a COVID stress disorder - a heightened anxiety in response to the virus and the stressors it brings.
If you have this fear of COVID, you tend to have other fears as well," Taylor said, like worries about the economic or social impact of the pandemic. He added some will find themselves checking news and data on the virus frequently, and could have bad dreams related to COVID.
In a 2020 study of American and Canadian adults who have never had COVID-19, Taylor said he found 15 per cent met the criteria for a COVID stress syndrome. But he also anticipates that number will fluctuate based on how big a threat the virus is at any given time.
When everything opens up, that number will probably be lower because people's anxiety levels will go down, but we don't know," Taylor said, adding it's hard to determine at this time how long these fears will linger. Part of the problem is we won't be able to assess the mental health impact of COVID-19 for years to come."
Fear of the virus for many is also rooted in a real and present danger," especially for those who are immunocompromised or close to those who are, said Dr. Shimi Kang, a Vancouver-based psychiatrist.
Kang said the fear of COVID exists on a spectrum - some people have minimized the threat of the virus and aren't afraid of catching it at all. Others have been extra vigilant, isolating themselves for the better part of the past two years despite mental health consequences, in fear of bringing the virus home to their young children or to elderly parents, she said.
But most are in between and are contemplating what to do, Kang said. Leaning on the psychology behind the stages of change, Kang said it's likely that 20 per cent of people will be ready to embrace the lifting of mandates. This leaves the remaining 80 per cent cautiously proceeding at their own pace. Some say their skepticism is driven by government distrust.
Nick Davis, a Toronto man who is in his 30s and triple-vaccinated, said he is among that 80 per cent. For him, the government's move toward lifting mandates feels hasty, rendering him unable to trust that it is the safe way forward.
Part of the issue, he said, is the halting of rigorous contact-tracing and the limited access to COVID-19 testing, making it difficult to assess whether it is actually safer to lift mandates and be out in public at this time. We haven't been given the tools to be able to decide what risks we are comfortable with," Davis said.
He added he has also observed otherwise healthy people around him who were sick with the virus struggle with the adverse effects of lingering symptoms, also known as long COVID, making him wary of getting sick himself. That really puts me on guard," he said.
Kaila Orr, a Toronto mother of a two-year-old child, said she was comfortable eating at restaurants with the mask mandate in place. Now that it will be lifted, she said she can't help but isolate herself again in fear of bringing the virus home.
I don't know what the right thing to do is, and I don't think anyone knows," Orr said, but she added mothers of children too young to be vaccinated, like her, would feel more at ease if their concerns were addressed by policy-makers.
The reality is that these transitions are difficult for most of us," Taylor said. Added to that, Kang said, are the habits people have practised for two years in an effort to keep themselves safe, which have become ingrained for some.
Whenever we do something repetitively, it becomes like a neural pathway, just like the trails in the forest," she said.
Above all, both experts said it's important that people exercise patience and understanding with one another as society enters this new phase of lifted restrictions, as many people will choose to proceed at their own pace. Kang's advice is for people to take an individualized approach to reopening. It can help to talk with a health-care provider, as well as friends, to come up with a plan that is both safe and comfortable.
People's fears and beliefs come from a complex variety of sources, and we should try to understand each other and be compassionate," Kang said.
As we open up and start to interact with people in workplaces and schools, we're going to see people at different stages."
Nadine Yousif is a Toronto-based reporter for the Star covering mental health. Follow her on Twitter: @nadineyousif_