How We Assess Risks With An Invisible Threat Like The Coronavirus : Consider This from NPR Millions of Americans traveled for Thanksgiving despite pleas not to do so from the Centers for Disease Control and Prevention. Dr. Deborah Birx of the White House Coronavirus Task Force says if you're one of them, assume you're infected, get tested and do not go near your friends or family members without a mask on.

Because COVID-19 is a largely invisible threat, our brains struggle to comprehend it as dangerous. Dr. Gaurav Suri, a neuroscientist at San Francisco State University, explains how habits can help make the risks of the virus less abstract.

Emergency room doctor Leana Wen discusses why it's tempting to make unsafe tradeoffs in day-to-day activities and how to better "budget" our risks.

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Why Our Brains Struggle To Make Sense Of COVID-19 Risks

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It's always hard coming back to reality after a holiday weekend, but that reality is here.


ANTHONY FAUCI: We expect, unfortunately, as we go for the next couple of weeks into December, that we might see a surge superimposed upon that surge that we're already in.

CORNISH: The experts hit up the Sunday news talk shows. That's Dr. Anthony Fauci on NBC's "Meet The Press." Public health officials had begged us not to travel, not together with extended family for Thanksgiving. So now here was Dr. Deborah Birx, the coordinator of the White House Coronavirus Task Force, on CBS with sobering advice for those who did.


DEBORAH BIRX: So if you're young and you gathered, you need to be tested about five to 10 days later, but you need to assume that you're infected and not go near your grandparents and aunts and others without a mask. We're really asking...

CORNISH: Throughout this pandemic, so much of the work of controlling the spread has been left in the hands of individuals, regular people asked to make the right decisions for themselves and the broader good, to resist the temptation to go visit grandma or throw a small birthday party or pull down that mask when it gets uncomfortable.


BIRX: If your governor or your mayor isn't doing the policies that we know are critical - masking, physical distancing, avoiding bars, avoiding crowded indoor areas - if those restrictions don't exist in your state, you need to take it upon yourself.

CORNISH: CONSIDER THIS - tens of thousands of lives depend on how much Americans respect the real danger of coronavirus. But to understand a largely invisible threat, we have to outsmart our own brains. From NPR, I'm Audie Cornish. It's Monday, November 30.

It's CONSIDER THIS FROM NPR. Everywhere you look, there are public health messages telling you what to do or not do to protect against COVID-19.


TONY GONZALEZ: Tony Gonzalez here urging you to stay at home. Take care of your family. Protect yourself.

JEROME ADAMS: We all have a role to play in preventing person-to-person spread.

UNIDENTIFIED PERSON: Wear a mask, and practice social distancing. It's that simple.

CORNISH: If that doesn't grab you, then there's the data - charts with arrows that only seem to be pointing up, maps - so many maps - with states colored yellow, orange and deeper and deeper shades of red and 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. For example...

LEANA WEN: I had a patient who was so careful about everything.

CORNISH: Leana Wen is an emergency room doctor.

WEN: 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: In addition to being a physician, Wen led Planned Parenthood at one time, and I met her when she was the health commissioner for the city of Baltimore. She says it's easy to get too comfortable around friends and family in particular.

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: We're going to hear more from Leana Wen in a minute, but first we're going to talk about why we - or, rather, our brains - struggle to make smart decisions about COVID-19. Gaurav Suri studies how we make decisions. He's a computational neuroscientist at San Francisco State University.

GAURAV SURI: Audie, 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 our brain. And 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 read about, or it's something that we've heard statistics about. And that kind of representation engages the 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.

CORNISH: Most of us feel overwhelmed. Like, we are listening to the news too much, right? 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 - 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. We're less likely to do it if we have internalized the concept but we haven't told people. So consciously telling our social network that this is something we're going to do is a excellent nudge because not - then in that case, not doing it produces dissonance.

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 6 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) and so I don't plan on having a play date with you and my kids - it's just - like, we're wiped, no?

SURI: 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 are not going through all the effort that we have to because it's new for us. Learning to drive is a lot more effortful than driving, and that's kind of where we are.

CORNISH: Gaurav Suri is a computational neuroscientist at San Francisco State.

So if we want to use his strategy and tell all our friends, our family what our COVID-19 plan is, well, first, we've got to come up with a plan. Dr. Leana Wen, the emergency room doctor we heard earlier, says think about the time you spend around other people like a budget - a risk budget.

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.

CORNISH: When we're sitting down and trying to make those trade-offs, can you give us some examples of what a risk budget might look like?

WEN: I think there is 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: 'Cause once you've been exposed, you've been exposed. I've definitely heard that kind of thinking.

WEN: Yes. And I've heard parents, for example, saying, well, my child is in school. So that's why I'm also going to do all these other extracurriculars. And I'm also going to do play dates because my child has one exposure. But the thing is that school is trying their hardest to keep risks as low as possible in the classroom. So in that case, you should honor the work that's being done in the school and cut risk in other ways. And so that's an example of setting the budget.

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. I know all of this is really hard, but we have to get through this winter because a vaccine is not far on the horizon, and we can make these difficult trade-offs now.

CORNISH: Dr. Leana Wen, former Baltimore City health commissioner.

You're listening to CONSIDER THIS FROM NPR. I'm Audie Cornish.

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