I’m sure you’ve already heard about as much as you want to about how Americans are not interested in helping each other, and our youth are a bunch of snowflakes who care only for their own interests and special uniqueness. Those are frequently offered explanations as to why it’s been difficult to get some Americans to follow instructions for maintaining social distance to prevent the spread of coronavirus.

I’d like to offer some alternative explanations which aren’t more versions of finger pointing and blaming.

The reasons for social distancing and the right ways to use protective devices such as gloves and masks have not always been communicated in clear, consistent ways. Example: what about masks? At first, we were advised that masks would not help at all, then we heard that masks should be used only by those who are already coughing or sneezing, to keep them from passing on infections.

More recently, using some form of mask is being suggested for everyone, the idea being that masks (or scarves) can decrease the amount of disease transmission by limiting the spray of potentially infectious droplets people breathe and spit out, as well as providing a barrier to infection by keeping the mask-wearer from inhaling other people’s droplets. Please excuse me if this is gross, but I want to be clear. I want to be the opposite of vague or ambiguous. If that means being gross, so be it.

People who don’t seem to be scared and don’t seem to be taking the epidemic seriously are at least as much confused or in denial as they are selfish. Denial may be the best explanation for people not cooperating with disease control recommendations. Denial is a defense, an involuntary psychological shift people make to avoid having to deal with something threatening. A person who is “in denial” handles painful or threatening information by refusing to acknowledge it. There are several ways to show denial. The person may act as if they didn’t hear or may seem not to take in the information. Or more obviously, they can literally deny the truth of what they’re hearing no matter what evidence is offered. Like this: “What do you mean I could be infected even though I feel fine? That doesn’t make any sense!”

It’s true, it doesn’t make any sense, but it happens to be the fact. Tests for virus particles taken from the noses of people who feel well and from those who feel sick clearly show that one quarter of people who are infected feel fine. They don’t look sick, either, even to medical professionals.

How to break through denial?

Gentle insistence, reasoning, and repetition, but not to the point of irritating the other person.

Humor can be a good tool. If you can get a person to smile or laugh at a difficult situation, it immediately becomes less threatening. One example of pandemic humor is the viral video at this address (https://www.youtube.com/watch?v=oWD2OI-jYMY. This message (it’s a song; contains explicit language) doesn’t try to be reassuring, but by describing the situation in a humorous way, it makes it less terrifying.

There are other ways to approach denial.

Although to my knowledge it’s never been effective to persuade someone to behave appropriately by insulting them, the other side of that coin is that most people have some impulse, and often a strong impulse, to conform. The more most people comply with their state or town’s curfews and other social isolation rules, the more pressure people who are not complying will feel to act according to this new social norm.

Don’t give up and don’t despair. And remember, it’s always easier to convince somebody if you are friendly or at least polite, rather than angry.

Eva Hersh is a family physician. Send your comments and questions to her by email at dreva@baltimoreoutloud.com

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Dr. Eva Hersh, MD
Dr. Eva Hersh, MD
Eva Hersh is a family physician. Send your comments and questions to her by email at dreva@baltimoreoutloud.com