Parents: Welcome To Decision Fatigue Summer
We have entered the maddening risk calculus phase of the pandemic — and the mental load is huge.
Last week, the CDC announced that fully-vaccinated people could forgo masks almost entirely — even indoors! — since they were unlikely to unwittingly infect anyone with COVID-19. That hopeful headline marked a turning point in the pandemic for many people — and a new era of ambiguity for many parents. The mixed-status family — in which parents and older children are vaccinated but under-12s are months away from being in the clear — is now caught in a morass of uncertainty.
Anyone who got the jab is free (mostly) to return to their pre-pandemic life, but it’s now more risky to take an unvaccinated child to a grocery store, a restaurant, or even an outdoor baseball game after mask orders and capacity limits are rescinded, says Dr. Thomas Russo, M.D., an expert in infectious diseases at the University of Buffalo. But it’s important to note that “more risky” does not mean dangerous. Russo cautioned that the increase is hard to strictly quantify. A doubling of a very low risk is still a very low risk.
The bigger effect may be the cognitive burden it places on caregivers: Will it feel comfortable to run errands with a child too young to wear a mask? How much reconnaissance is needed before accepting an invitation? Do things still have to be so hard?
For anyone vaccinated, this could be a summer of freedom, but for families with young children, this may be a summer of uncertainty — and therefore a summer of anxiety.
A public health approach that only relies on individual responsibility is almost never very effective, said Julia Marcus, Ph.D., MPH, an epidemiologist and associate professor at Harvard Medical School and Harvard Pilgrim Health Care Institute, when I spoke to her last winter. To make an impact, public health measures should be paired with structural supports.
Parents bear a particular burden navigating this new reality, and more privileged people will be able to avoid risks if they choose (e.g., by leaving their kids at home during errands or having groceries delivered). Less privileged people will face increased risks and the judgment of “failing” to keep themselves and their families safe.
The Misery Of Uncertainty
For anyone vaccinated, this may be a summer of freedom, but for families with young children, this may be a summer of uncertainty — and therefore a summer of anxiety. Managing ambiguity is difficult, and people don’t respond well to it, says Jennifer Taber, Ph.D., a health psychologist at Kent State University. Individual risks are difficult to assess, she said, which “makes it harder to calibrate behavior appropriately.”
The amount of cognitive labor (sometimes termed “the mental load”) that families do has grown during the pandemic, says Allison Daminger, a doctoral student in sociology and social policy at Harvard. Daminger wrote a 2019 paper on cognitive labor that categorized those efforts into four distinct types. Two of those types, “anticipation” (being alert for risks) and “monitoring” (making sure things are done, reviewing outcomes), tend to be done particularly by women. They’re also the most invisible, abstract types of cognitive labor, the ones a person is least likely to get credit for doing.
Beyond the obvious COVID-19-related tasks, there’s the increased cognitive labor associated with being home all the time. More snacks, more cleaning, more school stress, more nap schedules to remember to work around.
They abound in the pandemic, Daminger says. Beyond the obvious COVID-19-related tasks, there’s the increased cognitive labor associated with being home all the time. More snacks, more cooking, more cleaning, more nap schedules to remember to work around.
The evolution of the pandemic also forced repeated re-evaluations of choices. Just when a parent thinks they’ve gotten comfortable with a decision — such as sending a child back to day care or camp — new information may prompt them to reconsider. All this work takes a toll, in stress, anxiety, and frustration between partners, especially when the cognitive labor isn’t shared, Daminger said. It’s a hamster wheel of decisions, exhausting and going nowhere.
Many families have been dealing with a version of this issue already in states like Texas, where mask mandates ended months ago, or Georgia, which never had one. To muddy the risk perception waters further, the CDC masking rules for kids are much more conservative than the World Health Organization’s recommendations. The latter group doesn’t recommend them for kids under 5, a stance some American doctors support. Dr. Lucy McBride, M.D., a practicing internist in Washington, D.C., who writes a coronavirus newsletter, recommends that her young patients don’t because the transmission risks don’t justify it.
When Experts Change Their Minds
Amid choruses of “follow the science,” it can be hard to remember that “science” isn’t a settled or static recommendation. The COVID-19 pandemic has been a rapid research project in which the medical community has been investigating, digesting, and recommending updated measures almost in real time. Within the scientific community, there can be broad and vociferous disagreement about which recommendations are most supported by the available evidence. Normally those negotiations take place outside of the public eye.
Now, the back-and-forth of science has become politicized, along with masks and lockdowns. The intricacies of epidemiological risk modeling are not something the average person is qualified to sort through.
So instead, at least for people trying to abide by public health advice, we ping-pong from one set of regulations to the next. We try to incorporate the latest guidelines into a cohesive philosophy of masking and distancing. We take into account how crowded the store is, how much anxiety we can handle, and whether our kids are at high risk for complications were they to contract COVID-19. We think about who’s vaccinated and who’s not.
We have made these decisions hundreds upon hundreds of times during the pandemic, and we’ll continue to make them, hoping for the best and fearing the worst. Just when a light appeared at the end of the pandemic tunnel, it turned out that it only illuminated the next part of the maze. The angst and adjustments continue.