Up until recently, isolated states with small populations—like Vermont, Hawaii, and Alaska—had been spared the worst of the coronavirus pandemic. As we enter into the seventh month of the pandemic, even some of those recording low numbers of cases in the past are beginning to experience large increases. On August 31, for instance, Hawaii had 133 new cases, and Alaska had 37. Meanwhile, Vermont’s cases have remained very low, just 8 on August 31. How is this possible?
In July, Bill McKibben published a column in the New Yorker, in which he took a guess at Vermont’s long-standing success in managing the coronavirus. He noted that we are a healthy state to start with and benefit from strong statewide leadership. More than that, though, he noted, that we may benefit from how well we know and trust our neighbors. While these were intuitive remarks by McKibben, when we break them down, we see what seems like a well-constructed plan to avoid caution fatigue.
Caution fatigue arises when we are no longer vigilant about taking precautions, whether it is because we are tired of them, or we think they may no longer be needed, because no one around us has had COVID-19. Sometimes it feels like we are being bombarded by decisions we didn’t have to make in the past: whether to accept a playdate, to speak up about a potentially risky work situation, or convincing children to wear a mask. As time goes on, it is harder to choose well. Our perception of the risk is skewed. We begin to make decisions based on our old habits, which are easier, rather than based on recommendations to keep us safe. In other states, caution fatigue may be hitting an all-time high. Vermont’s unique characteristics may help mitigate it.
Vermont has ranked as the healthiest state in the nation by United Health Foundation’s America’s Heath Rankings. One might think that this alone might protect us from contracting COVID. While this may be the case, the healthy routines required to earn the healthiest-state status will also help combat caution fatigue.
Health experts at UCLA recommend taking care of your body as the top tip for reducing caution fatigue. At least 7 hours of sleep, a regular diet of nutritious meals, and daily exercise not only strengthen the immune system: they provide a full tank of energy to make good decisions. Vermonters may find that they have the mental stamina to choose wisely, whether that’s to wear their mask or to cook at home, rather than going out. The ability to make good choices, multiplied many times over, may relate to fewer cases.
According to USA Today, strong leadership and streamlined policies can also help. Kathleen Vohs, a professor at the University of Minnesota who studies self-control, was quoted as having said, “The more that requirements are in place, such as mask mandates, the less it’s a personal choice about what to do. And it makes it easier to make other, related decisions. You don’t have to agonize about whether it’s safe to go to the grocery store when you know that others will have masks on.” When many Vermont towns issued mask mandates, for instance, they may have freed mental space for their constituents to make good choices about the other risks they were encountering.
The caring relationships among neighbors that McKibben notes in his article have shown throughout the pandemic. We have seen people sew and donate masks to strangers, provide meals for healthcare workers, and write wonderful notes of encouragement.
Carisa Parrish, MA, PhD, of John’s Hopkins Medicine, listed “make a commitment” as her top tip for dealing with caution fatigue. “You want to do the right thing to keep yourself and others safe, even if that means a slight inconvenience,” she elaborated. Vermont’s innate “neighborliness” may inspire us to take greater action to protect each other, which could work to decrease cases overall.
While we are grateful that Vermont’s unique characteristics seem to make it a poor environment for COVID-19, we should be careful not to let up. We must continue to take good care of ourselves, praise the good and important work being done by our leaders, and continue to look out for each other. These qualities may have gotten us this far and continue to help us fight caution fatigue. Doing so may keep us strong and see us through.
Rachel Darby, PMHNP-BC, is a nurse practitioner at United Counseling Service in Bennington.