It’s not about information literacy: Why people’s risk calculus around COVID has changed

Image credit: Willet on the Beach by Korall  inWikimedia Commons

I’ve been doing so much thinking, reading, and writing on social media about COVID that I was honestly surprised to find that I hadn’t written much about it on this blog beyond talking a little about my experience with disability due to COVID (tl:dr – In 2022, I not only ended up with Long COVID, a few symptoms of which are still with me more than two years later, but also developed an incurable, painful, and life-changing autoimmune connective tissue disease). I’m one of millions of people for whom a single COVID infection radically altered their lives and I’m much luckier than most that I can still work. We know that further infections increase the likelihood of post-COVID sequelae or the worsening of existing symptoms (not to mention a grab-bag of organ damage and death). So those of us who have already been damaged by COVID know that avoiding getting it again is priority one. I still mask at work. I can count on one hand the number of times I’ve eaten in an indoor restaurant and it’s only at like 3 or 4pm when wastewater counts are extremely low. The only concerts I go to are my son’s band concerts and I take all the precautions I can. At work, I avoid most in-person gatherings. I have to teach classes and work at the reference desk, but if there’s a virtual option for a meeting, I’ll take it (even though hybrid meetings are terrible for those participating virtually), and if an in-person event is optional, I usually skip it. I know I’m missing out on a lot and I may not look like a team player when I don’t volunteer to sit in a crowded room full of students during Welcome Week, but I know this is what I have to do to protect the already diminished level of functioning I currently have.

While people definitely masked in Portland far longer than elsewhere, it’s become quite common for me to be the only person wearing a mask. I guess I shouldn’t be surprised by that, but I am. After all, I work with highly-educated faculty who keep up with what’s happening in the world. Surely I can’t be the only person who understands how potentially ruinous to one’s health a COVID infection could be. I also work with people deeply committed to social justice and inclusion and am surprised to see so little solidarity or concerns about accessibility for those more vulnerable (more on that in my next post).

The people I work with are the sort who did all the right things when COVID hit. They didn’t go to restaurants and sat outside to socialize. They didn’t fight mask bans, they got vaccinated as soon as they could, and masked longer than most. Many even criticized people who weren’t taking the precautions they were. But something changed in the past two years where I don’t even feel like I can talk about COVID or COVID mitigation anymore without sounding like a crazy person. And ironically, in that time, the research on the short-and-long-term impacts of COVID on perfectly healthy people has become even more clear and even more bleak. So that begs the question, why did all these smart, caring, worldly people stop taking precautions? 

For the folks I know, I wonder if part of the reason why they stopped masking is because nearly all of them got COVID between 2022 and 2024 and had pretty mild cases. Some even worked (remotely) through it. The only people I know who still mask at work had Long COVID symptoms. Before I got COVID in 2022, one colleague explicitly told me not to worry because it was just like a cold. But the research shows that the more times you get COVID, the more likely you are to have sequelae, so getting lucky the first time doesn’t mean you won’t get absolutely wrecked the second. In light of the research, believing it won’t happen to you is nothing less than hubris.

I don’t think information literacy is the issue here. Most people I know are quite smart, well-read, and adept at research. I don’t know if they read things about COVID anymore, but if they’re not, it’s not because they don’t know how to find it. I think a lot more is happening with people who avoid COVID information and ignore risks and I think it’s a mix of personal psychological factors, privilege, the absolute disaster that was public health messaging around COVID, and social pressure to align with the dominant narrative that COVID is over. I know we like to distill things down to a single cause (“they’re selfish!” “It’s Biden’s fault!”), but this is considerably more complicated.

Many of us are dealing with pandemic fatigue, which is a lot like burnout and leads to a “demotivation to engage in protection behaviors and seek COVID-19 related information” (Haktanir, et al., 2022, p. 7315). Ford, Douglas, & Barrett (2023) describe pandemic fatigue as “a complex set of emotions comprised of anxiety, hopelessness, depression, and anger.” There are a few of reasons people become fatigued in this way. The biggest is simply the length of time we were all expected to stay in a state of emergency and hypervigilance. Living in that state with no clear end in sight can easily lead to burnout as many of us who have worked in high stress jobs can attest. You can’t stay in a state of hypervigilance forever without eventually becoming exhausted and desensitized (Koh, Chan, & Tan 2020). Chen et al. (2024) found that even when they controlled for pandemic severity at particular points in time, pandemic fatigue increased in study participants an average of 5.8% every six months of the pandemic. Instead of vilifying folks who experience pandemic fatigue and decrease their precautions, the WHO portrays it as “a natural and expected reaction to sustained and unresolved adversity in people’s lives,” (7), an approach which I personally appreciate. Shame is not a motivator and these are very normal psychological responses.

There’s also the frog in the pot metaphor, which can explain some of this behavior. Over time, things that once seemed extreme become normalized without us really noticing. I’ve written about how sneakily overwork became the norm, the base expectation, in many workplaces because, over time, the “exceptional present” (Meyers, et al. 2021), became the everyday. The phenomenon is called shifting baselines. Many people simply got used to living in a pandemic, just like plenty of people don’t seem horrified anymore by the genocide and mass killing of children that has been happening in Gaza for over a year and which would have been unthinkable before. Even as more information about the long-term consequences of COVID came out and people learned that even a minor case could lead to permanent vital organ damage or a heart attack, it was just a small ratcheting up of the temperature to them and didn’t change their risk calculus. As Haktanir, et al. (2022) put it:

For instance, as time passes, individuals may become used to coronavirus’s existence; therefore, the most extreme circumstances may become normal, and the perceived threat of the COVID-19 pandemic may decrease. (7315)

As people become accustomed to even horrific situations, they become more numb to it. 

In their study of people who admitted to greater risk behavior than earlier in the pandemic, Haktanir, et al. (2022) found that “intolerance of uncertainty” plays a major role in pandemic fatigue (7320). Surprisingly, the other elements they discovered led to pandemic fatigue were fear of COVID, apathy, and a lack of self-care. The people they found taking risks were not less afraid of COVID; they just were less tolerant of ambiguity and less committed to taking care of themselves. And the people in this study were taking greater risks at a time when, in 2021, COVID deaths were skyrocketing to their highest levels ever, so their decision had nothing whatsoever to do with the actual risk they faced.

Two studies (Sulemana et al., 2023; Taylor, Rachor, & Asmundson 2022) found that economic privilege impacted whether or not people continued precautionary behavior. People who were more well-off economically were less likely to wear masks or take other precautions, which matches what I see in my own life. While few people wear masks at my community college, I’m rarely the only person I see in a day wearing one. At any event at my son’s school (which is in a wealthier suburb), my husband and I are always the only people masking. At my local grocery store, the only other people I see masking are people who work there. Of course, it’s easier to ignore the risks when you know you are financially able to access quality medical care and can afford to be sick and out of work. In addition, Taylor, Rachor, & Asmundson’s study found that those who were not taking precautions tended to be more “narcissistic, entitled, and gregarious, and were more likely to report having been infected with SARSCOV2, which they regarded as an exaggerated threat” (11). So in addition to privilege, perhaps there’s an element of selfishness and, as I mentioned earlier, the mistaken assumption that if one’s COVID case was mild the first time it would always be thus. It is quite a privileged position to assume that you are the exception to the rule. Steven Thrasher writes about this in his excellent book The Viral Underclass and rightly connects it to whiteness:

As I drove, it occurred to me that much of what had transpired in [Michael Johnson’s] life over the past half decade had flowed from the myth of white immunity: the misconception that white people are totally exempt from health risks, particularly viral risk. This myth tricks white people not only into making themselves needlessly susceptible to viruses, but also into refusing to see how at risk they are from all the harms and violence of society, which can grind one into the viral underclass. (page 231)

It’s this myth of white immunity and its inherent ableism that leads to the lack of solidarity we’ve seen around COVID risk, which will be the focus of my next essay.

People also experience message fatigue, which is a consequence of information overload and repetitive messaging. Like pandemic fatigue, message fatigue makes people tune out and stop adhering to safety precautions. And there are a lot of things about messaging that can lead to message fatigue, like the use of jargon (Shulman, Bullock, & Riggs, 2021), repetitive information (in 2020, Koh, Chan & Tan described a study found that each additional text message from health officials to healthcare workers led to a >40% decrease in recall of the message – yikes!), inconsistent or contradictory messaging (you know, like telling people masks don’t work and then later having mask mandates) (Taylor 2022), trust or lack thereof in public health officials (Seo et al., 2021), and “prolonged message exposure” (Ball & Wozniak, 2021). Two studies I read (Mohammed, et al., 2021; Wiedicke, Stehr, & Rossmann, 2023) found message fatigue stronger in people who watched broadcast media vs. online news and social media where there is more agency in what one is consuming. Message fatigue has been shown to lead people to simply tune out of these messages and also to exhibit reactance, which is like a rebellion against information one feels is suppressing their freedom, like refusing to mask. In addition, Hwang, So, & Jeong (2023) found that message fatigue was a strong predictor of people’s willingness to accept COVID misinformation.

There is a whole sub-field of risk communication that has explored the issue of how and why people choose to seek out or ignore information about risks. According to Ford, Douglas, & Barrett (2023):

In their seminal work theorizing the relationship between risk information-seeking and risk preventative behaviors, Griffin et al. (1999) identify seven characteristics that prompt individuals to seek and process health information in divergent ways: (1) individual characteristics, (2) perceived hazard characteristics, (3) affective risk response, (4) felt social pressures to possess relevant information, (5) information sufficiency, (6) personal capacity to learn, and (7) beliefs about the usefulness of information in various channels. Each of these characteristics sway how likely an individual is to seek out risk information and the extent to which that individual dedicates time and energy to critically evaluating risk information. (p. 2)

In their study, they found that while some people who had pandemic fatigue avoided information about COVID risks, it led other people to seek out that information, so there’s obviously more going on psychologically than just fatigue that predicts whether or not people will ignore risk information. They also write about how some people avoid risk information that scares them and others avoid risk information if they feel like it somehow doesn’t apply to them (3). It’s a complex interplay of psychological and external factors.

There hasn’t been much from the library field that has really reckoned with these issues, but I did find a fantastic article from Lloyd and Hicks (2022) that looked at safeguarding practices people employ to avoid message fatigue (or what they call “saturation”). Lloyd and Hicks  see creating boundaries around taking in more information an adaptive feature of information literacy:

Avoiding information creates the conditions and space to reduce the noise that is created by the pandemic’s accelerated information environments. The space created enabled participants to contextualise and reflect upon the narratives of the new norm and reconcile new information with current knowledge. (11-12)

At a time when information overload and misinformation are ever-present risks, making space to contextualize sounds like a positive step, and perhaps that is what some of the people with message fatigue are doing. However, even Lloyd and Hicks recognize that this safeguarding strategy could limit one’s ability to remain informed about the risks of the pandemic (14). It is worth considering though that there might be benefits to limiting what information one is taking in.

I think for some people trauma might also play a role in their choice to ignore the risks of COVID. For those of us who got to work from home in our sweatpants early in the pandemic, we avoided a lot of the extreme trauma that came in that first year. I can only imagine how deeply painful and stressful it was to be a nurse or doctor in New York City in the Spring and Summer of 2020. I also think a lot of people were traumatized by the isolation and loneliness they experienced early on. I recognize how lucky I was to be at home with my partner and child and also to not be an extravert. I can’t imagine that the memories of these experiences don’t impact some people’s willingness to mask or to take other precautions.

And of course peer-pressure is another factor that keeps people from masking, but honestly, it feels like a pretty pathetic excuse for an adult to have unless you live in a place where masking could put your safety at risk. I’ve felt the discomfort of being the only one wearing a mask in tons and tons of situations (including in deep red Eastern Oregon which hates us Western OR folks so much they want to become part of Idaho) and have gotten looks, but if that was enough to keep me from wearing one, it would be pretty stupid of me to put appearances and fitting in over my health. I’m not dying for the social approval of others.

I don’t think it’s possible to overstate how much inconsistent and contradictory public health messaging as well as the politicization of COVID shaped people’s perceptions of the virus and their risk. When public health officials lied to our faces about the efficacy of masks, even if it was in an effort to ensure hospital workers had access to quality masks, they not only created a persistent narrative, but damaged public trust. The World Health Organization (2020), which shared that same misinformation about masking, shared the following best practices for public health messaging:

Be as consistent as possible in messages and actions, and avoid conflicting measures

Be transparent by sharing reasons behind restrictions and any changes made to them, and by acknowledging the limits of science and government. 

Strive for predictability in unpredictable circumstances, for example, by using objective criteria for restrictions and any changes made to them. 

Tailor communication to specific groups that experience demotivation. Test messages and visuals with sample populations before launching them (5-6)

There is so much evidence out there that effectively designed public health messaging can significantly impact behavior (Nan, Iles, Yang, & Ma, 2022), but much of the messaging we saw from public health officials and politicians adhered to none of the best practices the WHO listed. And while Trump was responsible for a lot of the early misinformation, it was Biden who totally lost control of the narrative. In late-Spring 2021, around the time most Americans were getting their COVID-19 vaccines, Biden gave a speech like Bill Pullman in Independence Day declaring that we were about to defeat COVID: “After this long hard year, that will make this Independence Day something truly special, where we not only mark our independence as a nation, but we begin to mark our independence from this virus.” At that time, 89% of people believed that COVID was almost over (McCoy, 2023). Most of you will probably remember that the Delta wave hit that summer and by August, only 15% of people felt the situation with COVID was improving. That Fall, Dr. Fauci said that we could start getting back to normal when we went below 10,000 cases per day nationally, but I don’t think that has ever happened. Biden again declared the pandemic over in 2022 (something he can’t actually do for the whole world). So much for using “objective criteria.” Yet in spite of objective data, by 2022, only 19% of Americans saw COVID as a major issue and only 24% were concerned about contracting COVID (McCoy 2023). Whether people are clinging to early narratives that COVID is just like the flu or a bad cold, bought into Biden’s narrative, think the whole pandemic is a hoax, or simply became fatigued by the uncertainty and inconsistent messaging, it’s clear that horrible public health messaging played a role in why many people stopped taking precautions. And the biggest messages that have come out of the pandemic is that 1) the economy is far more important than human lives and 2) it’s perfectly ok for vulnerable people (“the viral underclass” as Steven Thrasher calls us) to die to keep the economy going.

By the Fall of 2023, I’d let down my guard a bit. I still masked at work and in most indoor spaces, but I’d sometimes not wear a mask when running a quick errand and I wasn’t checking COVID metrics anymore. I decided that after four years of not going to any concerts or big events, I was going to take my son to see the Nutcracker. It had been our annual tradition before COVID and I figured that at 14, this was the last possible year he’d consider going with me. I’d seen so many friends go to countless events unmasked and they never got sick. So we went, masked of course. But I didn’t consider the impact Long COVID, my autoimmune disease, and the meds I take for it might have had on my immune system. Three days later, on Christmas Day, I tested positive for COVID. My son who’d sat next to me was fine. I was terrified that I was going to get even sicker. But while my body couldn’t clear the virus for a month, the illness on the whole was milder, perhaps thanks, in part, to my immune system not putting up a fight.

Though I don’t seem to have gotten worse from this second infection, I won’t know for sure and  I lost an entire winter break where I could have spent quality time with my son who only has a few years left at home. And it could all have been so much worse. I know I see COVID through the lens of my own traumatic experiences. I won’t pretend that those of us who are COVID conscious are 100% rational and those of you not masking are 100% irrational. But I do think that when a dangerous, disabling, and deadly virus is surging in one’s community (which it was just a couple of months ago) and it’s spread by aerosolized particles from our breath and waste, it seems pretty rational to try and protect yourself. Taking precautions hasn’t kept me from living a good and full life and having fantastic travel experiences. But I don’t live exactly like I did before COVID because I’m living proof of the damage it can do. The pain, fatigue, and myriad other debilitating and disturbing symptoms that have been a daily part of my life since COVID (not to mention the dangerous drugs I have to take to function and the medical bills that have piled up) are potent reminders that a single infection can be life-altering, so altering one’s life in small ways to prevent it seems pretty reasonable.

ALL of what has happened has left us unmoored and struggling to make sense of the reality in which we’re living (or some of us have settled into extreme views that give us the comfort of certainty). In the great viral (pun intended) article entitled “How COVID broke reality,” Nate Bear writes “covid has broken everyone’s brain. Not because of viral host manipulation, or even bad information per se, but because so many people, wherever they place themselves on the political spectrum, lack an analytical framework through which to feed the last four years.” I highly recommend reading that along with Marianne Cooper and Maxim Voronov’s Scientific American piece “We’ve Hit Peak Denial. Here’s Why We Can’t Turn Away from Reality.” They share tactics that have led to collective denial about the dangers of COVID and use the frog in boiling water analogy to argue that “we think we no longer have a problem [with COVID], when we’ve just changed the standard by which we deem something concerning.” They also describe how “truth-tellers” who have not stuck to whatever dominant narrative exists in society have been marginalized, pathologized, and punished. So strong is the desire to return to “normal” that it’s much easier to believe that people still wearing masks have a psychological problem than to question whether maybe you should be wearing one too in some situations. 

Cooper and Voronov suggest that “when we mentally and emotionally recalibrate to the new normal, we also disassociate from our own humanity.” In my next post, I’ll be writing about ableism and solidarity and what a deeply disappointing experience it has been to see folks who claim to be strongly committed to social justice abandon people with disabilities and those particularly vulnerable to COVID. Something I saw people saying over and over across social media after the election was if you care about social justice, you’ll put on a mask. It’s an extremely easy, visible, and truly impactful way to show your solidarity with folks with disabilities – who in fascist regimes are often the first victims — and, frankly, with everyone around you. But I’m not seeing more people masking around here.

While I know the reason people don’t mask has nothing to do with information literacy and not having access to good information, I’m going to share a bit of information about COVID below in the hopes that if my post has made at least one person think about how they think about COVID, they will have easy access to that info in a single place:

• Here are several deeply concerning articles on how COVID damages the brain. Did you lose your sense of smell when you had COVID? Did you know that was actual brain damage? Having dealt with brain fog since I first got COVID, I don’t want to lose any more brain function than I already have. Already, I find myself constantly grasping for the right word, especially when I’m teaching, which makes me look addled. As knowledge workers, what are we without our ability to think clearly?
• And the brain isn’t the only organ COVID can harm (remember when we just thought of it as something that could damage the lungs? How naive we were!). The recent news that a single COVID infection can increase your risk of stroke or heart attack for three years after your infection is alarming. Here’s another article on the impact of COVID on cardiac health from the New York Times (gift link). COVID can also damage your digestive system, increases your risk of contracting diabetes, and may be responsible for an increase in cancer risk because it damages our immune system. From this excellent rundown of current research from the Pandemic Accountability Index, it’s clear that COVID can impact most organs of the body, even in previously healthy individuals.
• Also, your risk of disabling Long COVID may be higher than you think: Here is an article that looked at a cohort of healthy young (median age 18) Marines and found that 25% of them were dealing with long-COVID symptoms. A study of over 20,000 healthcare and social service workers in Quebec found that 13% had contracted Long COVID after a first infection, 23% after a second infection, and 37% after a third infection. A Health Canada study of a more general population of Canadians found strikingly similar rates by number of infections. Yikes.
• And remember how COVID wasn’t supposed to harm kids? Ooops! See “COVID is harming too many kids,” “Long COVID Rates in Kids Revised Upward: What to Know”, and the JAMA article “Characterizing Long COVID in Children and Adolescents.”

These risks aren’t theoretical, they aren’t rare, they aren’t only happening to people who are already unhealthy or disabled. Every time you get COVID you are playing a game of Russian Roulette. You might be lucky and end up unscathed or you could end up with disabling, painful, or terminal illnesses as a result. Maybe you are ok with that or maybe you don’t think it could happen to you (I had no risk factors before I got sick and only became part of “the viral underclass” as a result of having COVID), but there are simple precautions you can take to protect yourself and people you care about. No matter how long it has been since you put on a mask, it’s never too late to reconsider. It’s never too late to rethink.

Works Cited

Ball, H., & Wozniak, T. R. (2021). Why do some Americans resist COVID-19 prevention behavior? An analysis of issue importance, message fatigue, and reactance regarding COVID-19 messaging. Health Communication, 37(14), 1812-1819. https://doi.org/10.1080/10410236.2021.1920717 

Bear, Nate. “How COVID broke reality,” ¡Do Not Panic!

Chen, R., Tan, Q., Su, B., Wang, S., & Du, Z. (2024). A Systematic Review of the Definition, Measurement, and Associated Factors of Pandemic Fatigue. China CDC weekly, 6(36), 924–933. https://doi.org/10.46234/ccdcw2024.068

Cooper, M., & Voronov, M. (2024). “We’ve Hit Peak Denial. Here’s Why We Can’t Turn Away from Reality.” Scientific American, 331(3), 55–56.

Ford, J. L., Douglas, M., & Barrett, A. K. (2023). The role of pandemic fatigue in seeking and avoiding information on COVID-19 among young adults. Health Communication, 38(11), 2336-2349.

Haktanir, A., Can, N., Seki, T., Kurnaz, M. F., & Dilmaç, B. (2022). Do we experience pandemic fatigue? current state, predictors, and prevention. Current Psychology, 41(10), 7314-7325.

Hwang, Y., So, J., & Jeong, S.-H. (2023). Does COVID-19 Message Fatigue Lead to Misinformation Acceptance? An Extension of the Risk Information Seeking and Processing Model. Health Communication, 38(12), 2742–2749. https://doi-org.libproxy.pcc.edu/10.1080/10410236.2022.2111636 

Koh, P. K., Chan, L. L., & Tan, E. K. (2020). Messaging Fatigue and Desensitisation to Information During Pandemic. Archives of medical research, 51(7), 716–717. https://doi.org/10.1016/j.arcmed.2020.06.014

Lloyd, A., & Hicks, A. (2022). Saturation, acceleration and information pathologies: the conditions that influence the emergence of information literacy safeguarding practice in COVID-19-environments. Journal of Documentation, 78(5), 1008-1026.

McCoy, C. A. (2023). How does the pandemic end? Losing control of the COVID-19 pandemic illness narrative. Global Public Health, 18(1), 2195918.

Meyers, Natalie K., Anna Michelle Martinez-Montavon, Mikala Narlock, and Kim Stathers. “A Genealogy of Refusal: Walking Away from Crisis and Scarcity Narratives.” Canadian Journal of Academic Librarianship 7 (2021): 1-18.

Mohammed, M., Sha’aban, A., Jatau, A. I., Yunusa, I., Isa, A. M., Wada, A. S., … & Ibrahim, B. (2021). Assessment of COVID-19 information overload among the general public. Journal of racial and ethnic health disparities, 1-9.

Nan, X., Iles, I. A., Yang, B., & Ma, Z. (2022). Public health messaging during the COVID-19 pandemic and beyond: Lessons from communication science. Health communication, 37(1), 1-19.

Seo, Y., Ravazzani, S., Jun, H., Jin, Y., Butera, A., Mazzei, A., & Reber, B. H. (2021). Unintended effects of risk communication: impacts of message fatigue, risk tolerance, and trust in public health information on psychological reactance. Journal of International Crisis and Risk Communication Research, 4(3), 379-406.

Sulemana, A. S., Lal, S., Nguyen, T. X. T., Khan, M. S. R., & Kadoya, Y. (2023). Pandemic fatigue in Japan: factors affecting the declining COVID-19 preventive measures. Sustainability, 15(7), 6220.

Taylor, S. (2022). The psychology of pandemics: Lessons learned for the future. Canadian Psychology/Psychologie Canadienne, 63 (2), 233.

Taylor, S., Rachor, G. S., & Asmundson, G. J. (2022). Who develops pandemic fatigue? Insights from latent class analysis. PLoS One, 17(11), e0276791.

Thrasher, S. W. (2022). The viral underclass: The human toll when inequality and disease collide. Celadon Books.

Wiedicke, A., Stehr, P., & Rossmann, C. (2023). Issue Fatigue Over the Course of the Covid-19 Pandemic: A Multi-Method Approach. European Journal of Health Communication, 4(3), 114-137.

World Health Organization. (2020). Pandemic fatigue–reinvigorating the public to prevent COVID-19: Policy framework for supporting pandemic prevention and management (No. WHO/EURO: 2020-1160-40906-55390). World Health Organization. Regional Office for Europe.