#100 - Sam Harris, Ph.D.: COVID-19—Comprehending the crisis and managing our emotions

Mar 24, 2020 Episode Page ↗
Overview

Sam Harris, neuroscientist and author, joins Peter to discuss the COVID-19 pandemic, comparing it to influenza and analyzing its economic impact. They also explore how to manage stress, anxiety, and fear through mindfulness and communication strategies during this unprecedented crisis.

At a Glance
15 Insights
1h 32m Duration
17 Topics
3 Concepts

Deep Dive Analysis

Initial Reflections on the COVID-19 Pandemic

Predictability of the Pandemic and Societal Short-sightedness

Challenges in Communicating Uncertainty and Risk

Why COVID-19 is Not Like the Flu

Economic Impact vs. Public Health Measures

Why New York Became a COVID-19 Hotspot

Healthcare System Overwhelm and Non-COVID Mortality

Managing Anxiety and Negative Emotions During Crisis

Mindfulness as a Tool for Emotional Resilience

Finding Silver Linings and Rebalancing Life

Talking to Children About the Pandemic

Overcoming Irritability and the Role of a Supportive Partner

The Constructive Role of Shame and Apology

Optimism for the Future: Valuing Expertise and Government Role

Political Polarization and Navigating Complex Truths

Challenges in COVID-19 Vaccine Development

Rethinking Vaccine Risk Communication

Mindfulness

Mindfulness is a state of clear attention to present experience, allowing one to witness emotions like anxiety without judgment or reaction. By merely feeling the energy of an emotion without psychological content, its hold on you can be released, drastically shortening its time course.

Illusoriness of Self

This concept suggests that consciousness is an open space where thoughts and emotions appear, rather than being driven by a durable 'self' in the middle. Recognizing this allows one to stand free of emotional reactions, as consciousness is not harmed by negative mind states.

Non-linear Geometric Growth

This describes the rapid, exponential spread of the COVID-19 virus, unlike the predictable wave of influenza. It means that small head starts in infection rates for a city can lead to vastly different outcomes due to the compounding nature of the spread.

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Why is COVID-19 not comparable to seasonal influenza?

Influenza follows a predictable seasonal wave with uniform mortality spread over a year, while COVID-19 exhibits non-linear, geometric growth of new cases, hospitalizations, and deaths, meaning its full mortality potential is still unknown.

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What is the primary reason some cities, like Milan and New York, became severe COVID-19 hotspots?

These cities likely experienced a 'bad head start' due to stochastic factors, combined with high population density, active public transport systems (like subways), and a cultural tendency to underestimate the initial risk.

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How can one manage anxiety and fear during a crisis like the pandemic?

By practicing mindfulness, which involves clear attention to present experience and observing the physiology of anxiety without judgment. This allows one to 'puncture' the emotional state and release it when it no longer serves a useful purpose.

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How should parents discuss the pandemic with their children?

Parents should maintain honesty without necessarily revealing every detail that might cause undue anxiety. For older children, it involves acknowledging the situation and providing age-appropriate tools for understanding probability and risk.

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What are the potential challenges in developing a safe and effective COVID-19 vaccine?

Developing a vaccine for coronaviruses can be technically difficult, similar to RSV viruses, requiring a larger exposure to create immunity and potentially carrying a higher risk of adverse effects from the vaccine itself, making the risk-reward trade-off complex.

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What role should government play in future pandemic responses?

While private sector contributions are important, government is essential for crucial functions like monitoring, producing antivirals and vaccines, and coordinating responses. A more decentralized, federalist approach, empowering local cities to plan and procure resources, could be more effective.

1. Cultivate Emotional Agility with Mindfulness

Practice mindfulness to observe and feel emotions like anxiety without judgment, shortening their duration and reducing their psychological impact. This allows you to disengage from unnecessary mental suffering.

2. Release Unproductive Negative Emotions

Consciously let go of fear, anxiety, or shame once they no longer serve a useful purpose, recognizing that most moments spent in these emotions are unproductive and detract from well-being.

3. Develop Immediate Emotional Control

Cultivate the ability to immediately halt negative emotional reactions or behaviors upon recognition, whether through self-awareness or a cue from a trusted partner. This helps you respond constructively rather than reactively.

4. Address Uncertainty with Action

When faced with uncertainty, actively determine what you believe to be true and what actions you should take; once a decision is made, release the associated anxiety and proceed with your plan.

5. View Missteps as Growth Opportunities

When you make a mistake or feel shame, use it as an opportunity to practice mindfulness, disidentify from the ‘illusion of self,’ and focus on repairing relationships through sincere apologies.

6. Practice Honest & Measured Communication with Children

Be honest with children about difficult situations without oversharing anxiety-inducing details; instead, equip them with ‘adult-grade tools’ for understanding probability and risk.

7. Cultivate a Supportive Partnership

Foster a relationship with your spouse or partner where they understand your emotional regulation practices and can provide timely cues to help you pause and respond constructively in stressful moments.

8. Avoid Unnecessary Physical Risks

During times of crisis or strain on healthcare systems, consciously avoid activities that carry a significant risk of physical injury to prevent needing medical attention and burdening hospitals.

9. Appreciate Nuance and Uncertainty

Embrace the inherent nuance and uncertainty of life, and actively work to develop tools and ways of thinking that help you manage risk and make informed decisions in complex situations.

10. Identify and Appreciate ‘Silver Linings’

Actively look for and take stock of the unexpected positive aspects or ‘silver linings’ that emerge during challenging circumstances, and consider integrating these lessons into your life moving forward.

11. Document Crisis Lessons Learned

For future preparedness, systematically capture and document all lessons learned during a crisis, including what went wrong and what worked, to avoid repeating mistakes.

12. Cultivate Complex Truth-Holding

Practice the mental flexibility to simultaneously hold seemingly incompatible truths or perspectives without resorting to political dogmatism, especially when discussing complex societal issues.

13. Advocate for Preparedness & Decentralized Response

As an informed citizen, advocate for government and institutional preparedness for predictable disasters and support decentralized, city-specific approaches to crisis management.

14. Acknowledge Emotional Biases in Risk

Recognize that personal emotions and superficial differences can distort rational assessments of risk, and strive to make judgments based on objective data and statistics where possible.

15. Hold Countries Accountable for Practices

Advocate for international pressure on countries to cease dangerous cultural practices (e.g., wet markets that house wild species) that pose global health risks.

The moment you can merely feel it without judgment, without reaction, without contraction, without thinking about all the reasons why it's intolerable, or thinking more about the reasons why it's justified, if you just become willing to feel it in the moment, it loses its psychological content.

Sam Harris

Yeah, I mean, you want to feel fear when it's appropriate and useful to feel it, and you want to be able to release it the moment there's no point to it.

Sam Harris

What's happening in the moment is rarely that bad. But what's going on in my mind is often much worse.

Peter Attia

Optimism bias is not a bias I have in, in much quantity, but I have to think that there are certain errors of judgment that will become less common here.

Sam Harris

The real toxicity in all of this is in the duration over which we're caught. If this is all happening quickly, it's fine. If it's taking hours and days and weeks and months to sort out these problems, well, then you have a very unhappy life.

Sam Harris

Managing Unnecessary Emotional Suffering (Mindfulness)

Sam Harris
  1. Recognize when your wheels begin to spin and you are suffering unnecessarily from anxiety or other negative emotions.
  2. Witness the emotion as a matter of experience, moment to moment, rather than understanding it neurophysiologically.
  3. Puncture the emotional state by bringing clear attention (mindfulness) to the present.
  4. Feel the energy of the emotion in your body without judgment, reaction, or contraction.
  5. Avoid thinking about why the emotion is intolerable or justified; simply be willing to feel it.
  6. Observe the emotion losing its psychological content, becoming just a feeling like any other physical sensation.
  7. Recognize that consciousness is an open space where everything appears, and it is not harmed by the mind state.
  8. Allow the peripheral physiology of the emotion to dissipate quickly (over seconds) once the spell is broken.

Responding to Personal Missteps and Shame

Sam Harris
  1. Recognize that even when you screw up and feel shame, it is an opportunity to cut through the illusion of self.
  2. Use the feeling of shame as a signal to repair relationships if damage has been done.
  3. Offer a sincere apology to the person affected, acknowledging your wrong actions.
  4. Communicate a commitment to not repeat the behavior.
  5. Allow the other person (e.g., a child) to internalize that they were right in their judgment of your actions, empowering them.
  6. Practice mindfulness to shorten the duration of being caught in shame, allowing for quick recovery and constructive action.
0.02%
Mortality rate in Milan (total deaths per population) Based on approximately 2,200 deaths out of 10 million people.
0.0005%
Mortality rate in Rome (total deaths per population) Based on 31 deaths out of 6 million people, 40 times lower than Milan.
0.00006%
Mortality rate in Sicily (total deaths per population) Based on 3 deaths out of 5 million people, 300 times lower than Milan.
11,000-12,000
Known COVID-19 positive cases in New York City As of Monday, March 23rd, 2020, based on conservative estimates.
5X
Conservative estimate for actual infected population multiplier (known to unknown positives) Meaning for every known case, 5 more are actually infected; estimates range from 5X to 40X.
50,000
Estimated total infected people in New York City (conservative) Based on 10,000 known cases multiplied by the 5X conservative estimate.
4.8-4.9%
Percentage of COVID-19 patients requiring ICU care (Italy data) Similar to New York numbers at the time of recording (almost 5%).
4%
Conservative estimate of COVID-19 patients requiring ICU care Applied to the 50,000 estimated infected people in NYC, resulting in over 2,000 ICU beds needed.
Approximately 1,000
Baseline ICU beds in New York City Servicing NYC and surrounding areas.
2,000
Repurposed ICU beds possible in New York City By converting surgical ICUs and other areas.
25%
ICU beds occupied by non-COVID patients Estimated percentage of beds still needed for heart attacks, strokes, etc.
1,500-2,000
Effective ICU capacity in New York City after repurposing and non-COVID patients With potential to stretch to 2,000 by double ventilating patients.
3-4 weeks
Estimated time for total lockdown to burn out the virus Four weeks to include the 95th percentile, based on biological principles and China's experience.