Why Following COVID-19 Predictions Can Be Harmful If You’re Immunocompromised

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The pandemic has brought with it lessons for many of us, but perhaps none more striking than the unpredictability of the future during COVID-19.

At the beginning of the pandemic, epidemiologists (and everyone else) tried their best to predict what would happen: “This will all ‘fizzle out’ in a few months!” “Okay, this one will be the last wave.” Many of the rosier predictions, however, were followed by disappointment, grief, and despair.

If you’re immunocompromised, it can be tempting to cling tightly to expert predictions about when the pandemic will improve. After all, you’ve been taking every measure to protect yourself for two years and counting, and quite frankly, that has been exhausting and debilitating.

Still, following predictions too closely can do more harm than good. Here’s why — plus the helpful steps you can take instead.

Why COVID Predictions Often Aren’t Helpful

Despite many experts’ best intentions at the start of the pandemic, predictions have proven to be unreliable during COVID-19. Variants like Omicron that compete with each other for dominance are the wildcard of this virus — and they’re difficult to predict (so much so that many experts say they’re “done” making predictions, reports NBC News).

“The most prudent of the public health experts have now come to lead with, ‘We really can’t know the outcomes,’” says Kim Gorgens, PhD, Clinical Professor and Director of Continuing Education at the Graduate School of Professional Psychology at the University of Denver.

Dr. Gorgens says we’ll likely start to see less reliance, even from the authors of predictions, on the outcomes. Hopefully, that will go a long way toward qualifying these predictions as simply best guesses or probabilities, she says.

Most of us know this, of course. The reason we continue to Google is to capture some sense of control over a pandemic none of us have encountered before.

“We mistake our predictions for control — and there’s a comfort in that, but it’s all a folly,” says Dr. Gorgens. “There’s great research on the controllability of stress: We weather and handle stress better if we have a sense of control or a sense of predictability, so we crave it. We endeavor to design that circumstance for ourselves, but it’s ultimately foolhardy to think that anybody has a lead on what a public health crisis will do next.”

It’s understandable that you’d want to pay close attention to expert predictions. After all, you’ve tried to arm yourself with every mitigation effort possible during the pandemic.

“Throughout the COVID-19 pandemic, immunocompromised patients, such as those with rheumatoid arthritis, have faced particularly challenging conditions,” says Jacob Hascalovici, MD, Chief Medical Officer for Clearing, a telehealth platform for chronic pain patients. “To better manage their health, many of these patients pay close attention to COVID-related predictions.”

However, doing so, especially in this chapter of the pandemic, may ultimately make you feel worse — not better.

How Following Predictions Closely Can Affect Mental Health

You’ve likely noticed that when people cling too tightly to a “picture perfect” scenario (the perfect wedding day, the dream vacation, a flawless visit with extended family), they’re more likely to end up disappointed.

The same goes for navigating life during a rapidly shifting pandemic: When you follow predictions that change, you have continuously readjust. If you’re not primed to do so, it can be more difficult and tiring to cope.

“Having a really loose grip on predictions is important, so you can learn how to adjust and accommodate,” says Thea Gallagher, PsyD, a clinical psychologist at NYU Langone. “We call that cognitive flexibility, and it’s important because you can end up becoming really upset if you’re clinging to something as the law, but it’s not necessarily going to happen in the fashion you expect it to.”

Cognitive flexibility isn’t just for weathering pandemics: It’s involved in every complex behavior we undertake, and it varies widely from person to person, per Drexel University. Just think of how you need to drive slower when you turn off the highway and onto a small side street. Depending on the scenario, the rules that govern our behavior change, and that’s particularly true during a pandemic.

The other issue with hyperfocusing on predictions: It sets you up to live in a hypothetical future, rather than in the present.

“It has people living for the future, but they are starting to see that this might be part of our lives in some form or fashion for a long time,” says Dr. Gallagher. “We can’t keep living for the end, because then we’re not actually being present.”

Of course, living in the present — or being mindful of your surroundings here and now — is important for a number of reasons. Mindfulness exercises like meditation have been found to be helpful for a variety of conditions, including stress, anxiety, pain, depression, insomnia, and high blood pressure, per the Mayo Clinic.

You may feel that, given your underlying condition, you’re simply monitoring the situation. However, creating a contingency plan for what might occur is something best done with your doctor. After all, everyone’s unique medical situation and access to care will be different.

“While these predictions may help patients feel more informed and more able to manage their health outcomes, risks exist that prediction-monitoring may make patients feel more stressed, less in control, and less able to affect overall outcomes,” says Dr. Hascalovici. “Immunocompromised people then are placed in a difficult bind, both trying to maintain acute awareness of COVID-related news and prevention recommendations and also trying to maintain a balanced, overall life.”

When thinking about how to move forward, Dr. Gorgens refers to stoicism, a branch of philosophy founded thousands of years ago.

“Stoicism would say that the path to human enlightenment is to recognize things you can control and the things you can’t — and to focus your energy on the things you can control,” says Dr. Gorgens. “The stoicist mantra is ‘I don’t have control over what happens, I have control over what I do in response to what happens.’ I’m sure it’s a lesson many of us picked up along the way.”

How to Distinguish Helpful Research From Unhelpful Ruminating

Many people with conditions like obsessive compulsive disorder (OCD) are at high risk of unhelpful, compulsory behavior during the pandemic, but even those without an underlying mental health illness can find themselves constantly checking the internet in an effort to gain security and certainty.

However, there are little ways to tell if following COVID-19 predictions is becoming problematic in your life. For instance, you may be simply arming yourself with information if you Google a question about the pandemic once, find a satisfying answer from a trusted source, and then move on with your day. However, if you find yourself constantly checking (hourly or daily) even when you know there aren’t satisfying answers available, that signals compulsive behavior — and you should speak to a mental health professional.

Also ask your doctor what decisions you need to make to mitigate your risk for COVID-19, and then move forward knowing you have established parameters (and that there’s no need for extra searching). However, keep in mind that this will be an ongoing conversation that will change as the pandemic shifts.

“For patients I’ve worked with who are immunocompromised, it’s really important to come up with a plan with your doctor, and it might be iterative,” says Dr. Gallagher. “It’s about being able to adjust, make accommodations, and work with your health providers to do so.”

Another tip: Keep your information sources limited. For instance, you might check the U.S. Centers for Disease Control and Prevention  or follow a few select experts on Twitter for current guidelines and advice, but avoid spending time around “armchair” epidemiologists on the web — folks who claim to have answers, but don’t have the expertise to back it up.

How Following Predictions Closely Can Affect Physical Health

It’s not just about mental health: If you follow predictions that turn out to be wrong (or not applicable to your region or medical situation), you may mistakenly let your guard down when it comes to mitigating COVID-19 risk.

For instance, if you hear a prediction that there won’t be any more major waves of COVID-19, you might subconsciously — or consciously! — start to feel more comfortable taking your mask off indoors.

“Immunocompromised patients should still be vigilant,” says clinical rheumatologist Magdalena Cadet, MD, Associate Attending Physician at NYU Langone Health in New York City. “I think if anything, what we’ve learned in the past two years is that this virus is unpredictable. We don’t know what variants will emerge or whether they’ll be variants that cause severe disease and hospitalization.”

Even as the Omicron wave starts to wane, you should continue to follow the mitigation efforts you have been adhering to.

“I don’t think you should let down your guard completely — if you’re vaccinated and boosted, that does provide a level of comfort, but we are learning that the booster does decline in protection after a few months,” says Dr. Cadet. “I would still avoid large crowds at this point and socialize with people you know are vaccinated.”

We’ve also learned that certain types of masks like authentic N95 and KN95 masks can offer extra protection compared to other kinds of masks (here’s how to find these respirators in your community). Using mitigation efforts like these can help lower your risk in ways you can control.

How to Respond to Loved Ones Who Make Predictions

Of course, you may not always be the person following predictions. It’s easy to be weighed down by friends or family who believe they know the future (“Oh, everyone will get COVID-19 and then this will be over…”). These uninformed predictions can feel hurtful if the stakes are particularly high for you.

In these situations, pull from your toolbox of strategies you’ve used all along — the same ones you return to when someone makes insensitive remarks related to your underlying condition or asks why you can’t come along to an event when you “look fine.”

“For persons with any manner of immunocompromised condition or chronic illness, the same skills apply, and we’re better at managing those conversations than anyone,” says Dr. Gorgens. “You might say, ‘Thanks for the input, great to hear, now take good care.’ We have become really skilled at shutting down those conversations.”

Try to avoid ruminating over that person and their predictions, and instead put that energy toward adjusting your own behavior in the short-term to reduce your risk — and toward taking care of yourself. Think critically about the experiences over the past few years that have served you well (perhaps you’ve gotten a really good hold on your sleep hygiene or connected to new peer groups online). Be equally deliberate about evaluating the behaviors that haven’t served you well, like ruminating over COVID-19 predictions.

“If we assume this is a new baseline, get a real handle on what you’re doing to keep your head in the game and what is self-destructive and working deliberately against you,” says Dr. Gorgens.

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