COVID-19

[OPINION] Are we doomed to forget the lessons of COVID-19?

John Carlo Timbol
[OPINION] Are we doomed to forget the lessons of COVID-19?

Illustration by Guia Abogado

'A mere 10 years after the end of the [1918] pandemic, legislators could not be bothered to enact laws to help prevent another'

The last part of Daniel Kahneman’s Thinking, Fast and Slow explores an interesting, and unsettling, concept: that humans are composed of two selves, one experiencing, the other remembering. These two selves might mean that we are doomed to fail to learn from the past.

These two selves were demonstrated in various experiments. In one particularly vivid experiment, patients who underwent colonoscopy (this is a medical procedure wherein a tube with a camera is inserted up one’s anus and rectum, in order to visualize the intestines) without anesthesia were asked to rate how much pain they experienced.

Oddly, the patient’s perception of pain didn’t depend on whether the colonoscopy lasted six minutes or 60. What mattered were:

1) the most painful part of the procedure, and

2) how painful the last part of the procedure was

These findings, which Kahneman calls “duration neglect and peak-end rule,” were replicated in many other contexts. Duration neglect and peak-end rule, put simply, describes our tendency to remember only the most salient features of our experiences and how our experiences ended, at the expense of how long we were immersed in those experiences. Duration neglect and peak-end rule, says Kahneman, are hardwired into how we remember. 

This is important to keep in mind as we see a drop in the number of COVID-19 cases in our country.

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There is an edifying episode told in John M. Barry’s book, The Great Influenza: The Story of the Deadliest Plague in History, which documented the devastations wrought by the 1918 Spanish flu. A mere 10 years after the end of the pandemic, legislators could not be bothered to enact laws to help prevent another. Never mind that the most modest estimates say that the 1918 pandemic killed 20 million people, almost five times the number of people we’ve lost to COVID so far. Never mind that some estimates actually put the death toll at a staggering 50, even 100 million. Never mind that the pandemic ran roughshod over the world for three years. Could this have been because of duration neglect and the peak-end rule?

The 1918 flu pandemic ended on the virus’ own terms — the deadly strain mutated into a less virulent form, rendering it difficult to differentiate from an ordinary seasonal flu, or a common cold. The pandemic faded without vaccines or breakthroughs in treatment. There were no grand declarations of humanity’s victory over the pandemic The pandemic went away on its own, slowly, to little fanfare. Human memory is prone to forgiving such carnage more easily.

COVID-19 cases in the Philippines are at their lowest in months, and while I think this dip is just another trough in a series of case surges and recessions that still lay ahead of us, it is instructive to look back at the 1918 pandemic and how it petered out. In all likelihood, COVID-19 will fade slowly, its cycles of surges topping out at ever lower crests, as we vaccinate ever greater parts of the population, and as society learns to cope ever more efficiently. There might come a time when COVID-19 is seen as just another malady, just another nuisance, inconvenient, but ultimately something we can live with.

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While this development will be most welcome, the challenge is to maintain our enthusiasm for pushing for reforms in the healthcare system (foremost a humane salary package and benefits for healthcare workers) and educating people about the value of vaccines. We must maintain our ardor for holding government accountable for the budget it will allocate to health care, having seen how an overwhelmed healthcare system spills over into a backsliding economy. This won’t be easy — rigorous studies in psychology have already established that we humans are prone to having short, selective memories — but nothing worth doing comes easy anyway.

Ultimately, Daniel Kahneman wrote Thinking, Fast and Slow hoping to equip his readers with the vocabulary to identify cognitive illusions that cloud our thinking, therefore giving us the power to circumvent them. Hopefully, by giving a name to duration neglect and the peak-end rule, and by seeing how it may apply to how we feel about pandemics in hindsight, we can also circumvent the trap of sliding back to our old ways, condemning ourselves to another disruptive pandemic in the future. – Rappler.com

John Carlo B. Timbol is a physician currently working as a COVID-19 frontliner. He likes mountaineering more than books, but with COVID cases still surging, books will do.