LEBANON — As COVID-19 cases rise across Vermont and New Hampshire, and states rush to implement stricter safety precautions as the pandemic enters its ninth month, public health officials face a vexing challenge that has grown in recent months: pandemic fatigue.

“We tried to do confinement, but we didn’t succeed in bringing down the virus as they did in other places,” said Jay Buckey, a professor at Geisel School of Medicine who leads a research program focusing on people struggling with confinement. “People feel like this is never going to end.”

As the months wear on, many people feel the worsening stress or exhaustion that comes with constantly following safety guidelines, wearing masks and especially distancing from friends and family members, sometimes growing lax in their efforts. “Pandemic fatigue” refers to the emotional and mental toll that COVID-19 has taken over the last nine months, even for people whose physical health has not been affected.

Just like other kinds of confinement and isolation, Buckey said, the past nine months that people have spent social-distancing and quarantining can lead to interpersonal conflicts and depression.

“For some people, it affects their mood profoundly,” he added.

It’s unsurprising, Buckey said, that in the face of that isolation, some people have recently chosen to rebel and abandon safety precautions in order to get back to pre-pandemic normality.

Indeed, it’s not unusual for people to “relapse” within six months of making any kind of health-related behavioral change, according to a column published by CNN on Thursday by Texas A&M professor of public health Jay Maddox.

People once afraid of the fatal virus have seen the COVID-19 death rate decrease and have convinced themselves that their risk of death is relatively minimal, Maddox wrote.

Other factors, like jealousy at seeing others dining out, or a longing to see family members, play a big factor in the push to abandon the rules.

At this point in the pandemic, combating the virus is as much about state and local officials breaking through those feelings of ennui and exhaustion to ensure the public follow safety guidelines as it is about contact tracing or developing vaccines, according to some observers.

“They’re up against a real challenge,” said E.J. Powers, executive vice president of Manchester-based communications firm Montagne Communications. “We are looking to them to provide certainty in a really uncertain situation.”

“All of us are feeling like that message isn’t getting out there enough,” said Ellen Gnaedinger, nurse practitioner at the South Royalton Health Center. She’s among health care providers around the state who want people to abide by safety precautions like maintaining 6 feet of space and wearing masks in public.

“People are just saying, ‘Ugh, we want to get together with our friends.’ ”

Officials say the evidence of pandemic fatigue is apparent in little, every day occurrences; people gathering for deer camp or hosting birthday parties, or even just meeting over lunch.

Larger events are also making news. On Halloween night, Hanover police responded to two off-campus parties, leading Dartmouth College to launch an investigation into whether dozens of students broke COVID-19 safety protocols. In early October a maskless wedding in Woodstock sparked concern among health officials, and later that same month in Enfield a vendor who tested positive for COVID-19 attended a farmer’s market.

That’s reflected in the numbers, as well. Vermont recently saw a spike of 109 new cases on Thursday, which is the largest spike in the state since the beginning of the pandemic. New Hampshire also set a new daily record with 323 new cases reported Thursday.

Since October, 71 percent of the cases in Vermont that are associated with an outbreak came from social gatherings, according to a release from Scott’s office Friday.

The surge has led Vermont Governor Phil Scott to implement new stringent regulations, which go into effect Saturday night. They include closing all bars and clubs, ordering that restaurants must be closed for in-person dining by 10 p.m., and prohibiting all multi-household public gatherings.

Scott has been holding news conferences two to three times a week since the pandemic began, which are broadcast live and streamed online. He’s repeatedly urged people to keep up with safety precautions like social distancing while lauding praise on Vermonters for the state’s low levels of the virus, especially compared to the rest of the nation.

“I know this is incredibly discouraging especially because many of you have worked so hard and we’ve had much success for so long,” Scott said his Friday news conference. “But the fact is people getting together, not being careful and letting their guard down is why we’re in this position today.”

He added that people can prevent a further surge by holding their friends and family members accountable and spreading the word about wearing masks and avoiding gatherings.

“The more we get this message out, the more we get this information out, the more we articulate what the problem is, I think the quicker we solve it,” Scott said.

Some say the next steps require more than just cracking down on safety regulations and holding each other accountable; the specific ways that officials communicate with the public could help reduce pandemic fatigue.

Powers, of the communications firm, said in order for their messages to cut through feelings of fatigue or disillusion associated with a seemingly unyielding pandemic, officials must start share personal stories. By hearing about real people affected by the virus and real families who have had to quarantine or have lost a loved one, the gravity of the situation may set in for a lot of people, he said.

“Provide examples of how easily the virus spreads. … I still don’t think the public grasps how easily it can happen,” he said, suggesting officials even discuss how the virus has affected their own lives. “To be able to have that sort of understanding and empathy could be quite valuable.”

Another key message to get across is the harsh truth of what the virus can do, Powers said.

“Do you want this to be the last Thanksgiving with one of your family members?” he said, in response to the idea that some people may break social distancing guidelines to throw a holiday dinner. “That’s pretty stark but I think we’re at a point right now where we really need to hear the unvarnished truth.”

But along with the truth should come hope, Powers said. As people grapple with an oncoming winter and a questions over a vaccine, they should know that there’s “a light at the end of the tunnel,” he said.

“The public does need to know that there’s an end in sight, even if it’s further away than we need it to be.”

Buckey said people trying to fight against their own pandemic fatigue should not lose heart, and should start seeking out tools to help deal with a future lockdown, especially when it comes to dealing with intrapersonal conflicts that may arise from being in quarantine with family.

Finally, he echoed Powers’ calls for hope, adding that a key way people will find comfort through however many months of the pandemic remain, is by looking to the past for guidance.

“Many people may have parents or grandparents who were in World War II. Before that, people lived in the Great Depression,” Buckey said. “Looking back at what our ancestors had to deal with, we can handle this.”

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