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Death Anxiety and COVID-19

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Psychological mechanisms for providing socioemotional equanimity are especially important during the calamity caused by a major pandemic, when, given the need for physical isolation and social distancing, people are likely to be under greater stress while at the same time enjoying comparatively fewer chances to socialize or seek communal support. With the initiation and cultivation of personal relationships becoming more difficult to effect and maintain, their utility as efficient buffers against existential anxiety is greatly diminished right when they are needed the most—in response to the high levels of uncertainty, insecurity, and dread produced by the ongoing pandemic made salient by continuing coverage in the news. Moreover, the intense coverage of the spread of COVID-19, and the thousands of confirmed cases and mortalities announced each day is making the prospect of death ubiquitously and unavoidably salient on an international scale.

From an evolutionary perspective, threats of pathogens and diseases may stimulate existential anxiety since they are likely to prompt thoughts of mortality in opposition to the fundamental motive—self-preservation. Consequently, when faced with the specter of death made salient on a continuing basis by the coronavirus pandemic, TMT predicts individuals will turn to the utility of their CWV, self-esteem, and, when available, their close personal relationships to buffer the resulting anxiety. Indeed, extant research has shown how thinking about a virus outbreak—such as the Ebola epidemic (Arrowood et al., 2017) or the H1N1 pandemic (Bélanger et al., 2013)—has the same effect as a standard MS prime operationalized in the lab. In both cases, death thoughts become highly accessible, stimulating proximal and distal defensive behaviors that may often end in outgroup derogation, intolerance, and hostility toward dissimilar others.

Given the highly polarized nature of the political landscape in place even before the coronavirus pandemic began taking thousands of lives within the United States, TMT provides a clear explanation for much of the intolerance, hostility, political grandstanding, scapegoating, dissimilation, and deception engaged in by many political leaders, including the president of the United States, who has contributed to the problem by exacerbating an ongoing “infodemic” (WHO, 2020). Moreover, the coronavirus infodemic functions to further magnify the destructiveness of the COVID-19 pandemic by disseminating erroneous information giving rise to misunderstandings, interpretative mistakes, medically unsound and inaccurate statements, proliferation of supper spreader events (Aschwanden, 2020), fake news, conspiracy theories, and even antisemitism and racism, among other deleterious outcomes (Evanega et al., 2020; WHO, 2020). President Donald Trump, who was recently empirically demonstrated to be the single leading driver of misinformation about the COVID-19 pandemic (Evanega et al., 2020), has not only been accused of failing to contain the spread of the novel coronavirus but also of hampering efforts to curtail the deadly nature of the pandemic by actively playing a major role as a key “amplifier” (WHO, 2020), hindering efforts to deploy the best means of preventing its spread and continued destructiveness.

As Landau et al. (2004) and other TMT researchers have demonstrated, rather than a more rational consideration of the governance and leadership qualities possessed by political leaders, the public’s attraction to them is largely a function of the emotional and symbolic protection afforded by how such leaders are perceived. As it relates to the coronavirus pandemic, TMT research has shown how everyday stimuli, such as newspapers, television news, and social media can adversely affect people’s social interactions and negatively bias a range of outcome responses (Das et al., 2009; Landau et al., 2004; Massey & Johnson, 2018). Considering the recent widening in the polarization of ideological assumptions and practices associated with quarantining, mask-wearing, and social distancing, it should be no surprise how more negative outgroup perceptions, source credibility assessments, and personal and public health behaviors have come to aggravate and stymie efforts to contain and eliminate the spread of COVID-19.

As dozens of TMT studies have shown, elevated DTA motivates biased processing, such that, although people may show increased favoritism and tolerance toward those providing consensus for their own worldview, individuals will correspondingly exhibit greater hostility toward those threatening or merely holding a different worldview. What’s more, beyond attempting to derogate competing worldviews, such as can be observed when competing ideological positions encourage opposing responses to the coronavirus pandemic, anyone attempting to proclaim or publicize a compelling alternative approach to confronting the pandemic can not only undermine the legitimacy one’s own responses to the threat, but also, according to TMT, threaten one’s own overarching belief system, the basis of which acts as a vital buffer against the anxiety generated by death thoughts made salient by the pandemic.

As TMT posits, in such cases—when one’s own CWV is threatened by the mere existence of a competing CWV—individuals may often be motivated to engage in a defensive strategy called “threat accommodation” (Schimel et al., 2019), which involves keeping faith in one’s core worldview (e.g., the United States is powerful in spite of the “China virus”) but selectively modifying its peripheral aspects (e.g., by implicitly taking solace in the fact that Chinese health authorities have greatly reduced the spread of COVID-19 within China), so as to include otherwise-threatening ideas (i.e., the Chinese health officials’ responses to SARS-CoV-2 have been superior to our own) as a part of one’s own CWV (i.e., however, our medical science is the best in the world).

Another form of threat accommodation involves attempting to assimilate nonbelievers into one’s own worldview (Schimel et al., 2019), as for example often occurs via social media activity, as friends try to convert each other to their own way of thinking by exchanging friendly and helpful posts for others to learn about their own beliefs, or by showing how other intelligent and attractive people have been convinced to see the light. Social media may also have a significant impact on people’s risk perceptions and willingness to contribute to their friends’ awareness (Han & Xu, 2020). In this regard, MS can lead people to bypass the need to derogate dissimilar others in favor of simply attempting to convert the nonbeliever, thereby turning an otherwise worldview-threatening social interaction into a form of self-validation (Kosloff et al., 2017).

Although assimilation may be preferable to derogation, when rumors, gossip, and unreliable information are spread readily via the internet through social media, the propagation of diverse and contradictory views promoted by questionable web-based “experts” can produce confusion, anxiety, and panic that may further exacerbate pandemic spread, whether they are honest mistakes or intentional (Pazzanese, 2020). False or misleading information is dangerous, and it can cause widespread public reluctance to adopt well-founded infection control measures promoted by bonified medical authorities, and it can seriously delay the implementation of essential health interventions (WHO, 2018). Moreover, misinformation spread by government leaders may be even more harmful when it is disseminated over social media, for instance, when Facebook and Twitter posts include videos of President Trump expressing scorn for wearing masks and social distancing by willfully convening large, maskless, and crowded rallies (Baker, 2020; Egan, 2020), or by mocking his political opponent for so often wearing a mask (Mackey, 2020).

A TMT perspective also helps to explain how a political leader can continue to enjoy a devoted partisan following even in the face of an obvious failure to contain or curtail a crisis situation, or even in light of convincing evidence of the leader’s role in effectively intensifying the crisis. In the case of the coronavirus pandemic, as polls show, there is a clear relationship between people’s approval/disapproval of President Trump’s handling of the pandemic and their decisions to decline or choose mask wearing, social distancing, or seek a vaccination against the coronavirus. Ironically, this may perhaps not be such a bad thing, given how faith in the federal government to provide accurate information about the pandemic—and particularly trust in the White House, and Donald Trump in this regard—is at an all-time low, with more than two-thirds of Americans placing little or no confidence in the Trump Administration (Jackson & Newall, 2020).

Beyond those who were directly affected by a recent supper spreader event that took place in the White House Rose Garden (Buchanan et al., 2020)—likely including the President himself, along with at least seven other high ranking officials and lawmakers (Gringlas, 2020)—the spectacle of hundreds of unmasked people sitting shoulder to shoulder in the Rose Garden exhibiting a willful dismissal of precautions illustrates the failure of the White Hours to set an example useful in lowering the proliferation of COVID-19 (Fisher et al., 2020). The vehement rejection of the President’s policies and actions by his political opponents is only rivaled by the seeming blanket acceptance shown by his own party, which illustrates the polarizing nature of worldview bolstering and bashing predicted by TMT in response to the anxiety intensifying effects of colliding ideologies and conflicting worldviews.

In this regard, it is unsurprising to see both covert and overt racism toward Asians and Asian Americans. Since the first case of COVID-19 was discovered in China, xenophobia, discrimination, and verbal and physical attacks against Asians have intensified worldwide, and especially within the United States, as the pandemic has lengthened (Human Rights Watch, 2020) and President Trump has taken to referring to SARS-CoV-2 as “the China virus” (Yeung et al., 2020). Moreover, these observations, readily visible to lay observers, have been confirmed by empirical evidence. For example, Golec de Zavala et al. (2020) examined attitudes toward violations of traditional Polish norms in sexual and gender relations during the COVID-19 pandemic, collecting data both before and during the pandemic. Analyzing it via latent growth curve modeling, they found a linear increase in desires for national unity, authoritarianism, and rejection of sexual dissenters as the pandemic unfolded.

Along similar lines, Arrowood et al. (2017) found that reminding people of the Ebola epidemic (caused by a viral disease with a more deadly but lower infection rate than COVID-19) made death thoughts more accessible than the control condition and increased participants’ need for worldview defense. Similar studies examining responses to the Ebola epidemic have found DTA associated with reminders of the epidemic to increase political conservatism (Beall et al., 2016) and generate greater prejudice toward the gay community within the United States (Inbar et al., 2016). Likewise, Song et al. (2020) hypothesized that informational conformity in consumer behavior—which is formed on the basis of a desire to accurately interpret reality, and thus correctly behave—should buffer anxiety when mortality is made salient. Investigating the relationship among DTA, need to belong, informational conformity, and consumer behavior during the COVID-19 pandemic, Song et al. (2020) found DTA positively related to both the need to belong and informational conformity, which in turn influenced their consumer behavior. These findings are consistent with the TMT assertion that existential anxiety promotes the protection of traditional worldviews, while simultaneously stimulating the rejection of moral transgressors (Pyszczynski et al., 2015), and further illustrates how thinking about the coronavirus pandemic can initiate these biasing processes, resulting in actual behavioral outcomes.

Despite the existential threats involved, and likely because of the elevated levels of existential anxiety, there have been numerous emotionally volatile protests against official government directives in several countries around the globe, including the United Kingdom, United States, and Brazil (Fonseca & McGeever, 2020; Picheta, 2020; RNZ, 2020). Because these three countries in particular lean toward the individualistic end on the individualism-collectivism spectrum (Hofstede Insights, 2020), their populations tend to place relatively greater emphasis on personal freedoms; thus, when their governments issue official guidelines, such as practicing social distancing and wearing masks to slow the spread of the virus during the pandemic, a portion of their populations' protestors are likely to feel that such directives and preventive guidelines impinge on their freedoms.

From the standpoint of TMT, the importance of self-determination and individual freedom, and the consequent motivation to safeguard such rights and values can function as the basis for sustaining the integrity of one’s CWV, and thus an important form of distal defense capable of maintaining an effective shield against existential anxiety. Because the ongoing coverage of the COVID-19 pandemic is prone to provoking a stronger need for the anxiety buffering function of ones CWV, TMT would predict greater emphasis will be placed on individual freedoms, resulting in more intense objections to any preventive measures seen as hindering or violating them. On the other hand, more collectivist countries, such as China, South Korea, and Taiwan with cultural orientations inclined toward relatively greater interdependent interaction, should be more likely to welcome and eagerly adopt preventive measures such as social distancing and mask-wearing. Such behaviors should be seen as instantiating rather than violating important communal values; thus, complying with relevant government directives would demonstrate adherence to the dictates of one’s CWV, thereby strengthen the effectiveness of its anxiety buffering function.

Depending on the salient aspects of one’s CWV, either dissociative behaviors such as defiance, discrimination, and racism may be brought to the fore by the presence of divisive rhetoric in the news or more associative behaviors may be encouraged, such as promoting the socially beneficial aspects of preventative measures. Indeed, many simple, useful, and preventative behaviors are greatly on the rise (e.g., the use of hand sanitizer; Hiebert, 2020), which makes perfect sense in light of how they can function both as proximal defenses useful in fighting the virus and the physical threat it represents, and as distal defenses useful in dealing with the existential anxiety and psychological threat presented by the pandemic.

Given how proximal defenses are moderated by perceptions of their effectiveness at decreasing the threat of death and distal defenses are moderated by CWVs and self-esteem (Goldenberg & Arndt, 2008; Greenberg & Arndt, 2011), efforts can be made, respectively, to achieve greater compliance with preventive measures; promote more protective behaviors; and reduce intolerance, bigotry, and violence during calamitous events such as the COVID-19 pandemic. First, in terms of increasing successful proximal defenses, effective measures should be provided along with psychologically artful rhetoric and effective messaging capable of increasing public perceptions of the efficacy of preventive measures, as well as encouraging the receptivity of promotional messages.

Second, considering the importance and significance of the worldview validating role played by respected cultural role models, communicating the risks of COVID-19 and of the efficacy of available preventive actions by such admired people should be shaped in ways that help individuals cultivate a sense of adherence to the higher order values within their CWV. By engaging in and demonstrating preventative actions for the sake of the many as well as the individual, leaders, dignitaries, celebrities, and other admired notables can aid in normalizing such actions, helping to render them as common values, central to cultural norms.

As an effective means for slowing the spread of viruses, vaccines have played a fundamental role in controlling and eradicating diseases for decades, yet their acceptance is far from universal. Promoting vaccination not only as a critically important defense against pandemic spread, but also as a significant value central to the dominant CWV is another vital area in need of attention. At the present moment (March, 2021), scores of promising vaccines have been developed and undergone advanced human trials, with several now available and already in wide distribution (Pfizer-BioNTech; Moderna; and Johnson & Johnson) and two more in large-scale Phase-3 clinical trials (AstraZenica and Novavax), likely soon to be released (CDC, 2021). Yet, as dozens of polls indicate, there is both a national and a global hesitancy in accepting vaccination as a common preventative measure (Reynolds, 2020). Even among otherwise well-educated populations, “vaccine hesitancy” (Dubé et al., 2013) is a persistent problem for a number of reasons lacking in scientific merit, including a range of religious beliefs, superstitions, motives for indecision, and other correspondingly irrational beliefs (Bedford et al., 2018; Warner et al., 2017). Thus, countering such beliefs, and further, replacing them with more valid understandings central to a sound, well-founded, and scientific worldview should be a major goal of governments, public health authorities, educators, and concerned citizens worldwide.

Of more immediate concern, as it applies to the coronavirus pandemic, it is estimated that developing antibodies in at least 60%–70% of the population is necessary for achieving herd immunity (DeMarco, 2020); therefore, concerted efforts to attain high vaccination rates are imperative. From the standpoint of TMT, vaccine promotion by all elements of society—at the national, state, and local community levels—is critical for emphasizing the efficacy of COVID-19 vaccines, not only for immediate purposes of controlling the pandemic during proximal defense against mortal threats, but at the distal level as well, where self-esteem, interpersonal relationships, and meaningful aspects of CWV all play vital roles in ameliorating existential anxiety within the complex process of terror management defense.

Communicating Science in Times of Crisis

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