Keeping sane in a crisis: an autistic perspective

As someone with autism who’s neurologically predisposed towards obsessing over danger and freaking out over every little thing, I have forty years experience of battling dread and fear, and so the threat of a pandemic bearing down on us like a runaway train is just another day to me. However, it seems to be something new for large sections of society, and as panic starts to spread, I thought I’d share some of my thoughts on keeping sane in a crisis – because if an autistic guy can do it, so can you.

First a disclaimer: I’m not an epidemiologist. Nor are most journalists, or the person on Facebook claiming coronavirus is harmless, or the neighbour stockpiling toilet paper. None of these behaviours are particularly helpful, because they add to the noise and misinformation out there, making it difficult to know what to believe and harder still to keep a level head. That’s why I’ve held off blogging about Covid-19: because I didn’t want to add to that noise.

But since we seem to be at peak saturation for signal clutter, what can it hurt? And hell, in some small way it might even help.

1. Demystify what you’re afraid of

There is nothing scarier than the unknown, except, perhaps, the unknown over which we have no control. There’s a very obvious evolutionary reason for this – the unknown could be dangerous and might kill us, so it’s safer sticking to the familiar where we can manage the risks.

Unfortunately, this means we have a tendency to inflate the dangers of anything new, and downplay the severity of those dangers we face everyday. That’s why we’re afraid of terrorists (odds of dying in a terror attack in the UK: 1 in 7.3 million), flying (1 in 5 million) and sharks (1 in 900 million), and not the death machines parked on our driveways (1 in 20,000, or a staggering 1 in 240 in your lifetime).

One of the best ways of controlling our fear of Covid-19 is to make it familiar, and thereby strip it of its mystique. Look at the bald statistics from a reliable site (like the World Health Organisation and Worldometer) and they’re more reassuring than the unhelpful running totals on websites listing number of cases alongside number of deaths.

As of 9:40, Thursday 12 March, there have been 126,628 cases, of which 4638 have died and 68,325 recovered. More helpful, perhaps, are the stats on current cases: 53,665, of which 47,957 (89%) are mild, and 5,708 (11%) serious or critical. While the tabloids might delight in showing photos of people lying in hospitals on ventilators, and implying there are more than 100,000 of them, the truth is that, globally, there are 5,708. Even if you catch Covid-19, the vast majority will have mild or no symptoms.

And this is good news for the statistics. The mortality rate is based on the percentage of known cases that have died, but if up to 50% of cases are asymptomatic, there are undoubtedly thousands who are infected, or have been infected and recovered, without even realising it.

So how lethal is Covid-19? Answers vary depending on which source you look at, but the mortality rate is estimated to be around 2% (ranging from 0.7% to 3%). This varies greatly by age, however, falling heaviest on the elderly and those with underlying health issues. If you’re under 50, the fatality rate runs at 0.2% of those infected, or 1 in 500, giving you a 99.8% chance of recovery, while those in their 80s have an 85% chance of recovery.

Therefore, if you catch Covid-19, you’re still twice as likely to die in a car accident in your life than die of coronavirus this year. Indeed, not only will you most likely recover, you’ll probably have either no symptoms or the mild symptoms of a cough, a high temperature, and a shortness of breath. This doesn’t mean it isn’t dangerous or that we shouldn’t do everything to protect ourselves and those more vulnerable to the virus, but knowing what we face is far easier to deal with than worrying unduly.

2. Put your fear into perspective

Oftentimes, it feels like the end of the world. Especially as an autistic person, you spend your life magnifying things to the level of a catastrophe. Your chest tightens as you’re flooded with adrenaline, obsessing over the danger and letting it consume your every thought, because you can’t avoid the thing that’s coming for you. At these times, it’s best to step back and put things into perspective.

Look out of the window: is the world still there? Is the grass still green? Can you see insects buzzing and flowers growing and clouds scudding across the sky? Then it’s not the end of the world, even if it might feel like it.

For the past few months, people have been comparing coronavirus to the flu. For just as long, people have been saying, ‘Stop comparing it to the flu! Stop saying it’s only dangerous to the elderly and those with underlying health issues! Stop trying to minimise the dangers!’ Such people are, I think, missing the point of why these things are being said.

People are scared. People want reassurance. Comparing Covid-19 – the unknown bogeyman – to something we’re fairly comfortable with, like flu, is a way of dispelling some of that fear, and I don’t think there’s anything wrong with that. The situation is serious, yes, but uncontrolled fear leads to the kind of irrational, unhelpful behaviour we’ve been seeing with panic-buying and stockpiling, which places massive strains on supply chains and has the potential to be very damaging. In a crisis, the last thing you want is panic. Making sane, rational decisions is always better than rushed knee-jerk reactions.

Nor do I think it’s a problem stressing that 98% of those infected will recover, with most of the remaining 2% being elderly and/or those with underlying medical issues. There was an article in the Guardian yesterday about the people in that 2% ‘at risk’ group feeling thrown to the wolves to make the other 98% feel better (along with lots of the usual Tory-bashing), but while you must be feeling vulnerable in that 2%, the solution isn’t to fill the remainder with dread. This doesn’t mean that those who die from this pandemic are unimportant and that we shouldn’t do everything we can to keep them safe, simply that we shouldn’t panic by overestimating the lethality of this virus.

Putting Covid-19 into context shows that it’s much worse than the flu, which has a mortality rate of 0.1% and a mortality rate in the over-65s of only 0.83%. However, it’s far less lethal than recent health scares like bird flu (60%), Ebola (50%), MERS (35%), and SARS (10%). It’s also nowhere near as contagious as measles or chicken pox.

Looking at the big picture, the government’s worst case scenario – something that is unlikely to happen – is that 80% of the UK gets it, resulting in 500,000 deaths. While this seems terrifying, again we must put it into perspective. In the UK, there are around 600,000 deaths each year from all causes, which is around 1% of the population. Therefore, more than half-a-million people die around us each year and we barely even notice it. Many of the people in the government’s 500,000 would have died anyway and been included in the 600,000, so if we speculate that around 1 million people will die in the UK this year, the worst case scenario will increase our annual death rate by half a percentage point – from 1% to 1.5%. This is worth remembering.

It’s also worth remembering that all of these figures are speculative. Covid-19 has the potential to kill millions, but so far it hasn’t, and only time will tell how it pans out. As my mother always says, worry is a waste of energy – if the thing you fear doesn’t happen, there was never any point worrying about it, and if it does, your worry didn’t stop it.

You know what does kill millions of people around the world each year? Heart disease. It kills 18 million people a year, but very few of us heed the warnings and change our diets and exercise. Cancer kills 10 million, many of them preventable. 9 million die of hunger. 1.5 million die of tuberculosis. 1.1 million of dysentery.

Judging Covid-19 on what it has actually done, instead of what it might do, is a better way of keeping a level head. I understand those people who scream that Covid-19 could kill millions, because they’re right. I also understand those who say that coronavirus has only killed around 4500 people, and even if you do catch it, you’ve got a 98% chance of recovery, because they’re right too.

3. Switch off

As someone whose autism causes him to obsess over every little detail of an issue until it dominates every aspect of his life, I’m well aware that there comes a point where, for the sake of your sanity, you just have to stop. It’s understandable that people want to keep abreast of the situation, because you want to keep an eye on the danger and avoid it if you can, but we’re in a uniquely difficult age where our technology gives us 24-hour access to information. What starts as a desire to keep you and your family safe can quickly turn into an addiction.

Watching the news a couple of times a day is fine, but tracking the spread of Covid-19 in real time and checking your phone for updates every few minutes isn’t healthy. It gives you the illusion of safety while simultaneously heightening your anxiety – a wound can’t heal when you’re constantly picking at it. Following Covid-19 doesn’t make you any safer, but it does make you far more uptight about it. So learn what you need to learn, hear what you need to hear, and then switch off, or else you risk letting your fear of coronavirus take over your life.

Of course, distracting yourself from that feeling of impending doom is not always easy. Instead of telling yourself not to think about it, which only makes you think about it more, simply acknowledge it whenever it pops into your head and gently shift your focus onto something else. I find doing something that requires concentration, focus and hand-eye coordination – a jigsaw puzzle, a model, a paint-by-numbers – is a far better means of taking your mind off your fears than TV, movies or a book.

And once your mind is off it, go do something else. Count the leaves on a tree. Dance in the shower. Focus on the here and now and the things you have control over, instead of things that might happen tomorrow. Know that this will pass.

4. Learn to accept the things we cannot change

I think the biggest thing I’ve realised from watching this emerging crisis is just how resistant people are to accepting things. They might close the schools, they might cancel my holiday, it’s not fair, rage, fume. When you come up against a brick wall blocking your path, repeatedly bashing your head against it is nothing more than a futile gesture. Sure, it’s annoying to find our way blocked. The solution isn’t to cry, it’s to go back and find another path.

You also have to accept that we’re all mortal and will therefore one day die. I’ve seen tons of people in their 70s and 80s in denial, panicking that they’re going to die. Why? If you’ve not accepted your mortality by that age, when you’re already past the life expectancy of an adult human, you’d better start working on it. I’m 40 and I’m comfortable with the fact that this bundle of cells, animated by that mysterious force called life, will one day become nothing more than meat. If I die of coronavirus, or heart disease, or in a car accident, it’ll be sad for my wife and kids, my family and friends, but it’ll be normal, and natural, and it was simply my time. There’s no point feeling bitter over the years I didn’t get to have, because I was never entitled to them, and I never had them anyway.

Accepting that no amount of huffing and puffing will change the nature of the universe is a vital skill if you want to keep your head when all around you are losing theirs.

5. Keep a sense of humour, even if (especially if) it’s dark

The best way of dispelling fear in a crisis is finding the humour in your situation. I remember someone posting that you should look around at all your friends and know that two of them will die. Wow, I thought – with a mortality rate of 2%, she’s vastly overestimating my popularity!

I’m also bemused by people’s fear of self-isolating. To me, that’s a normal day.

I find social media an endless source of amusement. It’s fascinating how easily Covid-19 slips into political rhetoric. To the right wing, the crisis is the result of immigrants bringing in the virus; to the left, it’s because the Tories have cut health services. Various right-wing websites are claiming that Covid-19 is a biological weapon that escaped from a Chinese lab; various left-wing websites are claiming it’s an American biological weapon designed to crash the Chinese economy. You’ve got to see something amusing about that.

Perhaps the weirdest thing is how quickly people’s professed virtues flip to the opposite extreme. After Brexit, I lost count of the number of Tweets I read hoping that elderly Leavers would hurry up and die; then, in the run-up to the election, those same people were saying how we had to vote Labour or else millions of old people would be at risk. After the result showed most old people voted Tory, I again lost count of the number of Tweets saying they looked forward to the elderly dying in their millions as the Tories ran the NHS into the ground as it would serve them right; and now, those same people are saying, Save the Elderly! Save the Elderly! I mean, come on guys, pick a side and stick to it: do you want elderly Brexit-voting Tories to die, or don’t you?

One of the best jokes I saw online was: If there was a vaccine for coronavirus, most of you wouldn’t take it anyway. Now shut up and wash your hands.

We have some difficult times ahead of us, people. But keep calm and carry on.

Good luck on staying sane.

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