Mike Hoerger, PhD MSCR MBA Profile picture
Dec 20, 2023 10 tweets 8 min read Read on X
As a clinical health psychologist, I notice that many people are using psychological defense mechanisms to downplay the risk of COVID.

These are my Top 7 examples:

🧵 Top 7 Psychological Defense Mechanisms Used to Downplay COVID
#1 – Denial – Pretending a problem does not exist to provide artificial relief from anxiety.

Examples:

“During COVID” or “During the pandemic” (past tense)

“The pandemic is over”

“Covid is mild”

“It’s gotten milder”

“Covid is now like a cold or the flu”

“Masks don’t work anyway”

“Covid is NOT airborne”

“Pandemic of the unvaccinated”

“Schools are safe”

“Children don’t transmit COVID”

“Covid is mild in young people”

“Summer flu”

“I’m sick but it’s not Covid”

Taking a rapid test only once

Using self-reported case estimates (25x underestimate) rather than wastewater-derived case estimation

Using hospitalization capacity estimates to enact public health precautions (lagging indicator)

Citing mortality estimates rather than excess mortality estimates. Citing excess mortality without adjusting for survivorship bias.This is from a psychology book by Nancy McWilliams. I will post a link to a PDF of newer edition of the full book at the end of the thread. If someone has a better "ALT" trick, please educate me on this one.
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#2 – Projection – When someone takes what they are feeling and attempts to put it on someone else to artificially reduce their own anxiety.

Examples:

“Stop living in fear.” (the attacker is living in fear)

“You can take your mask off.” (they are insecure about being unmasked themselves)

“When are you going to stop masking?”

“You can’t live in fear forever.”This is from a psychology book by Nancy McWilliams. I will post a link to a PDF of newer edition of the full book at the end of the thread. If someone has a better "ALT" trick, please educate me on this one.
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#3 – Displacement – When someone takes their pandemic anxiety and redirects their discomfort toward someone or something else.

Examples:

Angry, seemingly inexplicable outbursts by co-workers, strangers, or family

White affluent people caring less about the pandemic after learning that it disproportionately affects lower-socioeconomic status people of color

Scapegoating based on vaccination status, masking behavior, etc.

“Pandemic of the unvaccinated”

Vax and relax

“How many of them were vaccinated?” (troll comment on Covid deaths or long Covid)

Redirecting anxiety about mitigating a highly-contagious airborne virus by encouraging people to do simple ineffective mitigation like handwashing

“You do you” (complainers are the problem, not Covid)

Telling people to get vaccinated or take other precautions against the flu or RSV but not mentioning Covid

Parents artificially reducing their own anxiety by placing children in poorly mitigated environments

Clinicians artificially reducing their own anxiety by placing patients in poorly mitigated environments

Housework to distract from stress

Peer pressure not to maskThis is from a psychology book by Nancy McWilliams. I will post a link to a PDF of newer edition of the full book at the end of the thread. If someone has a better "ALT" trick, please educate me on this one.
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#4 – Compartmentalization – Holding two conflicting ideas or behaviors, such as caution and incaution, rather than dealing with the anxiety evoked by considering the incautious behaviors more deeply (hypocrisy)

Hospitals and clinicians claim to value health/safety but then don’t require universal precautions

Public health officials claim to value evidence but then give non-evidence based advice (handwashing over masking), obscure or use low-value data over high-quality data (self-reported case counts over wastewater), etc.

Getting a flu vaccine but not a Covid vaccine

Interviewing long Covid experts who recommend masking in indoor public spaces but then going to Applebee’s

Masking in one potentially risky setting (grocery store) but not masking in another similar or more-risky setting (classroom)

Infectious disease conference where people are unmasked

Long Covid and other patient-advocacy meetings where only half the people mask

In-person only EDI events

Not testing because it’s just family

Mask breaksThis is from a psychology book by Nancy McWilliams. I will post a link to a PDF of newer edition of the full book at the end of the thread. If someone has a better "ALT" trick, please educate me on this one.
#5 – Reaction formation – expressing artificial positive feelings when actually experiencing anxiety

“It’s good I got my infection out of the way before the holidays”

“I had Covid but it was mild”

Anything quoted in Dr. Jonathan Howard’s book, “We Want Them Infected: How the Failed Quest for Herd Immunity Led Doctors to Embrace Anti-Vaccine Movement”

Herd immunity (infections help)

Hybrid immunity (infections help)

“It’s okay because I was recently vaccinated”

“Omicron is milder”

“Textbook virus”

“Building immunity”This is from a psychology book by Nancy McWilliams. I will post a link to a PDF of newer edition of the full book at the end of the thread. If someone has a better "ALT" trick, please educate me on this one.
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#6 – Rationalization – Artificially reducing Covid anxiety through a weak justification.

Examples:

“I didn’t mask but I used nasal spray”

“I don’t need to mask because I was recently vaccinated”

“It finally got me.”

“You’re going to get Covid again and again and again over your life.”

“It’s not Covid because I don’t have a sore throat.”

“It’s not Covid because I took a rapid test 3 days ago.”

“It’s not Covid because I’m vaccinated.”

“Airplanes have excellent ventilation.”

“I’ve had Covid three times. It’s mild.”

“Verily was cheaper.”

“Nobody else is masking.”

“Nobody else is testing.”

“My roommates don’t take any precautions, so there’s no point in me either.”

“I have a large family, so there’s no point in taking precautions.”

Surgical masks (they are actual “procedure masks,” by the way)

Various pseudo-scientific treatments used by the left and right

Handwashing as the primary Covid public health recommendation

Droplet transmission as a thing

Public health guidance that begins with “data shows” (sic)

Risk maps that never turn deep red

5 expired rapid tests

“Masks recommended” instead of universal precautions

“Seasonal”This is from a psychology book by Nancy McWilliams. I will post a link to a PDF of newer edition of the full book at the end of the thread. If someone has a better "ALT" trick, please educate me on this one.
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#7 – Intellectualization – using extensive cognitive arguments to artificially circumvent Covid anxiety

Examples:

Unending threads to justify indoor dining

Data-rich public health dashboards that use low-quality metrics and/or don’t change public health recommendations as risk increases

The entire justification for “off-ramps”

Oster, Wen, Prasad

Schools denying air cleaners because it “could make children anxious”

Schools not rapid testing this surge because it “could make children anxious”

The mental gymnastics underlying the rationales for who can get vaccinated, how frequently, or with what brand

Service workers told not to mask because it could make clients uncomfortable

“What comorbidities did they have?”

“The vulnerable will fall by the wayside”

Musicians and others holding large indoor events

5-day isolation periodsThis is from a psychology book by Nancy McWilliams. I will post a link to a PDF of newer edition of the full book at the end of the thread. If someone has a better "ALT" trick, please educate me on this one.
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Here's a link to the full book, a newer edition than what I own. The information on defense mechanisms begins on textbook page 100.

Please let me know if there's a more accessible alt-text solution that you would prefer so I can do better next time.
isotis.files.wordpress.com/2016/07/mcwill…

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More from @michael_hoerger

May 25
1) CDC & Biobot wastewater surveillance both show the West region in an apparent uptick in C19 transmission.

Here's the graph of regional transmission from CDC data with the West in green: Estimated Percentage Actively Infectious*						 		PMC Model		Raw CDC Data		 	National	0.6% (1 in 180)		0.5% (1 in 196)		 	Northeast	0.4% (1 in 236)		0.4% (1 in 257)		 	Midwest	0.5% (1 in 209)		0.4% (1 in 227)		 	South	0.6% (1 in 160)		0.6% (1 in 175)		 	West	0.8% (1 in 129)		0.7% (1 in 140)
2) This image zooms in on the West (green line) so you can see the apparent departure from the C19 lull more easily. Zoomed in graph from prior post. More stats in the ALT text there.
3) Biobot still provides national & regional C19 updates. They usually post sometime between Thursday morning & Saturday evening. IMO, their most recent data point can be viewed as the Wednesday of the prior week.

Like the CDC, they have an apparent uptick in the West (green). Biobot graph. What's striking is that the peak (for any region) is almost identical the past 3 waves, though the West apparently runs cooler on average. The West is presently highest and increasing, whereas the other regions are lower and still trending down at the time of these data.
Read 6 tweets
May 20
PMC COVlD Report, May 19, 2025 (U.S.)

In this national "lull" in transmission, we are seeing...
🔥A quarter-million daily infections
🔥90-360k Long COVlD cases from the week's infections
🔥600-1,100 deaths from the week's infections
🔥LA, SD, NE, & GU in high transmission10 waves of C19
Heat map, summarized in post
Current Levels for May 19, 2025	 % of the Population Infectious	 0.5% (1 in 185)	 New Daily Infections	 259000	 New Weekly Infections	 1813000	 Resulting Weekly Long COVID Cases	 91,000 to 363,000	 Resulting Weekly Excess Deaths	 600 to 1,100	 	 Monthly Forecast	 Average % of the Population Infectious	 0.8% (1 in 129)	 Average New Daily Infections	 371566.6667	 New Infections During the Next Month	 11147000	 Resulting Monthly Long COVID Cases	 557,000 to 2,229,000	 Resulting Monthly Excess Deaths	 4,000 to 6,600	 	 Running Totals	 Infections Nationwide in 2025	 66986000	 Average Number of I...
Year-over-year graph, currently closely tracking the median, Y4, and Y5
Full report: pmc19.com/data
PMC COVlD updates are also posted periodically on Plip Plop:

tiktok.com/@michael_hoerg…
Read 6 tweets
May 15
1) Good luck getting any new federal research to support #LongCOVID until "covid" is dropped from the dirty words that get grant applications triaged to the trash bin.

You know which senator to call.

I just did, and got a staffer instead of voicemail.Lengthy list of words that get federal grants triaged to the trash bin, unfunded after favorable review, or defunded if already in progress.   Includes "Covid-19," and no, it's not a matter of simply restating as "SARS2" or "The Rona." It might make it one step further in the review process, but this gets checked closed, and it will get canned. Hundreds of hours of work, flushed down the toilet.   And that's the point.
2) I told the staffer that #LongCOVID is affecting millions and that no research will be funded to address this while "covid" remains on the banned word list.

I asked if they wanted to hear more. He did...

Here's the word list, btw
pen.org/banned-words-l…
3) I told them about my family member who was a strong Special Forces veteran, got covid once, & according to their neurologist, it triggered #LongCOVID in the form of Dementia w/Lewy Bodies.

DLB is one of the worst conditions imaginable. After a 2yr battle, they died in 2024.
Read 5 tweets
May 3
30 million excess deaths attributable to COVID is a tremendous underestimate because most analyses insufficiently account for mortality displacement.

In the U.S., it's about 50% worse than people realize.
Mortality displacement or "harvesting" is the idea that so many people died of COVID in the early pandemic that we should actually expect to see *fewer* deaths today if COVID were "over."
In fact, we see similar or slightly higher mortality relative to pre-pandemic levels. Despite the millions of people that have died, the mortality faucet keeps running strong. It should have slowed.
Read 9 tweets
Apr 22
🧵1 of 8 | PMC Dashboard, April 21, 2025 (U.S.)

🌤️Only 1 in 5 days of the pandemic have seen transmission as low as today
🌤️1 in 196 actively infectious
⚡️BUT still 1.7 million weekly infections, resulting in >85,000 LC cases and up to 1,000 deaths

I'll walk you through it... Current Levels for Apr 21, 2025	 % of the Population Infectious	 0.5% (1 in 196)	 New Daily Infections	 244000	 New Weekly Infections	 1708000	 Resulting Weekly Long COVID Cases	 85,000 to 342,000	 Resulting Weekly Excess Deaths	 600 to 1,000	 	 Monthly Forecast	 Average % of the Population Infectious	 0.7% (1 in 147)	 Average New Daily Infections	 324800	 New Infections During the Next Month	 9744000	 Resulting Monthly Long COVID Cases	 487,000 to 1,949,000	 Resulting Monthly Excess Deaths	 3,500 to 5,800	 	 Running Totals	 Infections Nationwide in 2025	 62331000	 Average Number of Infecti...
🧵2 of 8 | PMC Dashboard, April 21, 2025 (U.S.)

We're in the 6th year. See the small red line, bottom left. Notice how closely it tracks the median (gray), year 4 (yellow), & year 5 (orange).

Acknowledging caveats, those are plausible gist-level scenarios for months ahead. year over year graph, summarized in post
🧵3 of 8 | PMC Dashboard, April 21, 2025 (U.S.)

Expect steady transmission bouncing up and down around the current national lull-level estimate the next several weeks. 200-350k daily infections nationally.

This is about as low as lulls bottom out anymore. Past 12 months and forecast, summarized in post
Read 8 tweets
Apr 14
🧵1/5 | PMC Dashboard, Apr1il 14, 2025 (U.S.)

🔹2.2 million weekly infections
🔹1 in 149 actively infectious
🔹>100,000 LC cases resulting from the week's infections
🔹>800 deaths resulting from the week's infections
🔹"Lull" transmission steady/slightly decliningCurrent Levels for Apr 14, 2025	 % of the Population Infectious	 0.7% (1 in 149)	 New Daily Infections	 320000	 New Weekly Infections	 2240000	 Resulting Weekly Long COVID Cases	 112,000 to 448,000	 Resulting Weekly Excess Deaths	 800 to 1,300	 	 Monthly Forecast	 Average % of the Population Infectious	 0.7% (1 in 138)	 Average New Daily Infections	 345366.6667	 New Infections During the Next Month	 10361000	 Resulting Monthly Long COVID Cases	 518,000 to 2,072,000	 Resulting Monthly Excess Deaths	 3,700 to 6,200	 	 Running Totals	 Infections Nationwide in 2025	 60891000	 Average Number of ...
🧵2/5 | PMC Dashboard, Apr1il 14, 2025 (U.S.)

Year-over-year transmission (red line, lower left) is tracking the median (grey), year 4 (yellow), and year 5 (orange) closely.

If that trend continues, expect steady yet bumpy transmission the next couple months, until June/July.line graphs, described in tweet
🧵3/5 | PMC Dashboard, Apr1il 14, 2025 (U.S.)

The heat map shows only 4 states in the CDC 'high' level and none in the 'very' high level.

Check local data. Those timing activities to lulls may see a clear opportunity.heat map, described in tweet
Read 6 tweets

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