Completely vaccinated but worried about a return to normal life? You could have “cave syndrome”

“You look at social media and you see people having a lot of fun,” says the 49-year-old product management consultant in suburban Rockland County, NY. “I can’t imagine myself in this photo”.

Since the Centers for Disease Control and Prevention gave the green light for vaccinated people to congregate indoors without masks and resume their pre-pandemic activities, many have eagerly returned to dining at restaurants, attending events. parties and catching a plane to see friends and family. (And many people did before.) Yet for others, returning to their old lives – and much of the outside world – proves difficult after more than a year of relative isolation.

Instead of feeling the freedom, many say they fear re-socializing and awkwardly decline invitations, avoid crowds, and dread, or even delay, returning to work.

The phenomenon is common enough to be called “cave syndrome” on social networks and in some psychiatric circles. “Cave syndrome really means people are just nervous about going out because they’re going to get infected,” says Coral Gables, Florida psychiatrist Arthur Bregman. He coined the term non-medical earlier this year after some of his patients expressed sometimes crippling fears of stepping out into society despite being fully vaccinated.

Dr Bregman says cave syndrome varies in degrees, from vaccinated individuals who are cautious but participate in limited social interaction to those who choose not to go out at all. It distinguishes between immunocompromised people who are unable to take full advantage of the protective effects of the vaccine and remain vulnerable to Covid-19 and those who, according to the data, enjoy considerable protection from the vaccine.

The growing spread of the Delta variant has been large enough that places like Los Angeles and Israel have reinstated indoor mask requirements in recent weeks, sparking more anxiety among those already worried about re-entering society. And unlike CDC guidelines, the World Health Organization also recently reiterated its global guidelines that everyone should wear a mask indoors.

The constantly changing information on Covid-19 along with changing and sometimes conflicting guidelines from government health officials have likely exacerbated fears, Dr Bregman said. Although the data shows that vaccinated people who catch the Delta variant are very unlikely to need hospitalization, “there is still this monumental fear and suspicion that people have that they are going to get sick,” and so they stay inside, ”he says.

Meanwhile, Covid-19 restrictions continue to be dismantled in many places, adding to the confusion many feel over what is a safe social practice. This week, England officially dropped almost all restrictions on coronaviruses, including mask requirements and size limits for gatherings, in the government’s bet that mass vaccination will stop another deadly wave of Covid -19. Canada said on Monday it would allow fully vaccinated Americans to enter the country for tourism activities from August 9, more than a year after the border closed to most travelers.

Studies suggest that many people will need time to adjust to the newly reopened society. In a June survey by Ipsos and the World Economic Forum, the majority of 12,497 adults in nine countries, including the United States, France, Japan, Mexico and the United Kingdom, said they would continue likely to distance themselves socially and wear a mask in public after being vaccinated. .

In a March study by the American Psychological Association, nearly half of 3,013 American adults polled by Harris Poll said they felt uncomfortable adjusting to in-person interaction once the pandemic over. Adults who were vaccinated were just as likely as those who were not vaccinated to say they were uncomfortable.

Andrew Ruiz, a 32-year-old technology analyst who lives in Fort Myers, Florida, has been fully vaccinated since April. He says he remains socially cautious and that in October he plans to skip New York Comic Con, which he has been attending since 2014.

“It’s just a matter of how it is in an enclosed space,” he says. “I want to play it safe and not be in a big crowd.” Plus, he’s not ready to get on a plane, he says, especially with news of the Delta variant spreading. “It’s probably best for me to wait another year and see if things calm down then,” he says.

Fear of the virus alone does not prevent some from re-entering society. Some holdouts have grown used to living in their bubbles and are reluctant to give up some of the positives of spending more time at home, says Paul S. Appelbaum, professor of psychiatry, medicine and law at Columbia University.

“It has become a comfortable model reinforced by the fear of the unknown,” he says. “Isn’t that going to be weird when I get back on the metro?” Won’t it be weird when I walk into the office? ‘ The familiar feels safe and the stranger always carries a little anxiety.

Eoin Hamilton says he “had a knot in my stomach all the time” as he celebrated his 43rd birthday with family at a Dublin hotel in early July. It was the first time Mr Hamilton, a graphic designer, had been in the crowd after spending the last 18 months of the pandemic mainly at home with his wife and children in Ballivor, a small village about an hour from the Irish capital.

“Everyone seemed to be doing perfectly fine, but inside I was just losing my temper,” says Hamilton, who has been vaccinated for months. “I had a feeling it might be a little weird, but I didn’t expect it to be that bad.”

More than the virus itself, “it’s the anxiety of being around people again because you’ve been conditioned to stay away from people,” he says, adding that the experience swore to continue to distance himself socially. “I used to love being in a massive group of people, drinking a few pints, but now I don’t want to be around people anymore.”

Eileen Ybarra, a 44-year-old librarian in Los Angeles, received her second vaccine in April and has started shopping in person and seeing family members again. But she still isn’t comfortable going to the movies or dining indoors.

“It’s a mixture of I don’t want to get sick in general, and maybe I’m just feeling more than a little traumatized by the past year,” she says. “I give myself time to resume a more or less normal life. “

She has recently been “in the slow reintegration phase,” she says, eating indoors for the first time earlier this month for a family birthday party. But recent orders from Los Angeles to re-hide in most interior spaces have once again undermined his confidence in venturing out.

“Now I kinda feel like, well, I guess?” ” she says. “It’s a little strange.”

Write to Ray A. Smith at [email protected]