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Editor's Choice

Behavioural fatigue: a flawed idea central to a flawed pandemic response

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3093 (Published 06 August 2020) Cite this as: BMJ 2020;370:m3093

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Behavioural fatigue is part of human nature.

Dear Editor,

Behavioural fatigue may not have had its debut in the psychology literature but it is as old as human nature itself. The concepts of voter fatigue, Brexit fatigue, physical fatigue, and attention fatigue are all too common as human experiences to even need an evidence base. The human condition"can only take so much" of a given stress or adverse situation to reach a stage of failure/fatigue/exhaustion. "The straw that breaks the camel's back" is the end game when all human resilience and reserves are gone and a tiny push causes demise. The world of materials knows about metal fatigue and the fatigue of tensile strength in ageing and overused materials. Athletes experience behavioural fatigue following excessive training.

I had a fox who came for lunch each evening during the Covid restrictions. Having my interest in nature rekindled due to travel and social restrictions I got so far as to be able to throw bread out the window and see her following it like a dog with a ball! The restrictions eased, We got back to usual pursuits and forgot the fox. She kept coming at variable times to check out the scene but these became more distant and I haven't seen her for several days. Is that an animal study in behavioural fatigue? She got fed up (sorry) coming and getting no food so fatigue set in.

More seriously in the context of Covid and NHS and health workers and ordinary people living under restriction, behavioural fatigue is a real problem. People get tired washing hands and wearing masks etc, health workers become exhausted from extreme effort for 4/5 months now without a break, and the prospect of a long haul coming down the tracks. Behavioural fatigue is here already and has always been here. It is common sense and human experience that "you can only take so much before something gives." A line is crossed and you can't function anymore. This is behavioural fatigue and it will be a major challenge in the years ahead. The sooner the authorities take it seriously (as many Trusts are) the better for the workforce and the population.

Competing interests: No competing interests

07 August 2020
Eugene Breen
Psychiatrist, Associate Clinical Professor
62/63 Eccles St Dublin 7