How has the COVID-19 pandemic impacted mental health?
The Covid-19 (SARS-CoV-2) pandemic has taken the world by storm. With its first human case reported by officials in Wuhan city, China in December 2019, it has now emerged as a global health crisis. With the number of positive cases becoming increasingly ubiquitous, this novel virus has brought unprecedented social, economic, physical and mental concerns to the forefront. Millions of lives all over the world has been negatively impacted by Covid- 19 related suffering at both a community and individual level.
Although not a "conventional" natural disaster, the proliferation of Covid- 19 posed emotional challenges that had to be addressed by health care providers as part of the pandemic response. The mass home confinement directives and imposed curfews that limit personal freedom, social distancing norms, travel limitations, stoppage of all non-essential services and work from home directives, to name a few, have forced individuals to adapt and adjust their lives to an extent that they have been unfamiliar with. In India, nationwide lockdowns and self-quarantine measures are new to its citizens and this raises questions about how people will react individually and collectively. While these steps may be important to mitigate the spread of the infection, they have resulted in consequences affecting the mental well- being of the population as a whole.
Research on the mental health outcomes of the pandemic lead us to understand that stress, anxiety, panic, depression, disturbed sleep, and posttraumatic stress disorder symptoms have seen a significant increase in the cases. There is also a substantial increase in loneliness, substance abuse, and child and domestic violence as schools and workplaces are closed and individuals are forced to stay home. Features specific to Covid- 19 responsible for deteriorating mental health include speculations about its mode of transmission, rapidity of spread and lack of definitive treatment protocols or vaccine. Besides, people employed in the informal and unorganized sectors are worst hit as they are struggling for, food, shelter and their livelihoods which created uncertainty leading to depression, suicide, self-harm etc. Social stigma in local communities has also emerged which is rooted in anxiety caused by lockdowns, many unknowns around Covid-19 and the fear of being infected. A “witch hunt” ideology has emerged worldwide, acting as a precursor for discrimination. Patients tested positive with the virus have been blamed and compared to criminals. There is also anecdotal evidence of racial attacks against the Chinese population.
Mental health issues of healthcare providers themselves is an underrecognized and unaddressed area. In spite of remaining the crisis management personnel working on the frontlines, health care workers are still vulnerable to psychological consequences. Several variables are associated with these consequences such as overworking, inadequate personal protective equipment, lack of social support, frustrations identified with patient care, personal fears and worries and the high rate of infection among medical staff. They also have concerns like caring and infecting their loved ones. A study conducted in April 2020 suggests that Covid – 19 can be an independent risk factor for stress in health care workers, showing its grave repercussions on mental health. In another cross- sectional study of 1257 health care workers dealing with Covid – 19 patients in multiple regions of China, it was found that a considerable proportion of these health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress.
In conjunction with mental strain originating from these causes, social media has played a conspicuous role in spreading fear and panic. While the field of info demiology has studied information patterns on the internet and in social media for at least 18 years, the COVID-19 pandemic has been referred to as the first social media “infodemic”, with a potential negative influence on people’s psychological well- being. Citizens are receiving rumours and misinformation in excess, which is neither authentic nor verified, creating a near- constant stream of news reports and updates about the outbreak. With news rapidly being shared on social media and networking sites, it can mentally drain and exhaust the individual. The crisis is heavily overwhelming. A 2017 research study indicated that there are only 0.5 hospital beds per 1,000 citizens. Moreover, severe shortages of resources for testing and treatment, inadequate health insurance coverage of citizens and weak medical surveillance systems additionally contribute to the increasing anxiety of citizens.
During the pandemic the focus of authorities continues to remain in the biological and physical domains of the population, neglecting the unmet psychological needs. In this situation, the mental health and emergency management communities should work together to identify, develop, and disseminate evidence-based resources related to disaster mental health, mental health triage and referral, needs of special populations, and death notification and bereavement care. Additionally, there are multiple resources available online which can be helpful in managing and coping with the stress arising out of the pandemic. People can engage in self- care and seek social support, which will form the backbone of getting through this difficult time. Reaching out and radiating compassion will play a critical role in maintaining a healthy relationship with yourself and others, allowing you to find a silver lining in this midst of this pandemic.