Covid and its impact on the Psychosocial Ambience
Prof (Dr) Riti Kumari
HOD,Dept. of Psychology
S.M.D. College, Punpun, Patliputra University, Patna, Bihar, India ABSTRACT
The moment the World Health organization pronounced the corona Virus COVID-19 to be a pandemic the entire population of the world entered into a state of crisis. Besides its impact on the economic status of the globe, it threw a plethora of hurdles for the day-to-day lives of all humans in the world. To control the disease spread the governments across the globe chose to impose lockdown and quarantine measures.
The chief needs of any individual are to think that they are safe and to move around without any restriction. These basic wants of individuals were affected as a consequence of the lockdown measures taken by the governments. This hugely contributed to disrupting the mental wellbeing of people. A marked decrease in the supply of essential commodities as a result of restricted transport networks and misinterpreted/fake news and information aggravated the situation and this, in turn, affected the psychological behaviour of folks in an unusual manner. The absence of effective treatment and non- availability of vaccines in the initial stages was a worry for the populaces. In this article, we try to present the impact of this infectious disease on the psychology of people from various strata from children to adults to the business community to people who are dependent on daily incomes. This article also brings to light the sources that played a key role in affecting the mental health of the people. A section that focuses on the reasons for an increase in domestic violence is present in this article that gives an idea of the gender inequality prevalent in different nations across the globe. A separate section is devoted to suggesting ways to overcome the psychological symptoms one is experiencing as a result of this unexpected global health threat.
Keywords
COVID-19, mental health, pandemic, quarantine, anxiety, insomnia, panic.
Introduction
The COVID-19 or the coronavirus infectious disease is undoubtedly a global threat in the present scenario. It is widely accepted that the infectious coronavirus disease had its origin in Wuhan in the Hubei Province of China in December 2019. This unusual virus is termed severe acute respiratory syndrome coronavirus 2 with the acronym SARS-CoV-2.This is called a common name COVID-19.Two other noteworthy virus outbreaks earlier to the COVID-19 pandemic are Severe acute respiratory syndrome (SARS) in 2002 and Middle East Respiratory Syndrome (MERS) in 2012[4]. Shreds of evidence show that the COVID-19 outbreak is the most severe global health emergency after the world suffered from H1N1 influenza (ie) the Spanish flu pandemic that occurred in 1918.
The rate of spread of the so-called Coronavirus is found to be greater than common cold and flu and it is reported to show an exponential spread rate. The mortality in the initial stages of this disease outbreak was high. The world health organization declared an emergency and the result is that most of the governments across the globe started to restrict their population as a measure to lessen the spread of this contagious disease. This sudden order in the form of lockdown from the government in which people are not allowed to leave their homes or if at all they move out of their homes that were with several restrictions impacted a major mental disturbance to the people who were freely moving earlier.
The graph below shows the rate of spread of the coronavirus against its counterparts.
Figure 1. Spread rate of COVID-19 in comparison with other contagious diseases [19].
Many of the services were affected in all the countries around the world. It is evident from several reports that the mental wellness of people is disturbed and is on the rise. Many suffer from anxiety, depression, loneliness, insomnia, anger, and many more. These symptoms could contribute much to the normal health system of humans [2]. A tabulation of some of the risk factors that possibly result in affecting the mental health of the people is presented below [2].
People from different sectors were subjected to mental health instabilities. This includes health care professionals, people with overseas travel history, special populations namely the elderly, people with Cardiovascular, neuromuscular, and neurocognitive disorders, children and adolescents, pregnant women, people from a marginalized community, people with diabetes, and hypertension [3]. When the health emergency was declared by the World Health Organization nearly one-third of the global population was restricted to move by the respective governments as a measure to control the spread of the disease. To cite an example the Indian Government announced a 21-day lockdown nationwide that started on March 25, 2020, and was extended to 40 days. The lockdown was imposed by other countries as well namely China, Italy, Bangladesh, Russia, and United States. This unexpected situation created panic among individuals. The quarantine measure was also new to many and they were psychologically upset. This created confusion, depression, and anger among individuals.
Table 1.Some of the risk factors that could affect the mental health of the individuals [2].
Sl.no Category Nature of Risk Factor
1
Biological
Female gender Children
Elderly population Physical Comorbidities
Family history of psychiatric illness
2 Social Low socioeconomic status
Students
People who live alone
Lack of recreational resources Less/no psychosocial support
3 Psychological Previous poor mental health status
Anxiety and Depression Bereavement of a loved one
4 Economical Poor economic condition
Loss or potential loss of job
Uncertainties regarding economic conditions
5 Disease-specific characteristic Nonspecific flu symptoms
Rapid spread rate of the infection.
Death
Lack of effective treatment Lack of Vaccine
The unavailability of medicines was also a reason for people to lose their mental confidence. Complete closure of shopping malls, transport, schools and universities, and recreational activities affected the incomes of many and they were trapped into a circle of confusion as they are dependent on the above-said portals for their earnings.The coronavirus is not only a challenge to the health care routine but it created a substantial fall in the economy around the world. It is believed that children and adolescents are less susceptible to infection.
Even if the risk of infection is less in children and adolescents they experienced major mental health disturbances due to various reasons. Older adults are considered to be at high risk of the infection and they will be subjected to various psychological symptoms namely stress, fear, loneliness, and anxiety.
Women are also subjected to mental illness as a consequence of this pandemic. Studies show that the fatality rate is high in men than in women. This may be attributed to several factors namely cardio-vascular and metabolic disease that are already in existence in a higher percentage of males, alcohol consumption, and smoking habits of males which are considered to be the risk factors. Besides greater percentage of women practice hand hygiene that could considerably reduce the risk of infection. The following is a tabulation of the percentage of men who lost their lives as a result of this infection.
Table 2.Lethal rate of Men against those infected [15].
Country Percentage of infected males
Percentage Dead Western
Europe
52 to 58
South Korea 40
Myanmar >50
Thailand >50
Albania >50
Wales >50
Social isolation is a contributor for many to experience prolonged loneliness and this had a direct connection with the mental wellbeing of those who are most socially vulnerable. Anxiety, exhaustion, anxiety, fear, anger, trauma are some of the symptoms that arose as a result of social isolation which in turn was a major contributor for the people to enter a state of depression.
Depression is associated with affecting the productivity of the individuals which in turn causes other health ailments. As a consequence of poor mental wellbeing, people started complaining.
The attitude to depend on others was on the rise. Even worse is that people stated delegations and these are not positive signs for optimal productivity. Studies show that there were cases attempting suicide which is even bothersome.
Domestic violence was on the increase in many households due to Gender inequalities that are still in existence in many nations. Lack of support for women from their relations and neighborhoods due to the social isolation and travel restrictions impacted the psychology of the women population to a larger extent. Gender inequality also implies that in many households males are the breadwinners and females are dependent on the males for many of their needs. As the females do not have enough financial aid they are subjected to domestic violence. Figure 2 gives an idea of the Gender inequality rate in nations across the world as per the report of the World Economic Forum.
In terms of economic consequences of this virus outbreak, the tourism and the travel industry suffered a huge loss. People who were dependent on this sector for their living got trapped into various psychological disturbances.In this paper, a comprehensive study of the different psychological disturbances experienced by humans belonging to different spheres of life is presented. The paper is organized into different sections namely a section that presents a review of some of the existing literature related to the psychosocial ambiance in the COVID-19 era, a section that presents the objectives to carry out this study, a section that presents an overview of various factors that were responsible to create panic among individuals.
Figure 2. Gender inequality index of countries [23]
There are sections where a discussion of the psychological ailments of children, women, the older population, and adolescents is discussed. A separate section is devoted to addressing the different measures one can practice to improve their psychological behavior. This article is prepared with necessary tables and diagrams that can help the readers understand certain facts and realities.
Literature Review
In this section, we will try to focus on a few pieces of works of literature that are already in existence by different authors.The authors in [3] made a study of the behavior and psychological variations that were observed among the university students which is a result of lockdown. The authors chose the Stimulus organism Response (SOR) model to create the theoretical foundation. Personal interviews and focus groups were also considered in the study.
Atlas. ti 7 software was used to perform a qualitative analysis of data. Academic anxiety, fear, irrational fear of dirt, panic buying, e-learning, community support are some of the symptoms that are in existence among the Universities, the authors inferred
The authors in [4] presented the results of the assessment that was performed on the study of the psychiatric and neuropsychiatric results of SARS, MERS, and COVID-19.SARS is an acronym for the severe acute respiratory syndrome that was the result of a disease outbreak in 2002.MERS is an acronym for Middle East respiratory syndrome that was prevalent in 2012.
They performed a comparison of the psychological disorders people were experiencing in the COVID-19 era to that of the days of SARS and MERS. The study included statistics from China, Hong Kong, South Korea, France, Japan, Singapore, the UK, and the USA. The authors concluded that anxiety, panic, insomnia, problems related to digestion, repression, and post- traumatic stress are the evident psychological disorders
The authors in [5] presented a review on the impact of social isolation on public health as a result of this COVID-19 Pandemic. The authors stress the fact that loneliness and social isolation are the possible factors to cause ill health. The authors considered the scenario of the developed nations in their study. The authors tried to give importance to a clear understanding of social isolation and loneliness and the role of the above two terms in causing mental illness. The result of the study given by the authors is that prolonged loneliness and social isolation can cause cardiovascular disorders. The authors in [6] made a study of the psychological aspects of the COVID-19concerning children who are equally affected. Even if the medical specialists state that children are likely to be affected by this Virus marginally they are the worst hit psychologically.
Prolonged quarantine at home and not attending schools and meeting their peers affects them psychologically and this is argued to be worse than physical sufferings. The absence of outdoor activity, atypical dietary and sleeping habits were found in most children in the COVID-19 era.
This could result in distress, impatience, annoyance which in turn may be the cause of child abuse and domestic violence.
The authors in [7] address the psychological disturbances that are in existence among the elderly the moment the Corona Virus Pandemic emergency was declared by the World Health Organization. As the older population is most probable for the infection a variety of Psychosocial therapies are to be given importance. It is observed that fear, anxiety, loneliness, and depression are on the rise among the elderly population. The authors in their article analyses and suggests various resilience procedures that can help the older population overcome the symptoms of mental illness they experience in this unanticipated period.
Objectives of This Study
The outbreak of the novel Coronavirus Pandemic had a serious impact on the day-to-day activities of mankind. The lockdown measures are taken by the various governments across the globe, the quarantine process which is viewed as a new procedure by many served to contribute to disturbing the psychosocial ambiance to a larger extent. This study aims to bring to light some of the mental illness syndromes experienced by people belonging to all sectors of life from children to the older population, from large business establishments to people who are dependent on daily income, and many others. The article also consists of a section that addresses how the stress factors can be handled that in turn can help achieve confidence among people.
Mental Health and Psychosocial aspects of COVID-19-An Overview
The global health threat that is in the headlines for the past year from January 2020, COVID-19 infectious disease has affected the mental wellness of people of all ages. The lockdown measures and quarantine procedures that were taken by the governments as a protective measure instilled a sort of thought in the minds of the people as curbing their freedom who were earlier freely moving. The medical unpreparedness, the death of their loved ones, travel restrictions, loss of a job, and many other unexpected happenings could be contributed as a cause for the people to enter into a state of depression.
Reports of persons attempting suicide with the fear that they are possible to be affected by the infection were given by certain studies [8]. The availability of too much information in the media is attributed to this type of psychological disturbance.
Major sources that were responsible for a psychological breakdown
Undoubtedly the onset of the COVID-19 pandemic has taken a considerable toll on people belonging to all walks of life. It affected/affecting the lives of the elders, people with acute ailments, migrant laborers, people who were stranded in other locations, folks who were quarantined at their residences or at public facilities, families of those who were under quarantine, etc. It is understood from the above-said statement that mental illness and emotional disorders are the possible signs of the people who could fit into any of the above categories [9].
Apart from the fear about the disease the too much news from social media and the other news platforms contributed to a considerable extent for the general public to behave in an over- reactive manner. Constant updates of the virus from dawn to dusk via news, mobile notifications, news from the social media platforms were responsible for having created a panic among the public [9].
Mental health issues of women
Although the mortality statistics of the COVID-19 pandemic states that the fatality rate of men is twice that of women, women are subjected to mental illness both at work and home.
Women were overloaded with work both at home and the workplace as a result of lockdown and quarantine measures. Reports show that 70 percent of the workforce in the health sector is women. The female workforce in western countries is illustrated by the following tabulation.
From the below table, it is evident that women are more exposed to the virus. The data from [10] shows that the infection rate of women in Italy and Spain is 66 and 72 percent respectively in comparison to that of men that stood at 34 and 28 percent.
Table 3.Statistics of the female workforce [10][11].
Country Percentage of
Women Work Force
Nature of work Job Role
World Wide 70 Frontline Health
Workers
Nurses Midwives
Community Health workers
Cleaners
World wide >70 Health Service Staff
Laundry Catering
USA
70 70 51
Hospital Jobs Pharmacy Jobs Grocery Store Jobs
Domestic violence was also on the rise in many countries [12]. It is believed that home is not a better place in durations of lockdown especially in countries where gender-based inequality is still in existence. Women received less support when they were subjected to gender-based violence in the pandemic period. Women hardly had domestic and emotional support from their friends and relatives when they were experiencing domestic violence and these affected the mental wellness of the females and reports of risks in the form of anxiety, depression, and stress were reported by studies[13][14][15].
Mental health issues of Children
Although children are comparatively at a lesser risk for the infection they are experiencing mental illness problems as a result of the measures taken by various governments to control the disease spread. It has been several months since children had gone to schools and met their friends and had in-person interaction with their teachers. The stress they encounter when they have to adapt to online teaching could hardly be expressed especially in countries like India.
Children were found to have less physical activity as they were confined to homes, they had changes in their sleeping patterns and diet patterns. These resulted in children gaining weight and possible to get affected by other complications [18].
Children belonging to marginalized communities are vulnerable to infection and we were able to evidence child labor, child marriage, child trafficking, etc. The children of single parents are also worst hit as the single parent finds it hard to balance the work and pay attention to the child's educational guidance. Many children who were unable to afford for a smartphone to attend their classes started working for daily wages in the rural areas. It is the role of the government to look into the above-said features and eliminate the educational inequalities and provide the children with basic medical facilities [6].
Mental health issues of the older population
As the spread rate of this COVID-19 Pandemic is high the older adults are experiencing a higher percentage of fear and worry due to several reasons. Especially the mental health of elderly people who are under medication for other diseases is particularly worse [16].The older population to a larger extent experiences cognitive distress, anxiety, insomnia, etc.
The older population who already have poor mental health are severely affected psychologically as a result of this pandemic [17]. Traffic restrictions, travel restrictions, and isolation procedures add to the severity of the mental health of older people. Also, patients with ailments namely renal failure, diabetes, cardio, and cerebrovascular diseases need to visit hospitals for regular follow-up and these travel restrictions made such people lose their mental stability[18].
The fatality rate of the older population is pretty high. The following table gives an overview of the number of persons who are categorized as older population ended their lives as a consequence of the coronavirus infection. This data is taken from the results published by the Chinese center for Disease Control and Prevention.
Table 4.The fatal rate in the older population [19]
Age(years) Fatality rate (%) 60-69 3.6
70-79 8 80 and above 14.8
Many aspects can be attributed to causing a mental health disturbance in the older population. Some of these include unexpected health emergencies, quarantine measures, inability to meet their loved ones, loneliness, and many more. The graph presented below is an indication of the risk of the older population to the coronavirus infection.
Figure 3. Illustration of the elderly to be at risk for coronavirus infection [19]
Mental health issues of adolescents
Even though the lockdown restrictions were steadily reduced the closure of schools and colleges had contributed equally to the mental wellbeing of adolescents and University students.
The drastic shift from classroom teaching to online coaching had its own merits and demerits.
Remaining isolated and not connected with their peers and exposure to more screen time are some of the cons of online learning. The increased use of the Internet by adolescents with poor mental health management ability in some situations proved to be a cause of the adolescents to go to the extent of attempting suicides [20].
In a country that is deprived of social and economic wellbeing students suffered a nutritional loss which was provided by the mid-day meals scheme of the government. The students who were unable to afford a smartphone or other electronic gadgets to study online had symptoms of academic anxiety and low self-esteem. Many adolescents were found to opt to work to support their families. The students got less psychological support from their teachers in the period of the pandemic and as a result, they were subjected to a variety of mental health disorders namely stress, frustration, violent behavior, anxiety,self-harming attitude, and many more[20].
University students who are in the stage of getting their placements and those who planned for their internships also were affected psychologically because of the outbreak of the pandemic. Fear of contamination and infection was also prevalent among the students. The time taken for the vaccination to begin caused fear among students who were in a fix about their future [7].
Measures and Practices to have a stable mental health
In this section we will have a discussion of some of the ways one can follow to have a stable mental status.
The health department of governments across the world is on the hunt for different strategies to control the spread of the virus. Equal attention is the need of the hour to pay attention to the mental health of those people who are living in isolation, those are who are still under panic and those made to stay at home. Disturbance in the regular social activities and being confined to home for a longer time will consequently affect the emotional comfort of individuals.
This section discusses some of the ways people can practice to overcome the panic they are experiencing as a result of this new situation.
No human is considered normal if he shows minimal signs of anger and frustration at times of grave calamity like that of the global health threat COVID-19. At the same time, it is the responsibility of individuals to accept the situation and have control over their emotions in an attempt to convert these frustrations into a disorder. Complaining about the difficulties can be the attitude at the initial stages of such a peculiar experience but even after several months if we are sticking on to the same attitude many complications arise. Changes in our thought process and behavioral changes in ourselves can help improve one's mental wellness. This pandemic has redefined our lifestyles in many ways. No physical contacts, the emergence of digitization of lives via social media, and virtual reality are the changes that are worth to be noted as a result of this pandemic. One must understand the situation and wholeheartedly embrace these alternative lifestyles to lead a stress-free life [21].
The news media and the social media updates about the coronavirus especially those that highlight the mortality rate will add fuel to one's anxiety. Additionally, rumors, fake updates, and speculation can worsen the level of fear an individual experiences. It is in the hands of every
person to find a balance between important updates and conversations that will make our mental health worsen [21].Searching reliable data (eg. WHO), spending less time on social media, temporarily avoiding group chats, restricting the time we spend on news platforms, sharing positive stories if any are some of how one can keep them mentally strong[21].Keeping in touch with friends and relatives by leveraging the technological advancements of voice and video chats/calls, doing workouts, trying alternate cuisines, yoga are some practices that can to some extent make one come out of the stress.
Figure 4. Measures that can be adapted to cope with the pandemic [19].
The figure below gives an overview of some of the factors that can help in overcoming stress and aid in having good mental health.
Figure 5. Causal and Protective Factors Affecting Mental Health [9].
The figure below is a diagrammatic representation of ways to manage emotional and mental ill-health in this pandemic circumstance.
Figure 6. Approaches to managing mental health symptoms during the pandemic [19].
Conclusion
COVID-19 pandemic played a crucial role in affecting the psychosocial ambiance. People from all spheres of life had a serious toll on their usual lifestyle as a consequence of this global health threat. From the discussions that are addressed in this article, it is evident that mental wellbeing needs to be given equal importance as that of physical health care. The procedures that many were not used to from the age they were born namely quarantine, social isolation, and lockdown were the possible factors for one to lose their psychological and emotional strength. It is the responsibility of the governments and other non-governmental organizations to work out strategies that will help the people maintaining a stable mental status. It is also the responsibility of the individuals, family, and friends, the news platforms to provide essential psychological support to the needy. One must adhere to the rules imposed by the governments (eg.wearing masks and maintain Social distancing norms) to avoid the possibility of infection which is directly connected to mental well-being. A clean thought process can to a major extend help one to be mentally strong. Rather than complaining about e-learning and other aspects, one can look at the benefits it offers and thus can stay healthy psychologically. It is the responsibility of every individual to cultivate self-control to overcome situations of this sort.
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