The Peter Salama Refugee MPH Scholarship  in Humanitarian Health

Sandesh Regmi

Pandemics are viral in nature, their onset initiates from animals and spreads to humans. Homo sapiens have had to endure numerous pandemics throughout history such as Plague of Justinian (541-750 AD), Black Death (1347-1351), Spanish Flu (1918-1919), Hong Kong Flu (1968-1970), SARS (2002-2003), Swine Flu (2009-2010), Ebola (2014-2016), and currently coronavirus (COVID-19).

These are some of the most severe and deadly pandemics in the entire human civilization to have victimized humans with pain and despair. Pandemics are larger scale epidemics affecting millions of people across multiple countries with the capability of spreading across globe – WHO.  The virus is supposedly brought to humans by animals, it is known that 20% of such infected humans despite remaining contagious do not appear to show symptoms of any sort, thereby leaving the community greatly exposed to risks of contraction. It is believed that those 20% in turn infect further 80%, signifying the extraordinary pace in which the virus is capable of spreading.

Pandemic show a number of visual sides. In addition to physical symptoms and hospitalization and eventually the prospects of being cured, facts like deaths of uncured, economic and political strain to individual and communities are worth a note. Hence, it is important that psychological reactions to the infection be considered as integral to spreading and contamination of the disease.

Pandemics by its nature exert significant psychological pressures to individuals, these pressures are stresses caused directly by the pandemic, related to uncertainty of course of pandemic. Health threats to self and loved ones appear to be one of the prominent reasons to these stresses, likewise, failing to maintain a routine life and rituals due to limitations placed on movements compounds the stresses.  The social isolation situation amid lockdown and quarantine creates fear of wage and job loss too, and in events, lengthy economic inactivity and closures can lead to shortage of survival needs and basic medicines, financial hardships might in some cases lead to malnutrition.

Psychoneuroimmunology researches suggest that heightened stress due to pandemic suppresses immune system, consequently resulting in health hazards and disease vulnerability.  The uncertainty around losing near and dear ones leads to trauma, and individuals caring the infected experience extreme stress. Communities find it brutal to think of not being able to attend death ceremonies and perform traditional funeral practices. Moreover, the indirect exposure to distress could to a great length be attributed to news and graphical illustrations of fatalities broadcasted on media.

Studies on the most recent epidemics (SARS 2003 and Ebola 2015) have shown that the epidemic of fear is worse than the epidemic itself, and that the psychological effect lasts longer than somatic effect. These previous experiences have shown how people avoided risk and disregarded health advices by refusing to vaccinate and adhere to hygiene practices and social distancing (currently social distancing is terminologically replaced by physical distancing).  Excessive fear and disability paves way to practice of unhealthy coping mechanisms like reassurance seeking and repetitive checking in response to the threats of infections.  In areas where the epidemic had hit the most people resorted to animal cruelty, as a direct response to assumptions that the perceived source of infections could expand to animals.  Being anxious and high level of stress commonly shows obsessive activities for instance cleansing money and washing hands frequently. Such stress is known to cause mental disorders like PTSD, anxiety disorders, mood disorders and in some cases depression and severe grief. The aforementioned studies, also found how folk remedies and superstitions became prevalent in the absence of scientific solution to the outbreak and its expanding intensity. During the Spanish Flu a Canadian man had been understood to have drunk hydrogen peroxide, reminiscent to that, rumors like the intake of alcohol and garlic are helpful for avoiding covid-19 infection are spreading during coronavirus outbreak.

Negative coping mechanisms get developed during pandemics, the mechanisms of negative emotionality, trait anxiety, overestimation of threat, unrealistic optimism bias are some examples. There are potential tragedies associated with pandemics like doctor shopping, panic buying, social and civil unrest likewise it is cautionary that at time of worldly unrest and crisis conspiracy theories, rumors, fear contagion, mass media and social media have known to create hype on people that makes them panic and heighten public anxiety. The elements surrounding this unprecedented situation are adequate to create a state of stigma.

The effects, risks and repercussions are real and with adequate reflection from similar outbreaks of the past and established body of knowledge, it can be suggested that healthy coping mechanisms be communicated. Instructions for managing stress and building resilience along with ways of dealing with stigma and prejudice can prove to be useful. Another helpful activity can be providing psycho-educational materials on grief, loss, fear, helplessness, hopelessness, panic, neuroticism, anxiety, depression, apathy, anhedonia, frustration, pain, anger, carelessness and more. Knowing the facts regarding the pharmacological treatment and vaccine development might decrease the chaos of pandemics. Similarly, hygiene practice like wearing mask, regular handwashing, use of antiseptics like sanitizers, boosting the immune system i.e. diet therapy and maintaining physical distancing are the key tools for self-care. Engaging in the in-house activities, drawing, gardening, playing music, doing yoga, learning new skills and making chit-chat with family members will certainly ventilate the stress of pandemics.  In case of severity, medicines like Selective Serotonin Reuptake Inhibitor (SSRI) and Cognitive Behavior Therapy (CBT) through trained medical practitioner and psychotherapist is helpful for managing emotional distress.

Do not forget psychologist are not the frontiers of pandemics and should not be trusted too much in pandemics.

Writer is a psychologist working at Manodrishti Psychological Services & Research Institute, sandesh@manodrishti.com

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