Mental Health Aspects of Pandemics

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This page collects observations, interpretations, and consequences for action about Mental health Aspects of SARS-CoV2. Please observe the structure of the page, when you add your content. Please use references where possible. Remember to find the relevant page. For example, if your observation is about transmission routes, please use that page, instead of posting your content here.

What is already known

  • Large scale disasters frequently have secondary consequences, including mental health outcomes among those affected. [1]
  • Symptoms may affect those indirectly and directly affected by a natural disaster [2], ranging from increased stress levels [3] and perception of threat with consequent behavioural changes to PTSD [4]
  • Fighting boredom and other psychological stresses of quarantine, muting the forces of stigma against those in quarantine, and crafting and delivering effective and believable communications to a population of mixed cultures and languages also were critical. The need for officials to develop consistent quarantine policies, procedures, and public messages across jurisdictional boundaries was paramount.[5]
  • During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. [6]
  • Online mental health services being used for the COVID-19 epidemic eventually could improve the quality and effectiveness of emergency interventions. [7]
  • Medical staff in China who were treating patients with COVID-19 infection during January and February 2020 had levels of anxiety, stress, and self-efficacy that were dependent on sleep quality and social support.[8]
  • Early strategies that aim to prevent and treat vicarious traumatization in medical staff and the general public are necessary. [9]
  • In the COVID-19 epidemic, the incidence of anxiety and stress disorder is high among medical staff. Medical institutions should strengthen the training of the psychological skills of medical staff. Special attention should be paid to the mental health of female nurses.[10]

Dealing with the anxiety of isolation

Observations

  • Observations are made of people becoming extremely anxious during the period of social distancing and self-isolation.
  • Persons placed in quarantine have their freedom restricted to contain transmissible diseases. This takes a considerable toll on the person. Longer durations of quarantine were associated with an increased prevalence of PTSD symptoms. Acquaintance with or direct exposure to someone with a diagnosis of SARS was also associated with PTSD and depressive symptoms. [11]
    • A combination of lack of knowledge, an incomplete understanding of the rationale for these measures, and a lack of reinforcement from an overwhelmed public health system were likely contributors to this problem. [11]
    • Of particular interest, strictly adhering to infection control measures, including wearing masks more frequently than recommended, was associated with increased levels of distress. [11]
  • Most health professionals working in isolation units and hospitals do not receive any training for providing mental health care. Fear seems more likely a consequence of mass quarantine.[12]

Analysis and interpretation

Consequences for action

  • Public Health Professionals must work to define the factors that influence the success of quarantine and infection control practices for both disease containment and community recovery and must be prepared to offer additional support to persons who are at increased risk for the adverse psychological and social consequences of quarantine.[11]
  • Mental health needs to be an explicit part of any deployment plan for health care staff in response to the COVID19 pandemic, including measures for dealing with quarantine induced anxiety.

References

  1. Neria Y, Nandi A, Galea S. 2008. Post-traumatic stress disorder following disasters: a systematic review. Psychol. Med. 38:467–80
  2. Rubin et al Enduring consequences of terrorism: 7-month follow-up survey of reactions to the bombings in London on 7 July 2005. BRITISH JOURNAL OF PSYCHIATRY (2007), 190, 350-356.doi:10.1192/bjp.bp.106.029785. Also at: https://www.kcl.ac.uk/kcmhr/publications/assetfiles/cbrn/Rubin2007-londonbombings.pdf
  3. Schuster,M. A., Stein, B. D., Jaycox, L.H., et al (2001) A national survey of stress reactions after the September 11, 2001, terrorist attacks. New England Journal of Medicine, 345,1507-1512.
  4. Waite et al 2017 The English national cohort study of flooding and health: cross-sectional analysis of mental health outcomes at year one BMC Public Health 2017; 17:129 https://doi.org/10.1186/s12889-016-4000-2
  5. DiGiovanni, C., Conley, J., Chiu, D., & Zaborski, J. (2004). Factors influencing compliance with quarantine in Toronto during the 2003 SARS outbreak. Biosecurity and bioterrorism: biodefense strategy, practice, and science, 2(4), 265-272.
  6. Wang, Cuiyan, et al. "Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in china." International Journal of Environmental Research and Public Health 17.5 (2020): 1729.
  7. Liu, Shuai, et al. "Online mental health services in China during the COVID-19 outbreak." The Lancet Psychiatry 7.4 (2020): e17-e18.
  8. Xiao, Han, et al. "The Effects of Social Support on Sleep Quality of Medical Staff Treating Patients with Coronavirus Disease 2019 (COVID-19) in January and February 2020 in China." Medical Science Monitor: International Medical Journal of Experimental and Clinical Research 26 (2020): e923549-1.
  9. Li, Zhenyu, et al. "Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control." Brain, Behavior, and Immunity (2020).
  10. Huang, J. Z., et al. "Mental health survey of 230 medical staff in a tertiary infectious disease hospital for COVID-19." Zhonghua lao dong wei sheng zhi ye bing za zhi= Zhonghua laodong weisheng zhiyebing zazhi= Chinese journal of industrial hygiene and occupational diseases 38 (2020): E001.
  11. 11.0 11.1 11.2 11.3 HAWRYLUCK, Laura, et al. SARS control and psychological effects of quarantine, Toronto, Canada. Emerging Infectious Diseases, 2004, 10.7: 1206.
  12. The emotional impact of Coronavirus 2019-nCoV (new Coronavirus disease). Psychiatry Res. 2020 Mar 12; 287: 112915. Lima CKT, Carvalho PMM, Lima IAAS, Nunes JVAO, Saraiva JS, de Souza RI, da Silva CGL, Neto MLR