During this Covid-19 pandemic, health and contracting the Novel Coronavirus is not the only immediate concern. Some quarters have called for reopening and rolling back on social distancing measures for fear of a crashing economy. And many have serious challenges with social distancing measures as humans have not evolved to be locked-down. One’s mental well-being could be seriously affected by isolation and quarantine. In this month of May, designated Mental Health Awareness month, let’s look at how social distancing can affect mental health and what we can do to prevent it.
In response to the accelerating pandemic, T&T has banned all nonessential activities in early April and asked residents to stay home. Across the country, colleges and offices have gone online, schools and restaurants are closed and nursing homes are barring visitors. Such social distancing can at least slow the spread of COVID-19. In fact, in many countries, these social distancing measures have proven to reduce the spread of Covid-19. However, many people have expressed anger, anxiety and depression due to these very same non-pharmaceutical measures to prevent the spread. Mental health experts are warning that losing everyday social connections comes with psychological costs. And those costs could go up the longer such measures drag on.
For some people, a lack of social connectedness feels as impactful as not eating. Research on the psychological toll of social distancing during epidemics is limited. But a review in the March 14 Lancet provides some clues. Researchers evaluated 24 studies looking at the psychological outcomes of people who were quarantined, an extreme form of social distancing, during outbreaks of SARS, H1N1 flu, Ebola and other infectious diseases since the early 2000s. Many quarantined individuals experienced both short- and long-term mental health problems, including stress, insomnia, emotional exhaustion and substance abuse. For instance, one study compared quarantined versus non-quarantined individuals during an equine influenza outbreak. Of 2,760 quarantined people, 34 percent, or 938 individuals, reported high levels of psychological distress, which can indicate mental health problems such as anxiety and depression, during the outbreak compared with 12 percent of non-quarantined individuals. Another study looked at the effects of the 2003 SARS outbreak on 549 hospital workers in Beijing. Those who were quarantined or worked in high-risk settings — almost half the sample — reported higher levels of alcohol abuse three years later than workers with less-intense exposure to the outbreak.
Certain factors increased the risk of psychological problems, such as quarantines lasting longer than 10 days (which was associated mostly with post-traumatic stress), poor information about the rationale for the quarantine, and lack of access to necessary supplies. Though most people living in coronavirus-stricken countries aren’t quarantined, research elsewhere suggests even less-extreme forms of social distancing, such as staying several feet away from other people or avoiding regular outings, might take a toll.
The potential for social distancing to become a long-term event is what worries many psychologists, psychiatrists and healthcare professionals. Problems associated with social isolation tend to crop up when the situation goes on beyond a few weeks. Walling people off from one another for months means the secondary effects of the pandemic, such as recession, social unrest and unemployment, could trigger unpredictable and widespread mental health challenges. A situation we indeed want to avoid.
Especially at risk are the elderly, who both get more ill from the coronavirus and already experience high rates of social isolation. As people age, they often lose the ability to get around and socialize, and their support systems shrink as friends and family die.
We already have a lot of social distance between us. Loneliness and isolation do harm our mental and overall health across age groups. Some people will fare better than others during this period of social distancing. Some may actually see their social contact increase as families hunker down together. And some people will stay connected through phone calls, text messages or joining an online community. Modern technology is no substitute for human touch, such as holding hands, hugging or massage, which studies suggest can affect health, including possibly lowering blood pressure and reducing the severity of symptoms from the common cold.
One also worries about those individuals requiring medical care during this pandemic, either for COVID-19 or some other condition. Many hospitals are barring visits from loved ones which makes sense to prevent the virus’ spread. But that also reduces touch when people need it most. Data shows that something as simple as hand-holding can reduce physical pain.
Our communication capabilities could prove to help provide medical and psychological care from afar. Limited research suggests that telehealth services work to alleviate loneliness or help those living alone or far from health centers. Prof. Terence Seemungal, the dean of the Faculty of Medical Sciences at the University of the West Indies, recently said at a Ministry of Health press conference that this is something being explored by the university and the medical community in T&T.
The Centers of Disease Control and Prevention (CDC) recommends the following to deal with pandemic stress and improve mental well-being:
- Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting.
- Take care of your body.
- Take deep breaths, stretch, or meditate.
- Try to eat healthy, well-balanced meals.
- Exercise regularly, get plenty of sleep.
- Avoid alcohol and drugs.
- Make time to unwind. Try to do some other activities you enjoy.
- Connect with others. Talk with people you trust about your concerns and how you are feeling.
Our social distancing measures has been extended into next week pending results form increase testing to assess community spread and our true prevalence. Till then we must wait and see what the future holds. In the meantime, be safe and take care of your health.
Dr. Visham Bhimull
Primary Care Physician
Diploma in Family Medicine (UWI)