COVID-19 pandemic took humanity completely by surprise. It took a minute infection agent that many scientists do not even consider a living organism a little less than three months to put two thirds of Earth’s population under lockdown, paralyze the world economy and start the worst recession in history. Ironically, its actual lethality is relatively low when compared to other infectious diseases like Ebola or MERS. What is much more frightening about the new virus is not the people it kills through medical complications but how it influences our lives indirectly, economically and psychologically. COVID-19 is just as important a lesson in viral spread of ideas, fears and panic as it is a lesson in actual epidemiology. Every day we can see new and new examples of irrational behavior, growing tension and palpable fear even among the most levelheaded and skeptical individuals.
While we should not downplay the real danger of the novel coronavirus infection, if we take a look at statistics, we will see that the degree of fear associated with it is somewhat excessive. We constantly hear about a deadly virus, about the mortal danger of exiting your home or talking to other people, about the potential hundreds of thousands of deaths. At the same time, even official statistics (that only take into account those who tested positively for the virus) indicate average lethality of about 4 percent. In reality, this percentage is likely to be even less, as some recent studies show that about 80 percent of all COVID-19 cases are asymptomatic. In other words, the real number of infected may be higher by a couple orders of magnitude – they simply did not develop any symptoms, were not tested for the virus and got rid of the infection without ever noticing it.
In other words, one’s chances of dying from COVID-19 are relatively remote even if one contracts it. Over the first three months of the pandemic there were a little more than 50,000 deaths attributed to COVID-19 worldwide. To put it into perspective, in 2017 almost 18 million people die of cardiovascular diseases every year. 2.5 million died of lower respiratory infections. 1.2 million died of tuberculosis. 1.25 million died in road accidents. There is nothing new about it – the numbers have been about the same for years. And it is exactly why we are not bothered by it. All these are common, normal causes of death that do not excite our imagination. Meanwhile, about 26,000 died in terrorist attacks and 13 – not thousand, but individuals – died in air crashes. However, these deaths are unusual, and on average there are more people afraid of dying in a suicide bombing than there are those who are genuinely afraid of a something as commonplace as a traffic accident – even though you about 50 times as likely to get into one.
People are afraid of COVID-19 for the same reason. It is something new and unexpected, something that does not fit into our normal picture of reality.
Meanwhile, mass media, government officials and doctors all go on about the dangers of the new virus and about its rapid spread. Ever more severe measures against it are introduced. The Internet is rife with news, both real and fake ones, about people dying of it and about what happens in the countries that have already been hit by it. One sees people in medical masks on the streets. One sees people buying toilet paper, rice and canned beans by the cartload. In such an atmosphere, even those who try to be realistic are gradually infected with fear, which leads to stress, panic and irrational behavior. It is even worse for those who are more prone to pick up the moods of those around.
Thus, the influence of COVID-19 on the emotional state of people is diverse and multilateral. It is not limited to the infected and those immediately dealing with them (i.e., medical personnel and their friends and relatives), but spreads like waves across the entire society. While the risk of dying from the disease is relatively low, especially when compared to diverse other dangers surrounding us in everyday life, constant flow of threatening news and constantly renewed statistics cause unhealthy fixation on the topic that takes up a significant amount of one’s attention and effectively paralyzes all other activity. And it is just the mildest result of this situation.
The ones who are naturally the most psychologically affected by the novel disease are those infected with it. While in absolute majority of cases the symptoms of COVID-19 are mild and resemble flu (and there is a potentially extremely high percentage of asymptomatic cases), being sick with a disease we know almost nothing about is a distressing experience that may lead to severe consequences. Depending on the country and measures locally taken to battle the pandemic, these patients may have to experience a varying degree of isolation: from hospitalization to home quarantine and social isolation. As it may take an infected individual up to a month to recover, the amount of time one has to spend in an unfamiliar or drastically changed environment can be quite significant, leading to stress, fear, panic and depression.
Another group, probably even more affected by the virus from the psychological point of view, are doctors, nurses and other medical personnel. Unlike patients who will not be directly exposed to COVID-19 after they get well, and the populace in general, who experience the effects of the pandemic only indirectly, medics are on the forefront of the battle against the contagion. They have to deal with the disease on a daily basis, they run a high risk of infection and they have to deal with an immensely greater workload than usual. It is especially true for the countries and regions that did not take sufficient preparatory measures before the pandemic hit them and suffered from the overload or even collapse of the healthcare system. In a sense, medical workers get the worst of the pandemic, and it is hardly surprising that psychological and emotional effects on them are harder than on anybody else.
Daily stress, lack of sleep, inability to help everybody, moral dilemmas associated with deciding whom to help first – all this creates an unprecedented degree of emotional pressure, and while the pandemic lasts, we are not yet ready to fully evaluate its severity. Emotional scars and nervous breakdowns that come as a result of such tension may not become evident for months to come, and only a couple of years from now we will be able to make final conclusions about the toll the pandemic took on medical personnel around the world.
However, having to go through quarantine and maintaining social distancing are not the only ways the pandemic influences our psychological and emotional state. The very fact of constant stress and tension among those around is enough to push some people over the brink. People working in Italian nursery homes during the worst of the outbreak reported strange cases in which patients who did not show any symptoms of the disease simply went to sleep and did not wake up. There is a significant possibility of their deaths caused not by the infection but by stress: elderly people, especially those suffering from dementia, are very sensitive to the changes in their environment. When exposed to the nervousness and panic of those around them and seeing people in protective gear instead of familiar nurses, the stress could have simply become too great for them to bear.
The same goes for those who have to stay under lockdown due to anti-pandemic measures. Many countries imposed severe measures trying to contain the spread of infection, effectively forcing the residents to stay at home for prolonged periods. However, this approach often leads to something akin to a mild case of cabin fever – when forced to stay indoors and spend more time than usual with their families, many people find the strain to be too much. China, for example, reported a dramatic spike in divorces as a result – simply put, too many people found their spouses unbearable when forced to be in constant contact with them for two months.
While one can see certain humor in this situation, other emotional and psychological effects of COVID-19 are far darker. As a huge number of people lose their jobs (according to UN agency, we can expect it to wipe out at least 195 million jobs globally), they encounter not just inconveniences, but real decrease in their quality of life, life expectancy and health. When compounded by the stress, social distancing and other direct and indirect effects of the pandemic, this creates an enormous amount of pressure on those affected by its economic fallout. In the United States, suicide hotlines already report 25 times as many calls as usual, and we are likely to have another epidemic – that of suicides – as the crisis gains momentum and people get more desperate.
However, it would be wrong to believe that negative effects of the current situation on our mental health will be limited to (hopefully) relatively short period of severe lockdowns and quarantines. Experts predict that prolonged exposure to the threat of this kind is likely to influence the humanity’s behavior on deeper levels and have long-lasting effects. It may even sway ideological and political views of individuals and entire societies.
The continuous fear of contagion, especially when it is constantly kept at a near-boiling point by mass media and politicians, is different from a short-term fright when encountering a physical danger. It goes on and permeates every aspect of one’s life, causing anxiety underlying everything you do. Moreover, the fear of disease has other effects, deeply rooted in our nature as humans and our prehistoric past. As a contagion was usually associated with something from outside one’s normal world, from outside one’s tribe, continuous exposure to this kind of threat is likely to enforce the aspects of conformism and tribalism, making people more suspicious of outsiders and less tolerant to individuals as opposed to groups. We already see certain signs of it, with both governments urging people to sacrifice their personal interests and wishes in favor of the society, and imposing limitations on movement and activities that would have seem impossible just a couple of months ago. It is characteristic that the majority of population seem to approve of these measures (even in countries traditionally known for their strong individualistic streak) and feeling annoyance and even rage towards those who are unwilling to accept this order of things.
Although the pandemic of COVID-19 has already taken its toll on human society in more ways than one, we are yet to achieve its peak. The information about the disease is still incomplete, preliminary and often doubtful. Effects on psychological and emotional state are currently not in the spotlight, and they are by definition less noticeable than the immediate effects of the disease on individual people, businesses, organizations and economy in general. The detailed and complete research on the subject will only become possible once the pandemic runs its course, and we can evaluate what it meant for the people who were directly and indirectly affected by it as well as humanity as a whole.