Potential Psychological Effects of Covid-19

Coronavirus was first reported in Wuhan, China, in December 2019 when pneumonia cases of unknown etiology were found. Within a short period, the number of cases dramatically increased not just within Wuhan but to other places in China. As a result of the rapid spread of the infection globally, the World Health Organization declared COVID-19 declared it as a global pandemic. Coronavirus infection is so far the biggest atypical pneumonia outbreak since the outbreak of SARS in 2003. It is a highly contagious infection affecting a substantial number of people. The number of COVID-19 cases and deaths has exceeded those of SARS and any of its ancestors. 

By the end of March 2020, the total number of confirmed cases had surpassed 600,000, and that of confirmed deaths worldwide exceeded 33,000 (Chinazzi et al., 2020). The disease has increasingly surged, affecting numerous countries in Europe, Asia, and America. A broad fragment of the population is currently constrained to their houses with respect to the countrywide lockdowns. Home confinement strategies have also been actualized in COVID-19 hit nations to prevent further transmission of the infection. 

The fast-growing infectious disease has caused global anxiety, awareness, distress, and natural psychological responses to the ever changing condition. Severe psychosomatic outcomes are projected to significantly rise because of the pandemic nature and the constant information flow and strengthened messaging derived through social networking services. The quick expanding mass panic and hysteria concerning the coronavirus has endured psychological issues to people from all socioeconomic angles, causing detrimental effects in the long run than the virus itself. This paper, therefore, seeks to discuss the psychosocial impact of COVID-19 on the population. It will further elaborate on the proactive steps the government should take to reduce the virus's detrimental effect on upholding the mental health of the people. 

Background information 

Extensive research suggests that people’s mental health has been substantially affected during this time of coronavirus outbreak. Therefore, it is vital to identify how the epidemic is impacting people’s mental health globally. COVID-19 has forced multiple countries to implement early measures to manage the spread of the disease. Quarantine measures are necessary to control tools that have been utilized to manage the infection. Apart from physical sufferings, quarantine consequences have caused mental health problems at both individual and population levels. 

The imposed quarantine measures applied by nationwide lockdown programs have generated extensive anxiety, distress, and hysteria that emanate from factors such as loss of control and getting corned. This can be worse if family members are separated by disease progression uncertainty; inadequate basic needs supply, heightened risk perception, the financial loss, which can be magnified by improper communications and incomplete information via media platform during the onset of the pandemic. According to Wen et al. (2020), past outbreaks indicate that quarantine's psychological impact differs from immediate consequences such as irritability, anger, fear, despair, loneliness, confusion, anxiety, insomnia, denial, frustration, and pain. 

Isolated individuals may suffer from anxieties because of the infection uncertainties and can develop obsessive-compulsive symptoms such as sterilization and temperature checks. Posttraumatic stress disorder can be reported, and its symptoms are mainly associated with quarantine duration. Individuals from quarantine may experience significant psychological symptoms and distress that are caused by financial losses. Societal rejection and stigmatization concerning the quarantine cordon in the form of insecurity concerning properties, discrimination, and social activities withdrawal can be experienced after the containing the epidemic (Brown et al., 2020). Children with coronavirus should be isolated in a special place and given special care to appropriately deal with fear, other psychological consequences and anxiety. Therefore, quarantine periods have significant and dysfunctional psychological impacts on a person's mental implications both in the short term and long-term. 

Common psychological reactions in the general population 

Numerous studies suggest that COVID-19 infections have the most relevant and profound psychological impacts on the general public. As much as particular and uncontrolled fears associated with frustration and boredom, pervasive anxiety, and loneliness are projected to affect the subjective quality of life and well-being, improved social support and resilience are factors that can assist in re-adaptation mechanisms and lifestyle changes. 

One of the common psychological reactions to COVID-19 experienced by people is 

uncontrolled fear. As indicated by Pan et al. (2020), people exposed to COVID-19 risks may develop pervasive fear about their health and infecting family members and friends. More so, people infected with COVID-19 may manifest more worries than others if they experience symptoms that are potentially connected to the infection and fear these symptoms even after several months of exposure. Other researchers indicate that pregnant mothers and young children develop the fear of being infected with the virus. 

Pervasive anxiety is another psychological reaction that is associated with COVID-19. Social isolation that relate with lockdown measures and restrictions is connected future uncertainties and fear of the unknown and new infective agents that result in increased anxiety. COVID-19 infection may relate to pervasive loneliness and sensory deprivation (Rubin & Wessely, 2020). Additionally, anxiety is closely linked with reduced performance and fatigue in healthcare professionals, while loneliness and boredom may result in anger, suffering, and frustrations connected to quarantine restrictions. Additional tragic consequences of pervasive anxiety in the pandemic include uncertainties and boredom, separation from loved ones, and perceived lower social support. 

COVID-19 infections can also result in boredom and frustration. Habit loss, abnormally decreased social and physical contact as well as confinement directly associate with frustration, social isolation, distress, and boredom. As opined by Prem et al. (2020), pervasive loneliness and frustration are derived by daily activities inhibition, social necessities interruption, and failure to participate in networking activities. Hopelessness coupled with other personal features such as childhood maltreatment experience and severe sensory processing patterns, suicidal behavior may significantly be predicted. 

Apart from boredom and frustration, disabling loneliness is another psychological reaction of COVID-19 infection. 

Pervasive boredom and loneliness is the last social isolation effect, which potentially causes detrimental effects on a person's physical and mental health. Pervasive loneliness is associated with heightened suicidal behavior and depression. Unfortunately, social isolation can continuously be worsened by panic, anxiety, and collective hysteria. Anxiety, hyper-arousal and loneliness feelings consequently affect decision making and cognitive functions. More so, social isolation and loneliness can be associated with drug or alcohol abuse. Social necessities, interruption, daily activities inhibition, and inability to participate in social networking activities derives both pervasive loneliness and frustration. In general, sustainable periods of quarantine or social isolation for particular diseases may negatively affect mental health. 

Psychological COVID-19 impacts affect different people in society. One of the most affected groups in the community is children. The psychological effect of the COVID-19 outbreak has been overlooked in children for a long time. Psychology that deal with development indicate that experiences that are learned through environmental factors when the child develops affect the basics for long-term success and behavior, which is a vital stage of emotional, psychosocial, and cognitive skill development. During pandemic such as COVID-19, parks, playground, and school are closed. This disrupts the usual lifestyle of children and can significantly foster confusion and distress. 

Because of playground and school closures, children may become demanding and find difficulties coping with changes that have been made. They may become hostile and impatient which makes them to suffer from mental and physical violence. Lack of direct relationship with friends, teachers, and classmates coupled with monotony, and inadequate individual space at home can trigger detrimental mental effects in children (Weitz et al., 2020). Home confinement, daily changes, and infection fear can worsen psychological reactions of the COVID-19 cycle. 

A study conducted in Europe revealed a significant correlation between children’s and parents’ fear of the 2009 H1N1 pandemic. The study showed the relationship between the fear reactions of children about the disease and swine flu information derived from parents and social media. During this time of COVID-19 outbreak, children may develop post-traumatic stress disorder and phobia after coming across worrisome information about the infection through social media. Children raised by single mothers or fathers may find it hard to adjust if their parents are quarantined. The separation between parents and children may make children nervous because of fear for their loved ones, heightening prolonged psychological impact. As much as online assignments and classes are appropriate for continued education at this time, experts have cautioned regarding being over-burdened. Therefore, it is essential to address specific healthy life-styles, psychological needs, useful parenting guides, and proper hygiene advice on the same platform. 

The old age group is another affected group in society. The common notion that elder individuals with severe complications are prone to devastating COVID-19 outcomes can develop significant fear among this group. The psychological effects that older people face include irritability, anxiety, excessive anger and stress. Older individuals with mental issues may become agitated, socially withdrawn and anxious during this time. Their needs require immediate attention. Therefore, this group of people should conduct an indoor physical exercise that is potentially important in maintaining their physical health to deal with psychological effects effectively. 

Additionally, the psychological impacts of COVID-19 also immensely affect domestic caregivers. The act of feeling overwhelmed about coronavirus affect the ability and resilience of family members while caring for patients at home (Saez, 2020). The secondary traumatic stress reactions caused by the pandemic include fear, withdrawal, and guilt. Besides, family members may find it emotionally difficult if they do not visit their loved ones in health centers because of stringent lockdown circumstances. More so, family members going to the health center to see their ill relatives who require immediate care can develop a feeling of helplessness and fear violating social restriction rules. 

Likewise, the COVID-19 psychological impacts have also affected the marginalized community, such as slum dwellers, daily wagers, migrants, and prisoners. International migrant workers and refugees in countries that have overstretched health infrastructure with high COVID-19 incidence make these people vulnerable to stigma, discrimination, and exclusion. The international migrant workers have psychiatric disorders such as depression and low quality of life, which can be affected as a result of government-imposed quarantine and the income lost during the COVID-19. As a result of the severe communicability of COVID-19, refugees, and migrants are at an increased risk for acquiring and transmitting the infection. 

The fundamental scarcity needs such as affordable water supply may make these individuals not to comply with the required hygiene regulations flaring neglect, segregation and deprivation feelings. A study conducted in China showed that migrants’ workers experienced a high distress level, making it more significant than all occupations (Al-Hasan, Yim & Khuntia 2020). Death incidences while migrating, the quarantine on boats and extensive chemical application over migrants have been reported in the world. This changes the fundamental human rights for health and self-esteem, making the affected people develops disobedience, mass anger, and sustainable psychological stigma. 

People that live can develop eviction fear that emanate from uncertain government policies during this pandemic period. Coronavirus arguably made a significant lockdown in the civilization history that adversely widened the miseries of migrant workers, daily wagers, and people that live in slums. Rapid income misfortune of migrant workers and daily wagers may add to their frustration, mental anguish, guilt, and depression, ultimately contributing to functional impairment and a rise in suicide rates. Since prisons are the epicenter of the COVID-19, the health of inmates ought to be prioritized in this time of the pandemic. Their psychosocial needs, coupled with preventive measures, should be dealt with care. 

The COVID-19 psychosocial ramifications spectrum can also be inflicted on citizens in a specific country. Extensive COVID-19 fear, notably referred to as “coronaphobia” occurs because of unpredictable disease course, perceived risk of acquiring the infection, and uncertainty intolerance, which generates negative psychological responses such as emotional distress and maladaptive behaviors. During the outbreak of coronavirus, the initial death news and expanding media attention increased individual’s fear, helplessness, anxiety, and frustrations over the situation. Many people were worried about lockdown emergencies and critical services which made them develop a fallacious feeling about daily essentials and resources. 

The risk factors that are associated with coronavirus psychological impacts include inadequate supplies and information. Essentially, frustration and uncertainty feelings occur in relation to insufficient fundamental supplies during the quarantine, which contribute to anxiety, anger as well as worries that can occur after four to six months from quarantine (Akseer, 2020). During the 2003 SARS outbreak in Toronto, the government was unable to meet groceries and other routine supplies required for daily living. 

Also, inadequate information from healthcare workers may be a vital stressor because it offers unsuitable directions about the call for actions or can lead to confusion about quarantine purpose or the significance of measures required, interrupting the spread of the pandemic. For instance, in the Toronto SARS epidemic, confusion relating to different approaches, poor coordination, and contradictory health messages was evident in various jurisdictions and government levels. Furthermore, post-traumatic stress symptoms relate with perceived difficulties in interpreting quarantine protocols and a lack of clear guidelines. 

Government mitigation strategies 

The response of the government to COVID-19 should come in two approaches. One of the coronavirus approaches should focus on immediate priorities and implement reforms that boost resilience beyond the crisis. The government must also concentrate on international travel restrictions and business stimulus to safeguard vulnerable households. To minimize coronavirus's detrimental effects, the government should adequately support the healthcare system, provide safety nets and incentives to the most affected people, and reduce cost and enhance transparency. 

As much as healthcare institutions previously struggled to cope with medical workers shortage, insufficient medical supplies, and poor infrastructure, governments should have a chance to deal with COVID-19 and treat people that require intensive care. Governments must support the healthcare sector by providing adequate funding, giving incentives to workers, and subsidies to the most vulnerable individuals (Anderson, 2020). 

Additionally, governments should provide incentives and safety nets to the affected individuals to mitigate coronavirus spread. Through regulatory support, and targeted tax incentives, the government will reduce the COVID-19 impact on the most vulnerable citizens. Social distancing measures adoption in the most affected places is essential in limiting the spread of the virus. Governments should collaborate with informal groups like trade associations with a broader reach to deliver monetary support to individuals in vulnerable employment. 

Apart from providing safety nets and incentives to the affected individuals, governments should reduce costs and improve transparency. Governments can decrease the value of governance by minimizing administrative costs and prioritizing the most appropriate development programs. By doing so, the money will be freed up for health and education spending and develop fiscal buffers to increase the country's resilience. Besides, minimizing public finances misuse by opening up budgets, commitment to transparency and fortifying anti-corruption institutions should be prioritized during COVID-19. Policymakers should also become responsive to lessen the consequences of impending economic and social crises and prepare the country for the future. 

The government should also provide green light subsidies for the production of medicines and medical supplies. It will do this by providing financial support to companies capable of increasing medical equipment production or speed up research. Apart from delivering green light subsidies of medicines and medical supplies production, the government should implement specific preventive strategies at the community level ( Fernandes, 2020 ). At the community level, the government should offer good psychosocial services to attenuate coronavirus's psychosocial and psychological impact. Health education should be improved by utilizing social media to address stigma and discrimination involved with this social crisis correctly. Furthermore, hospital protocols connected with appropriate health emergency management should be implemented, and healthcare workers should be supplied with ample protective facilities. 

Marginalized communities such as the disabled or people with psychological issues ought to consult psychotherapists to quickly determine the warning signs of the disease. Telemedicine ought to be utilized, particularly in places where mental health services are severely impaired by the lockdown restrictions and quick spread of the epidemic. Notably, symptoms associated with psychological crisis and the need to execute appropriate interventions utilizing adverse drug reaction monitoring and personalization that relate to psychoactive medications ought to be identified by healthcare professionals. 

Conclusion 

Conclusively, the 21st century is a period of emerging mental illness pandemic. Therefore, the social and psychosocial preparedness of coronavirus carries worldwide significance. Therefore, stakeholders and the government should appreciate the COVID-19 morbidities and examine the fatalities, burden, and accompanied consequences. The blame and stigma impacted by the coronavirus may obstruct finance, relationships, worldwide trade, and instigate unrest. To respond to this outbreak, due care is required to eradicate stigma that emanate from religious propaganda, disease, racism as well as psychosocial effects to be executed with specialist healthcare personnel. It is also vital to implement community-based strategies to bolster the resilience of vulnerable people during the coronavirus. The psychological effects of anxiety and fear induced by quick pandemic spread need to be noticed as a universal health priority for the government and policymakers who ought to develop succinct strategies to decrease the burden of the disease. 

With the increased occurrence of different pandemics in the 21st century, governments should develop mental health organizations to prepare for future epidemics. Health institutions' further research and delivery of mental healthcare and awareness programs at individual and community levels should also be developed. Additionally, a free helpline numbers as well as structured websites should be launched to alleviate psychological frustration among the public concerning coronavirus. Social media should also be utilized to sensitize individuals on the disease transmission, signs and symptoms of the disease, and medical consultation time. 

References 

Akseer, N., Kandru, G., Keats, E. C., & Bhutta, Z. A. (2020). COVID-19 pandemic and mitigation strategies: implications for maternal and child health and nutrition. The American journal of clinical nutrition, 112(2), 251-256. 

Al-Hasan, A., Yim, D., & Khuntia, J. (2020). Citizens’ adherence to COVID-19 mitigation recommendations by the government: A 3-country comparative evaluation using web-based cross-sectional survey data. Journal of medical Internet research, 22(8), e20634. 

Anderson, R. M., Heesterbeek, H., Klinkenberg, D., & Hollingsworth, T. D. (2020). How will country-based mitigation measures influence the course of the COVID-19 epidemic?. The Lancet, 395(10228), 931-934. 

Brown, E., Gray, R., Monaco, S. L., O'Donoghue, B., Nelson, B., Thompson, A., ... & McGorry, P. (2020). The potential impact of COVID-19 on psychosis: A rapid review of contemporary epidemic and pandemic research. Schizophrenia research. 

Chinazzi, M., Davis, J. T., Ajelli, M., Gioannini, C., Litvinova, M., Merler, S., ... & Viboud, C. (2020). The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak. Science, 368(6489), 395-400. 

Fernandes, N. (2020). Economic effects of coronavirus outbreak (COVID-19) on the world economy. Available at SSRN 3557504. 

Pan, X. W., Da Xu, H. Z., Zhou, W., Wang, L. H., & Cui, X. G. (2020). Identification of a potential mechanism of acute kidney injury during the COVID-19 outbreak: a study based on single-cell transcriptome analysis. Intensive care medicine, 1. 

Prem, K., Liu, Y., Russell, T. W., Kucharski, A. J., Eggo, R. M., Davies, N., ... & Abbott, S. (2020). The effect of control strategies to reduce social mixing on outcomes of the COVID-19 epidemic in Wuhan, China: a modelling study. The Lancet Public Health. 

Rubin, G. J., & Wessely, S. (2020). The psychological effects of quarantining a city. Bmj, 368. 

Saez, M., Tobias, A., Varga, D., & Barceló, M. A. (2020). Effectiveness of the measures to flatten the epidemic curve of COVID-19. The case of Spain. Science of the Total Environment, 138761. 

Weitz, J. S., Beckett, S. J., Coenen, A. R., Demory, D., Dominguez-Mirazo, M., Dushoff, J., ... & Rodriguez-Gonzalez, R. (2020). Modeling shield immunity to reduce COVID-19 epidemic spread. Nature medicine, 1-6. 

Wen, J., Kozak, M., Yang, S., & Liu, F. (2020). COVID-19: potential effects on Chinese citizens’ lifestyle and travel. Tourism Review.