The 'fear' factor
Pandemic-induced panic is taking a heavy toll on the minds of people and patients
The COVID-19 pandemic poses one of the greatest threats in recent human history as the virus has spread rapidly worldwide, affecting the lives and livelihoods of billions. The second wave of COVID-19 in India has turned even more lethal, infecting more people and taking more lives. This pandemic has affected all individuals, regardless of their age, gender or other demographics, creating panic in their minds through the prolonged changes in social and economic activities. The uncertainty about their present and future, coupled with the government's mandates to stay home, is all exacerbating mental illness. The feeling of being cooped up at home, staying away from loved ones, the loss of freedom, uncertainty over disease status, lack of social support and fear about new variants are increasing this mental illness, even leading to suicides.
My students, those used to attend Rural Science Centre in my village for practical demonstration of science, inform that they are desperately missing all those activities as they are forced to stay home. This has happened as I had to come to Kolkata due to unavoidable circumstances. At the same time, they are deprived of all the things they love to do such as play, swim, gossip and many more. Their parents are also reporting significant increases in behavioural and emotional problems. In this piquant situation, the most prominent problem reported by people particularly in urban areas is anxiety and depression.
We simply imagine intensely the symptoms we read about and begin to experience them in our bodies. This is practically a mental contagion. Also, if we imagine that someone has tested positive for COVID-19 and if he or she just witnesses the panic-inducing coverage from cremation grounds, then it would be difficult to maintain a positive mindset even though a huge number of people who are infected by COVID-19 recover. Keeping in mind these images and emotions, people fear that they are going to die, increasing their anxiety and panic. There is, however, a great difference between panic and awareness. With awareness, there is a sense of responsibility, a respect for the scale of the problem, and a calm consciousness of what needs to be done. With panic, sanity is lost.
The WHO has advised people to avoid watching, reading or listening to the news. Mental health doctors have also requested the media to avoid "panic-inducing" coverage that causes feelings of fear, but fear is an adaptive emotion that serves to mobilize energy to deal with the potential threat. Excessive fear may cause detrimental effects both at the individual level (e.g. mental health problems such as phobia and social anxiety) and at the societal level (e.g. panic shopping or xenophobia); and less fear can also cause harm for individuals and society (e.g. ignorance of preventive measures such as physical distance, use of mask and hand washing). In this context, it is pertinent to mention that physical distancing must be seen as only one part of the wider public health approach of containing the COVID-19 pandemic and needs to be implemented alongside combined strategies of people-air-surface-space management including hand hygiene, cleaning, occupancy and indoor space and air management, and use of appropriate protective equipment. The persistence of fear indeed triggers safety behaviour that can mitigate certain threats. In case of less fear that ignores preventive measures, the only option is to impose lockdown as a social safety measure to prevent the spreading of infections but the strict implementation of these measures for a prolonged time may have negative consequences (e.g., disruption of the economy, unemployment etc.) as observed during the lockdown in 2020.
In India, after the relaxation of a 3-month lockdown, cases are surging. The scientists and researchers had already warned in September 2020 about the risk of a second wave. The current Covid crisis in India is a product of the myopic governance at the Central level that completely failed to take appropriate actions to reduce the rate of infection of the virus. India and its people have become victims of poor governance. While the country was facing the threat, the politicians, irrespective of any political affiliations, continued to hold rallies. The government also allowed the Kumbh mela despite the risk of a second wave because the government did not dare to call the gathering off for the fear of disappointing their Hindu supporters. Even the media was busy covering the election campaign and failed to criticize the governments for their failure.
Now, hospitals are running out of oxygen and medicine, and bodies are stacking up in morgues. The government has miserably failed to control skyrocketing infections with new variants emerging on the scene. The lockdown period was not used effectively to increase the capacity of the healthcare system. There has not been a systematic restructuring of medical provision or redeployment of healthcare staff. As a result, the country is braced for further rapid transmission of the virus. In this context, it is pertinent to mention the plight of frontline workers including policemen, healthcare workers and journalists who are suffering from what is called occupational hazard. Obviously, the frontline workers are more likely to get demotivated by the failure to build the capacity of the healthcare system in India.
Urgent action supported by the behavioural and social sciences is needed to mitigate the potentially devastating effects of COVID-19. The mindset about stress can be changed with short and targeted interventions. According to many researchers, inducing a more adaptive mindset around stress may increase positive emotion, reduce negative health symptoms and boost physiological functioning under acute stress. It is time for India's policymakers to trust those with relevant expertise, to make sure the necessary data are collected and made available, and to accept the value of scientific findings even if they do not fit the government's narrative. Scientists, health workers and bureaucrats need to make even stronger statements and governments must listen and act accordingly. The most emergent need is to have a leader who can cultivate a sense that 'we are all together'.
The writer is a former Senior Scientist, Central Pollution Control Board. Views expressed are personal