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PSYCHOLOGICAL IMPACT OF COVID 19


Coronaviruses (CoV) are a large family of viruses that cause illnesses ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). [1] Covid 19 in itself is a highly contagious virus caused by SARS-CoV. It is spread from person to person through droplets released when an infected person coughs, sneezes, or talks. It may also be spread by touching a surface with the virus on it and then touching one’s mouth, nose, or eyes.


The most common signs and symptoms of COVID-19 are fever, cough, trouble breathing, fatigue, muscle pain, chills, headache, sore throat, runny nose, nausea or vomiting, diarrhea, and a loss of taste or smell may also occur. The signs and symptoms may be mild or severe and usually appear 2 to 14 days after exposure to the SARS-CoV-2 virus. [2]


The virus first appeared in December 2019 in the people’s republic of China and by March of 2020, it had reached 100,000 cases worldwide and was named a pandemic by the World Health Organisation. [3]


All over the world, countries tried to protect their citizens with strict isolation and social distancing regulations. Businesses, companies, organizations, public institutions, social and religious gatherings, national and international travel were shut down. Necessary work activities were shifted to virtual work.


These isolation practices and the high rate of morbidity of the new disease led to feelings of fear, uncertainty, and anxiety in people.


The pandemic and the experiences surrounding it evolved to include a broad range of public mental health concerns, including distress reactions (insomnia, anger, extreme fear of illness even in those not exposed), health risk behaviors (increased use of alcohol and tobacco, social isolation), mental health disorders (post‐traumatic stress disorder, anxiety disorders, depression, somatization), and lowered perceived health. [4]


The pandemic has impacted the lives of millions of people around the world and is likely to result in mental health problems among those with no previous mental illness as well as exacerbate the condition of those with pre-existing mental health problems/disorders. Mental health problems are likely to begin early and continue after the pandemic is over. Experience of the disease, breakdown of social support, and stigma are possible causes of short-term mental health problems while factors such as economic losses can potentially cause long-term mental health issues. [5]


The economic losses are related to job losses. Job and financial security keep decreasing as the days progress, and this causes increased levels of fear and anxiety in individuals.


In medical practitioners, the psychological distress of treating a fairly novel and unknown virus has been found to be diverse and widespread. Because the medical staff is the most likely to contact the virus and go through a quarantine process, their mental health is deeply affected by it. In the study done by Brooks et al, [6] hospital staff who might have come into contact with SARS found that immediately after the quarantine period (9 days) ended, having been quarantined was the most predictive factor of symptoms of acute stress disorder.


In the same study, quarantined staff was significantly more likely to report exhaustion, detachment from others, and anxiety. This review also suggests that the psychological impact of quarantine is wide-ranging, substantial, and can be long-lasting.


Nigeria is a West African country with developing healthcare systems. The treatments and care that can be offered with limited resources are not that extensive, and this can take a toll on medical practitioners. It has been predicted that because of these healthcare systems, the impact on worker’s mental health would be immense.


To date, very little has been documented about the impact of COVID-19 on mental health in sub-Saharan Africa. However, it's said to have similar effects as the ebola virus. The Ebola virus outbreak triggered serious psychosocial consequences at both individual and community levels. Stress, grief, anxiety, depression, and symptoms of PTSD were reported at the individual level while stigma, discrimination, and interruption of social networks were observed at the community level. [5]


A peer review [5] reported that similar to the Ebola epidemic of 2014 – 2016, COVID-19 is expected to cause anxiety, depression, and post-traumatic stress disorders. In addition to some of the well-documented predictors of mental health problems, the inability of families to care for sick relatives coupled with the inability of family members to perform traditional and religious burial rituals for loved ones causes psychological distress.


The impact of this virus even extends to children, with one study in Spain [7] reporting that strict lockdown measures led to heightened levels of stress and anxiety among young children. Previous studies from pandemics have also shown children have the potential of developing adverse psychological conditions.


In young adults, the pandemic-related lockdowns led to the closure of some of the places they are most active in. Public institutions like the university closed, There were transitions from physical work to online classes and loss in job and employment, all of which have led to an increase in mental health stressors. The Kaiser Family Foundation analysis of the Household Pulse Survey finds that throughout the pandemic, a large share of young adults (ages 18-24) have reported symptoms of anxiety and/or depressive disorder – 56% as of December 2020 – compared to older adults. [8]


During and after the pandemic, it can be summarized that there are major factors that are/will impact the population and may lead to mental health problems. These factors can be:


● The direct impact of the disease, particularly near-death experience during illness, isolation from loved ones during hospitalization which is a grim experience both for the family and the patients in most African communities where communal living and care is a major building block of a community.

● Efforts to contain the spread of COVID-19 through restricting and limiting physical interactions. This may lead to limited access to social support structures, inadequate supply of food and medication, limited access to treatment for those with existing mental health problems as well as other chronic conditions, and restricted access to faith-based institutions and leaders due to the ban on social gatherings. [5]


It is evident that the psychological effects of the covid 19 pandemic are prevalent and extensive. This means that mental health complications will have to be taken as seriously as thosof physical health in this period.


Ensuring that members of the society have easy access to adequate systems of mental health support.With the right training, community health workers could organize community-based mental health services and counseling that could help mitigate the psychological stressors of the pandemic.


Common social networking sites and apps could be used to provide basic counseling services and mitigate the levels of anxiety, depression, post-traumatic stress, and even insomnia. This virus is novel and so much is still being learned. The world will need innovative ways and solutions to help ease the psychological distress.








REFERENCES


1. Administrator. World health organization - eastern Mediterranean region [Internet]. Who. int. [cited 2021 Apr 1]. Available from: http://www.emro.who.int/health-topics/corona-virus/about-covid-19.html



2. NCI dictionary of Cancer Terms [Internet]. Cancer.gov. 2011 [cited 2021 Apr 1]. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/covid-19


3. Listings of WHO’s response to COVID-19 [Internet]. Who.int. [cited 2021 Apr 1]. Available from: https://www.who.int/news/item/29-06-2020-covidtimeline


4. Shigemura J, Ursano RJ, Morganstein JC, Kurosawa M, Benedek DM. Public responses to the novel 2019 coronavirus (2019-nCoV) in Japan: Mental health consequences and target populations. Psychiatry Clin Neurosci. 2020;74(4):281–2.


5. Semo B-W, Frissa SM. The mental health impact of the COVID-19 pandemic: Implications for sub-Saharan Africa. Psychol Res Behav Manag. 2020;13:713–20.


6. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395(10227):912–20.


7. Concerns raised over threat of COVID-19 to mental health in Europe [Internet]. Unric.org. 2020 [cited 2021 Apr 1]. Available from: https://unric.org/en/concerns-are-raised-over-the-threat-of-covid-19-to-mental-health-in-europe/


8. The implications of COVID-19 for mental health and substance use [Internet]. Kff.org. 2021 [cited 2021 Apr 1]. Available from: https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/














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