Epidemiology and TMGT

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Introduction

COVID-19 which started as a health crisis turned to an economic crisis, affecting the livelihoods of people, social wellbeing and political landscape. The impact of COVID-19 has been felt in all countries around the world, in every sector of the economy and in different aspects of human life. Mental health has been one main effect of COVID-19 and the United States has not been exceptional. Considering the overarching mental health impact of COVID-19, this assignment establishes how COVID-19 causes mental health with specific attention given to the United States, a chronology of events, relevant stakeholders, immediate and long-term impact.

COVID-19 Causes mental health in the United States

COVID-19 outbreak has impacted the mental health of individuals in the United States. Measures taken to contain the spread of the virus are causative factors to mental health. Lockdown, social distancing, isolation and quarantine accelerated mental health problems. In the survey conducted, for the period between January and April, with the outbreak of Covid-19, there was a fourfold increase in the number of people accessing Mental Health America Services, seeking help for depression, anxiety and other mental problems (Roush, 2020). This indicates that COVID-19 had a significant impact on mental health, a situation that was not unique to the United States but even in other countries around the world.

Cases of depression and anxiety have been increased attributable to the outbreak of COVID-19. On the comparative analysis, mental health screening increased since the period when COVID-19 case was reported in the United States, with anxiety screenings in June was 406% greater than in January while depression screenings were 457% greater than January, according to the number of people that sought Mental Health America Services (Roush, 2020). After lockdown and isolation measures were instituted to stem the chain of transmission of the virus, people diagnosed with risk for the psychosis spiked, and in June number increased 4 times compared to January. Suicide or self-harm increased six-fold while social consequences of the pandemic are noted as the main factors that were responsible for the stress. Findings show that loneliness and isolation were attributable to depression and anxiety at 73%, post-trauma at 46% while relationship problems account for 44% of mental health problems (Roush, 2020).

COVID-19 pandemic triggered government lockdown and drastic changes in the daily routine that were detrimental to mental health. Worsening finances, financial instability and lack of access to basic caused stress and psychological problems (Gloster et al…, 2020). For example, some people had lost jobs due to pandemic which has disrupted business production, other companies issued pay cut while others were sent on the unpaid leave, a situation that caused emotional instability and stress among people because the shortfall in the income levels made hard for people to access necessities such as food and payment of rent. The situation was dire, social wellbeing of Americans affected adversely, a situation that led Congress to approve a $2 trillion aid package to relieve Americans from prevailing economic problems, which allocated more than $350 billion to most hard-hit households (Hughes, 2020).

Social distancing, quarantine, disruption of daily routines such as work travel, leisure activities, fear of high contagious but invisible virus (Gloster et al..,2020). These changes and the looming threat of pandemic increased anxiety and depression. People was emotionally distressed that they could catch COVID-19, a virus that is highly transmissible but with no cure. Fear was all over among the people because one could not identify individuals that have contacted the virus, and with no cure with the immunity of an individual determining ability to fight the virus successfully, people were extremely worried whether they had enough immunity to enable them to fight the virus in the event are infected with the virus.

Another way through which Covid-19 caused mental health problem was through fear of loss of spouses and beloved individuals, fear of loss of job, aging combined with loneliness, stigmatization to those acquired virus but even isolation and recovering, people never believed that they had recovered but saw them as potential transmitters of the virus. All these factors caused psychological distress, anxiety and depression hence causing mental health problems to the Americans.

Considering another dimension of mental health impact, restriction measures imposed to contain the spread of pandemic separated people from their loved ones, resulted in the loss of freedom and uncertainty deteriorated mental health status. Individuals were placed away from the normal environment, for example, children were away from school with anxiety, distress, social isolation and an abusive environment that adversely impacted mental health. Unexpected changes in the eating habits, changes and avoiding activities that kids enjoyed past, increased sadness and worry and restricted interactions with other kids are all set of activities that Americans kids experienced which affected their mental health (Gloster et al…, 2020). It was upon the parent to calmly engage children and teens to explain why these changes are necessary and create awareness on the outbreak of COVID-19 and measures should take to cut the chain of transmission.

The elderly are prone to outbreaks of COVID-19 because they have weak immunity. Elders also require support from other people which necessitates demand for closer interaction for the provision of physical support. However, physical distancing had a drastic negative impact on the mental health of the elderly and disabled individuals (Javed et al.., 2020). The elderly depend on the young ones for the daily needs hence the implementation of social distancing and self-isolation affected the family system inducing anxiety, stress and depression to the elderly (Javed et al.., 2020). Elderly with underlying medical conditions such as diabetes were also in extreme fear that they could die any time if they contracted the virus. The elderly are also uncertain of what the future holds for them, which accelerated mental health problems.

Health care workers is another segment of people that have experienced mental health problems. A substantial portion of healthcare workers in America have contracted the virus and others have died from the virus which they have contracted on the line of duty. Fear of catching the virus, long working hours, inadequate PPEs, isolation from their families and loved ones, death of colleagues and the dire situation of patients form multiple factors that negatively influence the mental health of health care workers (Javed et al.., 2020). For example, as of September 2020, about 570,000 health care workers had been infected by the virus and more than 2500 had succumbed to the virus (PAHO, 2020).

Finally, other than the United States, taking a global perspective, COVID-19 has caused serious mental health problems. According to World Health Organization, self-isolation, quarantine, affected routine and livelihoods of people have resulted in to increase in loneliness, anxiety, depression, self-harm and suicidal behavior. Sanitary fights against invisible virus and handwashing develop obsessive-compulsive disorders and maladaptive behaviors (Kumar & Nayar, 2020). Similarly, mood-related and emotional outbursts such as panic, fear of meeting other people, fear of death, stigmatization, fear of getting isolated, and fear to lack basic items such as food contribute to mental health problems (Kumar & Nayar, 2020). These are mental health experienced globally and the United States is not exceptional.

Chronology of Outbreak of COVID-19 and Its Mental Health Impact

In 2019 December, the first case of COVID-19 was reported in Wuhan, China. Before the month could end, on the 21st of January 2020, the first case was reported in the United States. On 2nd February, global air was restricted on the following day, the US declared a health state of emergency. On March 11, COVID-19 was declared a global pandemic and Trump declared COVID-19 a national emergency (AJMC, 2021). On March 19, California issued a statewide stay-at-home and economic stimulus package worth $2trillion was passed by Congress on 26th March. (AJMC, 2021). Restrictions imposed to stem the spread of COVID -19 caused economic suffering and loss of jobs. On contrary, even though restrictions were imposed and the economy, cases continued to rise.

In April, Trump advocates the use of gating criteria to open the economy which requires state or metropolitan areas to achieve benchmarks of reducing Covid-19 cases or deaths before taking steps to reopen the economy (AJMC, 2021). On June 10, Covid cases had reached 2 million, 3 million cases surpassed on 7th of July, 75,600 cases reported in a single day, Covid reported third largest cause of death on August, on 23rd September more infectious strain is discovered, cases increases and eventually, US begins vaccination drive (AJMC, 2021).

With measures taken to contain the spread of the virus and with more cases and deaths reported. COVID-related restrictions, risk of infection, actual infection and deaths increased mental health problems. Frontline healthcare workers, the elderly, children, homeless individuals, and those in economic vulnerability are at high risk of experiencing mental health problems (Pedrosa et al…, 2020). Quarantine, social isolation, and social distancing are restrictions imposed to step rising cases of COVID-19 which resulted in solitude and loneliness which impacted the mental health of people. Fear and uncertainty attributable by the view that virus can be contracted from anywhere, suicidal behavior due to fear-related issues such as infection, stressors such as loss of loved ones and economic difficulty, financial loss, inability to provide for the family, food insecurity and post-traumatic stress disorder are multiple of factors that are Covid-related which cause mental problems (Pedrosa et al…, 2020). Therefore, having detailed chronological events that demonstrate increased cases and deaths, it is to true to state that mental health problems have increased accordingly in the United States creating a need to provide mental and psychosocial support.

Relevant Stakeholders

Three relevant stakeholders help to address the impact of mental health problems that are caused by the COVID-19. First, the government is an important stakeholder that is well informed of mental health challenges that people go through as a result of COVID-19. The government knows well that people have lost jobs because of coronavirus, COVID has left with no means to sustain and provide for their families, restrictions that the government has instituted to stem the spread of the virus such as quarantine, lockdown, self-isolation and social distancing are risk factors to mental health problems. Aware of problems that people go through and the hard economic challenges they are experiencing, the government instituted economic aid packages such as $2 trillion that shared among households, businesses, state and local government.

Frontline healthcare is another important stakeholder in the fight against a pandemic that have been heavily impacted by mental health problems. These are people that treat patient, suffer mentally seeing patient die on their hands having no way to help, fear getting infected and infecting their loved, are isolated from the families and other lost their colleagues. These and more other factors such as working long hours and inadequate PPEs are stressors to healthcare workers. This creates a need to provide mental and psychosocial support to the frontline healthcare workers.

Lastly, unemployed people and people that have lost jobs due to pandemic is the third segment of people that have experienced mental health problems. These are people who are not sure what tomorrow waits for them, uncertain how to provide for their families and foot necessary bills such as rent and are locked in families from the daily hustle. These multiple factors are psychological stressors that cause some people to suffer from anxiety, stress and depression, mental health problems that required urgent attention.

Immediate mental health impact of Covid-19

Anxiety, depression, stress and worry over Coronavirus and suicidal thought have been immediate mental health impact of COVID-19. With time, people will get back to normal when the cases declined and the economy is fully opened. However, before that happens, in the meantime, people are distressed and worried about the future, other people are still in fear that they can get the virus and deeply stressed because they are not sure if they can fight and win, others lost jobs and still have not established ways to make ends. Additionally, during the early days of the outbreak of CoVID-19, stigmatization was very common, with little mental and social support and fear because very little information was available about the virus. These factors exposed people to short-term mental health problems such as psychological distress, anxiety and depression.

Long-term mental health impact of Covid-19

Obsessive-compulsive behaviors, fear, amplified serious mental health problems, post-traumatic disorders and long-lasting deteriorating mental health possible long-term impact of Covid-19. For people with a genetic predisposition towards some form of obsessive-compulsive disorders, the stress of COVID-19 would trigger or worsen OCD (Panchal et al…, 2020). General anxiety is another long-term mental health problem that would experience related to COVID-19. There people in the society that suffer from anxiety but with experience of this deadly virus, people that feel anxious would feel more easily and the condition might get worse (Panchal et al…, 2020). Even after the virus ends, people might be over-anxious because they fear the threat of a new strain of the virus. Memory of trauma would be another experience that would be experienced by people especially those have gone through painful moment such as loss of friend, parents, children, colleagues or spouses to the virus. Therefore, post-trauma stress disorder would be a common long-term mental health problem.

Conclusion

In summary, the outbreak of COVID-19 has significantly impacted the mental health of Americans and other people around the world. Imposed restriction to stem the spread of the virus, social distancing, isolation, and fear of getting the virus, disruption of daily routines, economic and financial strains caused by the virus, inability to provide for the family, loss of jobs and loved ones, are dozens of Covid related factors that have contributed to mental health problems such as anxiety, depression, post-traumatic stress disorder, insomnia, OCD among others. Government, frontline healthcare workers, unemployed and those lost jobs reflect some of the key stakeholders to understanding the mental health impact of COVID-19. It is statistically correct that indeed, Americans and globally, mental health has been deteriorated by the Covid-19 pandemic.

References

AJMC. (2021). A Timeline of COVID-19 Developments in 2020. https://www.ajmc.com/view/a-timeline-of-covid19-developments-in-2020

Gloster, A. T., Lamnisos, D., Lubenko, J., Presti, G., Squatrito, V., Constantinou, M., ... & Karekla, M. (2020). Impact of COVID-19 pandemic on mental health: An international study. PloS one, 15(12), e0244809.

Hughes, S. (2020, March 26). The $2 Trillion Plan to Help the Economy. Wall Street Journal. https://podcasts.google.com/feed/aHR0cHM6Ly92aWRlby1hcGkud3NqLmNvbS9wb2RjYXN0L3Jzcy93c2ovdGhlLWpvdXJuYWw/episode/ZjdlOWQ0YmUtMjdhNC0xMWVhLWIzYTItNGZkZWQyZDNkMDMz?sa=X&ved=0CAUQkfYCahcKEwjAnqm0hf3vAhUAAAAAHQAAAAAQAg

Javed, B., Sarwer, A., Soto, E. B., & Mashwani, Z. U. (2020). The coronavirus (COVID-19) pandemic's impact on mental health. The International journal of health planning and management, 35(5), 993–996. https://doi.org/10.1002/hpm.3008

Kumar, A., & Nayar, K. R. (2020). COVID 19 and its mental health consequences. Journal of Mental Health, 180(6), 817-8.

PAHO. (2020). COVID-19 has infected some 570,000 health workers and killed 2,500 in the Americas, PAHO Director says. https://www.paho.org/en/news/2-9-2020-covid-19-has-infected-some-570000-health-workers-and-killed-2500-americas-paho

Panchal, N., Kamal, R., Orgera, K., Cox, C., Garfield, R., Hamel, L., & Chidambaram, P. (2020). The implications of COVID-19 for mental health and substance use. Kaiser family foundation.

Pedrosa, A. L., Bitencourt, L., Fróes, A. C. F., Cazumbá, M. L. B., Campos, R. G. B., de Brito, S. B. C. S., & e Silva, A. C. S. (2020). Emotional, behavioral, and psychological Impact of the COVID-19 Pandemic. Frontiers in psychology, 11.

Roush, K. (2020). Mental Health Effects of COVID-19. American Journal of Nursing. https://journals.lww.com/ajnonline/Fulltext/2020/11000/Mental_Health_Effects_of_COVID_19.5.aspx