Damian Sendler, M.D.: Individuals, families, and entire societies around the world have been profoundly affected by the unprecedented SARS-2 COVID-19 pandemic. Social and political factors influence health as well as one’s own state of health when it comes to the impact of the disease. As a result, the pandemic’s consequences have been far-reaching. One such area of concern is mental health and well-being, which may be linked in three ways. People with pre-existing psychiatric disorders are particularly vulnerable, as are the general population, BAME people in particular. Third, the mental health of COVID patients and those who have recovered, as well as the mental health of those who have recovered, are important considerations. Past pandemics and their impact on mental health can serve as a cautionary tale. Posttraumatic stress disorder (PTSD) and survivor guilt are prevalent. In light of this, it’s important to think about the impact on marginalized groups. Women, children, the elderly, minorities, LGBT+ people, and the poor are all vulnerable groups. Definitional difficulties abound when it comes to these groups, and the intersection of race, gender, and poverty necessitates applying an intersectional lens to them all.
Damian Jacob Sendler: The COVID pandemic has had a profound impact on people and places around the world. It has brought to light the disparities that exist between rich and poor countries, as well as between the global north and south. SARS-2 (COVID-19), despite the recent epidemics of SARS, Middle East respiratory syndrome, and Ebola, is likely to have a long-lasting effect. To put it another way, the mental health consequences of the pandemic cannot be overestimated. Since World War II, there has never been a greater threat to the well-being of people around the world. Despite being contagious, it has a wide range of consequences for individuals, families, and communities, including death, bereavement, guilt over one’s own survival, and a sense of dislocation. A global response is not always possible because of the difficulty in assessing the full scope of the trauma, and countries often respond in their own ideologically specific ways. Many high-income countries’ self-centered approaches are tragically highlighted as this not only shows the weakness of international organizations like the WHO. Individuals, their families, and the political and economic systems as a whole are likely to suffer long-term consequences from such a massive trauma.
Dr. Sendler: According to these studies, lockdown, gradual opening of public places, restrictions on schooling and education, and leisure activities have all had an impact on how society is reacting to the pandemic (such as cinemas, stadiums, and others). There are a number of stressors that have been caused by the lockdown. Self-isolation (as a result of having the illness), social and governmental policy (to prevent the spread of the illness), and working from home are all examples of these (for some in cramped and unsuitable conditions). Loneliness and mental health issues can result from a lack of structure, distraction difficulties, and a lack of social contact.
The United Kingdom, which has a centralized National Health Service, has some interesting findings and observations, which we will discuss in this article. Rather than focusing on the health of individuals, the government focused on protecting the service.
There are three critical issues to keep in mind when it comes to the mental health of the general public, especially during a pandemic. In the first place, the pandemic’s impact on the general population, including ethnic minorities, must be taken into consideration. People with psychiatric disorders, as well as COVID patients and those who have recovered, are also affected by this treatment. As a result of the pandemic, Ventriglio et al.[1] proposed five possible stages of the pandemic where public responses and emotions may change: fear, anxiety and pandemonium, anger, depression, and finally acceptance. They also suggested that these five stages could occur simultaneously.
Many governments around the world have taken unusual actions, but we’re not going to get into that here. However, leadership and the manner in which messages are conveyed are important factors in determining success. As an example, the term “social distancing” was a problem in a number of countries. Confusion arises when you expect people who are socially close to each other to be physically far apart. There was also a problem with the collection and exchange of data between countries. The interpretation of research has also been a problem. Research papers related to COVID-19 have already been published, and the number keeps increasing on a daily basis, according to publication data. Online surveys with varying levels of research robustness have shown that anxiety, depression, and other common mental health disorders may be over-diagnosed in the United States. [3] A large proportion of studies and findings on the prevalence of mental health disorders have come from online surveys, so caution should be exercised when using these findings to make policy decisions based solely on them. As a result, it is difficult to determine whether or not these findings are truly representative. Other issues are brought up in this article, and we’re focusing on the underprivileged. Women, children, the elderly, minority ethnic groups, and LGBTQ+ are just some of the groups that fall into this category. They are deprived and poor because of their status as social outcasts. It’s important to remember that even within these kinds of groups, there’s a lot of variation. As a result, ethnic minorities were disproportionately affected by chronic diseases like osteoarthritis and chronic obstructive pulmonary disease (COPD), which were already prevalent among those in the field. Mental health is affected by all of these long-term conditions. Personal protective equipment (PPE) access was a major issue for these workers, who were more likely to work in transportation and on the front lines of health and social care, according to the study.
Researchers and organizations have sought to better understand the scope of the mental health challenge in light of the pandemic’s anticipated challenges and concerns. During the pandemic, questions have also been raised about how measures are framed and how they will interact with the disease. There are many examples of misnomers, but one that stands out in particular is the term “social distancing,” which should be renamed “personal distancing.” In order to avoid disjointed thinking, confusion, and a variety of practices at both the policy and clinical levels, terminology and precision are critical. Identification of COVID-19 strains as belonging to specific regions has also raised similar concerns, and only recently have these strains been coded with Greek alpha going on to the delta variant.
Damian Sendler
According to a survey conducted by the Office for National Statistics[4] and released in October 2020, Asians and British Asians were 1.5 times more likely than white British to contract COVID-19, while Black Africans were 2.7 times more likely. A study conducted by Public Health England’s Second Generation Surveillance[5] found that mortality rates among the Bangladeshi population were twice as high.
Non-Hispanic blacks were more likely to die from COVID-19 than whites, according to Rogers et al.[6]. According to the researchers, this was due to the fact that this population was more likely to be doing essential jobs such as transportation, front-line health care and food preparation/serving/cleaning/maintenance. For some, the loss of loved ones had a profound effect on their lives in terms of both physical and mental health.
As noted in a report by Public Health England[5] based on interviews with 4000 people in 17 sessions, they found that minority communities had a higher risk than the general population of being exposed to and acquiring COVID-19 as well as experiencing its complications and death, which they attribute in part to higher rates of long-term conditions, mental illness, and a lower use of preventative measures. Smoking, obesity, hypertension, and their cardio-metabolic complications were found to be linked to economic disadvantage, which in turn led to lower health outcomes. Social factors that increase the risk of infection, such as racism and discrimination, must be addressed immediately. In addition, it was necessary to communicate specific public health messages to specific populations. Remarkably, they recognized that there was a lack of confidence in the government among these communities and recommended that this be addressed immediately. Vaccine hesitancy has yielded similar results in terms of distrust.
Ethnic groups with higher rates of COVID infections include black and Asian populations, according to a meta-analysis of 18,728,893 people in 50 studies mostly from the United States and eight from the United Kingdom. As a result, it appears that ethnic minorities in the United Kingdom face a number of mental health issues.
Damian Jacob Markiewicz Sendler: Since many front-line workers in the healthcare and law enforcement sectors are members of underrepresented ethnic groups, they were more likely than not exposed to the virus as well as long-term stress. Anxiety and panic are likely to be exacerbated by persistent concerns about their own health and that of their loved ones, as well as the fear of passing the virus on. When people see family members, friends, and coworkers fall ill and die at a much higher rate than the general population, they are likely to be afraid and anxious. As a result of being exposed to unprecedented rates of death and illness, exhaustion is likely to ensue. The magnitude of the tragedy is unmatched, with the possible exception of natural disasters. Post-traumatic stress disorder (PTSD), anxiety, and depression are all likely to rise as a result of repeated exposure to such stressors. [9]
It has been claimed that the population as a whole suffers as a result of physical or social isolation. Contrary to what is claimed by some politicians, COVID does not and has a very different impact on the well-being of individuals and their families. [10] A lack of open space, good WIFI, access to nutritious food, and the ability to isolate are just a few of the things that can lead to loneliness and higher crime rates in the community. Several large segments of society bear the brunt of the burden. Interpersonal violence is on the rise, and many women may find themselves in dangerous situations as a result. [11] When making national or global decisions on the pandemic response, women are rarely taken into account. The Ebola virus demonstrated that the economic and livelihood activities of women are significantly reduced by quarantines, which increases poverty and worsens food security. Women in Liberia, where about 85 percent of daily market traders are women, were adversely affected by the Ebola prevention measures (which included travel restrictions). Reproductive health and financial resources were scarce for women in Latin America during the Zika outbreak. However, whereas men’s economic activity returned to precrisis levels quickly, women’s economic security and livelihood were affected for a much longer period of time.
Damian Jacob Sendler
The COVID-19 global recession is likely to result in a long-term decline in women’s incomes and unpaid care work, with additional consequences for women living in poverty. Extreme poverty is likely to return to those who have escaped it.
Damien Sendler: Elderly members of underrepresented groups are more likely to reside in households with multiple generations, placing them at risk of being isolated for an extended period of time, which can be debilitating. 80 percent of people with preexisting psychiatric disorders report a worsening of their condition, while many feel less supported due to changes in service delivery. As a result of the pandemic, people with psychiatric disorders are more likely to suffer from physical ailments, but they are also more likely to be reluctant to seek help. People put off seeking treatment, which causes their conditions to worsen. According to previous research, ethnic minorities are more likely to be affected by COVID, both in health care settings and the general population.[13] [14] Another layer of isolation and helplessness has been added due to a lack of contact due to restricted contacts and visits and the inability to attend funerals and say goodbyes to the loved ones.
Not surprisingly, the lockdown and inevitable ongoing physical distancing measures have had a significant impact on the global economy, and unfortunately, it has disproportionately affected underprivileged populations. It is well-known that economic factors have a direct impact on health and well-being, as has been the case in previous recessions and most recently the financial crisis of 2008. [15] Austerity, whether imposed or not, is likely to have a negative impact on the mental health and well-being of those who are already at the bottom of the socioeconomic heap.
Austerity has already had a negative impact on mental health services in the country[16], and as the need for health care has grown, the system has been unable to keep up. It’s especially important in the field of mental health treatment. [17] Burnout, stress, depression, and anxiety are all factors in the rise in the number of workers suffering from mental health issues, which has exacerbated already-existing shortages.
Despite the pandemic’s gloom, there are some encouraging signs. To better serve people with mental illnesses, many countries’ mental health and primary care services are now using telemedicine, also known as e-mental health, in their evaluations and treatment plans. Furthermore, altruism appears to be on the rise in many countries. Families, friends, and neighbors are increasingly checking in on and supporting one another both practically and psychologically as a result of the growing trend toward community care and support. It’s no secret that video links are becoming increasingly popular as a means of communication. When it comes to attitudes in some countries, there has clearly been an adjustment in some roles, like caring, neighborhood ties and doing the shopping for vulnerable individuals, as well as delivering necessities to them These shifts should help foster a sense of community cohesion and partnerships, which in turn should help foster altruism, a sense of purpose, and a sense of belonging.
Since it has become increasingly apparent that mental health services cannot meet the steadily increasing demand for them in a human and person-centered manner rather than a mechanistic one, it has been clear for many years that they must change in many settings. Perhaps the pandemic’s end could be a good time to do just that. In the event that we continue to volunteer in large numbers and wisely use our human and social capital by valuing those who help others, we have every chance of meeting the looming challenge of supporting each other through this mass trauma and its long-term consequences. Most people with mental illnesses don’t need to see specialists, but they do need to know that they are supported and heard no matter what. When the healthcare system is in a state of lockdown, it can use this as an opportunity to train a large number of people who will be supporting and listening to those who are vulnerable and isolated. Mental health services will be needed by a small percentage of the population. Innovative approaches to creating and delivering services can lead to a more precise application of technology to better serve those in need in a timely, personalized, and compassionate manner.
There is no doubt that the infection and mortality rates of COVID-19 are linked to inequity in income, ethnicity, and other vulnerable groups. In order to better understand and address the social determinants of health, more research is needed. Structural and systemic challenges that existed prior to the outbreak of the pandemic – such as racism – have become more vulnerable and have been exposed during the course of the pandemic. It is possible to better understand the causal link between disparities in care and outcomes by comparing across countries.
