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Coping with a pandemic: Lessons from previous infectious disease outbreaks

Stephen Padilla
15 Apr 2020
A guide on dealing with anxiety for new nurses

Researchers in Singapore have synthesized in a recent review several psychological responses seen across infectious disease outbreaks in the past, including anxiety, depression, loss, stigmatization, isolation and cognitive restructuring.

For the current coronavirus disease 2019 (COVID-19) pandemic, practical considerations must be directed to the individual in the context of the larger social environment, focusing on raising awareness of the range of possible psychosocial responses, access to psychological help, selfcare and sustained engagement, according to the researchers.

“The extent to which each type of coping strategy was helpful for relieving psychological distress was associated with varied factors, including one’s risk appraisal, demographic factors and severity of the outbreak,” they said.

A narrative synthesis was conducted on published literature over the last 20 years, with a quality appraisal of included articles reporting both psychological responses and coping strategies within infectious disease outbreaks. The search yielded 144 papers, of which 24 met the inclusion criteria.

Eighteen studies assessed the psychological responses of the general population towards the severe acute respiratory syndrome (SARS) epidemic, four studies covered the Ebola epidemic, and two studies examined the H1N1 outbreak.

Although most of the common themes in psychological responses were mainly deleterious (eg, anxiety/fears, anger, grief, depression, guilt, loss, stigmatization and post-traumatic stress), a greater sense of empowerment and compassion towards others also emerged. [Singapore J Med 2020;doi:10.11622/smedj.2020046]

Coping strategies that were adopted in previous outbreaks included the following: problem-focused coping (ie, seeking alternative, self- and other-preservation), seeking social support, avoidance and positive appraisal of the situation.

“The use of different coping methods in reducing psychological distress differed across studies,” the researchers said. [Health Qual Life Outcomes 2017;15:8]

A study by Yeung and Fung found that problem-solving reduced sadness, but in other studies, such approach contributed to or was not associated with an increase in anxiety levels. [J Pers 2005;73:261-285; Br J Health Psychol 2014;19:592-605]

“The use of problem-focused strategies such as problem-solving should predict better adjustment in controllable situations, while emotion-focused strategies such as avoidance and denial would be favoured in uncontrollable situations,” the researchers said.

Epidemic survivors from several studies also found solace in religious practices and in the support of fellow survivors, as well as the presence of empathetic healthcare workers throughout their treatment and discharge. [Prehosp Disaster Med 2017;32:234-239; J Nurs Res 2015;23:217-224; Int J Nurs Pract 2005;11:150-160; Front Public Health 2016;4:142]

Across studies, survivors also attempted to cope through positive thinking and appraisals, with individuals putting their confidence in alternative treatments, the government or the healthcare system. [J Epidemiol Community Health 2003;57:857-863; J Formos Med Assoc 2010;109:524-532; Soc Sci Med 2002;54:955-969]

“Further research endeavours should seek to understand the longitudinal psychological impact of disease outbreaks, differences in psychosocial responses among population subgroups, inter-relationships with social media, and the influence of past experiences with infectious disease outbreaks, in order to better prepare ourselves psychologically to face future outbreaks,” the researchers said.

COVID-19 was first discovered in the city of Wuhan in China, but government censorship and inaction led to its global outbreak. As of this writing, more than 1.8 million people have been infected worldwide, with nearly 113,000 deaths reported.

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Most Read Articles
Jairia Dela Cruz, 22 Apr 2020
A wristwatch-like device that monitors pulse, breathing and blood oxygen levels of the user allows physicians to provide care remotely both in hospital and nontraditional settings, and may help in the fight against the coronavirus disease 2019 (COVID-19) pandemic.
Roshini Claire Anthony, 27 May 2020

The use of a vaginal cleansing intervention prior to Caesarean delivery reduced the incidence of surgical site infections (SSIs), according to a study presented at ACOG 2020. However, the addition of intravenous (IV) azithromycin prophylaxis had no added impact on SSI rates. 

Pank Jit Sin, 21 May 2020

Persons suffering from asthma should pay particular attention to SARS-CoV-2 precautionary measures such as social distancing, regular handwashing, and wearing of masks on top of keeping their asthma in control. This is because data collected so far paints a bleaker picture for asthmatics than the normal population should they catch COVID-19.

Natalia Reoutova, 2 days ago

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