With the spread of the coronavirus (COVID-19) over the past couple of weeks, things have gradually, but dramatically, shifted in America. It has become the main topic of conversation and many of us have started changing our behaviors. My wife Diane and I, for example, have put off a planned trip to see my elder sister and her family in the Chicago area. We have also postponed a flight to Houston to see our youngest granddaughter. We did these things to prevent spreading any potentially dangerous microbes and to avoid any exposure at airports.
Our oldest son, who lives in Dallas and travels a lot for business, took a short fight recently and returned with a bad case of the seasonal flu. Our youngest son, who works in New York City at a company that stages business expos, tells us that a lot of big corporations are withdrawing from events due to company travel restrictions.
Conferences and meetings across the country are canceling out, as well as other events like the premier of the new James Bond movie. I just received an email informing me that the National Association of Community Health Center’s 2020 Policy and Issues Forum in Washington, D.C., has been cancelled.
Webinars and teleconferences are now substituting for many face-to-face meetings. Medicare and Medicaid are working on making telemedicine services provided directly to people’s home electronic devices more accessible.
The use of video conferencing, Skype, and FaceTime is bringing us much closer to the world described by science fiction author Isaac Asimov, in his 1983 novel, “The Robots of Dawn.” Asimov envisioned a world in which a sizable portion of the population exhibits agoraphobia and almost all human contact is made through “trimensional viewing.”
Just recently Italy restricted movement across the entire nation and the prime minister called for all 60 million residents to stay at home. Harvard psychiatrist Harold Bursztajn says that “…the pendulum has swung from denial to near-pandemonium…”
Last weekend I saw a store clerk wearing an elaborate respirator and rubber gloves, as well as several other people wearing face masks. At Home Depot I watched a young couple purchase the last of the drywall dust ventilators. Herd mentality was obviously working and a number of customers asked when was the store going to get more respirators in stock.
At my place of work our usual suppliers will no longer accept orders for hand sanitizer, face masks, and other needed supplies for our health centers. Across the country people, especially in highly impacted areas, are hoarding everything from canned goods to toilet paper. I have to admit even Diane and I bought a new electronic thermometer.
In such situations, folks just want to do something dramatic and effective. Hand washing seems awfully weak and too ordinary to counter something as scary as the coronavirus. At the root of much of this behavior is simply our fear of the unknown. This fear drives individual behavior, as surely as it does the stock market. Psychiatrist Robert Ursano from the Uniformed Services University says that the “microbial world is mysterious, threatening, and frightening”. He notes that, “Human beings in general, and stock markets in particular, fear the unknown.” People who are retired, or who plan to retire soon, are experiencing the psychological stress of the volatile stock market, as their financial security has been severely threatened.
Fear can also lead to irrational, cruel, and even life-threatening behaviors. Actions based on irrational fear seldom take in to account long-term consequences. Fear can lead to distrust, stir up paranoia, and result in targeting someone to blame — for example, Asian-Americans, simply because the epicenter for the virus was China or because the wearing of face masks during flu season is a common cultural practice.
Johns Hopkins University psychologist George Everly has said, “The psychological contagion effect is always more far-reaching than the physical…” In 2007 Ronald Mandersheid, also from Johns Hopkins, predicted that in a pandemic, approximately one-third of the population will be psychologically unaffected, another one-third will become anxious and fearful, and up to one-third more may develop severe psychological symptoms. Below are a number of strategies that various authorities have suggested to help address the psychological consequences, as well as the physical threats of the coronavirus.
• Focus on the things that you can control. Make contingency plans for disruptions such as school or work closings and see if working at home is a possibility. Shore up your social support network and other resources.
• Identify trusted sources of information, such as the Centers for Disease Control and Prevention’s website (cdc.gov), the World Health Organization (who.int), local health departments, and reputable news organizations. Don’t, however, over do it. At some point information gathering can become counterproductive. Some experts suggest limiting virus information seeking to 30 minutes daily. People with pre-existing psychological disorders may be especially vulnerable to adverse over-exposure effects. Although the Internet can provide practical preventive measures, unfortunately panic and hysteria spread faster than good advice or messages of hope.
• Practice good mental hygiene. Employ meditation, relaxation or mindfulness techniques to help reduce stress and anxiety. Seek out support or counseling when needed. Stay connected with family and friends.
• Attend to your physical health: Exercise, get adequate sleep, and eat nutritious meals.
• Practice infection control precautions such as washing your hands for at least 20 seconds using soap and water. Use hand sanitizer that contains at least 60% alcohol. Avoid physical contact with others and keep 6 feet of separation. Avoid touching your face and cover your coughs. Stay home when you’re sick. Avoid crowds and enclosed environments (like airplanes). Self-quarantine if you have been exposed.
• Fight discrimination and efforts to blame COVID-19 on marginalized groups. Such bigotry could deter people from seeking necessary testing or treatment.
• Reassure your children and use this opportunity to discuss the importance of good hygiene and handwashing.
America has a proud tradition of responding honorably to crises. We stepped up when Henryville was struck by tornadoes, we have done this in response to every hurricane, flood or other disaster that has occurred. The coronavirus, however, presents a special challenge, in that the threat is highly personal, occurs over an extended period of time, and other people may be seen as a threat, rather than as neighbors to be helped. Our usual generosity alone is not enough. Diane says, in the midst of tragedy, however, there are always reports of Americans reacting with courage, a sense of humor, and hope. This is what we do best.