The worldwide lockdowns and other containment measures, such as the curfew and restriction of movement in Kenya, in a bid to curb the spread of Covid-19 is the best way yet to curb the spread of the pandemic.
The coronavirus disease is a public health crisis. But it is an economic and social crisis, too. The pandemic is projected to have a disproportionate impact on the older people, in the “baby boomer” generation — those over 60. People over 80 are at the greatest risk of dying from the disease, alongside those with underlying health conditions such as diabetes and high blood pressure.
But there are other legitimate reasons that call for concern. In the long run, we might see fatality rates among young and youthful people go up as a consequence of long periods of lockdown and isolation. Unsurprisingly, people who are quarantined are very likely to develop a wide range of symptoms of psychological stress and disorder. Low mood and irritability stand out among young people who are used to the outdoors and social events but are now glued to the home setting, hence bogged down by boredom.
The strategy of restriction or cessation of movement is meant to stop the contagion so that even at its peak it is manageable for the healthcare system. But even if that prevents more direct deaths from Covid-19 and indirect ones from healthcare systems being overwhelmed, can we suppose that the cost of economic and social meltdown are worth it, as a third of the global population is dealing with these intense stressors?
People care about all these things and are willing to make trade-offs between them in their daily lives. And it is simply not true that individuals care only about health and mortality risks. Amid the movement restrictions and quarantines, many will risk just to see their grandchildren or attend the funeral of a loved one.
Many people are afraid of coronavirus deaths, including of their loved ones, addiction, domestic violence and child abuse, all of which are showing early signs of increasing after just weeks of movement restriction, coupled by job losses, especially among low-income earners, widening inequalities in income, health and well-being.
There comes a point at which the economic and psychosocial costs of lockdown become too high a price to pay for the reduction on mortality risks from this pandemic.
The government should think of running a media series of psychosocial and mental health programmes to help such people as many will need treatment for trauma-related disorders due to the social distancing. Self-help interventions should be aired live to address the needs of large affected populations under restricted movement who are silently ‘dying’ of psychosocial stress, anxiety and depression.
Educate the people about the expected psychological impact and reactions to trauma. Let them understand that psychological reaction is normal. Address the psychosocial issues resulting from movement restrictions and economic hardship due to shutdown of businesses and places of worship.
On the brighter side, movement restriction has health benefits for the society as it contains the spread of the virus by reducing the number of infections and allowing the health system to treat those infected (as well as those that require other health services) better.
However, it would be prudent of the Health ministry to promote telemedicine as a means of providing health services during lockdown, especially for those unrelated to the pandemic. Patients would call a helpline number or access a phone application to order their medicines, which could reduce the risk of getting infected at the hospital, especially where referral facilities are few.
Public health professionals and infectious disease modellers cannot be expected to provide anything other than a very partial perspective on these issues. This is why it is vital that the policies enacted by the governments are informed by a range of perspectives that take in not only human health but also wealth, relationships and well-being.
A policy geared toward curbing the mental health issues that will be triggered by the containment measures undertaken by the government has never been more urgent than it is now. Furthermore, the school closures resulting from the pandemic can also negatively affect children’s mental health as the minors may no longer have that sense of structure and stimulation that is provided by that environment.
