As the world is grappling with the COVID-19 crisis, it is a clear reminder of how in the last five years, outbreaks of infectious diseases, disasters and conflicts have made the world susceptible to health emergencies. A glaring issue is a gap in how countries manage all-hazards, health emergencies and disaster risk (WHO Annual report 2018).
An emergency is defined as an uncommon situation in which people are not able to meet their basic survival needs, or there are severe and instant threats to human life and well-being. Emergencies can be classified into three broad categories: (i) rapid on-set emergencies which occur unexpectedly (e.g. wind storms, floods, wildfires, landslides, avalanches); (ii) slow-onset emergencies that escalate over a period of time (e.g. drought, proliferation of an agricultural pest or disease, progressively deteriorating political situation leading to conflict); and (iii) complex emergencies (FAO 1998). Mollica et al.,2004 pp2058 as cited in Ndunge, 2014 define a complex emergency as “a social catastrophe marked by the destruction of the affected population’s political, economic, sociocultural, and healthcare infrastructure.” Complex emergencies are the most severe kind of disaster due to their magnitude, their consequences, and the complicated response that is needed (Scholl and Shanks, 2001 as cited in Ndunge, 2014).
Given the above, the COVID-19 pandemic can, therefore, be defined as a complex emergency. During complex emergencies, it is commonplace to have the physical risk addressed first as the effects are most visible. This has also been the case with the COVID-19 pandemic, where the main focus of the interventions have been geared towards educating and ensuring that the general public are able to physically protect themselves from the disease. In the past decade, more efforts have been made to create awareness and draw attention to the psychosocial impact of complex emergencies on populations and how they can be managed (Cardozo et al., 2005).
The COVID-19 pandemic can have different effects on people. The people most affected are primary victims or survivors who have contracted the illness; emergency responders domiciled within disaster areas and who include healthcare workers, police, Red Cross, and other local emergency service experts; vicarious observers that include friends, relatives and others who know someone or have experienced the tragedy through mass media. Vicarious observers form the largest group. This makes it quite challenging to offer psychosocial support since interventions need to be customized to an individual’s needs (Psychological Effects of Emergencies, n.d.).
The impact of exposure to emergency events such as the COVID-19 pandemic on an individual’s emotional and social wellbeing or mental health can be mild or severe; short term or long-lasting. There is consistent evidence that between 5-40 percent of people involved in an emergency event are at risk of sustaining severe and protracted psychological injury (Johal et al., 2016).
During this period of the pandemic, people may experience complex emotional, spiritual, social and physical reactions. Some of the effects that individuals may experience include: difficulty with planning, decision making, setting priorities or anticipating their future needs. They may feel numb, shocked, disoriented, confused or uncertain about the future, or they may lose touch with their needs by the intense activity demanded by the situation (Johal et al., 2016).
In most cases, emotional reactions may be postponed or displaced onto seemingly unimportant things. People may also have significant difficulty in thinking and remembering. It is important to note that some of these negative psychological and social effects may require immediate attention and support, just as physical injuries do. In the weeks and months after the pandemic, it is expected that some people, may go through a wide range of emotions including distress, fear, grief, sadness, anger, uncertainty and insecurity about the future. In certain cases, reactions can be positive in nature, in that strong feelings of altruism, closeness and concern can develop (Johal et al., 2016).
In the longer term, people may experience a feeling of being overloaded or in a state of constant stress for many months. As a result, health may deteriorate, accidents increase, and relationships become tense. Often these problems develop slowly without those concerned noticing because of their preoccupation with more pressing needs. The family unit may experience considerable burden during this time as different members respond in their own way to recovery. Furthermore, the inequality of the effects of the pandemic may lead to community tensions, jealousy, rivalry and changes in friendship networks. Misunderstanding and confusion become common, together with doubt and skepticism about who and what can be trusted and accepted (Johal et al., 2016).
For some people, the impact of the pandemic will only emerge after a year or more. These effects can include economic hardship; poor health; mental health issues such as PTSD, depression, and anxiety; relationship problems; developmental, academic and behavioural problems in children; loss of leisure and recreation; loss of friendship networks; loss of a sense of direction in life; and continuing disturbing memories of the emergency. Pandemics challenge the resources and resilience of individuals and communities. Preexisting life situations, and stressors arising after the pandemic even where unrelated, may hinder people’s ability to recover.
In some cases, individuals may feel isolated from friends, family, and workmates as they may not comprehend some of the psychological reactions that they may be having. People who find their recovery taking longer than others may feel that their pre-existing networks are no longer a safe place to speak of their struggle. Instead of being supportive, some relationships may become a source of rejection and further loss. There can be considerable strain placed on families as a result of the range of emotions and reactions experienced after an emergency. Routines and lifestyles are often disrupted with the loss of family roles and responsibilities and this can have serious long-term consequences (Johal et al., 2016).
According to Johal et al. (2016), it is also possible that some people may have difficulty identifying and connecting with their emotional reactions, so care must be taken to ensure they are not unintentionally pressured into dealing with emotional needs before they are ready or able.
On the other hand, people who are well supported and able to plan and manage their recovery with a view to their whole situation, report gaining new or increased wisdom or understanding, positive shifts in priorities for their lifestyle and value system, and new or strengthened coping skills. It is our task as Institutions of Higher Learning to sensitize the public on the emotional and social effects of COVID-19 with a view to building a better nation and emerge more resilient after the pandemic (Johal et al., 2016).
In my next article, I will be tackling ideas on how organizations can support their staff to deal with the psychosocial impact of the COVID-19 pandemic.
1. Cardozo, B. L., Holtz, T. H., Kaiser, R., Gotway, C. A., Ghitis, F., Toomey, E., & Salama, P. (2005). The mental health of expatriate and Kosovar Albanian humanitarian aid workers. Disasters, 29(2), 152-170.
2. Ndunge. A (2014). Modelling the Health and Well-being of Humanitarian Aid Workers: Organisational and Individual Factors. Unpublished PhD thesis, University of Nottingham.
3. Johal, Sarb & Macdonald, Carol & Mounsey, Zoe. (2016). Framework for Psychosocial Support in Emergencies. Ministry of Health, New Zealand
4. Psychological Effects of Emergencies (n.d.). Retrieved March 30, 2020, from https://www.amnh.org/research/natural-science-collections-conservation/general-conservation/emergency-preparedness/emergency-response/psychological-effects-of-emergencies
5. WHO’s work in emergencies: prepare, prevent, detect and respond. 2018 Annual Report. Retrieved March 31, 2020, from https://www.who.int/emergencies/who-work-in-emergencies/en/
Article by Dr. Angela Ndunge, Deputy Executive Dean Strathmore University Business School.
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