Dealing with the trauma of COVID

Death in a hospital, on an ICU bed and under effective medical care brings a level of mental satisfaction to family members, of having done their best to save a life.

I strongly believe that we are at a juncture in the nation’s history when all shoulders have to be put to the wheel if we wish to contain and defeat the raging pandemic.

Government functionaries are involved in ramping up capability and infrastructure to reduce morbidity and arrest the pandemic but there are other abstract aspects that appear as side effects to this terrible phenomenon; these too need to seize our minds.

Much of this relates to the sheer trauma that hits society when a pandemic of such proportion occurs. It is almost akin to conventional wars, especially long-drawn ones, which see largescale human losses majorly affecting the balance and psyche of families, the core of society. It is the survivors who live to feel the trauma of loss and of turbulence in society’s way of life.

When negativity strikes, rarely is trauma thought about as an outcome as authorities struggle to restore the situation. The effects on individual and collective human psyche can sometimes have a debilitating outcome on comprehensive security.

Not until I was researching a dissertation on ‘Non-Military Threats to National Security’ many years ago did I realise the effect a pandemic has on the economy, geopolitics and societal behaviour of nations. We do have the model of the Spanish Flu of 1918-20 to fall back upon.

The huge loss of life (50 million to 70 million worldwide) brought many to a chronic state of helplessness and anxiousness. Humans could lose their belongings, savings and material assets but could not bear the simultaneous loss of parents, children and siblings in large numbers.

Parents had to come to grips with losing a child while some children suddenly found themselves parentless. It is something we are witnessing this time too, with loss of both parents and relatives reluctant to take the children under their care.

We are in the second phase of the pandemic. Which way the curve goes and how far is yet uncertain. What is certain is that in societies of developing countries, focus or attention towards mental healthcare finds lower priority among the options of promoting wellness.

Death even in slightly larger numbers usually does not perturb humans, but two reasons involved there do. First, if the deaths are across a cross-section of society, by which citizens perceive that they could very well be victims themselves. Second, by the nature of the environment that is causing death. In the current pandemic, a couple of issues stand out.

The first is uncertainty revolving around having themselves or family and friends being afflicted by the virus without a medical facility to fall back upon. The macabre dance of death is accompanied by the rigmarole of looking for doctors, medical facilities, oxygen, ICU beds and more.

Death in a hospital, on an ICU bed and under effective medical care brings a level of mental satisfaction to family members, of having done their best to save a life. However, chronic shortage of hospital beds, oxygen and ICU facilities, an inevitability of any pandemic, leads to loss of lives in waiting lists; unable to find a suitable facility even while having the means to afford the best.

This latter factor is an additional element that adds to the weight of guilt. The poor and impoverished, probably used to such challenges of life, will be far less affected. It’s the middle class and the upper middle class that suddenly find themselves disempowered.

Their ability to win favour through their backing of resources finds itself diluted leading to self-perception of diminishing of social status. It is a major factor in the subsequent trauma.

A pandemic with a larger-than-known infectious element attached has its own fallout. A loved one may find a bed in an ICU far from home and remain cut off thereafter until he is well enough to return or simply be confined to the statistics of death.

His life remains in the hands of anonymous medical staff and the powerlessness to influence anything leaves people shattered. With people many times working far from home towns and villages and without any support base in strange cities with a different cultural milieu, the feeling of isolation and the anticipation of being subjected to an infectious disease has an even greater adverse effect.

Jobs need to be retained and getting to the security of home is not an easy option. It plays on the mind. The effect of infection travels even after death where decent last rites cannot be granted. In human existence, decent last rites are considered a virtual human right but when mortal remains are themselves infected and can lead to further spread, their anonymous disposal is cause for guilt among survivors.

In 1919-20, researchers in Britain were reporting marked rise in nervous symptoms and illnesses among some patients recovering from influenza infection; among other symptoms, depression, neuropathy, neurasthenia, meningitis, degenerative changes in nerve cells and a decline in visual acuity were cited. This is straight out of the reports of that time.

It is yet early to determine how serious the ongoing psychological effect on the population is. However, it is good for people to be aware of such a phenomenon and that there are enough good people already involved in tracking this, fully conscious of its existence.

Psycho-social care and counselling in distress and trauma-like situations is yet rare in India due to the stigmas attached to anything to do with the term ‘mental health’. This is something that we will need to overcome quickly through regular appearances of psychologists in electronic media and elsewhere.

The National Disaster Management Authority (NDMA) is one national institution that recognises the challenges in this sphere. It has already opened helplines for those in acute distress.

In cooperation with the National Institute of Mental Health and Neurosciences (NIMHANS), it is spreading the word and facilitating the states to focus as much on psychological healing of the survivors and connected families as on the victims of the scourge.

Early recognition of the effects of trauma on individual and collective psyche and the need to keep addressing this through NGOs and civil society organisations will ensure a far quicker recovery from the debilitating effects of the pandemic. They say there are two more waves to come; perhaps a psychological preparation of the public for the same would become inevitable. 

(The writer is former Commander, Srinagar-based 15 Corps and incumbent Chancellor, Central University of Kashmir. He can be reached at atahasnain@gmail.com)