Bakul Kumar

On Sunday 10^th May 2020, the Prime Minister will be announcing the government’s roadmap for lifting the lockdown¹.

COVID Pandemic has been catastrophic to the whole world, with United Kingdom leading in Europe with the highest death count.

It is worth understanding few terms before going on the media hype:

 Case Fatality Rate (CFR) is the most commonly discussed measure, which relies on the number of confirmed cases and on the total number of deaths, and with COVID-19, some people who are sick and will die soon have not yet died. It is calculated as follows:

Number of deaths from disease   x 100

——————————————                                     =   CASE FATALITY RATE (In %)

Number of diagnosed cases of disease

It is not the same as the risk of death for an infected person, as the media suggest that it is!

 Crude Death Rate or Crude Mortality Rate measures the probability that any individual in the population will die from the disease; not just those who are infected.

It is calculated as follows:

Number of deaths           x 100

—————————                                  =  CRUDE DEATH RATE

Total population

What the country wants to know is the Infection Fatality Rate.²

Number of deaths from the disease             x 100

—————————————————–                                = INFECTION FATALITY RATE

Total number of cases

What do all these data mean to an individual?

 Death

 This pandemic has resulted in a significant number of people becoming sick and many have lost their loved ones.

The losses experienced can affect men and women differently. Social and cultural patterns determine how they will react. For example, men tend to repress painful emotions, and expressing them is interpreted as a weakness. Their emotional response may be to drink heavily or become violent. Women tend to communicate with each other more easily, to express their fears, and to seek support and understanding for themselves and their children. Death of a loved one can imprint on the part of victim’s lives and will never be erased from their memories.

Sadness, suffering and grief occur expectedly following the death of one or several loved ones.

 Impact on Mental Health

 It is estimated that between one-third and one-half of the exposed population may suffer from some form of psycho-pathological manifestation.

The disturbances among survivors are:

• Depression
• Transitory stress reaction

Leading to

• Generalised fear
• Adjustment disorders, which manifest as emotional alterations affecting social life, difficulty accepting the changes brought about by the loss

Later on, some may develop post-traumatic stress as a delayed type of disorder.

What happens after lifting of the lockdown?

People will still have:

• Fear of a new epidemic
• Aggression and protests against authorities and institutions
• An increase in unemployment above 9% after the government support via the Job Retention Scheme ends³.
• If the recession is equal to that of 2008, the UK can expect an additional 500 000 working-age group people to develop mental health condition⁴.
• Social and mental health side effects like depression, pathological grieving, post traumatic stress, alcohol and drug abuse
• Continuing rise of domestic violence

How can the Mental Health Services, Public Health England (PHE) of the UK help?

• The PHE can initiate a good mass communication strategy to promote recovery
• Continuous in-service training for teams of recovery workers
• Mental health care for the Key Workers
• Individual and group mental health services for affected people, families and communities, as a medium term psychological recovery plan
• Discussion of experiences and lessons learned
• Community forums should be set up for mutual support expression, sharing, understanding and listening where the impact is social⁵.

According to Dr Kluge, WHO Regional Director⁶ “the issue facing each and every one of us is how manage and react to stressful situation unfolding so rapidly in our lives and communities. We can draw on the remarkable powers of strength and cooperation that we also fortunately possess as human.”

References

1. https://www.telegraph.co.uk/news/2020/05/06/revealed-boris-johnson-roadmap-ease-lockdown-reopen-schools/
2. https://ourworldindata.org/mortality-risk-covid?country=GBR
3. https://www.bbc.co.uk/news/business-52364811
4. https://www.thelancet.com/action/showPd?pii=S0140-6736%2820%2930895-3
5. http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/3/mental-health-and-psychological-resilience-during-the-covid-19-pandemic