Recently, I posed some questions about a "return to normal" after COVID-10, see Changes in the Marketplace. There is potential for the world around us, and situations, to affect us emotionally and profoundly. This is also highlighted in some recent medical articles.
In May 2020, the International Journal of Mental Health Systems published Mental health and psychosocial well-being during the COVID-19 pandemic. The article refers to COVID-19 as "a truly formidable threat to humankind's existence." The upshot is that this pandemic is a "trauma" and that individuals may have "resulting . . . mental challenges." The authors warn that this infection could lead to "elevated levels of stress or anxiety," or even "an epidemic of mental illness."
The article stresses that what we see as preventative for COVID-19, such as social distancing and quarantine, may be causative factors for other maladies such as "depression, self-harm, harmful alcohol and drug use." There are also concerns expressed regarding the economic impacts on society and how various strata of society may react to those challenges. These are potentially additional stresses added to the primary impact of fearing or suffering from the virus itself.
The authors concede that the effect or impact "is only beginning to emerge," but challenge us to consider the potentials. They stress that these secondary impacts may come to light more slowly, warning of potential impacts in months or even years to come. They stress that it is important for us all to care for our mental well-being and to remain conscious of that. I have said the same, see Stress in the Time of COVID, March 2020. The authors of the paper conclude that the solution is more government money to further increase "mental health services." Seemingly the solution to everything always seems to be more government money.
I had that article on my mind when I happened across What Makes People Stop Caring, published by the British Broadcasting Corporation (BBC) in June. It is a must-read. This is similarly a psychology analysis, addressing how we individually and collectively react to tragedy such as death. It notes that as COVID-19 deaths then exceeded 400,000 and as a result, people may lose the ability to "really wrap . . . (our) head around such large numbers." It describes how a comparison may be seen as helpful, and notes that journalists describing the 100,000 deaths in the United States had begun comparing that to the number killed in the Vietnam War (or "police action" if you prefer).
The loss of American life in Vietnam was 58,220 according to the National Archives. According to CBS News, the American deaths in the Korean War (or "police action") were 54,260. So, we have now reached a COVID-19 milestone that exceeds the combination of these two conflicts (163,252 American COVID-19 deaths as of today).
For several years, I have been speaking and writing similarly about the volume of Opioid deaths in this country. I have also used the Vietnam war deaths as a comparison, see The Hot Seat, Opioids, Marijuana and More (2017) or Dying to me don't sound like all that much fun (2013). It is hard to believe that I have been on the overdose topic for a decade. Links to other posts are at the end of this one.
According to the Center for Disease Control (CDC), the following were the leading causes of death in the United States in 2017:
Heart disease: 647,457
Cancer: 599,108
Accidents (unintentional injuries): 169,936
Chronic lower respiratory diseases: 160,201
Stroke (cerebrovascular diseases): 146,383
Alzheimer’s disease: 121,404
Diabetes: 83,564
Influenza and pneumonia: 55,672
Nephritis, nephrotic syndrome, and nephrosis: 50,633
Intentional self-harm (suicide): 47,173
For some reason, the CDC does not include overdose deaths on this list, but does note the annual influenza figures. Despite many commenting publicly that COVID is "just a bad flu," may note that it is currently about 3 times the 2017 flu mortality rate and increasing daily. Will COVID-19 be put on this list, or will it also have a separate CDC website to segregate it from the overall statistics? Recently, there have been predictions that it could be third on the list for 2020.
However, on a different CDC webpage, it notes that in 2018 67,367 people died in the United States from drug overdose. If you are counting, that is also more than died in either Vietnam or Korea. It adds "Opioids were involved in 46,802 overdose deaths in 2018." So in fairness, the main list above should include overdose either right under Diabetes (total overdose) or just under "Intentional self-harm" (specific Opioid overdose). Why are these deaths not included on the overall list? Are we hiding drug abuse from ourselves?
The BBC article contends that we are unable to "comprehend the suffering" once these numbers get so large. With repeated reports of death, we are said to become numb or desensitized; "the more people die, the less we care." An expert cited in the article contends that we are best at empathizing with individuals, the focus is easier. An example is cited from a study that found we are most sympathetic when a person passes, and the sympathy changes even when there are two who pass. When the group grows, we become less attached, and our emotions less engaged.
Should we be sympathetic regarding each of the COVID-19 deaths? Absolutely. Should we be as sympathetic to each of the overdose deaths? Absolutely. Should we strive to understand the effects that any of our societal pressures have on issues such as drug use, "Intentional self-harm," overdose, and mental health generally? Absolutely. Society needs to remain concerned about the impacts that death and disaster have. But, we become numb and immunized against it. We strive to shut it out for our own protection, whether consciously or not.
There are emotional cohorts that may have a significant impact on both other individuals and society. Recognizing that this is possible should alert us all to the need we have to focus on our individual and personal well-being. We need to recognize the probability that we will become desensitized, and strive against that reaction. We recognize that death is traumatic and that avoidable death is only more so.
That is not true merely for COVID, or "Intentional self-harm," or overdose. That is true for death. It is also likely somewhat true even being hospitalized for COVID, or having a family member hospitalized will be traumatic; those are also traumatic. The challenges of child care, home-schooling, limited social interaction, and cancellation of our distractions are all traumatic. Can we change the trauma? Can we eliminate our collective sympathy bias in the face of large numbers? Can we recognize the effect of each little life effect on our individual mental state and coping ability?
I would suggest that what we can do is remain conscious of our personal emotional state. We can strive to control what we can, such as exercise, eating right, and resting during this time. We can remember that we never really know what those around us are going through. Remember, the person on the other end of that phone may have stresses, big or small, that we can never understand. They may be affected by stress in ways we would not be, which we perhaps cannot even imagine. We can remember that it is possible to disagree with one another without being disrespectful or dismissive. See Perspective and Respect.
Time will tell how COVID looks when compared in retrospect to these other challenges we face. We will all hope that when it is defeated the deaths will be far less than the 50 million who died from the 1918 influenza outbreak. And, hopefully, the experience will be a reminder that death is around us always, from many causes. Our ability to understand that and its effects on us may be a challenge, but it is around us. Whether we acknowledge it or somehow disavow it, it is there. The numbers are growing. For the sake of our own health and well-being, we must each take care or our own physical and mental health as we weather this pandemic.
Part of that may be caring for others. Part of that may be talking it out. And, it is possible that demand for therapy may remain increased for some time to come, even if it is in a remote fashion. It is time for us to be individually conscious of ourselves and our emotions, and to be carefully alert to those around us, in our phone conferences, in our hearings, and our other interactions. The warnings are there that COVID may impact us long after the SARS-CoV-2 becomes a memory. The impact or scars of it may challenge us for years. As we work through that, lets' remember the far larger population that has been killed by drugs as the figure mounts year after year.
Hey, got an Auto-Injector I could Use? (2014)
What Worthwhile Can You do in 11.2 Minutes (2015)
If Not, What is the Point? (2016)
Does Farr's Law Bring us Good News (2017)
PDMP and Opioids in Ohio (2017)
Like a Broken (Drug Death) Record (2017)
Opioids 2019 (2019)