PJAHS • Volume 4 Issue 1 2020 • (doi:10.36413/pjahs.0401.

005)

Letter to the Editor

Mental health in the times of the pandemic
Alejandro Baroque1,2, Gabriel Alejandro Baroque2
1Faculty of Medicine and Surgery , University of Santo Tomas , Manila, Philippines; 2University of Santo Tomas Hospital, Manila Philippines

Correspondence should be addressed to: Alejandro Baroque1; acbaroque@mnl.ust.edu.ph

Article Received: June 30, 2020

Article Published: August 15, 2020 (online)
Copyright © 2020 Baroque et al. This is an open-access article distributed under the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

With over 18,439,731 cases and 697,083 dished out and readily believed by the
confirmed deaths reported to date, and still unsuspecting lay individuals, eroding one’s
counting, COVID-19 pandemic is by far seems to sense of control pushing the same in a fatal
be an evolving most significant health crisis of tailspin that eventually causing catatonic freeze.
the century afflicting not only the physical state, These unique challenges presented by living in a
but more importantly includes adverse pandemic understandably could potentially
consequences in the realm of mental health and unravel and/or exacerbate devastating
well-being. psychological distress and serious clinically
significant psychoses, depression, and anxiety, as
Literally and figuratively, coronavirus fever is
revealed in recent preliminary studies.
gripping the world that has greatly influenced
the trajectory and priorities of how we presently Vulnerable groups identified include those
live our lives. Enormous changes have been afflicted with pre-existing psychiatric diseases,
brought about by the many unfamiliar the OFWs, geriatric age-groups, pregnant
challenges’ consequent to this novel coronavirus women, street-dwellers, and students studying
pandemic, such as tremendous uncertainties as overseas from mainland China. In our local
to the duration of the pandemic and setting, obviously, due to the very nature of their
overwhelming worry of one’s own vulnerability work, the overseas contract workers, police, and
to this novel unseen formidable enemy, total military personnel operating the checkpoints,
rearrangements of activities of daily living, not to mention the health workers in the
severe economic over-burdening that stares at a frontlines, are those who are the most vulnerable
bleak future, and social isolation among other population. The risk for mental health
things. These situation, lingering with no disturbances is magnified several folds
optimistic quick fix in the horizon, wears down particularly for those who have confirmed Covid-
easily the psychological and mental defenses that 19 affliction across the spectrum – asymptomatic
pushes resiliency to a critical level favoring on one end, requiring at least just a mandatory
longer-term psychological maladjustments and home quarantine for a good 14 days, to those
even major clinically significant psychiatric who are critically ill for isolation in a COVID
illnesses. hospital ward or intensive care unit.
Additionally, and most disturbing of all, are the Limitation in social interaction brought about by
disgusting inaccuracies and even false isolation during a simple quarantine is one of the
information all together coming from even the significant stressors understandably causing
traditional sources of news and information, unimaginable boredom and annoyances. The

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 PJAHS • Volume 4 Issue 1 2020 • (doi:10.36413/pjahs.0401.005)

locally stranded individuals (LSI) caught in the Additional stressors following quarantine and
sudden city lockdown bore the greatest impact of isolation include: socioeconomic distress due to
this abrupt curtailment, what with the loss of unforeseen financial difficulties, unemployment,
liberty and literally forced to be isolated in an poverty, direct hospitalization costs, misplaced
unfamiliar government designated areas of rejection and discrimination by people, even by
questionable facilities for basic necessities ( food, family members and the pessimistic outlook of
water, clothing, medical care and supplies). Add ever resuming a “normal” life after.
up to this is the flagrant poor, if not outright
The WHO recognizes the same psychological
failure, in proper coordination among concerned
issues that burden the healthcare workers and
health and LGU officials resulting in an over
front liners. The pressure of knowing the hazards
extended period of quarantine due to various
of the job, working under threats of being
circumstances reflecting the government’s
afflicted as well, intensified with the spaceman-
ineptness in effectively handling the pandemic.
like suits one is required to wear and rigid
Excessive and unavoidable worry of potentially
procedures for personal protection and,
contracting the dreaded virus and the emergent
unfortunately, the valid fears of their family
guilt feelings of realistically transmitting the
members or even the community communicated
infection to others particularly the family
through avoidant behaviors…magnifies several
members will incite numbing fear and dread.
folds an already challenging situation.
Extremely difficult psychological challenges
To manage the identified stressors and enhance
indeed confront more those in severe and critical
resiliency in addressing COVID-19 infection
conditions necessitating ventilatory support and
adverse mental and psychological health
institution of isolation for containment of this
consequences, gather and rely on factual
highly infectious illness in the acute treatment
information only from credible sources for
phase. Rapid and drastic loss of respiratory
guidance and acknowledge the need to limit
functions requiring such patients to be put on a
undue worries by avoiding excessive exposure to
ventilator in the intensive care unit will
COVID-19 media coverages that are perceived to
exacerbate issues in loss of control. There would
cause excessive worrying. Strategies you have
be immediate and complete segregation from the
used to resolve successfully previous life’s
family, therefore, feeling of isolation, being alone,
challenges and adversities can be captured and
and intrusive self-pity and depressive thoughts,
readily implemented again to manage
particularly if the prospects of fatality are
dysfunctions during the outbreak challenging
making the stricken more acutely aware every
times. Most importantly, practice self-care,
tick of the second. Signs and symptoms of
maintain a healthy diet, and a positive lifestyle.
delirium that has been observed to predominate
This means not only adhering to grooming and
in the acute phase of coronavirus infections,
hygiene routines and maintaining a healthy diet
associated with anxiety, depression, and
and physical fitness routine, but also playing
insomnia are all driven by these psychosocial
video games, eating chocolate, making or
burdens (stigma, isolation, fear of death, and
listening to music, watching your favorite
disruption of social life). These neuropsychiatric
movies, and snuggling with stuffed animals.
outcomes are typical of many severely ill,
intensive care unit populations. Treatment- There are established psychiatric treatment
emergent psychotic manifestations due to strategies designed to mitigate acute distress and
steroid administration, most often part of the assess the need for continued mental healthcare
acute phase management to combat the very through compassionate and supportive presence
fatal cytokine storm associated with Covid-19, in a state of utter social isolation. This is
are becoming evident a problem as well and composed of well-trained psychiatric personnel
should pose an additional burden. After infection (psychiatrist and nurses) skillful in providing
resolution, neurocognitive symptoms and more- emergent and continuous pharmacologic and
typical psychiatric syndromes (mood, anxiety, non-pharmacologic interventions and
and PTSD) persist. psychosocial support to the severely afflicted and
survivors.

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 PJAHS • Volume 4 Issue 1 2020 • (doi:10.36413/pjahs.0401.005)

The COVID-19 pandemic is not a hoax. The

mental health consequences are as real in this
time of the pandemic.

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