Will PTSD Be a Legacy of COVID-19?

The obvious legacy of the COVID-19 pandemic will be millions of lost lives around the world. In the U.S., we’re now hearing that “only” 100,000 lives lost will amount to a big success. But beyond the acute trauma of lives lost, we must consider the possibility of post traumatic stress for all of us dealing with this calamity. A new study in JAMA Network Open tells us that the mental health effects will be great for healthcare workers. We can also expect tremendous stress on the mental health of the broader population as COVID-19 disrupts everyone’s life. Thus, PTSD may well be a legacy of COVID-19.

Healthcare Workers in Wuhan

Jianbo Lai et al studied mental health outcomes for healthcare workers treating patients with COVID-19 in China. They collected data from 1,257 workers in 34 hospitals during January and February. They found more depression, anxiety, distress, and insomnia in those who were providing frontline care. At the epicenter in Wuhan, the risk was 62 percent higher. The risk of insomnia was especially striking. Frontline workers were three times more likely to have it. Nurses and women also had higher risks than men and other professionals.

In an invited commentary on these findings, Roy Perlis tells us:

This COVID-19 survey itself represents part of a massive effort by the Chinese government to contain disease fallout and address mental health. Nevertheless, just as the world has joined efforts to manage COVID-19 infection, it will be critical not to neglect the mental health consequences of the fight against the epidemic.

Across the world, physicians, nurses, and other frontline health care workers do heroic and lifesaving work in stressful settings on a daily basis. However, the toll that providing such care takes must also be recognized: sooner or later, every clinician is also a patient.

PTSD comes to mind as we read stories about the impact of COVID-19 for healthcare workers in New York City, Italy, and Spain.

Stresses for the Entire Population

Roughly 248 million Americans are living under conditions of a lockdown. It’s not quite a quarantine. People get out a bit. You see lots of walkers. But we are confined and confinement has important mental health effects. Samantha Brooks et al recently published a review of studies on the mental health effects of quarantine. Post traumatic stress, confusion, and anger are common findings.

However, they found that some things can limit the harm:

In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.

Longer Term

Without a doubt, the lingering effects will be great. Some observers have suggested that the economic effects may rival the Great Depression. Of course, we cannot know if this will be true, because the outcome will depend upon how we respond. But it is clear that the mental health consequences will be great. Economic disruption will add to the stressors already upon us. PTSD may well be one of the legacies of COVID-19.

What we can do is to prepare to adapt, respond thoughtfully, support each other in our losses, and act on opportunities to build better lives. One day at a time.

Click here for the Lai study, here for the Perlis commentary, and here for the Brooks review. For perspective on the human toll of the Great Recession, click here. Finally for ideas on coping with stress and anxiety in these times, click here and here.

Living with PTSD, photograph by J.M. Eddins Jr. © Airman Magazine / flickr

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March 31, 2020