The psychology of an epidemic

Five-year-old Biodun was spending Christmas and New Year with his grandmother in Ondo when both were taken ill. They got treatment, and Biodun returned to Abuja as soon he was okay. The grandmother still lay in hospital, and the doctors got a diagnosis: Lassa fever. “I am afraid my son is showing the same symptoms […]

Five-year-old Biodun was spending Christmas and New Year with his grandmother in Ondo when both were taken ill. They got treatment, and Biodun returned to Abuja as soon he was okay.

The grandmother still lay in hospital, and the doctors got a diagnosis: Lassa fever.

“I am afraid my son is showing the same symptoms as his grandmother,” Biodun’s father said then.

Epidemiologists from Nigeria Centre for Disease Control tracked down the grandmother in hospital. A state team from the FCT tracked down the grandson.

The family was in full-blown panic with Lassa fever when ‘the novel coronavirus’ hit news headlines.

Coronavirus has been a long time, but the strain in the current outbreak was different. It had no name, hence the ‘novel’ appellation. And it was emerging in humans for the first time. Nothing was known about it. But it is now officially called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

The number of confirmed coronavirus infections climbed to 82,171 by Thursday – more than 78,000 of them in China. The virus has popped up in 51 countries so far.

At least 2,800 people have died – 2,600 of them in China. The figures overshadow the reality that 33,130 people have gotten treatment and recovered.

Psychological ramifications

The virus isn’t just ravaging body, it is dealing mental blows to the mind.

“What this outbreak has done is make a lot of people powerless; feel like they have no control over their destiny, because they could be infected any time,” says Dr Ada Ikeako, a behavioural health specialist.

Fear, panic, anxiety, a sense of loneliness and frustration all feed into the psychology of an outbreak that looks set to become a pandemic.

Anxiety and suspicion work together, making people wary and question when, where and how the infection could get to them.

People with relatives in Wuhan, China, are anxious about the state of their loved ones. Health workers, afraid for the safety of their families, either spend their nights in hospital or avoid touching patients.

“There’s loneliness, isolation, fear, panic, paranoia, suspicion, hostility toward Asians – and if it’s not controlled, that will lead to people singling out people from that part of the world and discriminating against them. These are psychological impact of an epidemic,” says Ikeako.

“For people with pre-existing mental health challenges. It can exacerbate an acute episode of pre-existing condition. For those who have current medical illness, the stress of ‘what’s going on’ can also lead to an exacerbation of their current problem. There is a lot of psychological ramifications.”

The Nigeria Centre for Disease Control has issued advisories telling Nigerians what to do to prevent an infection.

But panic and fear make people who have symptoms reluctant to come forward for fear of stigma, says Ikeako. And people who are supposed to help provide aid to those who have the infection may not want to provide aid for fear of becoming infected.

Going astray

Every country has its own level of preparedness for an outbreak. But fear and panic drive people to act in ways that make an epidemic situation “more challenging to control,” says Adaobi Ezeokoli, chief editor at Nigeria Health.

“And this is where people who are not qualified to give advice or provide care begin to offer remedies,” says Dr Ifeanyi Nsofor, chief executive officer at EpiAfric and policy-and-advocacy advisor at Nigeria Health Watch.

“Fear on its own is a terrible mix during an outbreak.”

During the Ebola outbreak, the ‘salt solution’ cropped up to prevent infection, but claimed more casualties in Nigeria than the virus itself.

Now, it is coronavirus, and a pastor in Ghana is reported to offer ‘olive oil’ to his congregation so members can ward off the virus.

“Most of the time, fear could be based on misinformation, outright fake news, altering the news so people are misled,” says Nsofor.

Coronavirus now dominates newspapers, TV and radio news – and its constant mention also scares.

Measures to prevent and control infection rely on order and hierarchy that is easily torn down.

“The noise from panic during an epidemic outbreak can become expensive to quell and increases the workload of health professionals involved with preventing epidemics,” says Ezeokoli.

“Fear and panic come with an additional cost, by way of risk communication, so resources, which are in our context usually already scarce, get diverted to counter the spread of misinformation. This is an impediment to the work being done to prevent epidemics.

“The emergency that panic and fear drives is also likely to cause a drop in quality of healthcare service provision or delivery if not handled properly.”

“That’s why it is important to get your news from a reliable source,” says Ikeako.

“It is important to be very careful about the source of information you are giving about the spread of the virus, so it doesn’t feed into paranoia and panic.”

More than ever, social media amplifies the spread of noise about any outbreak. And it has spurred the growth of “fact-check” sites rushing to stamp out the fires of fake news.

“A more proactive and lasting way of dealing with this is people having access to health care. We need to take it down to primary health care. And a core component of primary health is health promotion – not prevention. And that’s putting out the information that people should know even before they get sick.

“It is just about 20% of Nigerians who have internet. So, no matter the factchecking you do on the internet, it gets to just a fraction of our population,” says Nsofor.

Biodun tested negative for Lassa fever. And his grandmother has been discharged from hospital.