The Trauma of COVID-19

The Trauma of COVID-19

Written by
May 20, 2020

As Elyssa Barbash, Ph.D., wrote in a recent article in Psychology Today, “much has been said about […] the all-consuming anxiety, panic, and fear that many are experiencing” in the coronavirus pandemic. In her view, something which “has not been discussed” is how “this pandemic is no doubt a psychological trauma crisis”.

What exactly is trauma? Trauma is often associated with something violent. However, as Dutch philosopher Ciano Aydin explains, a situation is traumatic when it “violates familiar expectations about someone’s life and world, sending them into a state of ‘extreme confusion and uncertainty’”. Traumatic events are not necessarily violent. For Barbash, a trauma specialist, “it is exceedingly clear […] just how traumatic this situation is for nearly every single person in the world”. People who experience trauma may react with “intense fear, horror, numbness, or helplessness”.

Tucker Higgins, writing for CNBC, starts to summarise the destruction of the coronavirus: it “has left millions without jobs, sent billions into isolation and forced nearly everyone on earth to grapple with the feeling that they or those they love are suddenly physically vulnerable”. It is for these reasons that Yuval Neria, the director of trauma and post-traumatic stress disorder at the New York State Psychiatric Institute, claims that “the scale of this outbreak as a traumatic event is almost beyond comprehension”. He goes as far as to state that “not even the Sept. 11, 2002 terrorist attacks or WW2 were adequate comparisons” as “the anxiety those events caused was at least limited by geography”.

The Trauma of Healthcare Workers

Many are concerned that healthcare workers will be the most traumatised. Jillian Mock wrote for Scientific American that not only is their emotional burden with such tasks as “facilitat[ing] final phone calls between the dying and their loved ones who are barred from entry”, but “more than any other group, they are in danger of getting sick from the constant exposure […] hundreds of clinicians have died worldwide”. The psychological burden is made worse by their risk of “moral injury”. Moral injury occurs when “a person does something that goes against his or her deeply held moral beliefs”. The coronavirus pandemic has created ethical dilemmas which may cause moral injury to health care workers. Clinicians are presented with them in certain scenarios, like when “there are not enough ventilators for the number of COVID-19 patients who need them”. Barbash notes they are “the people who go into work day in and day out and are faced with making life-or-death decisions about the patients whom they care for”.

Jessica Gold, a psychiatrist at the Washington University School of Medicine in St. Louis, suggests that “health care workers as a group could develop high rates of anxiety, depression, substance use issues, acute stress and, eventually, post-traumatic stress as a result of what they are experiencing on the pandemic front lines.” She also notes that “data from other pandemic, while limited, support these concerns”:

  • 89% of workers at high risk of contracting SARS during the 2003 outbreak reported negative psychological effects

Furthermore, one survey of 1,257 physicians and nurses during the height of the COVID-19 pandemic in China found that

  • 50 percent of respondents reported symptoms of depression
  • 44 percent reported symptoms of anxiety
  • 34 percent reported insomnia.

Gold also notes their psychological burden is exacerbated by how health care workers “are typically unlikely to seek help, lacking the time or flexibility to go see a therapist during a standard nine-to-five workday”. As Mock writes, “the hero worship of health care workers only goes so far to protect them from mental anguish”.

Some suggest that the hypervigilance and immense anxiety which seem to characterise life under coronavirus may also traumatise health care workers. Indeed, psychiatrist Karen Williams, who specialises in post-traumatic stress disorder, found in a recent survey of 245 Australia health workers that the country’s “medical workforce is being traumatised by the limited access to protective equipment in the fight against coronavirus”. To be specific:

  • “61% of doctors felt pressure from other staff not to wear a mask, and more than half felt guilt or shame for wearing one”
  • “86% reported feeling anxious about the level of PPE provided to them during the pandemic”
  • “83% did not trust that Australian guidelines were adequate”

This is a psychological issue. Although “eleven million new masks have been promised to hospitals by Health Minister Greg Hunt”, Dr. Williams said it was hospital culture that needed to change.

Israeli-born psychologist Guy Winch argues that trauma is the real threat of the coronavirus crisis. It is surely difficult, and apparently useless, to compare the trauma of the coronavirus pandemic with its physical effects. But we would be remiss to overlook the mental scars of this crisis, in our preoccupation with those more obvious physical wounds. And they may be more lasting.