The ongoing Covid-19 outbreak is in many ways unprecedented, in both the scale of this challenge, the scale of public health response, and the historical context in which all this is unfolding. Covid-19 is the first global pandemic of the social media age, the first of the “alternative facts” era, and is occurring at a moment when politics and society seem to be in a state of accelerated flux.
Yet for all that is new about Covid-19, the disease still behaves like any number of prior epidemics. It is, for example, similar to the 2003 severe acute respiratory syndrome (SARS) outbreak, an event which created a number of lessons for our present moment. SARS was, in many ways, the best-case scenario for responding to a global infectious threat. The spread of SARS was contained fairly quickly by public health efforts, chiefly through the widespread use of quarantine. But even this relative success still had consequences for health. In 2004, I worked with colleagues on a study of SARS control and the psychological effects of quarantine in Toronto, Canada. We found among quarantined persons a high prevalence of psychological distress, including symptoms of depression and posttraumatic stress disorder (PTSD). A key takeaway: Even if we can halt the physical spread of a disease through the expeditious use of quarantine and social distancing, we will still have to contend with its mental health effects in the long-term.
This is a message that is frequently forgotten. The mental health effects of Covid-19 can shape health for many years, long past the events that precipitated them. We have been focusing, correctly, on saving lives and mitigating the short-term consequences of Covid-19, but the long-term consequences may be equally, if not more, important. While it can be difficult to take the long view when the events of the moment are so compelling, it is necessary, if we are to ensure the steps we take now are in the best interest of public health once this pandemic passes and our task moves from one of response to one of recovery.
To envision how this long-term future may unfold, it helps to look to the past, and not just to past epidemics. Protests, riots, mass uprisings, and natural disasters can also teach us much about how large-scale, disruptive events can shape mental health. What do we know about the consequences of such events?
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