The international alert due to the hantavirus outbreak detected on the MV Hondius cruise ship has once again placed the mental health and psychology in the spotlight of social debate. Just six years after the covid-19 pandemic, concepts such as quarantine, isolation or confinement have revived in many people memories, emotions and fears associated with one of the most difficult stages experienced in recent decades.
Although health authorities insist that the current scenario is not comparable to that of 2020, the possibility of new restrictions or outbreaks once again puts the issue on the table. psychological impact that generate uncertainty, collective fear and constant overexposure to information. Anxiety, stress or emotional fatigue are some of the consequences that psychology and mental health experts continue to observe years after covid.
In this context, specialists remember the importance of staying calm, obtaining information from reliable sources and taking special care of our emotional well-beingboth individually and collectively. To analyze how society could react to a new health crisis and what effects it would have on our mental health, we spoke with Ana White, psychologist and clinical neuropsychologist specialized in anxiety, emotional disturbances and behavior.
-Six years after covid-19, is society psychologically prepared to face another possible confinement?
Talking about whether we are ‘prepared’ can offer a nuanced look at the current situation. Unlike 2020, as a society that has experienced an event of such magnitude, I believe that we no longer start from naivety. Today we have a procedural and emotional memory of what confinement implies. From psychology, two opposing situations could be observed: on the one hand, a feeling of chronic fatigue. Six years later, many people’s alert systems have still not been completely deactivated, accumulating wear and tear and a lower tolerance for uncertainty. A new confinement would perhaps not be greeted with the ‘newness’ of Covid-19, but with an incubated fear of reactivity, depressive symptoms and possible isolation. Although on the other hand, we have great learning from resources such as the normalization of telecare in almost any area, the management of loneliness in digital environments and greater awareness about the importance of self-care. So, rather than being ‘prepared’ in terms of strength, we are warned.
-What immediate emotional effects reappear in the population when we talk about outbreaks, quarantines or isolations again?
Well, when we hear terms like “quarantine” or “isolation” I think everyone remembers it as a hard time. The brain does not process this memory in a purely logical way, but certain areas such as the amygdala are activated, which recovers the sensations of fear, confinement or even losses and grief, which can increase present alertness, hypervigilance towards certain physical changes or news, or even the appearance of flashbacks.
-Is there currently greater collective sensitivity towards health alerts or, on the contrary, a certain fatigue and disconnection?
We could be facing a somewhat paradoxical situation in which both processes could occur together, although we would also have to take into account the type of coping that each person had at that time. Since, on the one hand, any stimulus that right now evokes the beginning of another crisis, such as an official voice, a specific word, an image of hospitals, quickly triggers immediate responses of defense or flight. And we are not talking about empathic sensitization, but rather reactive. And, on the other hand, there is a clear habituation to risk. The human brain cannot maintain a state of red alert indefinitely, since by pure cognitive economy, the nervous system ends up “normalizing” the threat in order to continue functioning. This being the mechanism that in some way we all began to adopt when the de-escalation and return to the “new normal” began.
-How does the memory of confinement influence the perception of risk for diseases such as hantavirus?
The fact of having that memory could be acting as a filter or an availability bias that can distort how we currently evaluate another type of threat.
Sometimes the human brain calculates the probability of an event occurring based on the memory of an already experienced example with many similarities, and our infectious disease “file” is very accessible right now. When faced with a hantavirus alert, the brain does not analyze the technical differences. Instead, it automatically projects the image of empty streets and full hospitals. And of course, it’s easy to panic. On the other hand, when faced with events with certain shared similarities, we usually tend to anchor ourselves and focus on the consequence such as the confinement that each one experienced and not on the real probability of contagion of the current new virus. An almost instantaneous panic response is activated because the anchor (confinement) was an eventual situation that no one saw coming, it developed quickly and was completely unexpected, and that is the perfect breeding ground for generating a traumatic experience.
-What impact could a new confinement have on the mental health of children and adolescents, taking into account the consequences left by the pandemic?
Well, this is a complex issue, since to this day consequences continue to be observed in the early development that children and adolescents experienced during COVID-19. A new confinement would not simply be a “repetition” of the previous one, but would possibly act on an already fragile basis and could be interpreted as a crisis of helplessness or learned hopelessness. Many minors today continue to suffer from anxiety problems, depressive symptoms, eating disorders (ED) or difficulties in social skills that skyrocketed after the pandemic, and a new confinement could turn temporary problems into chronic pathologies. In the earliest stages, certain setbacks could be observed in milestones achieved, and in adolescents it is likely that situations of excessive isolation would be repeated, making the subsequent return to “real life” difficult, generating a certain apathy towards the future.
-How would the possibility of returning to mobility restrictions or quarantines affect personal and family relationships?
I think this could cover a multitude of scenarios. It is true that the phenomenon of reactive incubation that we talked about before could occur, and even have flashbacks of situations already experienced with a significant negative emotional charge. But now we also have learning from lived experience. By having those memories we can come to consider whether we would repeat and whether we would not, which gives us some advantage and much more room for maneuver than in 2020.
-What recommendations would you give to protect collective mental health in the face of a possible new pandemic?
I believe that one of the main lessons that the Covid-19 pandemic left us is that mental health cannot be addressed only when the problem appears, but rather it has to be part of preparation and primary prevention from the beginning. Perhaps to protect collective mental health, several things would have to be involved, including clear, coherent and real information to reduce fear and uncertainty, and taking special care of the most vulnerable groups, such as young people, the elderly and health professionals.