The old saying, “Change is the only constant in life”, could not have been more relevant than it is today during the COVID-19 pandemic. The change society is witnessing across the globe has far wider ramifications than were ever visualised. The way of thinking, working, social behavior and conduct are being transformed across the globe, and India is no exception. The changes are impacting not only India’s socio-economic and political life, but also the psychological and mental wellbeing of its citizens.

In the absence of any effective known acquired immunity or preventive safeguard, such as the anti-SARS CONV-2 drug, the only available option for us to handle this pandemic is to keep individuals at a safe distance and prevent infection, a process that has come to be known as “social distancing”. This social distancing advisory has been defined by the Centre of Disease Control and Prevention (CDC), USA, and recommends that people should stay at least 6 feet apart from each other and should not gather in a group. The World Health Organization (WHO) also highlighted social distancing in their statement: “A mix of social distancing, testing and contact tracing and isolation will be crucial to curb the spread of corona virus already devastating much of the globe”.

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Clearly, social distancing is pivotal to the preventive measures advocated by various academic advisories and regulatory bodies and their experts. However, hidden cost behind this physical distancing also exists as already a majority of nations have been drawn into tremendous negative pressure on their economy due to the COVID-19-induced lockdown. Globally, a large number of people have lost jobs and livelihood, and are now suffering with a sense of deep uncertainty (as to how long the pandemic will last and its outcome), fear of getting infected with coronavirus, and sudden death of their family members and or themselves.

Over and above the economic turmoil, people now have signs of increased psychological distress and suffering. The COVID-18 pandemic is now posing a tremendous challenge to people’s mental health and wellbeing. The emerging crisis has triggered a wide variety of psychological problems, such as anxiety and depression. According to one study, nearly one-third of people surveyed had experienced varying degree of psychological distress due to pandemic.

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Even before the COVID-19 pandemic struck the world, rapid industrialization, pollution and fast pace of life were identified as the causes of widespread problem of mental illnesses, including loneliness. These illnesses were spread, just like an epidemic, across the globe, including India. The Lancet, a well-regarded medical Journal published from the UK, published a report titled, “The burden of mental disorders across the states in India: The Global Burden of Disease Study 1990-2017” released in February, 2020. The authors claim that nearly 197 million Indians were suffering from mental disorders, including 45.7 million reported to have depressive disorders, and 44.9 million suffering with anxiety disorders. Other nations reported a rise in similar mental disorders, and it is believed that today nearly 264 million of the world population suffers from depression.

The World Health Organization (WHO) has also warned that mental health problems will be the main cause of disability in the world in 2030. Now, people already suffering from mental health conditions are being adversely affected by the emotional responses elicited by COVID-19 pandemic. This is resulting in further deterioration of their existing mental health condition due to chronic stress, caused by economic and psychological turmoil. Besides, those people are not getting timely health services like therapy and medication because of disruption in health services across the country.

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The feeling of loneliness is another serious mental health issue, with a rising number of the global population becoming more isolated and lonelier. It is estimated that about 9% of the population of Japan, 22% of the population of the USA, and 23% of the UK population always or often feels lonely. Even in India, where the joint family structure is still widely intact, senior citizens are now increasingly left to live alone, and hardly any relatives or anyone close visits them. In this disintegrating society, the older generation rarely speak to their relatives on the phone and have no one to give them company or to have meaningful conversations with. The social distancing has sharply aggravated this old-age living.

Due to fear of being infected and getting others infected, the older generation is forced stay alone in their homes. The worst hit are those who were largely cared for by social and voluntary services. Clearly, the feeling of loneliness during the COVID-19 pandemic is expected to make this vulnerable population highly susceptible to mental disorders. Unfortunately, large per cent of people dying because of COVID-19 belong to the elder population, already suffering from other serious illnesses like diabetes, cancer and heart ailments. Moreover, government machinery, especially medical fraternity, is pre-occupied with COVID-19 cases and they have no time and resources to look after the people having mental illness and other ‘lonely’ elders. They are getting badly neglected.  

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Technology and social media have brought some relief but it is a double-edged weapon. For those who have access to technology and know how to use it, it can to some extent mitigate the impact of social distancing. As for the elder population, the adverse impact of social isolation can be negated by regular phone conversations and messaging by those who are perceived as close relatives. This group of people may be their siblings, children and grandchildren or friends, neighbours and caregivers. Having audio-visual communication through social platforms like Skype and Face Time, and being part of a joint interest group, can be useful in connecting an isolated group of people to the rest of the world. The emergence of virtual gatherings, parties and social events is a welcome move. It is desirable and recommended that the older generation should also engage in reading, dancing, yoga and pranayama, taking relaxing baths, and learning music and new skills.  Remember, no age is unsuitable for learning and gaining new experiences.

It’s a dilemma as elders are known to be most vulnerable to catch COVID-19 and thus must refrain from coming in contact with others; simultaneously, there is a need to assure them that they are not socially isolated. In a country like India, it is not easy for the government to provide a universal solution. However, it should be possible to develop “national guidelines for elderly and psychologically vulnerable people”, and ensure timely appropriation of resources and funds to safeguards against mental disorders/illnesses among this increasing population.

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No one exactly knows how long the COVID-9 pandemic will last in India or what will be its spread and rate of spread. It is too early to realise the aftermath of the pandemic as more efforts, like an antiviral vaccine or drug, are needed by experts. However, one thing appears definitive, that the government should enforce physical distancing and not “social distancing/ isolation”, especially for highly vulnerable section of the society. If a proactive approach is not brought to address the issue of mental health, a disaster is in waiting for the country. This could be the onset of a COVID-19 triggered economic devastation and a mental health crisis in the country.

(Balvinder Kumar is a retired IAS, author and a member of UP RERA. Views expressed are personal.) 

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