As the novel coronavirus, which causes the disease COVID-19, crept closer to the United States, many Americans ignored the news or dismissed the virus as only a bad flu. When it began spreading in the community, people at high-risk for health complications or poor outcomes from the virus took notice.
Most data suggests that the disease is most lethal among the elderly and those with pre-existing medical conditions. Early reports from Italy suggest that 99 percent of people who died of COVID-19 had pre-existing conditions. This indicates that statistics suggesting a 2 to 3 percent death rate may be misleading. Among young, healthy people, the mortality rate is likely lower, while people with pre-existing conditions may face a mortality rate as high as 10 percent.
If you’re at high risk for complications of COVID-19, it’s easy to feel anxious, overwhelmed, and powerless. Reassuring promises that it’s “only” the elderly and disabled who get sick may make you feel devalued and stigmatized. Here’s how to cope.
Am I High-Risk?
Most people who get very sick from COVID-19 have at least one other medical condition. Centers for Disease Control and Prevention (CDC) reports that these conditions may increase a person’s risk:
- Being obese, with a body mass index (BMI) of over 40.
- Being pregnant, though doctors continue to debate whether pregnancy increases the danger of COVID-19.
- Having a chronic respiratory or lung condition, such as asthma, COPD, or lung cancer.
- Living in a long-term care facility such as a nursing home, since the disease spreads more easily in close quarters.
- People with serious heart conditions such as congestive heart failure.
- People over the age of 65.
- People with medical conditions that weaken the immune system, such as diabetes, HIV/AIDS, or cancer.
- People taking immunosuppressant drugs. Transplant recipients and those with autoimmune disorders frequently take immunosuppresssants.
Because health care workers have a higher level of exposure and may not have adequate personal protective equipment (PPE), they may face a heightened risk of COVID-19.
Disability Discrimination and COVID-19
On social media and in the news, analysts and self-appointed experts frequently remind us all that COVID-19 almost always only targets the elderly and disabled. This represents a huge segment of the population, from children who have recovered from cancer to elder professors and politicians. People who belong to high-risk groups may feel devalued. COVID-19 may be intensifying the ableism and ageism many vulnerable people already face.
Mental Health Risk and COVID-19
COVID-19 doesn’t just affect physical health. Even among those who do not get the disease, the mental health consequences of the pandemic may prove catastrophic. A study of health care workers in Wuhan, China, the epicenter of the outbreak, found high rates of depression, insomnia, anxiety, and psychological distress. Witnessing people suffering can be a form of trauma, putting care providers such as health workers, first responders, and others at a high risk of mental health issues.
For people with pre-existing mental health issues, a family history of mental health diagnoses, or several other risk factors for mental health problems, the virus may erode emotional wellness. The pandemic presents several mental health risk factors, including:
- Increased isolation
- Uncertainty in the face of danger
- Scarcity and deprivation
- Financial peril
- Among those living with abusive people, increased exposure to violence and mistreatment
- Intense time constraints, especially among parents with young children who must now work from home without child care
- The pressure to homeschool children released from school
Anxiety about the virus as well as the unique home conditions it has left many families grappling with may cause a number of mental health maladies. So people at high risk of mental health struggles are also a high-risk population.
Managing the Mental Health Impact of COVID-19
Living through a global pandemic is inherently stressful. The United States has never faced such widespread lockdown conditions, and no one knows what will happen. It’s normal and reasonable to feel anxious—not a sign of bad coping skills or weakness. People should not beat themselves up for their reasonable reactions to an unreasonable situation.
Some strategies can make the stress feel bearable. Try the following:
- Put yourself on an information diet. If you are already doing all you can to stay safe, there is no need to constantly watch the news or read COVID-19 reports. A steady stream of bad and frightening news can make it impossible to relax.
- Reach out to others. Find new ways to connect across distance. Some people schedule video chats with loved ones or virtual cocktail hours with groups of friends.
- Take care of your body and mind. The self-care strategies that have worked for you before are even more important now.
- Find meaning in the crisis. Now is a good time to embrace a new hobby, to cultivate more self-sufficiency through gardening or cooking, or to learn a new skill if you’re temporarily out of work. Find an enjoyable way to pass the time.
- Help others. If you are able, find a way to help another person. Even just calling to check on a friend or messaging an acquaintance on social media may help you feel better.
- Ask for help when you need it. Many people want to assist those struggling the most with the virus. They can’t help you if they don’t know you’re struggling. Reach out to a sympathetic family member. Tell friends how ableist or ageist language makes you feel.
- Set reasonable expectations. It is simply not possible to work full-time, be an exceptional homeschooling teacher, keep an immaculate house, never get angry at your spouse, and remain calm for the duration of the virus. Don’t demand perfection. Instead, try setting just one or two attainable goals each day.
Therapy can be immensely helpful. Social distancing does not have to mean ignoring your mental health or quitting therapy. Many therapists are now offering telehealth options. Some apps even offer coronavirus-specific resources. For help finding a therapist who can support you to navigate this challenging moment, click here.
A Telehealth Solution for Mental Health Professionals
As therapists and other mental health professionals navigate life right now, we know and understand how current events may be impacting your professional commitments to the patients you care for, your own family, and your personal well-being. We want to help you maintain as much normalcy as possible during the next few weeks. If you’re ready to pick up sessions right where you left off, we’re so excited to share that we’re officially offering our members (on select plans*) free telehealth. We hope this closes the gap and eases social distancing for you and your patients. Learn more and get started here.
*Included at no cost for Annual and Annual Billed Monthly membership plans. Monthly members have access at no charge for 90 days then will billed $9.99/month after the trial period ends.
- Ebhardt, T., Remondini, C., & Bertacche, M. (2020, March 18). 99% of those who died from virus had other illness, Italy says. Retrieved from https://www.bloomberg.com/news/articles/2020-03-18/99-of-those-who-died-from-virus-had-other-illness-italy-says
- Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., … Hu, S. (2020, March 23). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Network Open, 3(3). Retrieved from https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2763229
- People who are at higher risk for severe illness. (2020, March 26). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/people-at-higher-risk.html
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