Pandemic Fatigue: the exhaustion of living with Covid-19

With the advent of the Covid-19 pandemic, the World Health Organization and the European Union have emphasized the importance of attention to psychological, social and communication issues for an effective fight against Covid-19.

Thus it was created the document “Pandemic fatigue – reinvigorating the public to prevent Covid-19”, commissioned by the member states of the European Union, which suggests some strategies for maintaining and renewing public support for anti-Covid-19 safety regulations.

What does this project consist of? What is the experience of the San Raffaele University regarding the “pandemic fatigue”? We are answered by Prof. Andrea Fossati, Professor of Psychometrics and Dean of the UniSR Faculty of Psychology, and by Dr. Antonella Somma, Researcher in UniSR Psychometry.

The "Pandemic fatigue” document

With the action “Pandemic fatigue – reinvigorating the public to prevent Covid-19”, WHO and EU address the issue of prostration linked to both the difficulty of people living their lives in the presence of the Covid-19 pandemic, both the weight that the containment measures of the pandemic in place have on people’s lives.

Above all, it represents a great impetus to psychological studies to establish whether we can use a passe-partout term as “pandemic fatigue” or if we have to differentiate the different scenarios that can flow into a general loss of interest and energy of people in participating. actively opposing Covid-19 for the implementation of more incisive and less costly containment policies in terms of psychological well-being, also thinking about possible future scenarios.

It is an impact that takes place on all the people involved, the outcomes of which depend on numerous political, social and individual factors. Recognizing the impact that living with a pandemic and its consequences has on the behavior and psychological well-being of people, with particular reference to EU citizens, and recognizing the need for an exchange of knowledge between different countries for the development of measures of sustainable contrast, the action represents not only a change of pace in the WHO/EU policies to fight the pandemic in progress, but also a paradigm shift, underlining the importance of the psychological (and communicative) aspects in the management of a pandemic.

Risk addiction

To the awareness of the impact of the measures to fight the Covid-19 pandemic on psychological well-being, the WHO/EU action seems to add the knowledge that the “new normality” is neither normal nor new, at least based on widespread reactions.

What seems to emerge is the tendency of people to become accustomed to risk if this persists over time, a phenomenon known since the experiences of the civilian and military populations involved in the conflicts of the 1900s.

It is certainly not our intention to compare a theater of war with its atrocities to a pandemic phenomenon: it is just an example to make us understand how addiction to danger is a phenomenon known for some time and how this addiction leads to neglect its nefarious results.

A shared “fatigue” even outside EU

In this regard, a first desirable outcome of the WHO/EU action will consist in avoiding to merge the term fatigue with different phenomena, with different origins, of which prostration can represent the outcome, not the nature.

Since the first months of 2020, works by the Chinese scientific community [1, 2] appeared in the Lancet which reported how the pandemic containment measures adopted in China, effective in terms of contrasting the spread of COVID-19, had a significant impact in terms of anxious and depressive conditions on people [3, 4], particularly in adolescence (where post-traumatic phenomena were not rare).

The data referable to Western populations largely confirmed the first communications relating to the impact of containment measures, despite the marked difference between the strategies adopted in Europe and those adopted in China (as well as in the variability of the measures between different European countries).

San Raffaele University surveys

For example, our first online survey of over 1200 Italian participants before the lockdown measures in March 2020 indicated a possible prevalence of internalizing problems (anxiety, depression, stress, etc.) in less than 15% of the participants.

Our second survey [5] of around 300 online participants who had agreed to be followed throughout the lockdown provided a different picture: around 43% of the participants indicated that they had internalizing symptoms (anxiety, depression and/or acute stress) of clinical significance at the start of the lockdown, which was reduced to approximately 32% at the end of the lockdown.

It is easy to understand how these aspects had begun to produce a reflection in the scientific community of psychology (and not only): if anxiety leads to avoiding danger – therefore to adopt protective behaviors – the depressive aspects cause one to lose confidence both in one’s ability to address the difficulties, both in the proposed measures. To this must be added the concerns for the economic and working situation that many people had (and have) linked to the containment measures.

San Raffaele University for the protection of students and health professionals

Awareness of the impact of lockdown measures on people’s psychological well-being has been a central element in promoting our Faculty a series of actions related to the protection of both our students (for example, actions on the quality of sleep) and health workers involved in fighting against Covid-19, not to mention the activities in support of patients and their families and the important scientific activities related to Covid-19.

It was also one of the reasons that led us, for the most part, to prefer online lessons, to make our students feel our presence and that of the whole University and to preserve the class-groups in their function of mutual peer-aid.

Bibliography

[1] Lee, J. (2020). Mental health effects of school closures during COVID-19. The Lancet Child & Adolescent Health, 4(6), 421. DOI: https://doi.org/10.1016/S2352-4642(20)30109-7

[2] Wang, G., Zhang, Y., Zhao, J., Zhang, J., & Jiang, F. (2020). Mitigate the effects of home confinement on children during the COVID-19 outbreak. The Lancet, 395(10228), 945-947. DOI: https://doi.org/10.1016/S0140-6736(20)30547-X

[3] Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020a). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. International Journal of Environmental Research and Public Health, 17(5), 1729. DOI: 10.3390/ijerph17051729

[4] Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R. S., ... & Ho, C. (2020b). A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, Behavior, and Immunity. Advanced online publication. DOI: https://doi.org/10.1016/j.bbi.2020.04.028

[5] Somma, A., Krueger, R. F., Markon, K. E., Gialdi, G., Colanino, M., Ferlito, D., Liotta, C., Frau, C., & Fossati, A. (2020b). A longitudinal study on clinically relevant self-reported depression, anxiety and acute stress features among Italian community-dwelling adults during the COVID-19 related lockdown: Evidence of a predictive role for baseline dysfunctional personality dimensions. Manuscript under review.