A pandemic
occurs when a disease spreads across large populations across countries, races
and continents. When COVID occurred in one person it was an infectious viral
disease. But when it transformed into a pandemic it has become a behavioral
problem- the cause of the body damage in individuals is the virus but the cause
of spread is the people’s behavior.
CULTURAL
FACTORS
India has
been a crowded country for ages. And we have practiced social distancing in the
form of ‘UNTOUCHABILITY’. I am absolutely against untouchability and regard it as
a blot on our culture- but the point is- it can be done. So also the hygiene
measures- we have myriad of purity rituals. And the mask use- we have imposed
the purda system on women for centuries. So overcrowding and poor resources is a
difficult but not impossible problem to solve. According to me the real problem
is a lack of understanding. People have not been able to understand the nature
of the problem and hence their response is lacking.
In general,
we are a culture with a poor habit of reading. And the illiterate folks have a major
disadvantage on that front. With literate people, the information that gets
attention should be to be religious or have some ability to elicit shock or amazement.
A disease that can be controlled by simple measures of behavioral change- no
that information is not likely to be consumed or believed. The only way to
overcome this issue is to involve community leaders and repeat the information.
POOR
COMPREHENSION
Among
seniors, my personal experience is that due to ageing factors- there is
considerable impairment of judgment. So even now, when I got out, I see a very
large number of seniors- some even unable to walk- out in the open. Their
masks are barely there. Upon enquiring if they had to go out due to being
alone- most said they were out due to boredom and also a feeling that they did
not need to fear death. Is this silent suicide? But its definitely a form of
poor comprehension.
Younger folks
with anti social traits, hyperkinetic nature and intellectual challenges also
find it difficult to follow precautions. These are the cases of the infamous ‘corona
parties’ in the US. Youngsters who don’t feel the empathy for seniors and do
not take precautions like wearing mask- citing flimsy reasons like inability to
exercise outdoors wearing a mask. The complex comprehension of risk vis a vis
individual rights is missing here.
IMPAIRED
JUDGMENT
I would say the key element of dysfunctional
behavior is an impaired judgment. Many folks with absolutely zero symptoms of
mental illness can have a poor judgment. I see impaired judgment more in the
community than in my clinic. Especially folks who are highly qualified or have
a good financial or social status are prone to believe that they have nothing
to fear from anything that is essentially killing the poor and those who are in
contact with them. They are happy with banning domestic workers from their
premises and then they don’t believe in following any precautions. . It is
harder to modify their behaviors because they are up to date with google
research and alternative medical philosophies- plus have a tendency to take
offence easily. The problem is- that the virus is highly opportunistic and any small
slip-up can lead to infections.
MENTAL
ILLNESS
The
pandemic also increased the stress levels in all.
People who had some vulnerability in the form of prior mental illness or a
genetic pre disposition- they did develop the symptoms of mental illness. This
would not have happened without the pandemic situation- not definitely in such
large numbers in such a short period of time. So this is another the dimension
of the behavioral impact. But unless the person is in a manic episode- where
the person leaves caution to the wind- most people with mental illness will be
socially withdrawn and the infection part of the pandemic reduced. Manic
episodes are extremely rare. So mentally ill people did not contribute to the
pandemic at all.
CONCLUSION
In
countries where people were able to practice sustained behavioral change, they
were able to control the pandemic earlier and more robustly. But where the people’s
judgment was impaired due to various reasons- they didn’t practice healthful
behaviors and the virus has moved in for the kill. Just as the infection is
spread by the asymptomatic and the pre- symptomatic virus carriers- it is amply
aided by those mentally impaired people who don’t have features of mental
illness- but whose judgement is clearly impaired. Thus covid is an infectious
disease but covid pandemic is a mental health issue.
No comments:
Post a Comment