A look at the psychological burdens of COVID lockdowns

With the dramatic increase in infections in the United States, there are growing discussions about whether states should revert to severe social restrictions or even lockdowns, in which only essential workers are allowed. to leave their home. But many people are not happy with the idea of ​​getting into lockdowns because lockdowns come at both an economic and an emotional cost.

While we probably have a lot of hard data on the economic costs, some New Zealand researchers have decided to look at the emotional toll. They carried out a detailed investigation during the height of the lockdown and found that, as expected, the restrictions were having an impact on people trapped in their homes for weeks. But the impact was more pronounced on young people and on those who had already experienced psychological distress.

Lockdown NZ

Public health officials who advocate lockdowns in response to soaring infection rates recognize that lockdowns have an emotional impact on people who need to stay home. The tradeoff for this toll is to avoid death, serious illness, overloading health systems, etc. And lockouts are meant to be temporary; Once infection rates drop sufficiently, less draconian control measures (such as social distancing, limiting gatherings, and using masks) can keep infection rates low.

Understanding how to balance these costs and benefits requires some degree of quantification – we would like to know both how effective lockdowns are in limiting infections, as well as some idea of ​​their economic and emotional costs. It was the latter element, the psychological cost of lockdowns, that was the focus of a team of researchers at the University of Otago in New Zealand.

In some ways New Zealand is the perfect place for this kind of study. Its lockdown was severe: all non-essential schools and businesses were closed, and anyone not considered essential workers had to stay home for more than 30 days. This was the most restrictive approach adopted by any high income country. Even before the start of the COVID-19 pandemic, the country’s public health departments had regularly surveyed the population to get an idea of ​​their mental health, providing heaps of data for comparison.

The only limitation on New Zealand’s use was that its lockdown and travel restrictions were so effective that very few people in the country have found themselves with direct experience of the severity of the uncontrolled spread of SARS-CoV. -2.

The research team conducted a thorough investigation on days 19-23 of the lockdown, reaching a total of more than 2,000 residents. While these were not fully representative of the country’s demographics, there were enough of them for the researchers to adjust their responses to representative proportions.

Many of the questions were about the living situation – how many people shared the house, was there access to personal and outdoor space, etc. Beyond that, the questions largely used the same measures of mental health that had been used in previous surveys of the New Zealand population: the Kessler Scale of Psychological Distress, Generalized Anxiety Disorder Rating and the World Health Organization Well-Being Index.

Not happy

More than 80 percent of those polled described themselves as satisfied with their living conditions, and a similar number said their general health was good while in lockdown. Twenty per cent worked in jobs deemed essential and therefore left home regularly. About a quarter said they had a disease that put them at high risk if they contracted COVID-19. So based on these numbers, there doesn’t appear to be anything particularly unusual about the survey population.

Despite being satisfied with their living conditions, many interviewees were not particularly satisfied overall. About 30% scored above the threshold that would mark them as having at least moderate psychological distress. This was particularly pronounced among younger participants – just under half of 18-24 year olds reported this level of distress. When it comes to anxiety, just over 15% classified themselves as moderate to severe. As with distress, anxiety decreases as people get older. Just under 40 percent reported poor well-being at the WHO level (with only 9 percent falling in the excellent category).

In pre-pandemic surveys, only about 8 percent of the population reported distress, while only a quarter reported poor well-being based on the WHO scale. So it’s clear that the foreclosure conditions seemed to make things more difficult for people. About 20 percent of the population had a previous diagnosis of a mental health problem, but they only made up about 10 of the 30 percent who were in distress while in lockdown. About half of those who had already been diagnosed felt things had deteriorated during the pandemic, while only 15% felt things were better during the lockdown.

Six percent of the population had suicidal thoughts during the lockdown, which is not good. But over 80% of them had had similar thoughts before the lockdown started, so most of them may have involved the triggering of an underlying trend.

Always look at life on the bright side

Despite all of this, a surprising number of respondents saw bright spots in the lockdown. About 45% of respondents found positive aspects for themselves, while 38% felt that there were positive aspects for the company. Positive responses ranged from being able to spend more time with family to enjoying the reduction in noise and pollution resulting from fewer people leaving their homes. A number also liked to work from home.

So the data confirms what everyone suspects: lockouts come at a psychological cost. But beyond that, the data offers an abundance of potentially useful information. This includes identifying people who may be most at risk of having problems due to prolonged confinement: young adults and those with a history of mental health diagnoses. These people could be targeted by public health officials so as to minimize the impacts of the lockdown. The data also suggests that there are things people might find useful about the lockdown that could be highlighted in order to make people more aware of them.

With more mental health programs in place, it might be possible to minimize the emotional costs of lockdowns and shift the balance of benefits towards more aggressive control of the pandemic. And, given recent infection rates, many countries are at risk of a second lockdown in the near future.

PLOS ONE, 2020. DOI: 10.1371 / journal.pone.0241658 (About DOIs).