CoronaPhobia & Mental Health

13 min readJan 3, 2021

We’re all in the same storm but not in the same boat

COVID Survival Rates: https://drjarryd.medium.com/race-covid19-survival-rates-f0ef563850

5 Ways to be More Introverted: https://drjarryd.medium.com/5-ways-to-be-more-introverted-so-we-can-defeat-covid19-sooner-21bb39fb6c6d

Nasal Resistance: https://drjarryd.medium.com/race-nasal-resistance-to-covid-a-gamergirl-story-23cf6d7b087f

Racist Neighbors: https://drjarryd.medium.com/racist-neighbors-vs-quarantine-fatigue-a-response-to-gamergirl-4ced6000ff90

Contraception & COVID: https://drjarryd.medium.com/19-reasons-why-covid19-contraception-8b344132246c

Table of Contents (click to Fast Travel)

· Viral Inoculum / Infective Deposited Dose

· Social Distancing (14 studies)

· Mental Health (Coronaphobia)
∘ China
∘ Columbia
∘ India
∘ Italy
∘ Middle East
∘ Norway
∘ Philippines
∘ Turkey
∘ United Kingdom
∘ United States
∘ Religion
∘ Sex Differences

· Japan
· South Korea

· Iatrogenic Effects of Testing Introverts

· Civic Capital & Political Social Identity
· Infection Growth Rate & Political Social Identity

→ Counseling and Psychological Services (CAPS — UCSD)
→The Trevor Project
-→ National Suicide Prevention Hotline

Quaranteen 15 vs. Freshman 15

Groundbreaking research suggests that quarantine negatively affected the physical health of university students (Son et al., 2020). Quarantine increased academic stress in a population that was already stressed out (Grubic et al., 2020). The long-term behavioral changes of quarantine may have long-term psychological consequences (Serafini et al., 2020).

a reduction in infection growth rate on a specific day was best accounted for by the degree to which people in a county were physically distancing between 17 and 23 days earlier. (Gollwitzer et al., 2020)

Allcott et al., 2020 → “..significant gaps at the individual level between Republicans and Democrats in self-reported social distancing”

Simonov et al., 2020 → “..a 10% increase in Fox News cable viewership (approximately 0.13 higher viewer rating points) leads to a 1.3 percentage point reduction in the propensity to stay at home.”

Romantic Adherence → people worried about infecting their bae are more likely to adhere to social distancing (Ebrahimi et al., 2020).

Viral Inoculum / Infective Deposited Dose

Bielecki et al., 2020 → Social distancing can “prevent the outbreak of COVID-19 while still inducing an immune response and colonizing nasal passages. Viral inoculum during infection or mode of transmission may be a key factor determining the clinical course of COVID-19.

Chen et al., 2020 → “Linking social distancing behavior with an epidemic model, we estimate that reductions in movement have causally reduced SARS-CoV-2 transmission rates by 49%.”

Gandhi et al., 2020 → Masks reduce the inoculum or deposited infective dose of #COVID for the mask-wearer, leading to more mild & asymptomatic infection manifestations.

Guallar et al., 2020 → Among infected individuals who #WearAMask, they had less severe symptoms as face masks reduced the COVID-19 severity by decreasing the infective dose to which the infected individuals were exposed.

Wang et al., 2020 → “Universal masking at MGB was associated with a significantly lower rate of SARS-CoV-2 positivity among healthcare workers.”

Yang et al., 2020; Goolsbee & Syverson, 2020; Chetty et al., 2020

Voluntary social distancing quantitatively matters (dramatically reducing mobility) and needs to be explicitly modeled because official state lockdown policies (mandated distancing) cannot fully explain the reduction in mobility.

Social Distancing (14 studies)

SIPO = Shelter in Place Order

Abouk & Heydari, 2020 on how Stay at Home orders led to a >600% increase in staying home → “We show that statewide stay-at-home orders had the strongest causal impact on reducing social interactions. Other policies such as school closure mandates, large gathering bans, and more limited stay-at-home orders do not show any significant impact on keeping people at home.”

Brouard et al., 2020 → Conscientiousness was positively associated with adherence to social distancing. Extraversion & Neuroticism were negatively associated with adherence to health behavior recommendations.

Chernozhukov et al., 2020 → “both policies and information on transmission risks are important determinants of Covid-19 cases and deaths and shows that a change in policies explains a large fraction of observed changes in social distancing behavior.”

Courtemanche et al., 2020 → “Adoption of government-imposed social distancing measures reduced the daily growth rate of confirmed COVID-19 cases…”

Dave et al., 2020 → “approximately three weeks following the adoption of a SIPO, cumulative COVID-19 cases fell by 44%”

Devaraj & Patel, 2020 → ”daily COVID-19 incidence case growth rate is 1.994 percentage points lower for counties in SIPO states relative to those bordering in non-SIPO states”

Ebrahimi et al. (2020) → there was more social distancing adherence among women, among people worried about infecting their lovers (romantic adherence), unemployed people & people who reported low difficulty working from home, greater access to information, people who engage in voluntary distancing, altruistic people, & older people.

Interestingly, the authors stated that “suspecting oneself to be infected by the coronavirus was unrelated to adherence”

Flaxman et al., 2020 → Europe’s #SocialDistancing played a significant role in containing the first wave of the COVID-19 outbreak

Friedson et al., 2020 on California → “California’s statewide SIPO reduced COVID-19 cases by 125.5 to 219.7 per 100,000 population by April 20, one month following the order. We further find that California’s SIPO led to as many as 1,661 fewer COVID-19 deaths during this period.”

Jinjarak et al., 2020 → “Our results suggest that policy interventions are effective at slowing the geometric pattern of mortality growth, reducing the peak mortality, and shortening the duration to the first peak.”

Kraemer et al., 2020 → social distancing played a significant role in containing the first wave of the COVID-19 outbreak in China

Lyu & Webby → Shelter in Place = “SIPOs reduced the daily mortality growth rate after nearly three weeks from enactment, and the daily growth rate of hospitalizations two weeks after enactment”

Yehya et al., 2020 → “Delays in statewide emergency declarations and school closure were associated with higher Covid-19 mortality. Each day of delay increased mortality risk 5 to 6%.”

Schmeisser et al., 2020 → “Our findings indicated that the higher 607 individuals score on Neuroticism or Openness, the less trust they put into the Public Health Agency, which is accompanied by less compliance with the containment recommendations. On the other hand, the higher individuals scored on Agreeableness, the more trust they put into the government which is associated with more compliance.”

Mental Health

Current & forthcoming research on the mental health outcomes of the COVID19 pandemic reveals that the higher individuals’ perceived risk of getting COVID-19, the greater their stress (Limcaoco et al., 2020 [25 countries]; Salari et al., 2020 [meta-analysis]). Clinical psychologists & other health professionals have referred to this as Coronaphobia.

China

Higher scores of depression were reported among healthcare workers in as a function of their perceived susceptibility to contracting COVID-19 (Lam et al., 2020), higher psychological distress among young Chinese adults (Qiu et al., 2020), and higher anxiety among residents of Hong Kong (Kwok et al., 2020);

Columbia

COVID susceptibility predicted higher stress (Campo-Arias et al., 2020; Pedrozo-Pupo et al., 2020);

India

About 80% of participants reported heightened anxiety, distress related to social media discussions of COVID, & difficulty sleeping (Roy et al., 2020);

Italy

Perceived infection risk predicted higher anxiety (di Fronso et al., 2020);

Middle East

Perceived susceptibility was associated with Saudi Arabian students’ self-reported stress (Al Ateeq et al., 2020), Iranian medical doctors’ heightened stress was positively associated with their age (Abdulah & Mohammed, 2020), which is consistent with higher risk of developing severe-COVID & dying among older adults (Centers for Disease Control and Prevention, 2020);

Norway

Social distancing & quarantine were associated with a 2x-3x increase in the prevalence of Norwegians presenting with depression & anxiety (Ebrahimi et al., 2020);

Philippines

Teachers’ / educators’ perceived vulnerability was associated with higher stress, and moderate stress was reported by more than half of all teachers (Oducado et al., 2021), and disaggregated data among Filipino adults revealed that older males and those with pre-existing conditions had higher chances of severe COVID19 & fatality (Garcia et al., 2020).

Turkey

Perceived susceptibility was associated with higher death distress among Turkish adults (Yildrim & Guler, 2021), & among Turkish students’ self-reported rumination & anxiety (Arslan et al., 2020);

United Kingdom

Over a third of Britons have reported experiencing loneliness, depression, anxiety, & somatic disorders (Li & Wang, 2020);

United States

Adults’ reported significant increases in loneliness during the pandemic compared to before, & this was positively associated with suicidal ideation & depression (Killgore et al., 2020);

Religion

Lee et al., 2020 → COVID anxiety is associated with negative religious coping , in addition to hopelessness, suicidal ideation, and coping with alcohol & other substances.

Sex Differences

Women have generally reported higher COVID related stress than men across continents (AlAteeq et al., 2020; Younas et al., 2020; Limcaoco et al., 2020).

Japan

In October, suicides among women in Japan increased almost 83% compared to the same month the previous year. For comparison, male suicides rose 22%

In Japan, more people died from suicide last month than from Covid in all of 2020

More people died from suicide in Japan in October than succumbed to Covid-19 all year. And more women are taking their…

www.cnn.com

South Korea

Suicide → There has been a 40%+ increase in suicides by South Korean women in their 20s, though the rate for South Korean men had been decreasing in 2020.

Self-Harm → There was a 36% increase in the number of people in South Korea who engaged in self-harm themselves in the first half of 2020.

“In the first 6 months of COVID, Seoul women in their 20s attempted suicide nearly 5x more frequently than any other demographic.

South Korea is a very homogenous nation, and there is a very clear and very high standard for beauty among young women. And when they do not measure up to that standard, they get depressed.”

Japan and South Korea see surge of suicides among young women, raising new questions about pandemic…

TOKYO — Suicide rates among young women have increased notably in Japan and South Korea, raising possible links to the…

www.washingtonpost.com

“South Korea has the highest suicide rate among Organization for Economic Co-operation and Development (OECD) countries, about 2.4 times higher than the average suicide rate of other OECD countries. However, despite the high suicide rate, the prevalence of depression in South Korea has been reported to be much lower than in other countries” (Kim et al., 2020).

Image via https://www.telegraph.co.uk/news/2020/12/20/suicides-among-women-japan-south-korea-have-soared-covid-pandemic/

Refugees

Ebrahimi et al. (2020) → refugees, lesbian/gay, bisexual, transgender, divorced & single, & unemployed individuals reported clinically significant levels of anxiety & depression.

“Lebanese & Turkish refugees live in poverty; food insecurity and nutritional deficiencies remain problematic (Cuevas et al., 2019; Syrian Center for Policy Research (SCPR) 2019; Yassin, 2019; Syrian Center for Policy Research (SCPR) 2020); more likely to be unvaccinated, have communicable disease (e.g., measles), multidrug-resistant infections, malaria, & hepatitis (Doganay and Demiraslan, 2016; Tayfur et al., 2019; Ozaras et al., 2016).

These conditions are similar to those affecting other international refugee populations during the COVID-19 pandemic; poor political protections, reduced access to healthcare, low-quality accommodations and compromised water, sanitation and hygiene (WASH) conditions are showing that capacity to distance is limited (Alawa et al., 2020); conditions have the potential to exacerbate COVID-19 spread quickly in refugee communities (Truelove et al., 2020).” (Munajed & Ekren, 2020).”

World Health Organization. (2020). WHO Coronavirus Disease (COVID-19) Dashboard.

WHO Coronavirus Disease (COVID-19) Dashboard

World Health Organization Coronavirus disease situation dashboard presents official daily counts of COVID-19 cases and…

covid19.who.int

“In conclusion, it is still important to keep social distance policy since it could not only reduce the transmission risk of SARS-CoV-2 but also be related to milder clinical course among patients. Although it could increase the difficulty of identifying the cases, the burden of health institutions may be reduced and save more medical resources especially in developing countries.” — Tianming Zhao et al (Correspondence The importance of social distancing policy)

Iatrogenic Effects of Testing Introverts

Acemoglu et al., 2020 → A point of broad agreement among different approaches is that ramping up testing capacity is one of the most effective ways of combating the pandemic (see e.g. Searchinger et al. [2020], Brumfiel [2020], and BruSoe-Lin and Hecht [2020]). How do different testing strategies impact voluntary social distancing decisions of individuals?

We assume that there is a fixed supply of tests and then investigate how these should be allocated. If there is sufficient testing capacity, it is optimal to test everyone. However, for intermediate or low values of testing capacity, it isn’t socially optimal to test everyone.

High-value agents should be tested first because they are socially more active, more likely to be infected, & thus more likely to transmit the virus (especially super spreaders who are socially very active).

This is about the impact of testing on voluntary social distancing:

additional testing over this range would reduce voluntary social distancing so much that it would have no benefit in terms of containing the infection. It increases the infection probability of low-value agents and does not change the infection probability of high-value agents.
…uniform testing policies, where tests are allocated without reference to the type of agents, are worse than targeted testing policies.”

For the introverted low-value agents, a COVID testing facility may expose them to the highest number of people they’ve had to be in the same room with since March.

To be clear, introverts should be tested for COVID19. Having them conduct a self-test in isolation places them at significantly less than having them appear within a COVID testing facility filled with more people than they’ve seen in months.

Non-Essential Business closures

Gupta et al., 2020 https://www.nber.org/system/files/working_papers/w28139/w28139.pdf

“The voluntary increases in social distancing in the early days of the epidemic hides considerable heterogeneity in behavioral response to the threat of infection along lines of political affiliation, race and other socioeconomic and demographic characteristics (Aksoy et al., 2020; Allcott et al., 2020; Huang et al., 2020; Mongey and Weinberg, 2020). Personality is relevant to the biopsychosocial outcomes of consequential COVID behaviors.
Non-Essential Business closures provided a binding constraint on individual behavior because even those not voluntarily complying with social distancing recommendations had fewer locations to visit.”

Exercise With a Mask

Haraf et al., 2020 on Exercise → “At rest and during mild to moderate exercise, surgical masks and likely cloth masks have been demonstrated to have no physiological impact. At intensive exercise, the available evidence (albeit very limited) suggests that there may be marginal physiological impact that is unlikely to be clinically significant.”

Wing et al., 2020 → “one additional NHL/NBA game leads to an additional 783 COVID-19 cases during March-mid May and an additional 52 deaths.”
“… an additional NCAA Division 1 men’s basketball games results in an additional 31 cases and an additional 2.4 deaths.”

Civic Capital & Political Social Identity

“Using mobile phone and survey data, we show that during the early phases of COVID-19, voluntary social distancing was higher when individuals exhibit a higher sense of civic duty” (Barrios and Hochberg, 2020)

Building on Almond and Verba (1963) and Guiso et al. (2011), we define the civic capital of a community as the “set of values and beliefs that help a group overcome the free-rider problem in the pursuit of socially valuable activities” (Guiso et al., 2011). In communities with higher civic capital, individuals display prosocial behavior that does not have an immediate personal utility (such as voting, volunteering, or donating blood), and trust other fellow citizens more in general. In these communities, citizens are able to solve coordination games better and provide public goods (Herrmann et al., 2008).
In the United States, Trump leaning counties comply less (Alcott et al., 2020; Barrios and Hochberg, 2020). In Europe, regions that trust the government more comply more (Bargain and Aminjonov, 2020). Our analysis moves beyond political affiliation and shows that civic capital has a vital role in explaining the behavior of individuals during the COVID crisis. We find that after controlling for political affiliation, civic capital can explain compliance with social distancing not only in the United States but also in Europe.”

Infection Growth Rate & Political Social Identity

“Hillary Clinton districts more likely to socially distance than districts of the other person in a Geo-tracking study of ~15 million cell phones. Lower distancing in deep Republican counties was associated with an increase in #COViD infections.

Infection Rate: Both for general movement and visiting non-essential services, physical distancing between 17 and 23 days before a given date most strongly related to lower infection growth rate on that date. In other words…

a reduction in infection growth rate on a specific day was best accounted for by the degree to which people in a county were physically distancing between 17 and 23 days earlier.

Fatalities: we found that counties’ physical distancing 25–31 days before a given day most strongly related to lower fatality growth on that day. Collectively, these results suggest that counties’ degree of physical distancing 17–23 and 25–31 days earlier best accounts for reductions in infection and fatality growth rates, respectively.

Republican counties’ infection growth rate would have been 1.17% lower if they had socially distanced to the same extent as more Democratic-voting counties — a swing of 1.76 percentage points in infection growth rate.

Media: We found that the degree to which people in different counties watched Fox News over CNN and MSNBC was associated with lower levels of physical distancing. …And, as was the case for partisanship as assessed by 2016 vote gap, the observed partisan media differences in physical distancing strengthened over time.

Our findings thus tentatively suggest that partisan differences in physical distancing predicted higher growth rates of infections and fatalities in pro-Trump counties” (Gollwitzer et al., 2020).

Gollwitzer, A., Martel, C., Brady, W. J., Pärnamets, P., Freedman, I. G., Knowles, E. D., & Van Bavel, J. J. (2020). Partisan differences in physical distancing are linked to health outcomes during the COVID-19 pandemic. Nature human behaviour, 4(11), 1186–1197.

My apologies as this piece covered some emotionally heavy content. Serving as a faculty advisor of Active Minds at the University of California San Diego is one of the opportunities I’m truly thankful for, especially during this time when so many students are facing unprecedented historic hardship. Please don’t hesitate to reach out to support services if necessary:

Hopefully these 2 images provide some positive affect; each in their own way