Fear, despair more in Covid second wave: Expert

BENGALURU:  The second wave of Covid- 19 is like a “tsunami” and has “compounded the sense of fear and despair among the people,” according to Dr Pratima Murthy, professor and head of the Department of Psychiatry, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bengaluru.

“People with Covid-19 also need to be evaluated for neuropsychiatric symptoms and provided follow- up support. Those with substance use disorders need special attention, particularly for withdrawal management and relapse prevention,” she pointed out.

Given the surge in infections in the second wave, entire families getting infected, constant bombardment with news about the lack of hospital beds, oxygen and medical care, the “sense of helplessness, anger and despair is ever more in the current wave than the previous one,” said the leading NIMHANS psychiatrist. “A constant exposure to haunting images of people denied oxygen, undying funeral pyres are so deeply disturbing that the reality that most people still recover from Covid uneventfully has faded from memory.

The initial lassitude and fears of vaccination have given way to desperation to receive the vaccine and overcrowding in vaccination centres, making them loci of high risk. Despite scientific bulletins that most of the drugs being used are not ‘magic bullets’ and are useful only when used in specific conditions, there is a raging rush to keep and even to hoard them,” she noted. Dr Murthy said that an often less discussed aspect of Covid-19 is that the infection itself can “produce direct neur o p s ychi a t r i c symptoms.

Delirium, encephalopathy, disturbances of smell and taste, headache, behavioural changes, strokes, psychotic and mood disorders and catatonia have also been described, because of the intense immunological reaction the Novel Coronavirus can produce,” she added. Mental distress and Covid- 19 can be looked at from two aspects. “One is from the psychological reactions that people have experienced for more than a year now, both during the pandemic and specifically during last year’s lockdown, and secondly, the experiences of being affected by Covid-19 and its neuropsychiatric sequelae,” she said.

Comparing the two cycles of the pandemic in India, Dr Murthy said that in the first, people had learned to cope during the first lockdown by keeping themselves busy, reconnecting with old friends online, spending more quality time with families. “They were encouraged not to panic in response to misinformation, to avoid watching too much television, to develop healthy hobbies and spiritual pursuits and to wait it out. The second wave is different and more difficult,” she said.

All viral infections of the respiratory system can affect many other systems, including the central nervous system. “These are particularly likely in older persons and those who are more vulnerable. People who recover from Covid19 require longer- term mental health support as rates of depression, anxiety and post-traumatic stress disorder are higher among them,” said the psychiatrist.