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Running Head: PSYCHOLOGICAL EFFECT OF A PANDEMIC

The Psychological Effect A Pandemic Has On the Mental Health of Health Care

Workers, Students, and the General Population

Peyton Machado

University of North Florida

HSC4730: Public Health Research

Dr. Amber Barnes

October 12, 2020

A pandemic poses many challenges to not just the general population, but to

significant roles in society such as health care workers and students. The panic

following the major outbreak of disease can lead to panic, and in turn burden, society’s

mental health. Being stuck in a nationwide lock down or having to continue on with

normal daily life in a pandemic can cause depression, anxiety, stress, and even

symptoms of PTSD. Surveys were administered to the public in order to accurately

collect data on how this pandemic has affected all different aspects of the general

population, both during the initial outbreak and some period of time after. Variables

affecting rates of mental health issues are how one views their level of health, their

social support system, and having any physical symptoms of the virus. Programs are

being implemented to support anyone struggling with their mental health during these

times; especially for health care workers, to ensure they are best fit to help others.
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Introduction

A pandemic can be described as a disease that has been spread throughout the

country and eventually spreads internationally. This can happen for many reasons

including international travel and trade of goods between many different countries.

When a disease is first discovered in a specific area, it is important to quickly figure out

where and how this disease could have spread. Pandemics have been occurring for the

entirety of the Earth’s existence, and researchers are still trying to figure out how to slow

them down and how to deal with the extreme aftermath. Each country handles these

pandemics in a different manor, but the effects of the pandemic can be uniform

throughout. The following paragraphs will discuss the impacts of recent pandemics, with

a focus on the most recent Coronavirus, also known as COVID-19, outbreak among

general population, as well as health care workers and college students.

Effect On the General Population

When trying to control a pandemic, it is common for the government to issue

lockdowns to prevent rapid spread of the disease. When going through a lockdown, you

are often stuck at home and can only leave for emergencies or if your job is deemed

essental. Being so sedentary and having little to no contact with the outside world

combined with the panic that comes with hearing about a widespread disease can lead

to many mental health disturbances, especially if you live alone. Studies were done to

examine the mental state of the general population of Spain and China during the onset

of the COVID-19 pandemic and the changes in mental health status throughout.

Spain
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In a study done by González-Sanguino et al., (2020) a survey was issued online

in Spain to participants that were recruited through social networking channels. This

survey contained 80 questions about the participants’ sociodemographic variables, the

psychological impact of the outbreak, discrimination, loneliness, social support, sense of

belonging, self-compassion, and spiritual well-being. By asking questions about these

different components of life, researchers can have a better idea of just how seriously

this onset of new disease effected the residents of Spain. The survey in this study found

that 18.7% and 21.6% “exceeded the cut-off point” on the depression and anxiety scale

respectively (González-Sanguino et al., 2020). It was also found that 15.8% of

respondents showed signs of developing PTSD (González-Sanguino et al., 2020).

Loneliness and discrimination were indicators that a respondent was going to develop

symptoms of PTSD, depression, or anxiety disorder. This is significant because we

know that about twenty percent of survey respondents developed a serious mental

health issue as a result of this pandemic. This tells researchers that they now have to

come up with a plan to ensure this doesn’t happen as drastically or at all in future

pandemics.

China

Similarly to the survey conducted in Spain, Wang et al., (2020) conducted a

survey in mainland China to collect data on the mental health impact of the recent

outbreak of the COVID-19 pandemic. This study, however, looked into many different

variables that could have played a part in the decrease of mental health during this time.

Although there was no significance in the change of scores on the DASS tests for

depression, anxiety, and stress from the initial outbreak to four weeks later, there was a
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significant decrease in PTSD symptoms using the IES-R scale (Wang et al., 2020).

Variables that were greatly correlated with higher DASS and IES-R scores include

having physical symptoms of COVID, having a history of chronic illness, and having a

poor self-rating of one’s own health status. This tells us that if an individual were more

education on how to keep up with their health, then a pandemic this big would not affect

them as much mentally. A question that needs to be asked, however, is why these

individuals are rating their health status so low, and what can be done to improve this.

Healthcare Workers

Although an outbreak of a virus or disease can be extremely stressful for the

general population, it can be even worse for front-line healthcare workers. Knowing

each time you go into work that you could contract this virus or pass it onto your family

in some way can burden these workers mentally. Factors that contribute to these

worries include their socioeconomic status, their medical history, and psychological and

social status (Vindegaard & Benros, 2020). As found in other studies related to

pandemics, healthcare workers are expected to have higher psychiatric symptoms,

especially if they are female (Vindegaard & Benros, 2020). Anxieties amongst

healthcare workers are also contributed to by the uncertainty of their available

resources, the capacities at which they will be working, and the risks associated with

their job (Albott et al., 2020). This tells us that the mental health of HCW needs to be

taken even more seriously and there must be programs developed and programs set in

place to ease their worries.

The traumatic experiences HCW endure during a pandemic have a lasting effect

on their psychological health. Healthcare workers, specifically physicians and auxiliary

pandemic (Preti et al., 2020). With these long-lasting symptoms also come professional

burnout. Professional burnout can be defined as “the long-term hazards of

depersonalization, emotional exhaustion, and perception of reduced accomplishment”

(Albott et al., 2020). The effects of professional burnout include an ongoing sense of

distress, worry, disturbed sleep, lowered ability to concentrate, an increase in substance

abuse, and depression (Albott et al., 2020). This information is also very important in the

need for developing programs to better assist healthcare workers through pandemics.

College Students

Regardless of the stage of life you are currently in, a pandemic will most

definitely have an impact on your life. For college students, however, this can be an

even harder situation to be in, especially if the government imposes lockdowns and

causes schools to close.

A Change in Education

At the beginning of the current COVID-19 pandemic, a lockdown was placed on

the United States causing a major shift in education. For college students, this meant

transitioning to online school and being kicked out of on-campus housing earlier than

planned. With online school comes many new challenges, including figuring out how to

administer important exams like midterms and finals, and having to reconfigure the

layout of an entire course. This can be extremely stressful both students and

professors. This change has students fearing for how this is going to affect their exam

performance (Sahu, 2020). International students are also extremely affected by this
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outbreak in that it is unknown if they will be able to return home; they often rely on on-

campus housing and may not have an alternative living situation (Sahu, 2020).

How the new format of Education is Affecting Mental Health

These changes in education will more often than not negatively impact the

mental health of students and it is key for universities to stress the importance of

students prioritizing their mental health during these times. College students in China

were found to have increased anxiety about this situation if they were living alone,

resided in rural areas, had family with an unstable income, or have an infected relative

or acquaintance (Cao et al., 2020). Students also faced increased anxiety about

academic and economic delay, the influence of this outbreak on their daily life, and the

social support they would receive (Cao et al., 2020). Similar trends were observed in a

study done amongst Guangdong college students and was also found that the older the

students, the more aware they were, the higher the chance of changed behavior related

to this pandemic, and the lower rates of anxiety and depression (Chang, Yuan, & Wang,

2020). These data tell us that it is crucial to emphasize that students must also take

care of their mental health and universities should do something in support of these

students.

What Is Being Done for Mental Health

The virus SARS-CoV-2, the virus that causes COVID-19, could potentially have

effects on the brain and trigger immune responses which in turn could also affect

emotional health (Holmes et al., 2020). This is important to know in order to continue

research to figure out how to lessen the effects on mental health this virus has. With the

new information acquired from this outbreak combined with information from previous
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related outbreaks, a new database must be created, and new research programs

should be developed (Holmes et al., 2020).

Albott et al. is working on an intervention program called The Psychological

Resilience Intervention which focuses on self-care, self-efficacy, and social connection

to deal with the mental health issues arising from the recent COVID-10 outbreak (2020).

This intervention has three main goals with three levels of support to reach these goals.

The goals include supporting health care workers in their self-care needs, connect these

health care workers with their peers, department heads, and a mental health consultant

to maintain a “no one left behind” approach, and to identify and support at-risk

individuals (Albott et al., 2020). The three levels of support include a peer, a unit or

department, and a mental health professional. A concept called “Battle Buddies” was

created to connect each HCW with another HCW to keep each other in check and

ensure they are prioritizing their own health through these times (Albott et al., 2020).

Finally, a three-tiered public health model was created by Miotto, Sanford,

Brymer, Bursch, And Pynoos in order to address the mental health needs of health care

workers. The first tier consists of broad-based support with educational trainings and a

centralized selection of resources; the second tier addresses the needs of high-risk

health care workers and the resources are highly visible, easily accessible and non-

stigmatizing; the third tier is focused on health care workers who have pre-existing

mental health conditions and what can be done to prevent a spike in these mental

health disorders (Miotto, Sanford, Brymer, Bursch, & Pynoos, 2020). These programs

and interventions are important, because health care workers are the backbone to

dealing with and recovering from outbreaks.

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Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., & Zheng, J. (n.d.). The

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