The Psychology of Epidemics

“When the conditions are right, epidemics can potentially create a medical version of the Hobbesian nightmare - the war of all against all. A major outbreak of novel, fatal epidemic disease can quickly be followed both by plagues of fear, panic, suspicion and stigma; and by mass outbreaks of moral controversy, of potential solutions and of personal conversion to the many different causes which spring up. This distinctive collective social psychology has its own epidemic form, can be activated by other crises besides those of disease and is rooted in the fundamental properties of language and human interaction. It is thus a permanent part of the human condition - and widely known to be such.”

~Philip Strong (Epidemic psychology: a model; download paper here)

In recent years we have seen the outbreak of diseases both new and old. Currently the world is watching and worried about the coronavirus. Measles, mumps, polio, ebola and, of course new strains of the flu have all taken hold is some part of the world. Some of the outbreaks are in far-flung regions, others are close to home as the hesitancy of people in seeking vaccines is putting children at risk for diseases that we thought were dead.

Along with the physical illnesses now comes the mental worry about how far these diseases can spread and whether some could become full-fledged pandemics. Fear and anxiety are manifesting themselves as an epidemic of a different kind.

Imagine how our ancestors must have felt as plague, smallpox, influenza, scarlet fever, typhus and other infections and viruses attached their communities.

Fear of epidemics can spread through a community in just the same way the disease epidemic does. It arises from fear of the unknown: what is the nature of the sickness? In the case of diseases, the fear will manifest itself much more severely if the infection has not been experienced before. Concern will be highest when no treatment is known, and outcomes cannot be predicted. People will naturally be fearful and suspicious about others who become sick and that the illness can be spread. They will be fearful that contagions may be contracted by many different means.

The fearfulness becomes an obsession in itself, even among those whose risk is very low. Even those occupying the roles of caregivers may be prone to apprehension about exposing themselves to potential infections. Results in the past have been to avoid, segregate or even persecute those who become sick or who may be thought to be carriers of a sickness. One need only think of how individual with human immunodeficiency virus or HIV.

Would people living in past centuries who came down with the plague, smallpox, cholera or influenza have been viewed much differently?

Until a disease is fully understood and its effects can be quantified, there will be disagreements in how it is transmitted and what treatment options will be the most effective. These unknowns also cause controversy and panic. In the short term, friends and family members may be isolated, the sick may lack care, unfounded ideas of who is to blame will surface and communities will be paralyzed by inaction.

The psychological effects of epidemics will be negatively impacted until normal routines can be resumed, a disease has run its course and/or effective treatment protocols are in place.

This is where we are now with respect to the Coronavirus, not unlike where societies were in the 14^th to 18^th centuries with the plague. We can imagine that similar deleterious mental health effects were experienced by our ancestors in the same way that we have observed going on in recent decades. Would they have impacted families more severely given they did not have the knowledge about and access to modern medical methods we now have available?

 

Scanning electron microscope image showing SARS-CoV-2 (yellow), also known as 2019-nCoV, the virus that causes COVID-19 (retrieved 9 March 2020 from https://commons.wikimedia.org/wiki/File:SARS-CoV-2_49531042877.jpg)

Disease epidemics have perhaps been among the most deadly of natural phenomena disasters. It has been estimated that the Black Death of the 14^th century took up to 60% of the population of Europe before it ran its course. The Spanish Flu in 1918 infected over 25% of the world’s population (500 million people) with a death rate of 3% of those who contracted it. The Swine Flu of 2009 may possibly have infected three times as many, but the death rate was 1/10 of what resulted from the Spanish Flu.

Whether natural disasters emanate from epidemics or the psychological effects of stress it has always been clear that Mother Nature has had a significant impact on the well being of people and communities.