Treating the pandemic of fear

Samar Razaq

doi:10.3399/bjgp20X710501

Samar Razaq

Michel de Montaigne, the 15th century French philosopher, once wrote in his Essais, ‘He who fears he shall suffer, already suffers what he fears’.

The rapid spread of COVID-19 has brought with it not only physical trauma, but an unprecedented wave of psychological debility. It has ground the engine of the world to a halt in a matter of weeks.

While there are signs of the initial impact of the pandemic waning, the biggest challenge now facing the government is to get that engine moving again. However, there are scars left behind that will not be so easily healed.

For the last few months the government had the unenviable task of slowing the rate of transmission of the virus. This required making the public aware of the risk of the virus, and rightly so. If left to spread unchecked, the health system may well have been overwhelmed. The controlled rhetoric used by the government, however, was distorted by unbridled social media outlets. Uncurbed messages spread fear at a transmission rate far superior to that of the virus.

PATIENT ANXIETY AND MISINFORMATION

Not a day does not go by where I do not speak to patients suffering from anxiety in one form or the other.

Conspiracy theories have flourished in this atmosphere of fear. Blame being laid on 5G masts being the cause of the illness and ethnic minority patients being left to die in hospitals in Bradford are just some of the bizarre rumours that have been circulated.

Some doctors have also played their part in this. Well-intentioned videos, to ensure adherence to the lockdown, circulated on WhatsApp, in which the mortality rate from COVID-19 was quoted at fifty times that of seasonal influenza.

The passage of time helps readjust the figures but the fear that they leave behind takes much longer to heal.

As a result of this, I speak to patients suffering from anxiety in one form or the other on a daily basis. The untold harm being done to their mental health does not make the daily evening government briefings. The whole nation is now obsessed with the daily death rate, despite being unable to place the numbers in any context. While all the attention has been transferred to COVID-19, other health phenomena are taking place in the background that receive little to no media attention.

THE TRUE IMPACT OF THE VIRUS

As of 29 May 2020, COVID-19 had been mentioned in just over 50 000 deaths in the UK. However, there have been approximately 64 000 extra deaths above the usual number at this time of the year.¹ What is the cause of these extra 14 000 deaths? The answer may not be clear until the end of the year but this shows the true impact of the virus and the associated lockdown.

One of these was a sad case I encountered a few weeks ago on a night shift. An elderly man called for an ambulance because of central chest pain. By the time the paramedic crew arrived the pain had subsided and initial investigations were normal. The patient did not want to attend A&E despite medical advice due to fear of catching the virus, and hence was left at home. A few hours later he collapsed again. On arrival of the paramedic crew, sadly, he was already deceased, presumably from a heart attack. This is just one example of the collateral damage that the rampant fear has caused. Meaningless numbers continue to incapacitate people and no reassurance is available elaborating the low individual risk to them.

This patient, however, is a lost statistic, to be dealt with at the end of the year, at which point we may or may not realise the untold damage done by the propagation of disproportionate fear. Many of my colleagues are aware of the impact the loss of jobs and economic downturn has on the use of primary care services. This impending workload is not too far down the road if the downturn is not reversed. Once COVID-19 no longer makes the headlines, the clapping every Thursday evening will stop, but the misery and pain left behind will continue to cripple the NHS.

Meaningless numbers continue to incapacitate people and no reassurance is available elaborating the low individual risk to them. It is important to continue to stress the necessity to not spread the virus but more has to be done to mitigate the fear that has crippled the nation.

While we continue to worry about catching the dreaded virus, it may well be the case that more important things will pass us by which have a greater bearing on our lives.

Perhaps it would be best to end with the words of Montaigne again: ‘There were many terrible things in my life and most of them never happened.’