Pandemic Wellness
Jennifer Cox Tatyana Lay Catherine Prairie Louis Vella
Introduction
Focusing on UN Sustainable Development Goal 3- Good Health and Well-being is a challenge that transcends borders and, in turn, becomes a global mission that we believe has taken center stage, especially in the wake of the COVID-19 pandemic.
Over the last century, society grappled with four significant pandemics: the 1918 Spanish Flu, the 1957 Asian Flu caused by the H2N2 influenza virus, the 1968 Hong Kong Flu attributed to the H3N2 influenza virus, and most recently, COVID-19. These health crises have highlighted four key areas where proactivity is crucial as we navigate the terrain from the aftermath of a pandemic toward a new normal.
As we strive to address these areas, we must seek solutions that do not complicate but simplify. So, we draw inspiration from the simplicity of a child's perspective, cutting through the knots of complicated rules and regulations that, at present, are causing more harm than good, fostering isolation and division. An integral part of this process involves revisiting the past. The history of pandemics, lessons gleaned from each, and the wisdom that hindsight affords us can be our compass as we navigate toward a future that will inevitably see more such challenges.
Social-emotional
Mental Health
Preventative Care
Physical Activity
(Click each icon for more information)
Learn more about UN Sustainable Development Goal 3 here.
Pandemic Planning in the US
A Historical Timeline
Before evaluating the COVID-19 pandemic and its subsequent impact, it it is critical to review the history of pandemic planning and any mitigating efforts.
(Click to continue)
2000 - 2005
2006 - 2010
1970s
1980s
1990s
Click each decade to learn more
(All information sourced from Iskander et al., 2013)
And then the world stopped
(Katella, 2021)
What is the Impact of COVID-19?
Click the icons to learn more
Mental Health
Physical Activity
Preventative Care
Social-emotional Impact of Distance Learning and Telework
Advance to next section when complete
Impact of Mental Health
The pandemic resulted in restrictions in the healthcare system, specifically neurological and psychiatric disease care, which typically require in-person contact/care. However, this ceased altogether once the pandemic began, pointing to a need to adjust the mental healthcare infrastructure as a top priority (Khanma & Jones, 2021). In addition, the direct biological impact of SARS-CoV-2 infection and the stressors associated with the effects of the disease, as well as the measures to contain the pandemic, can lead to new-onset mental illnesses or worsen existing ones (Hellek et al., 2023).
The worsening of mental health disorders can be linked to a reduction in the quality of medical care and to unfavorable health-related behaviors, such as lower physical activity levels, extended periods spent in bed, and continuously thinking about the same negative or distressing thoughts. Additional stressors can arise from quarantine- loneliness, remote working, home-schooling, economic uncertainty, and concerns about loved ones (Hellek et al., 2023). These stressors involve repeated or sustained activation of the biological stress system, which could result in physical changes and damage in the brain, leading to behavioral and mental health problems (McEwen & McEwen, 2017, as cited in Arnsten et al., 2021). The impact is especially pronounced in brains that are still developing (Cohodes et al., 2021, as cited in Arnsten et al., 2021).
With similar observations across all age groups, the pandemic and its containment measures have heightened other mental illnesses, such as anxiety and eating disorders, and increased psychosocial stressors, like domestic violence and family conflicts, leading to a higher demand for mental health services (Hellek et al., 2023).
Overall, the moderate-to-vigorous intensity physical activity (MVPA) levels per day lowered during the pandemic and remain below the recommended levels set forth by public health officials. Additionally, adult and children's sedentary rate continues to rise even with a somewhat return-to-normal post-pandemic phase (Jago et al, 2023).
There is significant importance with physical education within the education system, especially after the Covid-19 pandemic, because introducing PE in childhood promotes physical activity (PA) behavior into adulthood (Blain et al., 2022).
"A focus on promoting participation with health-enhancing levels of physical activity in the immediate and more extended terms (i.e., later life) has increasingly become a core priority for the subject. (Blain et al., 2022, p. 3).
It is well known that physical activity is important to overall health and well-being. But let’s consider how the pandemic has impacted our physical activity.
Click to continue
Impact on Preventative Care
The illnesses related to the post-COVID syndrome are not exclusively biomedical in nature. Covid-19 has caused illnesses that have triggered psychosocial issues induced by social distancing, shutdowns, and the slow-down of public and personal activities (Scharf & Anaya, 2023). The forced quarantine measures can exacerbate issues, potentially leading to obsessive behaviors like anxiety, acute panic, hysteria, paranoia, and depression.
The pandemic has had profound psychosocial effects with induced public and personal life changes, creating mental health issues, economic burdens, and financial losses (Scharf & Anaya, 2023, p. 3). As such, the ongoing understanding and management of post-COVID syndrome cannot be based on biomedical research but should also include sociological and psychological studies, to fully comprehend the impact of pandemic conditions on physical and mental disorders. (p. 12).
The CDC (2021) reports that Long COVID can cause various symptoms and illnesses that persist for weeks, months, or years after infection. Symptoms and illnesses include diabetes, heart conditions, blood clots, and neurological conditions. These conditions can significantly impact the quality of life of individuals living with Long COVID and are a part of the wide range of persistent symptoms that people with Long COVID may experience.
The pandemic has been a significant stressor, creating social and emotional challenges. Children had to abruptly adapt to school closures and loss of predictable daily routines, while parents and caregivers had to juggle home-schooling and simultaneously maintaining work responsibilities (Arnsten et al., 2021). The protections required to safeguard against COVID-19 also blocked access to activities and social relationships important in reducing stress (Gruber et al., 2020, as cited in Arnsten et al., 2021). Disruptions in routine and loss of resources related to the pandemic are especially harmful to children coming from disadvantaged backgrounds due to job loss, lower economic resources, reduced access to health care, lower-quality education, and other adversities stemming from systemic racism and inequities in the U.S. (Condon et al., as cited in Arnsten et al., 2021).
Social-emotional impact of Distance Learning and Telework
Regarding adults, a study conducted by Petcu and team (2023) investigated how teleworking during the pandemic impacted individual well-being regarding social and emotional development and health. It was found that the existence of adequate communication and work-life balance while teleworking ensured employee well-being, but if work intensity increased, well-being decreased. While there are positive effects of working from home, such as increased productivity, reduced absences, improved digital skills, increased loyalty to employment, and decreased time and carbon emissions wasted during commuting, there are also negative effects, such as psychological impairment (anxiety, exhaustion, depression, social disconnection, mental fatigue, dissatisfaction, loneliness), work-life imbalance, increased personal costs, increased responsibilities of working mothers, increased work dependence, reduced free time with family, and reduced interaction with friends.
Where was the breakdown?
Insufficient Prioritization and Communication
Lack of Proper Oversight
Narrow Focus
Problems such as insufficient funding, overlapping roles, supply chain vulnerabilities and counter-dependence on other countries, inadequate surveillance, and insufficient testing capacities had been escalated by experts and oversight agencies for years but were overlooked by all branches of the federal government (Peters, 2022).
Over 10 preparedness-specific recommendations from the Government Accountability Office, Health and Human Services (HHS) Inspector General, and HHS reflective reports made since 2007 remained unimplemented (Peters, 2022). There was also a significant lack of consistent information being circulated- by the government and media- and spread of misinformation by citizens.
While federal pandemic planning and frameworks had been in place for years, pandemic planning from 2005-2019 narrowly focused on influenza and failed to incorporate other potential infectious disease threats (Peter's, 2022).
What's the Solution?
(Click each photo to learn more)
Access to consistent
Information
Mental Health Services
Access
Public Awareness and
Communication
Why is this important?
A pandemic causes fear and anxiety, social isolation, economic stress, grief, and potentially work-related stress. Many large corporations already integrate mental health programs as a benefit offered to their employees; however, our experience during the COVID-19 pandemic revealed that many people, especially in underserved communities, do not have any access to mental health care, making this a critical yet complex issue.
Creating a mechanism to communicate consistent and accurate medical information to individual citizens allows our governments and societies around the world to be better prepared to ease the mental health challenges of a pandemic and ensure that individuals have access to the care they need.
Conclusion
“Considering the fast transmission of the virus between humans, high mortality rates, and strict prevention measures, including travel bans, home confinements, social distancing, compulsory face mask wear, and school suspensions, this time of global crisis is characterized by strong negative emotions and deteriorated mental health" (Belen, 2021, p. 186).
History shows us that epidemics are not merely matters of health, but social experiences with profound implications for the character of social situations, whether by virtue of the imagery they promote or how they distribute the costs of disease and reconstruction (Taylor, 2020, para. 20). The COVID-19 pandemic left us questioning the conditions leading us to this point and the need to conserve and build on the social resources we possess. Coming to a solution requires setting ego aside and working together towards a transparent solution from the top down while working on adding members of the public alongside government bodies for planning to ensure other experiences are heard and accounted for.
Given the massive impact on mental health globally, governments should prioritize mental health care and ensure that policies and services are in place to provide these services. By developing and deploying a Certified Emergency Planning Information Portal (CEPIP), we are better equipt to prepare citizens to thrive rather than react when another inevitable pandemic hits, helping to ease mental health deterioration experienced by many during the COVID-19 pandemic.
References
Arnsten, A. F. T., Condon, E. M., Dettmer, A. M., Gee, D. G., Lee, K. S., Mayes, L. C., Stover, C. S., & Tseng, W.-L. (2021). The prefrontal cortex in a pandemic: Restoring functions with system-, family-, and individual-focused interventions. American Psychologist, 76(5), 729–743. https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=edspdh&AN=2021-43329-001&site=eds-live&scope=site&custid=s8856897
Belen, H. (2021). Self-blame regret, fear of COVID-19 and mental health during post-peak pandemic. International Journal of Psychology and Educational Studies, 8(4), 186–194.
Blain, D. O., Standage, M., & Curran, T. (2022). Physical education in a post-COVID world: A blended-gamified approach. European Physical Education Review, 28(3), 757–776.
CDC. (2021, September 16). Long COVID or Post-COVID Conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html
Hallek, M., Adorjan, K., Behrends, U., Ertl, G., Suttorp, N., & Lehmann, C. (2023). Post-COVID Syndrome. Deutsches Ärzteblatt International, 120(4), 48–55. https://doi.org/10.3238/arztebl.m2022.0409
Iskander, J., Strikas, R. A., Gensheimer, K. F., Cox, N. J., & Redd, S. C. (2013). Pandemic influenza planning, United States, 1978-2008. Emerging infectious diseases, 19(6), 879–885. https://doi.org/10.3201/eid1906.121478
Jago, R., Salway, R., House, D., Walker, R., Emm-Collison, L., Sansum, K., Breheny, K., Reid, T., Churchward, S., Williams, J. G., Foster, C., Hollingworth, W., & de Vocht, F. (2023). Short and medium-term effects of the COVID-19 lockdowns on child and parent accelerometer-measured physical activity and sedentary time: a natural experiment. International Journal of Behavioral Nutrition & Physical Activity, 20(1), 1–15. https://doi.org/10.1186/s12966-023-01441-1
Katella, K. (2021). Our pandemic year—A COVID-19 timeline. Yale Medicine. https://www.yalemedicine.org/news/covid-timeline
Khanma, A. and Jones, G. B. (2021). Envisioning post-pandemic digital neurological, psychiatric, and mental health care. Frontiers in Digital Health, 3. https://doi.org/10.3389/fdgth.2021.803315
Leavitt, M. (2006, May 25). Testimony before the special committee on aging U.S. Senate: Preparing for pandemic flu. Department of Health and Human Services. Retrieved on June 19, 2023, from chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.aging.senate.gov/imo/media/doc/hr157ml.pdf
National Library of Medicine. (2021, September 20). Pandemics throughout the history. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8525686/
References
Peters, G. (2022, December 7). Historically unprepared: Examination of the federal government’s pandemic preparedness and initial COVID-19 response. Senate.gov. https://www.hsgac.senate.gov/wp-content/uploads/imo/media/doc/221208_HSGACMajorityReport_Covid-19.pdf
Petcu, M. A., Sobolevschi-David, M. I., Crețu, R. F., Curea, S. C., Hristea, A. M., Oancea-Negescu, M. D., & Tutui, D. (2023). Telework: A Social and Emotional Perspective of the Impact on Employees' Wellbeing in the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 20(3), 1811. https://doi.org/10.3390/ijerph20031811
Scharf, R. E., & Anaya, J.-M. (2023). Post-COVID Syndrome in Adults—An Overview. Viruses (1999-4915), 15(3), 675. https://doi.org/10.3390/v15030675
Taylor, r. (2020, July 16). History lessons: Can we learn from the past? Social Science Research Council. Retrieved on July 1, 2023, from https://items.ssrc.org/covid-19-and-the-social-sciences/democracy-and-pandemics/history-lessons-can-we-learn-from-the-past/
Thomas, L. E., Emich, A., Weiss, E., Zisman, C., Foray, K., Roberts, D. M., Page, E., & Ernst, M. (2023). Examination of the COVID-19 pandemic's impact on mental health from three perspectives: Global, social, and individual. Perspectives on Psychological Science, 18(2), 513–526. https://doi.org/10.1177/17456916221078310
2000 - 2005
2000- California, Maryland, Minnesota, and South Carolina received funding through the CSTE to develop and submit state plans. A national pandemic influenza steering committee was formed, comprising of the CDC, CSTE, NACCHO, and the Association of Public Health Laboratories, transforming the planning process from a federal effort to a national effort. Federal funding was also increased, increasing the number of states engaged in a pandemic plan, including Florida, Indiana, Massachusetts, New Hampshire, and New Jersey. Arkansas, Arizona and Oregon developed their own plans, while Tennessee and Pennsylvania already developed plans in 1999.
2001- In January, Federal funding was added to allow for Kansas, Washington, Nebraska, Connecticut, and New York to join the pandemic plan. In September, the 9/11 attacks occurred, shifting the focus of public health preparedness and funding toward bioterrorism emergency response for all states.
2003- Reemergence of avian flu A (H5N1) begins.
2004-2005- H5N1 spreads throughout East and Southeast Asia, prompting US policymakers and public health experts concerned about the H5N1 outbreak in the US to provide substantial funding ($550 million per state) towards federal-level planning, vaccine development and procurement, and state and local pandemic preparedness efforts. The National Strategy for Pandemic Influenza was announced in November 2005.
Certified Emergency Planning Information Portal
Local and federal governments must collaborate to ensure that help reaches everyone, including underserved communities. A Certified Emergency Planning Information Portal (CEPIP) should be established, funded by the federal government, and managed by all the agencies involved in mitigating the impact of future pandemics. The CEPIP will ensure that all information, data, and directives are authentic and timely. Local governments should encourage civic engagement and ensure that focus and special interest groups have input and access to the CEPIP.
Mental Health Focus
In the rehabilitation effort for mental health, clinics should be established and operated in places such as local shelters, food banks, schools, and other public facilities to ensure that underserved communities have equal access to them. Remote mental health services should be launched using tools like video conferencing or chat platforms. Peer support groups established pre-pandemic can be activated, enabling people to share their experiences, tips, and encouragement, which can be very beneficial in isolation periods.
2006-2010
2006- The White House’s National Implementation Plan was published, addressing federal planning and response strategies to include international transport and border control, protection of human and animal health, and security and continuity of operations issues. The Biomedical Advanced Research and Development Authority (BARDA) was also established within the Department of Health and Human Services, creating a centralized effort to coordinate research, development, and procurement of countermeasures against a natural or intentional public health emergency.
Concurrently, the US government begins purchasing influenza antivirals for the Strategic National Stockpile- enough to treat 25% of the US population. Additional investments were initiated to procure ventilators and personal protective equipment (PPE) such as respirators. BARDA and the CDC awarded contracts for the development and evaluation of clinical point-of-care rapid diagnostics to identify seasonal flu and H5N1 viruses. The WHO met to discuss guidance and support global pandemic preparedness, providing visibility and readiness for future outbreaks. The US provided financial support and technical assistance to help countries develop capacities for rapid response, laboratory diagnosis, and surveillance. The 2006 Pandemic and All-Hazards Preparedness Act called for a review of comprehensive state and local preparedness.
2009- Results of the Pandemic and All-Hazards Preparedness Act review results were released to the public, and the A(H1N1)pmd09 pandemic (“swine flu”) occurred.
1990s
1993- NVPO formed the federal interagency Group on Influenza Pandemic Preparedness and Emergency Response (GrIPPE), which included non-federal consultants and representatives from the CDC, FDA, National Institutes of Health, and Department of Defense.
1995- Council of State and Territorial Epidemiologists (CSTE) released survey data indicating that less than 60% of the state health departments felt there was a need for a state-specific plan.
1996- 40 state and local health officials met in Atlanta in September and identified four “pillars” important to state and local pandemic planning- surveillance, vaccine delivery, communication and coordination, and emergency response.
1997-The Atlanta meeting group drafted guidelines for state and local pandemic preparedness in January. Four states (Connecticut, Missouri, New Mexico, and New York) and one local area (East Windsor Township, New Jersey) were chosen to participate in a pilot to test the drafted guidelines. Maine volunteered to test guidelines without CSTE support. Additionally, the GrIPPE published a pandemic planning framework.
1998- The five locations conduct the pilot and come up with three recommendations: 1) A fifth pillar area focusing on guidance for the use of antiviral drugs should be included, 2) Format should be consistent with the national plan, and 3) All states should receive the revised guidelines to develop state-specific plans.
1999- World Health Organization (WHO) published a pandemic plan in an ongoing effort to prepare for future.
Consistent and Accurate Information
- Local government agencies and volunteer groups should launch public awareness campaigns, informing the public about the implications of future pandemics, including the impact on mental health.
- The information shared should be certified by the CEPIP and involve social media campaigns, virtual webinars, television, and radio.
- For the many people who do not have access to these traditional means of communication, the information should flow through more accessible means such as print media, community meetings, and healthcare facilities.
1978
First pandemic plan was developed under CDC leadership, which included recommendations for annual flu shots for persons at high risk, strengthening of surveillance, expanding research, and establishing a planning and policy framework.
1980s
1983- The pandemic plan was revised to include new recommendations for influenza antiviral drug development and distribution. 1986- Legislation created the National Vaccine Program Office (NVPO) to coordinate federal vaccine-related activities.
Pandemic Wellness
Jennifer Cox
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Transcript
Pandemic Wellness
Jennifer Cox Tatyana Lay Catherine Prairie Louis Vella
Introduction
Focusing on UN Sustainable Development Goal 3- Good Health and Well-being is a challenge that transcends borders and, in turn, becomes a global mission that we believe has taken center stage, especially in the wake of the COVID-19 pandemic. Over the last century, society grappled with four significant pandemics: the 1918 Spanish Flu, the 1957 Asian Flu caused by the H2N2 influenza virus, the 1968 Hong Kong Flu attributed to the H3N2 influenza virus, and most recently, COVID-19. These health crises have highlighted four key areas where proactivity is crucial as we navigate the terrain from the aftermath of a pandemic toward a new normal. As we strive to address these areas, we must seek solutions that do not complicate but simplify. So, we draw inspiration from the simplicity of a child's perspective, cutting through the knots of complicated rules and regulations that, at present, are causing more harm than good, fostering isolation and division. An integral part of this process involves revisiting the past. The history of pandemics, lessons gleaned from each, and the wisdom that hindsight affords us can be our compass as we navigate toward a future that will inevitably see more such challenges.
Social-emotional
Mental Health
Preventative Care
Physical Activity
(Click each icon for more information)
Learn more about UN Sustainable Development Goal 3 here.
Pandemic Planning in the US
A Historical Timeline
Before evaluating the COVID-19 pandemic and its subsequent impact, it it is critical to review the history of pandemic planning and any mitigating efforts.
(Click to continue)
2000 - 2005
2006 - 2010
1970s
1980s
1990s
Click each decade to learn more
(All information sourced from Iskander et al., 2013)
And then the world stopped
(Katella, 2021)
What is the Impact of COVID-19?
Click the icons to learn more
Mental Health
Physical Activity
Preventative Care
Social-emotional Impact of Distance Learning and Telework
Advance to next section when complete
Impact of Mental Health
The pandemic resulted in restrictions in the healthcare system, specifically neurological and psychiatric disease care, which typically require in-person contact/care. However, this ceased altogether once the pandemic began, pointing to a need to adjust the mental healthcare infrastructure as a top priority (Khanma & Jones, 2021). In addition, the direct biological impact of SARS-CoV-2 infection and the stressors associated with the effects of the disease, as well as the measures to contain the pandemic, can lead to new-onset mental illnesses or worsen existing ones (Hellek et al., 2023).
The worsening of mental health disorders can be linked to a reduction in the quality of medical care and to unfavorable health-related behaviors, such as lower physical activity levels, extended periods spent in bed, and continuously thinking about the same negative or distressing thoughts. Additional stressors can arise from quarantine- loneliness, remote working, home-schooling, economic uncertainty, and concerns about loved ones (Hellek et al., 2023). These stressors involve repeated or sustained activation of the biological stress system, which could result in physical changes and damage in the brain, leading to behavioral and mental health problems (McEwen & McEwen, 2017, as cited in Arnsten et al., 2021). The impact is especially pronounced in brains that are still developing (Cohodes et al., 2021, as cited in Arnsten et al., 2021).
With similar observations across all age groups, the pandemic and its containment measures have heightened other mental illnesses, such as anxiety and eating disorders, and increased psychosocial stressors, like domestic violence and family conflicts, leading to a higher demand for mental health services (Hellek et al., 2023).
Overall, the moderate-to-vigorous intensity physical activity (MVPA) levels per day lowered during the pandemic and remain below the recommended levels set forth by public health officials. Additionally, adult and children's sedentary rate continues to rise even with a somewhat return-to-normal post-pandemic phase (Jago et al, 2023).
There is significant importance with physical education within the education system, especially after the Covid-19 pandemic, because introducing PE in childhood promotes physical activity (PA) behavior into adulthood (Blain et al., 2022).
"A focus on promoting participation with health-enhancing levels of physical activity in the immediate and more extended terms (i.e., later life) has increasingly become a core priority for the subject. (Blain et al., 2022, p. 3).
It is well known that physical activity is important to overall health and well-being. But let’s consider how the pandemic has impacted our physical activity.
Click to continue
Impact on Preventative Care
The illnesses related to the post-COVID syndrome are not exclusively biomedical in nature. Covid-19 has caused illnesses that have triggered psychosocial issues induced by social distancing, shutdowns, and the slow-down of public and personal activities (Scharf & Anaya, 2023). The forced quarantine measures can exacerbate issues, potentially leading to obsessive behaviors like anxiety, acute panic, hysteria, paranoia, and depression.
The pandemic has had profound psychosocial effects with induced public and personal life changes, creating mental health issues, economic burdens, and financial losses (Scharf & Anaya, 2023, p. 3). As such, the ongoing understanding and management of post-COVID syndrome cannot be based on biomedical research but should also include sociological and psychological studies, to fully comprehend the impact of pandemic conditions on physical and mental disorders. (p. 12).
The CDC (2021) reports that Long COVID can cause various symptoms and illnesses that persist for weeks, months, or years after infection. Symptoms and illnesses include diabetes, heart conditions, blood clots, and neurological conditions. These conditions can significantly impact the quality of life of individuals living with Long COVID and are a part of the wide range of persistent symptoms that people with Long COVID may experience.
The pandemic has been a significant stressor, creating social and emotional challenges. Children had to abruptly adapt to school closures and loss of predictable daily routines, while parents and caregivers had to juggle home-schooling and simultaneously maintaining work responsibilities (Arnsten et al., 2021). The protections required to safeguard against COVID-19 also blocked access to activities and social relationships important in reducing stress (Gruber et al., 2020, as cited in Arnsten et al., 2021). Disruptions in routine and loss of resources related to the pandemic are especially harmful to children coming from disadvantaged backgrounds due to job loss, lower economic resources, reduced access to health care, lower-quality education, and other adversities stemming from systemic racism and inequities in the U.S. (Condon et al., as cited in Arnsten et al., 2021).
Social-emotional impact of Distance Learning and Telework
Regarding adults, a study conducted by Petcu and team (2023) investigated how teleworking during the pandemic impacted individual well-being regarding social and emotional development and health. It was found that the existence of adequate communication and work-life balance while teleworking ensured employee well-being, but if work intensity increased, well-being decreased. While there are positive effects of working from home, such as increased productivity, reduced absences, improved digital skills, increased loyalty to employment, and decreased time and carbon emissions wasted during commuting, there are also negative effects, such as psychological impairment (anxiety, exhaustion, depression, social disconnection, mental fatigue, dissatisfaction, loneliness), work-life imbalance, increased personal costs, increased responsibilities of working mothers, increased work dependence, reduced free time with family, and reduced interaction with friends.
Where was the breakdown?
Insufficient Prioritization and Communication
Lack of Proper Oversight
Narrow Focus
Problems such as insufficient funding, overlapping roles, supply chain vulnerabilities and counter-dependence on other countries, inadequate surveillance, and insufficient testing capacities had been escalated by experts and oversight agencies for years but were overlooked by all branches of the federal government (Peters, 2022).
Over 10 preparedness-specific recommendations from the Government Accountability Office, Health and Human Services (HHS) Inspector General, and HHS reflective reports made since 2007 remained unimplemented (Peters, 2022). There was also a significant lack of consistent information being circulated- by the government and media- and spread of misinformation by citizens.
While federal pandemic planning and frameworks had been in place for years, pandemic planning from 2005-2019 narrowly focused on influenza and failed to incorporate other potential infectious disease threats (Peter's, 2022).
What's the Solution?
(Click each photo to learn more)
Access to consistent
Information
Mental Health Services
Access
Public Awareness and
Communication
Why is this important?
A pandemic causes fear and anxiety, social isolation, economic stress, grief, and potentially work-related stress. Many large corporations already integrate mental health programs as a benefit offered to their employees; however, our experience during the COVID-19 pandemic revealed that many people, especially in underserved communities, do not have any access to mental health care, making this a critical yet complex issue.
Creating a mechanism to communicate consistent and accurate medical information to individual citizens allows our governments and societies around the world to be better prepared to ease the mental health challenges of a pandemic and ensure that individuals have access to the care they need.
Conclusion
“Considering the fast transmission of the virus between humans, high mortality rates, and strict prevention measures, including travel bans, home confinements, social distancing, compulsory face mask wear, and school suspensions, this time of global crisis is characterized by strong negative emotions and deteriorated mental health" (Belen, 2021, p. 186).
History shows us that epidemics are not merely matters of health, but social experiences with profound implications for the character of social situations, whether by virtue of the imagery they promote or how they distribute the costs of disease and reconstruction (Taylor, 2020, para. 20). The COVID-19 pandemic left us questioning the conditions leading us to this point and the need to conserve and build on the social resources we possess. Coming to a solution requires setting ego aside and working together towards a transparent solution from the top down while working on adding members of the public alongside government bodies for planning to ensure other experiences are heard and accounted for.
Given the massive impact on mental health globally, governments should prioritize mental health care and ensure that policies and services are in place to provide these services. By developing and deploying a Certified Emergency Planning Information Portal (CEPIP), we are better equipt to prepare citizens to thrive rather than react when another inevitable pandemic hits, helping to ease mental health deterioration experienced by many during the COVID-19 pandemic.
References
Arnsten, A. F. T., Condon, E. M., Dettmer, A. M., Gee, D. G., Lee, K. S., Mayes, L. C., Stover, C. S., & Tseng, W.-L. (2021). The prefrontal cortex in a pandemic: Restoring functions with system-, family-, and individual-focused interventions. American Psychologist, 76(5), 729–743. https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=edspdh&AN=2021-43329-001&site=eds-live&scope=site&custid=s8856897
Belen, H. (2021). Self-blame regret, fear of COVID-19 and mental health during post-peak pandemic. International Journal of Psychology and Educational Studies, 8(4), 186–194.
Blain, D. O., Standage, M., & Curran, T. (2022). Physical education in a post-COVID world: A blended-gamified approach. European Physical Education Review, 28(3), 757–776.
CDC. (2021, September 16). Long COVID or Post-COVID Conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html
Hallek, M., Adorjan, K., Behrends, U., Ertl, G., Suttorp, N., & Lehmann, C. (2023). Post-COVID Syndrome. Deutsches Ärzteblatt International, 120(4), 48–55. https://doi.org/10.3238/arztebl.m2022.0409
Iskander, J., Strikas, R. A., Gensheimer, K. F., Cox, N. J., & Redd, S. C. (2013). Pandemic influenza planning, United States, 1978-2008. Emerging infectious diseases, 19(6), 879–885. https://doi.org/10.3201/eid1906.121478
Jago, R., Salway, R., House, D., Walker, R., Emm-Collison, L., Sansum, K., Breheny, K., Reid, T., Churchward, S., Williams, J. G., Foster, C., Hollingworth, W., & de Vocht, F. (2023). Short and medium-term effects of the COVID-19 lockdowns on child and parent accelerometer-measured physical activity and sedentary time: a natural experiment. International Journal of Behavioral Nutrition & Physical Activity, 20(1), 1–15. https://doi.org/10.1186/s12966-023-01441-1
Katella, K. (2021). Our pandemic year—A COVID-19 timeline. Yale Medicine. https://www.yalemedicine.org/news/covid-timeline
Khanma, A. and Jones, G. B. (2021). Envisioning post-pandemic digital neurological, psychiatric, and mental health care. Frontiers in Digital Health, 3. https://doi.org/10.3389/fdgth.2021.803315
Leavitt, M. (2006, May 25). Testimony before the special committee on aging U.S. Senate: Preparing for pandemic flu. Department of Health and Human Services. Retrieved on June 19, 2023, from chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.aging.senate.gov/imo/media/doc/hr157ml.pdf
National Library of Medicine. (2021, September 20). Pandemics throughout the history. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8525686/
References
Peters, G. (2022, December 7). Historically unprepared: Examination of the federal government’s pandemic preparedness and initial COVID-19 response. Senate.gov. https://www.hsgac.senate.gov/wp-content/uploads/imo/media/doc/221208_HSGACMajorityReport_Covid-19.pdf
Petcu, M. A., Sobolevschi-David, M. I., Crețu, R. F., Curea, S. C., Hristea, A. M., Oancea-Negescu, M. D., & Tutui, D. (2023). Telework: A Social and Emotional Perspective of the Impact on Employees' Wellbeing in the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 20(3), 1811. https://doi.org/10.3390/ijerph20031811
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Thomas, L. E., Emich, A., Weiss, E., Zisman, C., Foray, K., Roberts, D. M., Page, E., & Ernst, M. (2023). Examination of the COVID-19 pandemic's impact on mental health from three perspectives: Global, social, and individual. Perspectives on Psychological Science, 18(2), 513–526. https://doi.org/10.1177/17456916221078310
2000 - 2005
2000- California, Maryland, Minnesota, and South Carolina received funding through the CSTE to develop and submit state plans. A national pandemic influenza steering committee was formed, comprising of the CDC, CSTE, NACCHO, and the Association of Public Health Laboratories, transforming the planning process from a federal effort to a national effort. Federal funding was also increased, increasing the number of states engaged in a pandemic plan, including Florida, Indiana, Massachusetts, New Hampshire, and New Jersey. Arkansas, Arizona and Oregon developed their own plans, while Tennessee and Pennsylvania already developed plans in 1999.
2001- In January, Federal funding was added to allow for Kansas, Washington, Nebraska, Connecticut, and New York to join the pandemic plan. In September, the 9/11 attacks occurred, shifting the focus of public health preparedness and funding toward bioterrorism emergency response for all states.
2003- Reemergence of avian flu A (H5N1) begins.
2004-2005- H5N1 spreads throughout East and Southeast Asia, prompting US policymakers and public health experts concerned about the H5N1 outbreak in the US to provide substantial funding ($550 million per state) towards federal-level planning, vaccine development and procurement, and state and local pandemic preparedness efforts. The National Strategy for Pandemic Influenza was announced in November 2005.
Certified Emergency Planning Information Portal
Local and federal governments must collaborate to ensure that help reaches everyone, including underserved communities. A Certified Emergency Planning Information Portal (CEPIP) should be established, funded by the federal government, and managed by all the agencies involved in mitigating the impact of future pandemics. The CEPIP will ensure that all information, data, and directives are authentic and timely. Local governments should encourage civic engagement and ensure that focus and special interest groups have input and access to the CEPIP.
Mental Health Focus
In the rehabilitation effort for mental health, clinics should be established and operated in places such as local shelters, food banks, schools, and other public facilities to ensure that underserved communities have equal access to them. Remote mental health services should be launched using tools like video conferencing or chat platforms. Peer support groups established pre-pandemic can be activated, enabling people to share their experiences, tips, and encouragement, which can be very beneficial in isolation periods.
2006-2010
2006- The White House’s National Implementation Plan was published, addressing federal planning and response strategies to include international transport and border control, protection of human and animal health, and security and continuity of operations issues. The Biomedical Advanced Research and Development Authority (BARDA) was also established within the Department of Health and Human Services, creating a centralized effort to coordinate research, development, and procurement of countermeasures against a natural or intentional public health emergency.
Concurrently, the US government begins purchasing influenza antivirals for the Strategic National Stockpile- enough to treat 25% of the US population. Additional investments were initiated to procure ventilators and personal protective equipment (PPE) such as respirators. BARDA and the CDC awarded contracts for the development and evaluation of clinical point-of-care rapid diagnostics to identify seasonal flu and H5N1 viruses. The WHO met to discuss guidance and support global pandemic preparedness, providing visibility and readiness for future outbreaks. The US provided financial support and technical assistance to help countries develop capacities for rapid response, laboratory diagnosis, and surveillance. The 2006 Pandemic and All-Hazards Preparedness Act called for a review of comprehensive state and local preparedness. 2009- Results of the Pandemic and All-Hazards Preparedness Act review results were released to the public, and the A(H1N1)pmd09 pandemic (“swine flu”) occurred.
1990s
1993- NVPO formed the federal interagency Group on Influenza Pandemic Preparedness and Emergency Response (GrIPPE), which included non-federal consultants and representatives from the CDC, FDA, National Institutes of Health, and Department of Defense.
1995- Council of State and Territorial Epidemiologists (CSTE) released survey data indicating that less than 60% of the state health departments felt there was a need for a state-specific plan.
1996- 40 state and local health officials met in Atlanta in September and identified four “pillars” important to state and local pandemic planning- surveillance, vaccine delivery, communication and coordination, and emergency response.
1997-The Atlanta meeting group drafted guidelines for state and local pandemic preparedness in January. Four states (Connecticut, Missouri, New Mexico, and New York) and one local area (East Windsor Township, New Jersey) were chosen to participate in a pilot to test the drafted guidelines. Maine volunteered to test guidelines without CSTE support. Additionally, the GrIPPE published a pandemic planning framework.
1998- The five locations conduct the pilot and come up with three recommendations: 1) A fifth pillar area focusing on guidance for the use of antiviral drugs should be included, 2) Format should be consistent with the national plan, and 3) All states should receive the revised guidelines to develop state-specific plans.
1999- World Health Organization (WHO) published a pandemic plan in an ongoing effort to prepare for future.
Consistent and Accurate Information
1978
First pandemic plan was developed under CDC leadership, which included recommendations for annual flu shots for persons at high risk, strengthening of surveillance, expanding research, and establishing a planning and policy framework.
1980s
1983- The pandemic plan was revised to include new recommendations for influenza antiviral drug development and distribution. 1986- Legislation created the National Vaccine Program Office (NVPO) to coordinate federal vaccine-related activities.