Coping with COVID-19: Tips for Healthcare Providers and Patients

Potential Consequences of COVID-19.¹ COVID-19 will likely contribute to increased loneliness, anxiety, depression, substance use, domestic violence, and child abuse. The 3 steps you can take to prepare for the impact of COVID-19 on mental health are: 

1. Address loneliness with virtual technologies, especially for those at high risk for isolation (eg, the elderly)
2. Establish surveillance mechanisms for domestic violence and child abuse
3. Bolster the mental health system (Medicare has expanded coverage for telemedicine for mental health services)

General Tips for Coping with COVID-19.^2-4 The elderly, teenagers, COVID-19 responders, and people with chronic illnesses may have stronger emotional responses. Ways to cope include:

• Take breaks from news/social media and get updates at specific times once or twice a day
• Maintain routines
• Prioritize self-care: breathing, meditating, eat healthfully, exercising, avoiding alcohol/tobacco/drugs
• Engage in enjoyable activities: read, take an online course, DIY home activities
• Support and connect with others
• Focus on positive, hopeful stories
• Thank carers and health care workers

Tips for Healthcare Providers.^2-4 Responders may experience secondary traumatic stress resulting from exposure to another person’s trauma. Symptoms include fatigue, illness, fear, withdrawal, and guilt. Ways to cope include:

• Take breaks, give yourself time to recover
• Prioritize self-care
• Take a break from the news
• Maintain contact with friends and family
• Ask for help if you feel overwhelmed or less able to function
• Develop a buddy system if you experience avoidance due to stigma or fear; reach out to colleagues who may be experiencing the same thing

Tips for Parents.^2-4 Common reactions in children include excessive crying/irritation/worry/sadness; regression to past behaviors; unhealthy eating/sleeping; poor school performance/avoiding school or activities; difficulty concentrating; unexplained headaches/body aches; use of alcohol/tobacco/drugs; increased need for attachment; and acting out. Ways to support children include:

• Address concerns over COVID-19
• Reassure, find positive ways for children to express fear and sadness
• Limit exposure to the news
• Keep regular routines
• Model healthy behavior
• Avoid separating children from parents. If separation is necessary, ensure appropriate alternative care with social worker follow-up. Provide regular, daily contact with parents/carers

Tips for People at High Risk: Older Adults, People with Chronic Illness. Common reactions include increased anxiety, anger, agitation, withdrawal, guilt about needing help, and feeling isolated. Ways to support high-risk individuals include: 

• Check in regularly, help connect them to loved ones
• Know their medications, stock up on 2-4-week supply of medications
• Monitor their medical supplies (oxygen, incontinence, etc.)
• Create back-up plan: help them know how to call a taxi, order food delivery, etc.
• Stock up on non-perishable items
• Help them learn exercises at home to maintain mobility/decrease boredom
• Have procedure and referrals ready for anyone who shows severe distress, signs of hurting themselves or others

Resources for Help:

• 911
• SAMHSA Disaster Distress Helpline: 1-800-985-5990, or text TalkWithUs to 66746)
• SAMHSA Guide to Helping Older Adults after Disasters
• National Domestic Violence Hotline (online chat 24/7): 1-800-799-7233 and TTY 1-800-787-3224
• CDC Emergency Responders: Tips for Taking care of yourself
• National Suicide Prevention Lifeline (24/7): 800-273-TALK (8255)
• National Alliance on Mental Illness COVID-19 Resource and Information Guide: links to helplines, online support groups, and more

References:

1. Galea S, Merchant RM, Lurie N. The mental health consequences of COVID-19 and physical distancing: The need for prevention and early intervention [published online ahead of print, April 10 2020]. JAMA Intern Med. 2020. doi:10.1001/jamainternmed.2020.1562
2. Centers for Disease Control and Prevention. Coronavirus Disease 2019 (COVID-19): Stress & coping. Centers for Disease Control and Prevention Web site. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html. Updated April 16, 2020. Accessed April 16, 2020.
3. World Health Organization. Mental health and psychosocial considerations during the COVID-19 outbreak. World Health Organization Web site. https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf. Published March 18, 2020. Accessed April 16, 2020.
4. National Alliance on Mental Illness. COVID-19 resource and information guide. National Alliance on Metnal Illness Web site. https://www.nami.org/covid-19-guide. Updated April 6, 2020. Accessed April 16, 2020.