COVID-19 could be worsening Canada’s mental health, but key data are missing

This article was originally published on the SWCC Blog | Photo credit: Serkan Göktay, pexels.com

The number of Canadians expressing increased levels of anxiety and depression has quadrupled since the arrival of COVID-19, according to a recent report by Mental Health Research Canada.

Ontario responded by making therapy free for people with anxiety or depression. Minister of Health Christine Elliott explained that individuals will be assessed by a “trained mental health clinician” and then “offered a therapy program that best addresses their level of need.”

Research is underway to better understand the impact of the pandemic on the mental health of Canadians. The Centre for Addiction and Mental Health (CAMH) in Toronto regularly updates its survey numbers online.

CAMH found that 25 per cent of respondents report moderate to severe anxiety levels. Women, people with children under the age of 18, and younger adults (aged 18-39) are more likely to feel anxious and depressed during COVID-19. People with a job that exposes them to high risk of infection are also more likely to have high levels of anxiety. Job loss also negatively affected people’s mental health.

“This is the first of a series of surveys,” explains Hayley Hamilton, a senior scientist in the Institute for Mental Health Policy Research at CAMH. “We asked a series of questions, such as ‘To what extent are you worried about the impact of COVID-19 on your personal finances, about getting COVID-19?’”

Hamilton says these questions help link COVID-related events to the person’s mental health at the time. As data rolls in from proceeding surveys, she is getting a clearer picture of how events of the day are affecting people’s wellbeing.

People have been dramatically affected by social isolation and overall uncertainty of what is to come. 

“We have to be on the lookout for changes in how the population is adjusting,” Hamilton said. “As we re-open, what are people experiencing? Are anxiety levels going down? Are people drinking less? We’re hoping to see reductions in loneliness as people re-engage on a personal level with others.”

More information is needed on the mental health impact of COVID-19 in Canada. However, research from China offers insight into what we might expect. Just days before the World Health Organization declared COVID-19 a pandemic, scientists in China began surveying populations for psychological distress.

Cuiyan Wang, a researcher at the Institute of Cognitive Neuroscience at Huaibei Normal University, measured the connection between the pandemic and people’s mental states. Results of the  study are published in the International Journal of Environmental Research and Public Health. Wang and colleagues collected data on how people were coping just two weeks after the initial outbreak in China, one day after the WHO declared the virus and international public emergency.

The study examined 1,210 respondents from 194 cities. Of this population, 53.8 per cent reported a moderate to severe psychological impact score. In a follow-up study a month later, Wang found that people felt less distressed as the government took action to contain the virus. Most people surveyed were concerned about their family contracting the virus. They also were more likely to report anxiety if they were feeling physical symptoms associated with the virus.

Jianyu Qiu and a team from the Shanghai Mental Health Center shed additional light on the link between COVID-19 and mental health in China. Their study, published in March, analyzed 52,730 survey responses. Of these, 53 per cent reported a moderate or severe psychological impact from COVID-19. Migrant workers experienced the highest levels of distress. This was due to concerns about virus exposure when returning to work, reduced work hours, and reduced income. People over the age of 60 were also among the most vulnerable to distress, as COVID-19 is particularly lethal to this age group. The study also found that women were vulnerable to distress and more likely to develop post-traumatic distress disorder. This suggests that COVID-19 will adversely affect the mental health of some groups more than others, particularly if they are more at risk of infection.

Hamilton’s research reveals that women, people with children, and people who have lost their job are taking the brunt of psychological distress in Ontario. But some populations remain unaccounted for.

So far in the province, 80 per cent of COVID-19 deaths have occurred in long-term care.  In Toronto, the five most-affected neighborhoods are more likely to have low-income, racialized, and immigrant populations. The pandemic is also adversely affecting homeless shelters’ ability to provide adequate support to people on the street—a population already vulnerable to physical and mental health conditions. More research is necessary to determine how these peoples’ mental health are affected by the increased risk of infection and death.

What cancer taught me about social distancing

Photo credit: Rame Abdulkader/The Fulcrum | This Op-Ed was published in The Fulcrum on March 22, 2020.

I used to have a pretty bad cough.

It was common for me to get sick in October. Busy with courses, I was usually on my third cup of coffee by 3 pm — a feeble attempt to offset the stress and fatigue that came with courses in the middle of the semester. And working with children between classes meant I was exposed to all sorts of freshly incubated bacteria. 

It was just a matter of time before I had to take a couple of days, sip on hot broth, and watch Disney Pixar’s Up for the umpteenth time. And as soon as I felt well enough, it was back to the grind of work, courses, thesis, and the perils of student government.

When you’re a busy 20-something in university, it’s easy to ignore signs that your health is deteriorating.

I was having night sweats. My apartment’s heating system was notorious for being exorbitantly hot; surely that was why I was sweating so much.

Back pains? Well, my posture hasn’t been good lately. Must be a pinched nerve.

My pants were getting a bit loose. I’d been quite active lately; I must have lost weight by running around with kids at work.

I also had a cough that went on for months. I thought that was normal for the season; it’s probably just lingering from when I had a cold. I’ll rest when I have time.

This went on until Christmas break, when my parents forced me to go see their family doctor.

The doctor took note of my symptoms and narrowed it down to two possibilities: a heart infection, or blood cancer.

After further testing, we discovered that my cough was caused by a swollen infected lymph node pushing on my airway. My back pains were caused by lymph nodes near my lower spine. My night sweats were caused by fevers. And I was losing weight because the cancer was wreaking havoc on my body.

I was formally diagnosed with Hodgkin’s disease in February 2016.

I began chemotherapy a month after my diagnosis. The side effects were not fun. I had a dramatic loss of energy and appetite; my body ached from the harshness of the chemicals; everything tasted like metal; my skin felt dry as paper; and I was chronically constipated.

It sucked.

But there was one side-effect that concerned me above all else: I was immunocompromised.

To mitigate this, I was advised to refrain from going outside unless I had to. I was to avoid visiting grocery stores during peak hours. To not participate in public events with large crowds. And if I was planning a get-together, anyone with the sniffles had to stay away.

Sound familiar?

With COVID-19 threatening the health of thousands, I’m getting eerie flashbacks to this period in my life.  I’m reminded of a couple of lessons I learned from my cancer experience.

Lesson one: no one is immune to getting sick. As cliché as it sounds, we all think we’re bulletproof in our 20s. You may not be thinking this out loud, but it’s there in the background, subtly influencing your choices. In many cases, this is a good thing — it gives you the confidence you need to try new things, to get out there and take the risks that make life worth living. But in the middle of a pandemic, this is dangerous behaviour.

As we learn more about the risks of COVID-19, it’s easy to get hung up on this statistic: One study from the Chinese Centre for Disease Control and Prevention found about 80 per cent of COVID-19 cases are mild. 

But Globe and Mail health columnist André Picard is keen to remind us thatwe don’t know the long-term health impacts of COVID-19.One in four patients who survived SARS had a permanent disability due to lung damage. The same risk exists now. My message to you: don’t wait until you catch COVID19 to find out whether it will hurt you long-term.

Lesson two: social distancing works. When I was self-isolating during chemo treatments, I knew I couldn’t go to events with large crowds. But sometimes the cabin fever got the best of me. I went out with my girlfriend to see La Machine during Canada Day festivities in the summer of 2017. This was a special time to be in Ottawa, with thousands exploring the streets.

We were forced to weave through a crowd to get to a secluded vantage point on the other side. I must have been surrounded by people for no more than a minute. That was enough to get me sick. I ran a fever during my treatment the following week. If I had just stayed home, kept myself socially distant, I would not have contracted a cold.

The point here is that viruses spread easily in crowds. If my immune system was not compromised at the time, I might not have gotten sick — but I would still have been carrying the virus. Public health officials are telling us that COVID-19 spreads in a similar way. Protect yourself and avoid close contact with people as much as possible.

Lesson three: we are not powerless against disease — especially if we work together. When I was diagnosed with Hodgkin’s, I was connected to a support group of young people who were facing — or have previously faced — the same disease as me. They taught me the power of solidarity and support. We bonded over shared experiences, talked about our deepest fears, and celebrated each other’s victories.

The COVID-19 pandemic is undeniably scary. Now, more than ever, we need to lean on our support networks. The safest thing to do is avoid in-person contact with others, but we thankfully have technologies that can help bridge that social gap. If you are feeling isolated, anxious, or uncertain, you’re probably not the only one. My hope is that you can reach out to your loved ones to offer support, and to receive support in return.

If the negative feelings are truly overwhelming, I also encourage you to connect with mental health services in your area.

We’re living in unprecedented times. But if my health experiences have taught me anything, it’s that we can make it through. One step at a time. Together.

On this, we can agree: not all glasses are rose colored.

Disclaimer: if you haven’t yet read The KLF: Chaos Magic and the Band who Burned a Million Pounds, I encourage you to do so before reading this post. It’s a hell of a read.

In The KLF: Chaos, Magic, and the Band who Burned a Million Pounds, Higgs explores ideas that are as chaotic as the band he’s biographing. He discusses religion, aesthetics, art, and philosophy, then uses these concepts to paint a magical picture of his subject.

In his version of the story, The KLF are the butterfly wings that cause a hurricane—the hurricane of the 2008 economic crash.

This, of course, is ridiculous. And Higgs says as much.

Higgs explains that he can create this narrative—that the KLF caused the recession of 2008—because he’s using a type of thinking that allows him to do so. You see, he’s looking at the KLF through Allan Moore’s concept of the Ideaspace. This allows Higgs to draw connections where, perhaps, there are none. For example: connecting the burning of a million pounds to the biggest economic crash in recent history.  But if you put on a different pair of glasses—one this is not quite so magical—the story changes dramatically.

This is the lesson Higgs is trying to teach us. And, if applied correctly, can change how a person approaches communication.

If you are an active participant in the marketplace of ideas (e.g. a journalist, academic, filmmaker, etc.), you’ve probably had to write some of those ideas down. The challenge with writing—or any kind of communication, really—is that sometimes the ideas get stuck in the doorway. They all try to come out at once, but they obviously can’t all fit.

This is when we start to make choices. Not all our ideas will fit neatly into a clear line of thought, so we string them together the best we can. These choices, whether made consciously or not, are warped by the models we use to experience the world. These models are worn by the individual like a pair of sunglasses, influencing everything she sees.

In this book, John Higgs challenges us to think about our glasses. What do they see? What do they choose not to see? What would happen we swapped our lenses for something different?

Higgs’ story of the KLF is not just about a band who burned a million pounds; it’s a story about how we build stories. Higgs claims that the KLF caused the 2008 financial crises because the model he’s wearing a pair of glasses that allows him to do so. Swap glasses, you see different things, and find a different story.

Our glasses inform how we talk about the world. Maybe we should try a new pair once in a while. You never know what we might see.