Psychological Impact of Behaviour Restrictions During the Pandemic
eBook - ePub

Psychological Impact of Behaviour Restrictions During the Pandemic

Lessons from COVID-19

Barrie Gunter

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eBook - ePub

Psychological Impact of Behaviour Restrictions During the Pandemic

Lessons from COVID-19

Barrie Gunter

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This volume examines the undesirable or harmful cognitive, emotional and behavioural side-effects of COVID-19 and of the behavioural restrictions imposed by governments on their populations during the pandemic.

Societal "lockdowns" and other intervening behavioural restrictions, built significantly around social isolation, used by governments to control the spread of COVID-19 disrupted the lives of most people. There were economic costs for many as workplaces closed down, as well as severe stresses on friendships and romantic relationships, an increase in instances of abuse and domestic violence, and concerns about people drinking too much alcohol or gambling too much as compensatory behaviours. Understanding which people were at risk, and in what ways, could teach important lessons for the future. Presenting a timely review of the most recent international research and evidence, author Barrie Gunter assesses the major collateral, psychological side-effects of the pandemic. Looking forward, Gunter also considers how new models might be developed that take into account not just the need to halt the spread of a new virus, but also minimise collateral damage which could be every bit as severe in both the short term and long term.

Identifying and analysing the nature and severity of collateral side-effects of pandemic-related behaviour restrictions, this is essential reading for students and researchers in psychology, public health and medical sciences and policymakers assessing government strategies, responses and performance.

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Chapter 1 The COVID-19 Pandemic: Hindsight and Foresight

DOI: 10.4324/9781003274377-1
When first identified, the novel coronavirus, COVID-19, was a completely new virus about which little was known and for which there were no established preventative or treatment-related medical interventions. Being new also meant that human beings had no acquired immunity to it, although a few may have had some serendipitous natural immunity. Despite this particular virus being new, the family of coronaviruses was not unknown. Yet, the distinctive characteristics of this specific coronavirus meant the whole world was confronted with a steep learning curve in trying rapidly to understand more about its structure, infectivity, symptoms and potential to cause death. It also meant leaning heavily on non-medical or non-pharmaceutical interventions, initially, to bring it under control as it spread rapidly around the globe.
In turning to non-pharmaceutical measures, which were based on recommended personal hygiene and protection behaviours and limited social contact with other people, restrictions were introduced that brought sweeping changes to people's lives. It was quickly apparent also that these so-called “protective” measures could cause considerable collateral damage of their own to individuals, families, businesses and services. The enforced closure of many physical spaces in which people would normally inter-mingle was implemented by many national governments because there were doubts that reliance on the public's voluntary compliance would not deliver the desired results.
Mistakes were made. Some governments closed down too late. Others did not close down sufficiently or for long enough. Some failed to get to grips with the types of physical spaces that posed the greatest risk of infection spread. Many defended their decisions by reminding everyone that this was a major crisis involving a new virus and its impact was being felt across the world on an unprecedented scale. Too little was therefore known to provide detailed strategic guidance about how best to tackle the rapid spread of highly infectious disease The defence of “benefit of hindsight” did not always ring true, however, given previous warnings governments had received from public health experts and scientists about the risks of major pandemics (Henig, 2020, 9th April). To be clear, pandemics were known about and had been recently experienced, even during the 21st century. The deployment of non-pharmaceutical interventions was also established practice for dealing with pandemics until effective medical treatments were available.

Advance Warnings

In August 2010, the Director General of the World Health Organization (WHO) warned, as the world recovered from H1N1 pandemic, that pandemics were unpredictable and could have unexpected impacts. The H1N1 pandemic had been relatively mild, but it could have turned out differently. The WHO issued advice however that people should continue to observe good personal hand and respiratory hygiene, take up vaccines when offered and observe other locally recommended practices designed to control the spread of the virus (WHO, 2010, August).
In a widely viewed TED Talk delivered in March 2015, five years before the onset of the 2020 novel coronavirus pandemic, the entrepreneur turned philanthropist Bill Gates issued a warning that a global pandemic would soon occur for which the world was ill-prepared. It would infect hundreds of millions and kill millions and place health systems under considerable strain. In the absence of pharmaceutical protection from vaccines and therapeutic drugs at the outset, societies would need to deploy a range of non-pharmaceutical measures and this would entail the suspension of normal activities and extensive shutdown of their workforces costing the global economy trillions of dollars. Gates offered some insights into how governments and the international community could prepare, but few did (Gates, 2015).
Ralph Baric, an epidemiologist at the University of North Carolina, warned about the risks of pandemic outbreaks in papers published in Nature in 2015 and PNAS in 2016. His warnings were especially poignant and prescient given its references to viruses circulating in bat populations that might prove to be zoonotic. Baric and his co-workers identified further variants of the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome (MERS-CoV) coronavirus could emerge. In fact, a bat coronavirus was already known about then that could be a candidate (Menachery et al., 2015, 2016).
A report produced by the National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Global Health; Committee on Global Health and the Future of the United States (2017, 15th May) outlined in some detail the future threats and risks associated with outbreaks of new pathogens for which no vaccines or effective therapeutic treatments were available. The principal threat derived from so-called zoonotic viruses that jump from one species to another. Over time, the ability of humans to protect themselves from new diseases had grown primarily through scientific discoveries and associated new medical treatments, including a range of preventative measures (i.e., vaccines) and treatment drugs. The main concern for the future was that if a new zoonotic virus jumped into humans and caused severe symptoms and even death for some (or many), there would be no pharmaceutical protections available. Many people could end up in hospitals overwhelming health services and resulting in many deaths. The only interventions available to tackle such pandemics would entail extensive closure of societies and their economies. This would be especially necessary with airborne viruses. The cures could be as damaging as the disease.
Various ongoing changes and trends caused by humans were contributing to increased risks of zoonotic virus pandemics. One principal factor was the increased urbanisation of many societies that was destroying the natural habitats of wild animals that could harbour zoonotic viruses which resulted in those animals living in closer proximity to humans. Another factor was the progressive globalisation of economies that resulted in greater movements of people and goods between countries. Both of these factors could convey viruses vary rapidly around the world. Hence, highly infectious diseases can potentially be more readily seeded and more extensively spread than at any previous time. They represent a real threat to the well-being of nations. Experts studying these diseases had been issuing warnings for many years and certainly throughout the 21st century that countries needed to be better prepared to deal with pandemics. While global pandemics occurred only occasionally, there were signs that another was overdue and that the conditions under which a major outbreak of a new virus to which humans had no natural immunity had grown in prevalence (Mackenzie, 2020).
During the 21st century alone, there were a number of outbreaks of diseases including avian influenza, Ebola, hantavirus, Marburg, MERS and SARS that occurred either through zoonotic viruses or pathogens that had infiltrated specific communities with which others then came into contact. Increased urbanisation has had the impact of decreasing the biodiversity of specific environments that have also created opportunities for these and other established diseases such as tuberculosis, to thrive and among populations with little or no in-built resistance (Pongsiri et al., 2009; Allen et al., 2010).
In 2019, Dan Coats, the Director of National Intelligence, issued a Worldwide Threat Assessment and concluded that the United States (and the rest of the world) would be vulnerable to the next flu pandemic or largescale outbreak of a contagious disease. It could cause large numbers of deaths and have serious effects on economies (Coats, 2019, 29th January).

COVID-19: First Signs

US intelligence agencies had learned in November 2019 about a new viral contagion sweeping through China's Wuhan region which had impacted upon the way businesses operated and people went about their normal lives. Early reports indicated that this new disease posed a serious threat to the population. This outbreak eventually turned out to be caused by the novel coronavirus that swept across most other parts of the world in the months ahead. It was reported that this evidence was presented to the National Security Council, the Pentagon and the White House. Further briefings were presented to key policymakers and decision-makers in the United States federal government. It was further noted that for any of these reports to be presented at this level, they would have had to go through a process of serious vetting and verification that probably would have taken weeks. It was concluded from these initial assessments that the Chinese leadership knew that the epidemic was out of control and concealed important information about it from foreign governments and international public health agencies (Margolin & Meek, 2020, 9th April).
Another report appeared in the autumn 2019 based on research undertaken by the Economist Intelligence Unit (EIU) working with the Nuclear Threat Initiative (NTI) and the Johns Hopkins Center for Health Security (CHS) that assessed the threats from and preparedness of different nations and their health systems to prevent, detect and respond to major new pandemics (McGrath, 2019, 25th October). The conclusions reached were neither positive nor reassuring. Most countries were thought to be ill-prepared for such a catastrophe. Their societies could be seriously undermined by major biological events whether triggered by the spread of a new naturally occurring pathogen or an engineered organism. A Global Health Security Index was developed with input from a group of international experts from 13 countries. Countries were scored on a 100-point scale, on which a score of 100 indicated being fully prepared. The average score was 40.2. Even amongst the 60 highest income nations, the average score was only 51.9. The UK's score was 77.9, the second highest after the United States. Yet, as the 2020 pandemic eventually demonstrated, this evaluation is probably rather flattering.
Globally, it is the responsibility of the WHO to identify new diseases and epidemics and to initiate appropriate responses in partnership with relevant national governments. The WHO reacted swiftly once it was established that a new respiratory virus had been detected in Wuhan, China, orchestrating information dissemination to health authorities around the world and producing guidelines for national health systems based on rapidly accumulating scientific and clinical understanding about it. In examining WHO-initiated actions and events over the January to April period in 2020, when the virus spread globally, it is clear that from early on, there were concerns that national governments around the world were not prepared to tackle this pandemic and many underestimated the risk it posed to their populations.
While events of this kind happen once in a lifetime at most, a mixture of complacency and ill-preparedness meant that the new virus spread rapidly through the populations of numerous countries – even those living in the most highly developed countries in the world – and quickly threatened to overwhelm even the best-resourced health services. In the United Kingdom, there was initial government inaction during a period when the WHO, was issuing severe warnings about the possible impact of this new disease and then adoption of the wrong approach in trying to reduce infection rates because of flawed psychological thinking about the kinds of interventions and restrictions people would tolerate.
By the time a harsher approach was adopted, the virus had already spread far and wide. Fortunately, most of those infected either experienced no symptoms or only mild ill effects. For an unlucky minority, however, the virus could cause serious respiratory illness requiring hospitalisation and for a few it could be deadly. Those at serious risk comprised only a tiny portion of the population in percentage terms, but when translated into numbers of cases, they reached the tens of thousands and this was enough to place the country's National Health Service under great strain, and quite possibly, according to some epidemiological modelling, overwhelming its ability to cope.

Historical Pandemics and Interventions

The COVID-19 pandemic was not the first time the world had experienced a major disease outbreak that spilled out beyond the borders of a single nation. During the Spanish flu pandemic that spread around the globe at the end of the First World War and subsequently killed tens of millions and made many more ill, many authorities reacted by shutting down specific activities and public spaces and placed responsibility of the public also to do the right thing. Schools were closed, and mass gatherings of people were banned. People that became sick were quarantined or isolated themselves to protect others. More recent coronavirus-based outbreaks (SARS-CoV-1 and MERS) had occurred in the 21st century but had been largely restricted to Asia. The countries affected by these viruses however learned valuable lessons from these outbreaks that served them well when SARS-CoV-2 broke out.
The 1918 influenza pandemic had high worldwide infection and mortality rates and triggered a number of different public health interventions on the part of national governments in an effort to contain the disease. The extent of this pandemic varied around the world. There was considerable geographic variance in the spread of the disease across the United States, for instance, compared to Europe. In many places, there were three peaks to ...


  1. Cover
  2. Half Title
  3. Title Page
  4. Copyright Page
  5. Contents
  6. 1 The COVID-19 Pandemic: Hindsight and Foresight
  7. 2 Lockdown Side-Effects: Public Fear
  8. 3 Lockdown and Loneliness
  9. 4 Lockdown and Mental Health
  10. 5 COVID-19, Mental Health and the Young
  11. 6 Lockdown and Panic Buying Behaviour
  12. 7 Friendships, Romance and Social and Sexual Relations
  13. 8 The Pandemic and Destructive Behaviour
  14. 9 Lockdown and Alcohol Consumption
  15. 10 Lockdown and Gambling Behaviour
  16. 11 Re-Setting Public Behaviour
  17. Index