Prevention & preparedness

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Finally the Government of Nagaland has ordered the closure of all educational institutions and University in the State from March 17 to April 12 (exception for the ongoing CBSE, CISCE and other board examinations) as precautionary measures against Covid-19, even though till date there is no reported or suspected case of coronavirus in the State. This welcome decision was taken at a high level meeting convened by the State Chief Minister on Monday. Besides closure of educational institutions, the meeting also decided to ban all tourist entry (foreign and domestic) into the State with effect from March 18 till further orders, besides decision to man and screen all entry points and check gates into the State. As stated by State chief secretary Temjen Toy in today’s meeting, the two important aspects of the pandemic were prevention and preparedness, and it is laudable that the State is doing everything in its power to prevent the virus from entering the State as well as preparing for any eventuality. We can say that the global climate changes, the air connectivity and international exchange have gifted us the COVID-19. It is cutting across countries leading to anxiety, acute stress to real or impending threat of virus, and widespread panic attacks apart from medical morbidity and death. Though we are not new to these threats as we have defeated flu like illness psychologically earlier, but media coverage has highlighted COVID-19 as a literal death threat. This has led to hoarding of masks, hand sanitizers and virtual absence of related medical equipments from the market inclusive of online availability as well. Here we must keep in mind that resilience, not panic, is the psychological remedy. The fear pendulum of COVID is swinging gradually from denial to crisis and what is required at this time is sensible health policy to avoid spreading of this highly contagious disease. Everyone is focusing on quarantine and rightly so, but that itself from mental health point of view would cause short term fall outs like irritability, frustration, anxiety and fear psychosis which would need a psychiatrist’s intervention and if isolation is prolonged to a long term phenomenon called post traumatic stress disorder (PTSD) with likely substance abuse as well. The disease has started crossing continents from China to Iran, Italy, Middle East, India and is now knocking in our doors. As said it is laudable that the State Government is taking all preventive measures to ensure that the virus do not enter our State. However, if the worse happens the State should be geared to tackle panic attacks, hysteria and anxiety. These common mental health conditions will travel, and travel more quickly than the idea of resilience and hope. When any treatment is still awaited there will be a downhill course to despair with far reaching consequences, unless positive mental health is promoted by our doctors to augment psychological support system. This can be best achieved by people working together, and promoting mutual trust. Washing hands thoroughly, not touching face, keeping a good distance from a sick, are reasonable measures, but quarantining whole community is certainly not advisable. We must focus on resilience as it is most important tool which gives people the psychological strength to cope with stress. It carries people through trauma and prevents them from falling apart. Fortunately our society is resilient to a good extent but it can be learnt by many ways as well, like we should avoid trying to solve problems with same thinking that created it, by staying tough, keep growing and by staying prepared. A simple but one of the best ways to be resilient is to be aware of what’s happening. By remaining aware a resilient person can control an awkward situation and think of new strategies to tackle issues. A typical person is not only aware of his emotions but also the behavior of people around him. Here the internet and media may act as a double edged sword. With its instant, indiscriminate reductive messages will spread panic, anxiety and hopelessness very fast. What is expected of a psychiatrist and mental health professional at this stage is to provide psychological support through its support teams, promote correct knowledge and spread it as quickly as possible. Electronic counseling and mental health screening directly as well as by referral for depression, anxiety, panic and suicidality has to be taken up as soon as possible. Let’s be mentally tough to counter COVID-19 in our part of the world.