​                                                       Pandemic Psychology
 
            Steven Taylor is a professor of psychology and a practicing psychologist at the University of British Columbia. In October 2019, he published a book titled The Psychology of Pandemics.[1] He wrote the book because he had noted the literature on pandemics did not really examine the psychological responses to a pandemic. He focused on pandemics of the 20th and 21st century and noted recurring patterns, which by now are familiar to us all.
The work is a literature survey and includes many theories of personality that seek to explain the observed phenomena, although his research interest is in anxiety disorders and his practice relies heavily on cognitive behavioral therapy.
 
            “Psychological factors also play an important role in the way in which people cope with the threat of pandemic infection and its sequelae, such as the loss of loved ones. Although many people cope well under threat, many other people experience high levels of distress…Psychological factors are also important for understanding and managing the potentially disruptive or maladaptive defensive reactions, such as increases in stigmatization and xenophobia, that occur when people are threatened with infection.”
 
            He arrived at no global conclusions about the mechanism of psychological responses to pandemics, but had a number of recommendations about communications between health authorities and the public which, by and large, have been followed during the coronavirus pandemic. Unfortunately, human nature being what it is, this has not changed the observed response much, if at all.
            In a follow up lecture given 28 September 2020 and available online,[2] he summarized the observed phenomena from previous pandemics, including a rise in racism, panic buying, sporadic looting, rumors and conspiracy theories, mask rebellion, vaccine refusal, profiteering, but also a rise in altruism. He reported a survey his group did of 2,078 Canadian adults about their personal response to the pandemic. 45% reported they had experienced personal growth—more appreciation for what they had, deeper connections, and/or increased spirituality.
            On the other hand, he described two syndromes, one at each end of a Gaussian distribution of response, each encompassing 10-15% of the population. The one getting the most press today is what he termed “Covid Disregard Syndrome.” This is manifested by dismissing the threat as exaggerated, belief in one’s being at low risk, belief in conspiracy theories, being non-compliant with safety recommendations, and being anti-vaccination. Not everyone manifests all of these features of the syndrome, but the typical example does. The other extreme is “Covid Stress Syndrome.” This is characterized by heightened anxiety, xenophobia, traumatic stress disorder, and compulsive checking for new data and seeking reassurance, which paradoxically increases susceptibility to “fake news.” The final feature is concern about the social and economic impacts of the pandemic, which may be real.
            His final observation is a guess that 10% of the population will suffer from PTSD after the pandemic ends, but he notes the end is rarely clean and self-evident, so the anxiety and hypervigilance will persist long after the actual threat has subsided. There is no evidence that the health care workforce is different. Recent wire service news articles have made it clear that many, if not all, hospitals are suffering from acute and now chronic staff shortages. Attempts to cover using traditional strategies are not working well, particularly the use of temporary, “registry,” staff. Hospitals are seeing nursing staff leave established positions to work registry, mostly because the money is much better, but they are also seeing an increase in people leaving the workforce or retiring early.
            Some of this may be a higher incidence of PTSD than predicted by Prof. Taylor, but some of it may be a reflection of a more global problem—workers are deciding their previous employment was not worth the money. While some may follow the money, others seem to be looking for a totally different path in life. Certainly, the problem of the toxic work culture in medical organizations has made it easier for people to leave, and managers and physicians who thought their staff were loyal despite being treated as FTE’s have been sorely disabused. The challenge, then, is to make drastic changes under conditions of financial and demand stress, a challenge many will likely fail.
            I think a useful way to look at pandemic responses is to compare a it to a graded exercise stress test. Many people may have coronary artery disease, but doing a stress test is a way of finding out which ones need more aggressive therapy. Psychologically, the pandemic is also a stress test—it will identify those whose coping styles expose them to increased dysfunction. At the macro level, the pandemic stress test exposes both the strengths and the weaknesses of the existing systems of care, and results need to guide efforts to “build back better” as the political phrase has it. At the individual level, though, we should not be surprised by what we have seen. After all, each person, when given a bad diagnosis, is being exposed to a stress test, and clinicians have seen all the responses seen at the population level. Any effort to achieve better results from a rebuilt health care system needs to be tempered by the knowledge that only 70-80% of the people will eventually learn to cope appropriately. Caring for the other 20-30% will require new strategies and probably new organizations, if the goal is “population health.”
 
6 September 2021


[1] Taylor S. The Psychology of Pandemics: Preparing for the Next Global Outbreak of Infectious Disease. (Cambridge: Cambridge Scholars Publ., 2019

[2] Steven Taylor (Professor and Clinical Psychologist) in talks with Ralph Simon #TEDxGateway Webinar
Sep 28, 2020. Accessed 27 August 2021 at https://www.youtube.com/watch?v=bTNerpwAIHc.
 

Further Reading

Beyond Toxic Organizations
Are medical organizations toxic environments or is the problem one of changing generational expectations?

Horizontal Violence and Nursing Staff Turnover
A recent study shows horizontal violence - conflict between nurses in a hospital - is common and a major cause of job dissatisfaction and intention to leave. What can be done about it?

Individual and Organizational Stress During the Pandemic
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Measuring Stress in Your Team
Making health care organizations more successful may begin with recognizing distress in the persons providing the care. But how?

More on Human Capital
Human capital is essential for any organizations, but failure to nurture it spells doom. Yet organizations routinely ignore this. Why?

​Population Health
Population health is a phrase that disguises some hard realities as illustrated by two recent reports.