Last week, a Covid-19 patient, and the husband of another positive patient died by suicide, in separate incidents in the city. The pandemic has created panic and worry among most, bringing the spotlight on counselling and emotional care.
Most city hospitals make sure that patients who are admitted or will be following home quarantine know how to handle the situation. Medical practitioners and doctors counsel them and make them aware about steps to follow.
While most patients calm down with diligent care from the hospital and support from staff and family, around 15 per cent of the cases end up needing more counselling, say doctors.
Worry for themselves, families and social stigma, are some of the reasons cited in such cases.
Around 15 per cent have ‘corona phobia’
Dr Ramesh K N, professor of medicine, nodal officer for Covid-19, Bowring and Lady Curzon Hospital says that people around create fear in patients.
He says, “Electronic and social media continually mostly stress on negative news. Any patient would feel frightened seeing doctors in PPE kits around. A more positive approach is important.”
Around 15 per cent of the total patients have ‘corona phobia’. “Most patients are reassured by doctors using counselling techniques. Some who feel restless, are not able to sleep and are more anxious about family, will need phone or video counselling sessions,” he says.
He adds that the psychological health of a patient is also affected by how society deals with the pandemic, like how BBMP seals houses with tin sheets and locks houses of positive cases up.
‘Rounds now take longer’
A majority of the patients have anxiety and stress and those with co-morbidities suffer more, says Dr Naveen Jayaram, consultant psychiatrist, Sakra World Hospital.
“Around 90 per cent of them come with fear. Initially nurses talk to the patients about how it is important to stay calm. Our physicians speak to them constantly and the patients also have an option to opt for further counselling,” he says.
Doctors take more time when on rounds and are dedicating much more time to patients now, he adds.
Patients with suicidal thoughts, insomnia, claustrophobia, constant worry about conditions like wavering blood pressure or heart rate are forwarded for further counselling.
Dr Naveen adds, “Some end up needing medicication but mostly telecounselling helps. For most people the anxiety rises not just because of the disease but the whole process of how BBMP officials seal their premises and do contact tracing.”
Understanding that Covid-19 is just another disease is important
At Rajiv Gandhi Institute of Chest Diseases (RGICD), senior doctors attend to most Covid-19 cases. Dr C Nagaraj, director, RGICD says, “The doctors make sure that the patients are aware about the virus and the care they should take.”
Medical social workers of the hospital also interact with these patients and counsel them. “They understand the situation and talk to patients freely. Apart from administering drugs, psychotherapy is important. The staff makes patients understand that they will be there to address any situation. Patients with hypertension and diabetes experience more panic,” he says.
About 10 to 15 per cent of the patients need more attention, which is when a teleconsulting session with doctors from NIMHANS is arranged.
“One has to understand that the scenario is much like how it was with other diseases like Tuberculosis in the past, which is dealt with calmly now. One has to understand that Covid-19 is like any other disease.”
Social stigma is a big worry, he adds.
Many think it’s ‘end of the journey’
Dr Karthik R, emergency physician, CMH Hospital says that many think that getting infected means the ‘end of the journey’.
He says, “We have many more recovery cases now. Most healthy patients are treated and recovering well. The moment a person starts getting treatment from us, we reinforce the importance of staying positive and tell them about the many cases who have recovered and been discharged.”
The doctors cite themselves as examples as they attend to many cases every day but are not exposed or infected.
People with children and elderly at home are usually more anxious, he adds. “After constant interactions, if the patient still feels emotionally down, we get experienced psychiatrists to counsel them in person. If a patient is in the ICU, his or her family is counselled so that they can reassure the patient,” he says.
The physician attending the patient also counsels the latter’s attenders.
Panic due to infodemic
Dr Sunil Kumar, consultant - interventional pulmonology, Aster CMI Hospital, says the mass hysteria comes from the economic burden (due to loss of jobs) and usage of heavy words like home quarantine, isolation and lockdown. He says, “The anxiety is due to the infodemic (a flood of information through media and mass), which adds to the anxiety. People with minimal symptoms also start imagining themselves to be infected.”
Instead of the words social distancing, physical distancing is what needs to be used, he adds.
How to beat stigma around Covid-19
Do not give out names or details of any individuals or family who might have contracted the disease.
Do not make videos or post photos of an infected person, or of them being taken away in the ambulance.
Do not post on social media about details of infected people, which could give rise to bullying.
No one intentionally gets infected. Extend support to those who need it.