The present COVID-19 pandemic, also known as coronavirus, has scientists, analysts, and world leaders working to mitigate the virus’ direct health threat, while also offering solutions to meet the fiscal, social and mental health needs of the world. As a result, we have nationally-scaled social experiments, in the form of how different governments are attempting to combat this massive health threat. In addition to testing and self-isolation, a country’s response to COVID-19 ties into its national identity. It therefore stands to reason to examine how national attitudes might influence the mental health of individuals and communities across the globe during the current crisis.
The United States has seen a wide-variety of responses by state and political affiliation, fluctuating between a possible quarantine of New York City to a since-discarded assessment that the worst of the pandemic will be over by Easter. While a broad spectrum of US-based health organizations is working to study, treat and protect against the virus, national concerns have been raised that the somewhat delayed response to the pandemic has curtailed the efficiency of its efforts. Additionally, a cultural heritage of personal freedom and individualism has seemingly contributed to stockpiling necessities, leading to shortages in basic food and hygiene items.
So how can all this influence Americans’ mental health response to the pandemic? The answer seems to focus on increased anxiety. As they face an ever-increasing threat to their health and their financial stability, the different approaches the US have been oscillating to and from have left many Americans unsure how to acclimate to the present reality. This uncertainty can add to the global increase in anxiety over the nature of COVID-19. And with anxiety-based conditions, such as social anxiety and obsessive-compulsive disorder being triggered, Americans may likely experience an influx of the stress that comes with such conditions.
As the assumed source of COVID-19, China initially saw a massive outbreak of coronavirus infections and deaths, but has since attained a firmer grip on the situation, by instituting severe isolation policies upon its population. A nation that stresses the importance of communal values, China implemented public monitoring, mass quarantines, as well as a severe punishment system for isolation breaches, complemented by a reward system for maintaining it. The approach resulted in a sharp drop in the country’s infection rate, and has since been praised for its success. That said, global health organizations caution against taking such drastic measures, with the WHO and Bruce Aylward, who had recently led a fact-finding mission to China, accounting China’s success rate to an “exceptionally high degree of population understanding and acceptance” of ceding personal freedoms in favor of the common good.
China’s reaction to the coronavirus does seem to be related to its national identity as a collectivist nation, whose citizens adhere to their leaders and common sentiment. It is also worth noting that collectivist cultures like China have been found to exhibit higher rates of hypochondria and disgust from diseases, both of which can partially explain the Chinese people’s strong reaction to protect themselves against the current pandemic.
The UK, for its part, is betting on its famous stoicism to endure the current coronavirus hardships, as they calmly muster through. “We Brits might like to think that stoicism, our stiff upper lip, sets us apart from what we imagine to be more flappable peoples,” says Newstatesman journalist Jeremy Cliffe. And while their initial approach seemed to toe the line of business as usual, the gravity of the situation was made glaringly clear after British Prime Minister Boris Johnson was infected with the coronavirus. The UK has since altered their mitigation strategy to include more substantial social distancing policies.
Facing the threat of COVID-19 without much complaining may seem like a testament of national resilience, but Britain’s approach also encapsulates a lack of honest communication, as well as an introverted attitude. This has been shown to leave individuals particularly vulnerable to social phobias and anxieties, as well as to PTSD, increasing the likelihood that more UK residents will develop these conditions.
Refraining from mandating a total shutdown and a self-isolation policy, Sweden has decided to manage the corona crisis in its own way. The decision has set it apart not only from most of the modern world, but also from the rest of the Scandinavian countries—Denmark, Finland, and Norway. The decision is said to have been based on the Swedish tradition of non-forceful interference with freedom and personal autonomy. As state epidemiologist Anders Tegnell explains, “That’s the way we work in Sweden. Our whole system for communicable disease control is based on voluntary action.”
Sweden’s attempt to manage the present health emergency rather than react to it may work to protect the nation’s citizens against added anxiety. Allowing citizens to choose to self-isolate underscores their own strengths, and their ability to contribute to their community’s needs, all of which contributing to a sense of relative security. However, it is yet to be seen how this voluntary approach impacts the spread of infection.
Conformity is what Australia is relying on in the wake of the corona outbreak (with The Guardian’s Ben Doherty noting that “Despite Australians’ cherished self-image as a band of rugged nonconformists, this is a country that, in fact, embraces obedience”). Generally speaking, the Australian people seem to be toeing the government line, in an effort to avoid a fast-paced infection rate.
The idea expressed above speaks to the tension between an individual’s “true self,” which expresses their own needs and desires; and a “false self,” which acts as a more socially acceptable persona that adheres to standard expectations. In Australia, reports are detailing the general obedience of the public at large to COVID-19 mitigation policies. And while this can help protect the population from infection, attention should also be given to the instability and fragile sense of security that may arise as a result of an increased gap between the obedient false self and a more rebellious true self that certain individuals might harbor during this pandemic.
Germany is a particularly interesting case when it comes to its response to the coronavirus. While its rates of infection are high, the rate of mortality due to COVID-19 is only 1.6%—much lower than Italy’s 12%; Spain, France and the UK’s 10%; China’s 4%; and the US’s close to 3%. The answer appears to rely in part on German efficiency and law-abiding compliance: Germany has provided coronavirus testing kits free of cost, and quickly moved ahead with testing much larger portions of the population, which meant it was able to quarantine and treat those who had caught the virus much sooner. In addition, Germany was able to institute more rigorous contact tracing early-on to mitigate the rapid spread. And while its infection rates initially saw a rapid increase, the German population’s adherence to government instructions have helped institute and maintain protective social interactions. As Prof. Hans-Georg Kräusslich, a leading virology expert at one of Germany’s research hospitals stated, “Maybe our biggest strength in Germany is the rational decision-making at the highest level of government combined with the trust the government enjoys in the population.”
In its efforts to control the spread of COVID-19, Germany’s most famously debaucherous city—Berlin—has made significant sacrifices to its way of life. Since personal freedom is now being seen as a major point of vulnerability for societies at large, Berlin has toed the national line and put a stop to its traditional hedonism: “Berlin is in a state of emergency. Freedom? Irrelevant. The insolence? Despondent. The diversity? Closed. The openness? Kept away.”
Creativity has been repeatedly linked to a number of mental health conditions, and particularly to depression. Emphasizing compliance over self-actualization could block forms of creativity and self-expression, thereby hindering the population’s ability to tap into their own thoughts and feelings, and to express them to those in their support networks.
“Dethroning” China as COVID-19’s new focal point, Italy, with its older population, is currently under a national lockdown, aimed at finally curbing the virus’ spread. The Mediterranean country’s incremental acknowledgment of the magnitude of this epidemic is understandable, due to the coronavirus’ unprecedented progression and effect. But Italy’s response has also been tied to the nation’s more sociable attitude, which seemed to play a role in the population’s initial reluctance to adhere to stricter guidelines—and the government’s less-than-authoritative attempts to oversee them. “It is not easy in a liberal democracy,” said top Italian Health Ministry advisor Walter Ricciardi. The President of Italy’s Lombardy region, Atillo Fontana, elaborated on this point by explaining that in the earlier days of the coronavirus’s spread through his region, mixed messages from the national government led people to believe “that everything was a joke, and they kept living as they used to.” For many Italians, this meant continuing with many social engagements, congregating with loved ones in crowded settings and maintaining close physical contact with each other.
Italy’s current nationwide lockdown goes against the nation’s sociable tendency, and as such may increase the national level of stress, even beyond the anxiety-inducing threat of the coronavirus. Such incongruence between the necessary isolation policy at present and a general attitude that promotes communal interaction creates a tension between an individual’s false and true selves, which over time can weigh on their own well-being.
Another early center for coronavirus, South Korea’s reaction to the pandemic in its midst was markedly different from China’s. A democracy fighting for its continued existence through key strategic alliances, South Korea relied on communication, transparency and mutual support in its fight against corona. Like other Far East nations, South Korean culture promotes collective thinking and cooperation; during the corona outbreak, this inclination has translated into open lines of communication between government agencies and pharmaceutical companies working on developing a vaccine. Additionally, the South Korean government’s approach has been to manage the crisis, as opposed to sweeping reactions: this included keeping schools open, as well as most factories, malls and restaurants. Coupled with widespread testing and a pro-active isolation policy when an infection has been detected, such measures have helped protect South Korea from truly disastrous consequences when it came to its population.
South Korea’s handling of the coronavirus seemingly blends its collectivist nature with an emphasis on individual rights. As such, the South Korean government and people immediately took action to mitigate the virus’ effect on the nation, while aiming to gradually return personal freedoms to its residents as soon as possible.
Different nations have taken different approaches in the fight against corona. It remains to be seen which take will prove to be the most effective, and what mental health issues will arise under each of the attitudes represented in their policies.
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