Coronavirus is putting us under wartime-like levels of stress. How to deal with it?

At Masaryk University in Brno, Julie Dobrovolná leads a team of fifteen researchers in the study of stress. In her opinion, what we are currently experiencing due to the coronavirus outbreak has some similarities to a state of war. Dobrovolná, an MD and Associate Professor at the Department of Pathological Physiology, says that we can find relief in routine and responsibility. And, surprisingly, also in a denial of certain negative – though realistic – thoughts.

She urges people to provide each other with support. “I’d by no means mock those who’ve stocked up on groceries. Knowing they have enough provisions to eat can keep people calm – it’s an effective stress reduction strategy.” 

How should we cope with the fact that people around us (even those very close) may well start dying? “It might sound odd, and not all psychologists would perhaps subscribe to this, but short-term denial works very well in adverse situations. What helps in severe circumstances, and a state of global pandemic is nothing if not severe, is to stop wondering whether mankind will go extinct tomorrow, and instead deny the threat, say to yourself: ‘we will survive’.”

Many people are currently experiencing stress caused by the global pandemic of COVID-19. Can the stress itself pose risks to their health? Is it a downward spiral?
Yes, triggering the so-called ‘stress axis’ can indeed have far-reaching consequences on people’s health, especially when the trigger persists. Mood swings and aggravation of chronic health conditions are to be expected along with changes in eating habits and other unwelcome effects. The good news is that the severity of the whole reaction mostly (but not always) depends on how seriously we perceive the situation that triggered it. By managing our perception of the degree of risk, we can also change the degree to which the whole system is activated.

Does it make sense to compare the events that we’re currently experiencing to a state of war?
It does and it doesn’t. The epidemic is a population-scale threat. However, so far it’s not in any obvious way connected to interpersonal violence – on this point, of course, such a comparison breaks down.

How do we effectively deal with stress and minimize health complications, or “merely” avoid symptoms of cabin fever when we’re stuck at home?
It all boils down to routine. The army and other armed forces know this, as do astronauts – it’s a tried-and-tested fix and extremely effective. People exposed to stress need to adhere to a particular routine. Especially if you’re at home with your family and children, I’d advise that you plan exactly what you’re going to do. Set a timetable, draw up a schedule. Wake up at a given time. Have breakfast, wash, and do some structured activities. Cook lunch together. Eat it, rest, and then do afternoon activities. An evening wash, bedtime. I myself am shut in with two children – a twelve-year-old daughter and a four-year-old son – and I’m working from home, too. Yesterday, we had another talk about what the coronavirus is and made a collective decision about how we’re going to be spending our time. My husband is a neurosurgeon, so we’re also preparing for the contingency that a moment may come when he’ll be transferred somewhere else and we might not see him for a while.

How long ahead should we plan? Aren’t long-term plans rather counterproductive, since the situation keeps changing on an hourly basis?
Absolutely. While it’s good to have a plan, you also need to keep possible changes in mind. Rigid adherence to a pre-set routine may be counterproductive in certain situations. From the perspective of anxiety management, it’s better to make plans for shorter periods – about a week or two. The program can be written down, very much like a timetable. Plan your activities for six hours a day. Plan your meals, bedtime, waking up time. And focus on whatever it is you’ve planned. If you’re all cooking a meal together, you and your family will naturally be concentrating on the job at hand, and your thoughts won’t stray towards the epidemic. Any kind of handicraft relieves anxiety, too. Sewing, origami, knitting, modelling, drawing – you name it. What is extremely important is physical activity. Working out. Exercise, too, needs to be a part of daily routine. Scout camps as well as the army put exercise on their schedules for a reason. It may perhaps feel a little ridiculous at first, and quite unfamiliar too, but you will be thanking yourself a few weeks down the line. Get a punchbag, as one of my colleagues – a kinanthropologist – recommends, set up an obstacle course, or try rope skipping. And what is terribly important – sleep. Personally, I’m very strict about this point. Sure, kids don’t have to get up for school, so theoretically they could stare at their screens until late in the evening, but this will mess up their routine and disturb their emotional well-being. Let’s set ourselves a bedtime and abide by it. I’d also urge people to find a way to act positively and supportively towards each other.

Don’t condemn others. A crisis usually stirs a host of dormant prejudices, and besides, people are secretly looking for a scapegoat for their negative feelings. I’d by no means mock those who’ve stocked up on groceries. Knowing they have enough provisions to eat can keep people calm – it’s an effective stress reduction strategy. Moreover, having your kitchen shelves full also helps break the chain of contagion – when the epidemic peaks, it will be better to avoid associating in groups, to meet no-one and stay indoors.

So it’s better to self-isolate, if you can?
That’s right, observe all quarantine orders and public health officers’ recommendations. Now is not the time for civil disobedience, for grumbling and bellyaching. That moment will come in six months or so, when this thing has blown over and we’re analysing what decisions people got right and what they didn’t. At the moment, it’s necessary to respect the authorities. If a public health authority decides that you should be in quarantine, do as they say. Not for yourself, but to protect others. Not just grannie and grandad, but also healthcare professionals, who are about to come under enormous strain. It’s not a good idea to meet other people at this point. I’d even recommend against self-help babysitting groups and day camps. Make a beeline for home and stay put, unless you have a job in the public health sector.

How do you explain this to teens, for example, who are having a break from school and act like they’re on holiday?
This is no holiday! Even millennials have to follow rules, however hard it is to make them stay in. You can keep track of a small child so that it doesn’t wander off, but doing the same is much harder when it comes to teenagers. But they, too, have to maintain discipline. I understand that they don’t have lessons and feel the need to meet and perhaps even support one another in this predicament. Nonetheless, they have to understand that this is what Skype is for, that they have to avoid bringing separate families and other groups into unnecessary physical contact.

From the perspective of stress, how taxing is it to work from home?
If you’re working from home, don’t blur the distinction between your work and your private self. If you are about to have a Skype call with your employer, make sure you look nice – no sweatpants and greasy hair – put on a clean top, comb your hair, place a vase with a flower within the frame. It does sound funny, but it’s a strategy that works. Mainly because this situation will last a while, you won’t be working from home for a day or two, but a month. To give you an example: I get up in the morning and I put on a striped top – meaning I’m wearing my “work clothes” – and I sit down at my computer. When I’m done, I change into a T-shirt – meaning my work shift is over.

That’s a piece of advice that could also apply outside the epidemic.
Well, what’s happening now is a huge opportunity for personal growth. All of us will have our values shaken up.

It’s clear by now that our economy will suffer a blow. But how will we react in terms of politics?
In the next election, people will be looking for a leader capable of protecting them, a quality that few would have sought in their political representatives before. Boris Johnson has been accused of having insufficient grasp of public health; if Theresa May had been in Number Ten, perhaps she’d be making better decisions. The same goes for the U.S.: the assumption is that Barack Obama would be more competent than Donald Trump in terms of making public health decisions. However, I’d say it’s a good thing that here in the Czech Republic we’ve been taking fairly strict, timely measures. We started early, which is great. I don’t want to sound too political, but the government’s steps are legitimate and understandable. I’d even go as far as to say that we should have heeded Minister of the Interior Jan Hamáček, who already suggested shutting down schools back on March 2nd, after the first three cases of coronavirus infection had been reported. I’m under no illusion that this was his own idea, someone just gave him good advice. But that, too, is an important quality in a politician – having someone give you good advice and not tuning out their recommendations, but accepting what the experts are urging and pushing it through. We’re learning a huge lesson for the future. If we can now all agree that listening to public health experts is the wise move, there’s a chance that politicians will also listen to them next time – and prevent the next crisis from taking place.

On the other hand, what do you say to those people whose businesses have now gone under?
That must be frustrating – and our society has a longstanding problem with communicating frustration. We avoid it when we raise our children, when we bring up teenagers. We keep suppressing it. The current situation will put those who can cope with frustration at a great advantage. I’ve already witnessed some cases that bear this out. I get it: it’s tough being self-employed and running a cinema or restaurant, and you lose your job because everything is in lockdown. But you have to accept this, because it’s in the interest of public health. It’s not just that by preventing people from meeting at the pub you run you’ll probably help save the lives of a few hundred older people. You’ll also help prevent the healthcare system from being overwhelmed. What happens with people suffering a heart attack while paramedics have their hands tied due to the spread of the coronavirus? What the people working in the catering industry and in culture should be hearing now is that once the epidemic has ebbed away, we’ll all be there to help them; that their time will come. All of us will need them. We’ll need plays about the coronavirus, we’ll need art-therapy of all sorts, therapists’ couches – we’ll need artists. But now is a time for the pragmatic restrictions that are heading our way. And that’s how things ought to be.

And who do we need right now?
Doctors, journalists, IT professionals. The IT people have to take care of everything that’s supposed to operate remotely. Journalists have to be able to communicate key decisions in such a way that the public understands them correctly and acts accordingly. No need to comment on doctors, is there?

How do we help healthcare professionals, since you’ve said that it’s better not to meet them face-to-face?
Healthcare professionals are the most endangered group – they face the highest risk of infection and they’re under enormous stress. We should undoubtedly express our support for nurses and doctors, show our appreciation for what they do. Why not write on social media how much you value their work? And if your gran refuses to obey her doctor, support the doctor, not your gran. This is extremely important and it’s something that everyone can do in their community. To explain and urge people to stick to the measures that are being introduced. Now is not the time to rail at doctors: quite the opposite, it’s necessary they get huge public support. Sure enough, bad decisions are no doubt taking place. Later on, these will be picked apart once the time comes for an appraisal, but what matters now is support and solidarity. Still, I’d warn against patting each other on the back too much – now is not the time for indulging in sentiment about how united we stand. Now is the time to take pragmatic and quick precautions, and observe them with discipline.

How do we cope with the fact that, very likely, this epidemic will soon start to kill people close to us?
First of all, we don’t know exactly how things will develop in our region, we’ll see in the coming days. It might sound odd, and not all psychologists would perhaps subscribe to this, but short-term denial works very well in adverse situations. What helps in severe circumstances, and a state of global pandemic is nothing if not severe, is to stop wondering whether mankind will go extinct tomorrow, and instead deny the threat, say to yourself: “we will survive”. Dwelling on the probability of infection and survival is not an effective adaptive strategy right now, the best strategy is to adopt a special regime at home: exercise, the daily schedule, the striped top. If soldiers had asked beforehand how the D-Day Normandy landings would turn out, and about their odds of survival, everyone would have deserted and the war would have unfolded very differently. It’s by focusing on your day-to-day routine that you win a war.

How do we talk about all this to children?
Be frank. Don’t pretend this is just a holiday – tell them there’s a bad bug around and it has to be wiped out. Even if you told them nothing, they’d still pick up on your anxiety. It would help to stop railing at the government, public health authorities, the EU and Italy, and fight the virus instead. Say what you will about the government, it didn’t cause the coronavirus. Our frustration should have an abstract focal point, and the whole situation should unite society rather than divide it – we’re not at war with each other, we’re at war with the contagion.

Translated by Petr Ondráček.