Health Science Journal

The emergency of coronavirus disease 2019 (COVID-19) outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in Uganda and Lira city in particular, a situation of socio-economic crisis and psychological distress rapidly occurred worldwide [1-14]. Although social activities have been restricted in most countries, almost all not essential individual movements were prohibited due to quarantine, while the local hospitals received suddenly thousands of critically ill COVID-19 patients and were forced to implement their emergency protocols.

In most context, during locked down most of the families suffered both psychologically and socio-economically since the movement was restricted, the sources of livelihood for the generally population especially self-employed people. To make the situation warts, the confirmation of Covid-19 cases in most family especially my family created the dangerous situation basing on the facts that sigma and discrimination was the topmost challenges associated with the infection of Covid-19.

Additionally, most of the people in the community become vulnerable to emotional impact of COVID-19 infection due to both the pandemic and its consequences globally [3]. Many psychological problems and important consequences in terms of mental health including stress, anxiety, depression, frustration, uncertainty during COVID-19 outbreak emerged progressively [5].

Common psychological reactions related to the mass quarantine which was imposed in order to attenuate the transmission of Covid-19 worldwide but specifically in Uganda on 31 march 2020 to contain the spread of Covid-19 in the community causes generalized fear and pervasive community anxiety which are typically associated with disease outbreaks, and increased with the escalation of new cases together with inadequate, anxietyprovoking information which was provided by media especially every day by updating the community with the number of daily cases , deaths and the contacts to the infected people.

The psychological reactions to COVID-19 pandemic may vary from a panic behavior or collective hysteria to pervasive feelings of hopelessness and desperation which are associated with negative outcomes including suicidal behavior. As the general population became increasingly exposed, anxiety-provoking topics related to this emergence of the health and socio-economic crisis need to be rapidly identified to early detect dysfunctional processes and maladaptive lifestyle changes potentially leading to the onset of psychiatric conditions [6]. The psychological impact of quarantine related to COVID-19 infection was basing on the facts that all individuals are able to rapidly travel and communicate has been rarely forced to the current social isolation and restrictions which are linked to feelings of frustration and in certainty. This unprecedented situation related to COVID-19 outbreak is clearly demonstrating that individuals are largely and emotionally unprepared to the detrimental effects of biological disasters that are directly showing how everyone may be frail and helpless [14]. Social distancing and important lockdown restrictions have been carried out in Uganda where countries such as Kenya, Tanzania and DRC experienced a tragic growth of the number of positive cases.

Although government regulations are necessary to maintain social balance and guarantee the safety of all individuals, a direct strategy aimed to manage the psychosocial issues related to COVID-19 crisis and its consequences in the community is currently lacking [3]. The psychological outcomes for subjects who have been quarantined compared with those who did not, have been examined by both cross-sectional 10-14 and longitudinal studies.

During these uncertain times, many will worry about their loved ones becoming infected, which may exacerbate anticipatory grief reactions. Due to social distancing policies, many have not been present before and during the time of death of their loved ones. As a result, these individuals have been unable to say their final goodbyes. Funeral services are restricted, with a small number of people allowed to be present. Those who have had recent contact with the deceased are expected to self-isolate and are unable to attend. Social networks and connectivity have been affected, with many working from home. Individuals may experience disenfranchised grief because of these various processes.

Therefore, the lives of people must be considered during the current Covid-19 pandemic since the rate of suicide, family violence, poverty, mental health problems and some diseases has increased drastically due to Covid-19 transmission and infection in the community [5].

Notably, most people who are dying may be due to psychological fears and worried about the situation of being separated from other family members incase when they get infected or fear of being stigmatized and rejected from the family or even the community itself. Some of the government interventions such as social distancing, isolation, quarantine, closing of some areas where people enjoy social activity like bars, football competition, closing of schools and places of warships has caused more psychological effects in the minds of many people.

Therefore, the journal article aims at assessing the psychological impact of Covid-19 infection in my family and the entire community.

Methodology

Study design

The design was descriptive cross-sectional approach which employed qualitative data collection methods. The methods helped to explore more on the understanding of the psychological impact of Covid-19 on the affected families especially my family. The data was collected using the interview guides and analyzed using the recessive abstraction methods of data analysis.

The study employed focus group discussion and the method for data collection in which the 14 respondents was divided into two groups.

Participants

Selection of participant was based on the non-probability sampling techniques in which 14 respondents was selected in our family and they participated in the Focus group discussion.

Eligibility criteria

All the family members were allowed to participate in the study. People who were sick severely during data collection and those with mental health problems were excluded from the study.

Data collection material

The researcher developed interview guides as the tool for the data collection. The tools were developed and divided into two sections such as socio-demographic information and psychological impact of pandemic in the family especially my family.

Data collection methods

The data was collected using focus group discussion, during the study, the researcher divided the family members into two group and organized the day and time for the discussion for each group. The Focus group discussion lasted for about 45-50 minutes for each group. During that, the researchers ask questions and allows the group members to response to them as they discussed. Their answers recorded as texts and voice recorded for analysis.

Analysis of data

The qualitative data was analyzed using MAXQDA.

Data management

The data collected was protected by the researcher through putting the collected data in locked cabin, ensuring the privacy and avoid using the names in the report.

Ethical consideration

The following ethical consideration was practiced during data collection by the student.

Consent

Informed consents were sought from respondents 18 years and above and the assent from the parent/guardian to allows data collection from children below 18 years.

Confidentiality

The interviewer did not use identifiers like names, actual place of residence, and phone numbers in questionnaires. The information got in the field was coded and fed into a computer with passwords.

Privacy

The privacy of the subject was assured by interviewing them in private places so that they are protected from exposures.

Finding/Results from the Study

The socio-demographic information from the respondents

The data from the socio-demographic information after the analysis shows that most of the participants were female of 67%, majority of them were students from schools due to locked down 46%, Anglican religion accounted for 45% more than all the other religions in our family, majority of them were self-employed who trade in the daily and weekly market and lastly all of them were lango by 100%.

Psychological impact of quarantine

Lira City is one of the busiest cities in Uganda with a lot of activities and when someone is forcefully placed in the quarantine due to contacts with Covid-19 patients, the individual may be exposed to feeling of frustration and in certainty. The study findings shows that most of the family members who was forced to quarantine were emotionally unstable and helpless.

26 years old women reported “I was ambushed to go to the quarantine center in the district, which made me feel that the world was ending for me”.

Social distancing and important lockdown restrictions have been carried out in Uganda and in the other. The respondents reported psychological impact such as emotional disturbance, depression, stress, mood alteration, irritability, insomnia, posttraumatic stress symptoms, anger, and emotional exhaustion among those quarantine in different families and also mine as well.

I don’t think if we can come back to the normal life because we used to show love to each other by sitting near to each other during sickness but due to this diseases “Corona” our people are dying lonely as if people are not there “45 years old mother reported during FGD.

Notably psychological response to quarantine was reported include fear, anger, anxiety and insomnia, confusion, grief, and numbness have been identified as additional psychological responses to quarantine. Long-term behavioral changes like vigilant hand washing and avoidance of crowds as well as a delayed return to normality even after many months after the quarantine were also reported. Thus, the quarantine period seems to have important and dysfunctional psychological consequences on the individual’s mental health not only in the short-term but even in the long-term period

Psychological reactions to COVID-19 infection

During data collection, the unrolled reaction to Covid-19 was fear of being infected among the general population. This is commonly one of the most frequent psychological reaction to pandemics. Many respondents reported pervasive fears about their health, worries to infect others and fear infecting family members. One of the pregnant mothers reported fear of becoming infected and transmitting the infection to her children. Pervasive anxiety social isolation related to restrictions and lockdown measures was linked to feelings of uncertainty for the future, fear of new and unknown infective agents resulting in abnormally increased anxiety according to the researcher. Anxiety may be directly related to sensorial deprivation and pervasive loneliness, in this case first insomnia but later depression and post-traumatic stress occurred. In addition, anxiety is closely associated with fatigue and reduced performance in healthcare workers while boredom and loneliness are directly related to anger, frustration and sufferings linked to quarantine restrictions.

45-year-old man reported “This kind of diseases has never happened, know feel lonely due to closing of Bars by the presidents and it is difficult to express myself which make me feel lonely.

Additionally, effects of pandemic reported by the respondent perceived lower social support, separation from loved ones, loss of freedom, uncertainty, and boredom. Frustration and boredom Distress, boredom, social isolation, and frustration are directly related to confinement, abnormally reduced social/physical contact with others, and loss of usual habits. Therefore, the researcher investigated thoroughly the psychological impact of covid-19 in Lira district.

Discussion of the Results

Socio-demographic factors

According to this study, most of the people who experienced psychological mental health problems were children and mothers. The community report from the study respondents shows that most of the mother’s fear being infected and again transmitting the infection to their children. Most of the mothers who was put in quarantine reported that being in quarantine was like the jail and they were so worried about the live of her children left at home. On the other hand, some of the children came back from school when they were already infected with covid-19 hence making them totally depressed after my family members being infected.

Statement from the respondents

“I was about to commit suicide after confirming me positive for Covid-19 with my lovely mother. Because don’t wont that any of my family member die of Covid-19 “17-year-old girl reported during FGD.

The above finding is similar to the study conducted in Kenya on the mental health issues arising due to Covid-19 in the community [7]. Their finding shows that in all bad situation like Covid-19, the lives of people affected most are the Children and mothers. This supports the above finding in the community.

Psychological impact of quarantine

The rapid influx in the community transmission of covid-19 in the country affected the lives of people in the community in many ways. According to the data collected and analyzed by the researcher on the psychological impact of covid-19 in the affected families in Lira district shows that the lives of people is affected psychologically, spiritually, economically and the physically. The catastrophic effects could be due to the restriction in movement, closed of all the place of warship, closing of Bars, stopping of the movement across and out of the district, isolation of infected people and putting others in Quarantine. Most of these activities occurs especially in is especially from 31 March 2020 to around June 2020. The above finding is similar to the study conducted in Italy [11], the study shows that Covid-19 exposed many people to the mental health issues especially those affected directly through death of their beloved one, one of the family member felt severely ill or as the results of quarantine the family broke down due to the individual in which the live of the all family depend on either being infected, put in quarantine or death due to Covid-19 related infection.

Psychological reaction to Covid-19 infection

During data collection, the unrolled reaction to Covid-19 was fear of being infected among the general population. This is commonly one of the most frequent psychological reaction to pandemics. Many respondents reported pervasive fears about their health, worries to infect others and fear infecting family members. One of the pregnant mothers reported fear of becoming infected and transmitting the infection to her children.

I think that Covid-19 diseases could be transmitted to my lovely and newborn child. It gave me a lot of worries about my feature and even the issues associated with antenatal care was a big challenge at the time of total locked down “29 years old pregnant woman reported”.

Pervasive anxiety social isolation related to restrictions and lockdown measures was linked to feelings of uncertainty for the future, fear of new and unknown infective agents resulting in abnormally increased anxiety according to the researcher. Anxiety may be directly related to sensorial deprivation and pervasive loneliness, in this case first insomnia but later depression and post-traumatic stress occurred.

In addition, anxiety is closely associated with fatigue and reduced performance in healthcare workers while boredom and loneliness are directly related to anger, frustration and sufferings linked to quarantine restrictions.

45-year-old man reported “This kind of diseases has never happened, know feel lonely due to closing of Bars by the presidents and it is difficult to express myself which make me feel lonely.

The above finding is in relation to the study conducted in Wuhan City on the psychological impact of Covid-19 [3]. Additionally, effects of pandemic reported by the respondent perceived lower social support, separation from loved ones, loss of freedom, uncertainty, and boredom. Frustration and boredom Distress, boredom, social isolation, and frustration are directly related to confinement, abnormally reduced social/physical contact with others, and loss of usual habits. Therefore, the researcher investigated thoroughly the psychological impact of covid-19 which must be address properly the stakeholders and the policy makers since the rise in the mental health disorder in the community.

Conclusion

Therefore, the researcher found that, most of the people in the community are affected psychologically due to the restrictions such as quarantine, social distancing, locked down or closing of some social activities which encourage large gathering, death of the beloved one due to covid-19 and unemployment. The identified impact includes emotional disturbance, depression, stress, mood alteration, irritability, insomnia, posttraumatic stress symptoms, anger, and emotional exhaustion. The longterm effect identified after infections include Frustration and boredom Distress, boredom, social isolation.

Additionally, researcher recommend that the Implementing, community-based strategies to support resilience and psychologically vulnerable individuals during the COVID-19 crisis is fundamental for any community and must be conducted both by the government or the non-governmental organization as the way of mitigating the impact of Covid-19 in the mental health of the individuals.

To conclude, the psychological impact of fear and anxiety induced by the rapid spread of pandemic needs to be clearly recognized as a public health priority for both authorities and policy makers who should rapidly adopt clear behavioral strategies to reduce the burden of disease and the dramatic mental health consequences of this outbreak.

Acknowledgment

Special thanks to the Almighty for the accomplishment of this piece of work, and my highest and sincere appreciation to all those who have contributed in one or the other to the conduction of this study, especially the staff of Lira university department of psychology and psychotherapy toward writing this academic journal.

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