March 20 (UPI) -- The new coronavirus outbreak continues to spread across the United States, as does the anxiety among Americans, because people aren't sure what's happening or what to do, experts say.
With confirmed cases of COVID-19 now topping 16,600, according to Johns Hopkins University, many communities across the country have issued "social distancing" guidelines and some states -- California, Florida and New York among them -- have instituted enforced shutdowns of non-essential businesses or "shelter-in-place" orders to stem the spread.
With each new restriction and announcement, concern among the public grows. This was noted earlier this month in guidance issued by the World Health Organization, which said the COVID-19 outbreak -- ahead of calling it a pandemic -- was "generating stress in the population."
"There is a lot of frustration in general due to people not knowing what will happen," Prairie Conlon, who offers counseling services over the phone and online, told UPI. "I believe it is the fear of the unknown that is amplifying anxiety. One question I am continually hearing is, 'When do you think this will be over?' Without a definitive answer, it can really shake people."
Mental health suffers in outbreaks
Of course, COVID-19 is not the first global crisis to elevate stress and anxiety levels, and there is research showing the effects these events have on the public.
A review of the findings of 24 studies of the psychosocial effects of the Ebola virus outbreak in west Africa from 2014-2016 found that high numbers of survivors, and those not directly affected or infected, still experienced significant "psychological distress." This distress may include depression, anxiety, anger, grief, guilt, flashbacks, sadness, worthlessness, substance addiction, suicidal tendencies and self‐stigmatization, researchers wrote.
In addition, researchers said that even after the outbreak was over, family and community responses to those who survived ranged from "acceptance to rejection, isolation, stigmatization and discrimination -- all of which can have an obvious impact on mental health.
"So for something like this current outbreak, we could be seeing mental health effects for months or even years after it resolves," noted Dr. Dana Rose Garfin, an assistant adjunct professor of psychology in the Sue & Bill Gross School of Nursing at the University of California-Irvine. Garfin's research work focuses on trauma, stress, disasters and health psychology.
"We see time and time again after these types of events people with mental health problems tend to fare worse," she added.
According to Garfin, media coverage of crises like the COVID-19 often doesn't help. Daily press briefings from politicians, government agencies and others can do more to raise anxiety levels than reduce them, studies have found.
A landmark study published in 2016 in the journal Comprehensive Psychiatry, for example, found that survivors of the 1995 Oklahoma City bombing were more predisposed to "adverse reactions" to media coverage of the September 11 terrorist attacks six years later. Problems included worsened anxiety and depression and even post-traumatic stress disorder.
What to do
The WHO recommends people "protect yourself and be supportive to others" as one method of mitigating the mental health effects of the COVID-19 crisis.
For Conlon, with what little the public can do to contain the outbreak, this means focusing on "things you can control."
"Make a list for just a few things to accomplish each day, such as de-cluttering a closet, or finding an exercise program on YouTube you can do in your living room," she said. "Just the act of accomplishing something can help bring your world back into balance."
Conlon and Garfin also both echo the advice of the WHO, which urged the public to "avoid watching, reading or listening to news that causes you to feel anxious or distressed" and "seek information mainly to take practical steps to prepare your plans and protect yourself and loved ones." The agency also suggests scheduling times of the day to check news, in addition to choosing credible sources "to help you distinguish facts from rumors."
"Turn off the news if you find it triggers you," Conlon added.
That said, Garfin emphasized that it is still important to keep up-to-date with current U.S. Centers for Disease Control and Prevention and WHO recommendations as the outbreak unfolds. Just do so in moderation.
In addition, both Garfin, who is not a clinician, and Conlon, said there are plenty of "self-care" measures people can take even in a climate of "social distancing," as recommended by the CDC and others to stop the spread of COVID-19. Simple gestures like talking to friends and family on the phone or online and offering words of support can help, as can relaxation techniques like meditation and yoga.
"Fear is spreading even faster than the virus itself," Conlon said. "Feelings of helplessness as we watch this event unfold can have detrimental effects on those who are already struggling with mental illness. Further, I think we are going to see more instances of mental illness develop."
Still, on the positive side, Garfin offered some reassurance, describing the outbreak as "temporary."
She added, "This will pass."