‘I Regret Getting Tested’: Avoiding Doctors Amid Fear, Stigma In A Pandemic

The psychological impact caused by Covid-19 stays longer than the disease, say experts.

KUALA LUMPUR, August 31 — When Brian Lee, a 55-year-old Sarawakian, found he had Covid-19, his wife called in the Ministry of Health (MOH) to sanitise his office and their house in Kuching, Sarawak.

Then, people took photos of health personnel wearing full protective gear at their home and spread it on WhatsApp, together with the GPS location.

Lee, who was positively detected with coronavirus last March 30 in Kuching, had been quarantined for 42 days. He said he did not face much of a psychological issue when he was first diagnosed with the viral disease.

But, he was saddened that parts of the community who did not fully understand the disease attempted to taint his family.

“That was quite sad for me to see somebody do such a thing to someone they don’t even know,” Lee told CodeBlue in an interview.

According to a feature film by R.AGE, Covid-19 patients were stressed, anxious, worried, and afraid when they first diagnosed with the disease.

“I just did not want to die.”

“Will I still be alive tomorrow?”

“I felt so sad because my son got the virus from me.”

Some of the expressions that the patients had mentioned in the video clearly shows that Covid-19 left an emotional fear among people in general.

What Does Emotional Distress Mean To Covid-19 Patients?

A study in Milan, Italy, revealed that more than half of Covid-19 patients who received treatment in hospital suffer from a psychiatric disorder after one month.

According to the study, 55 per cent from a total of 402 patients surveyed suffered from at least one psychiatric disorder, such as post-traumatic stress disorder (PTSD), depression and anxiety.

Some of the patients even suffered from insomnia, a sleeping disorder, and had obsessive-compulsive (OC) symptoms or widely known as OCD.

Psychiatrist Dr Devaki Sathiaray.

“Stress, anxiety, worriness are some of the emotional challenges associated with Covid-19 patients in the country,” said Dr Devaki Sathiaray, a psychiatrist at a Ministry of Health (MOH) hospital in Malaysia.

“The fear of general public is about the disease itself — whether I will become unwell or going to die of this Covid-19; how if I’m really diagnosed to have positive symptoms — I’ll be isolated, I’ll be sent to quarantine centres; and again the stigma, thinking that ‘if I admit, and if the Covid test turns out to be positive then I’ll be quarantined. If I’m quarantined, then I’ll lose my job’.

“So when this starts to kick in, then there is a high chance for them to be resulted in psychiatric illness,” Dr Devaki told CodeBlue.

“Of course, initially they’ll have this fear. But later on, they might refuse to go and see a doctor. This is what we call avoidance behaviour. When this part kicks in, then it is no more a normal reaction. It’s obvious that they need some sort of psychological intervention,” she added.

Avoidance behaviour often occurs in a panic situation when the anxiety level increases. This will eventually raise the fear more as the behaviour will stop someone from solving the problem completely, but will drive them towards a temporary escape.

“When we had a case coming to the hospital actually, he had a contact before and he knew about it. But I am not sure what was his fear about revealing his past activities’ history. So he didn’t tell until there were many medical staff who were actually in close contact with him,” Dr Devaki said, who declined to name her workplace.

“Two days later, when the Covid test turned out to be positive, then only he revealed his past activities’ history. The medical staff were upset and worried about their own status and also about the patient.

“For the patient it may be a stigma for him to reveal. He might have thought that he’ll be blamed for it.”

Alex Lui An Lien, a clinical psychologist, mentioned that the intensity of fear of death is heightened among people during this pandemic.

“Even without the pandemic, depression and anxiety are the most common mental health issues in the population. During treatment, the fear of death is real. The worst thing about Covid-19 is that you will die alone with family members not being able to be by your side. This can be a very lonely and painful experience,” Lui told CodeBlue in an interview.

Lui also highlighted that psychological issues might have a long-lasting impact on Covid-19 patients, even if they have recovered physically from the respiratory disease completely. Malaysia has a very low case fatality rate of Covid-19 at 1.35 per cent, while about 97 per cent of Malaysia’s 9,334 confirmed Covid-19 cases have recovered and were discharged from hospital.

“It really depends on the kind of support they have from people around them. If they have family members or friends who are sympathetic and are able to offer physical help, they will probably not go through as much psychological issues as those who do not,” said Lui.

“It also depends on how much the illness has affected them, whether physically or mentally. The more changes they experience due to the disease, the more they will be affected,” he added.

A study conducted by the Department of Psychological Medicine, Faculty of Medicine, University of Malaya, in May stated that pandemics impact the poor and vulnerable population.

People with pre-existing mental illness tend to face fear and anxiety, as well as risk of mental illness relapse.

Health Care Workers Stigmatise Covid-19 Too

Bandar Kuching MP Dr Kelvin Yii. Picture by Boo Su-Lyn.

Bandar Kuching MP Dr Kelvin Yii stated that stigmatising Covid-19 patients even happens among health care workers who know the nature and severity of the disease.

“A health care worker called me and cried. She said that she went for a Covid-19 test voluntarily. She did not display any symptoms. When she tested positive, her co-workers started blaming her,” Dr Yii told CodeBlue in an interview.

“She said to me that she regretted doing the test.”

Dr Kelvin Yii, Bandar Kuching Member of Parliament

According to Dr Yii, health care workers who are exposed to the coronavirus should be encouraged to do frequent tests instead of being ashamed.

“We are talking about recovery. It is not about physical recovery, but also about mental recovery,” Dr Yii added.

“We talk about economic recovery. If the workers are not protected emotionally, how can they ensure productivity?”

A study published in The Lancet stated that mental health conditions in the workplace were estimated to cost the Malaysian economy RM14.46 billion in 2018.

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