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Fear, Anger, and Media-Induced Trauma During the Outbreak of COVID-19 in the Czech Republic

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  • Vysoká škola aplikované psychologie, Terezín

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Fear, anger and hopelessness were the most frequent traumatic emotional responses in the general public during the first stage of outbreak of the COVID-19 epidemic in the Czech Republic (N = 1,000). The four most frequent categories of fear were determined: (a) fear of the negative impact on household finances, (b) fear of the negative impact on the household finances of significant others, (c) fear of the unavailability of health care, and (d) fear of an insufficient food supply. The pessimistic communications used by the Czech mass media contributed to intensifying traumatic feelings, fears and psychological distress in the general public during the outbreak of the COVID-19 epidemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Psychological Trauma: Theory, Research, Practice, and Policy, 2020, 12(5), 546549
Fear, Anger, and Media-Induced Trauma During the
Outbreak of COVID-19 in the Czech Republic
Radek Trnka1, 2, Radmila Lorencova3
1 Prague College of Psychosocial Studies, Czech Republic
2 OUSHI, Palacky University Olomouc, Czech Republic
3 College of Applied Psychology, Terezin, Czech Republic
Abstract
Fear, anger and hopelessness were the most frequent traumatic emotional responses
in the general public during the first stage of outbreak of the COVID-19 epidemic in the
Czech Republic (N = 1,000). The four most frequent categories of fear were
determined: (a) fear of the negative impact on household finances, (b) fear of the
negative impact on the household finances of significant others, (c) fear of the
unavailability of health care, and (d) fear of an insufficient food supply. The pessimistic
communications used by the Czech mass media contributed to intensifying traumatic
feelings, fears and psychological distress in the general public during the outbreak of
the COVID-19 epidemic.
© 2020, American Psychological Association. This paper is not the copy of record and may not
exactly replicate the final, authoritative version of the article. Please do not copy without authors'
permission. The final article is available via its DOI: 10.1037/tra0000675
Keywords: COVID-19, Virus, Pandemic, Epidemic, Outbreak, Coronavirus SARS-
CoV-2, Trauma, Psychological Trauma, Mass Trauma, Mass Traumatic Events,
Psychological Traumatization, Traumatic Stress, Traumatic Feelings, Emotional
Reactions to Traumatic Events, Fear, Anger, Hopelessness, Depression, Anxiety,
Anxious, Psychological Distress, Coping with Stress, Isolation, Mental Health, Well-
Being, Existential Concerns, Mass Media, Public Communication, Media
Communication, Journalist, Media Officials, Decision Making, Public Health, Decision
Makers, Restrictions, Interventions, Measures, General Public, Traumatized Public,
Health Care, Government, Optimism, Pessimism, Optimistic, Pessimistic,
Unprecedented Crises
MeSH Headings: Emotions, Fear, Anger, Stress, Stress Reaction, Stress Response,
Stress Reactivity, Defense Mechanisms, Affect, Feelings
The present report provides basic information about distress and traumatic
responses accompanying the first seven weeks of the outbreak of the COVID-19
epidemic in the Czech Republic (see also Cao et al., 2020; Kisely et al., 2020; Lei et
al., 2020; Liang et al., 2020; Röhr et al., 2020; Usher, Durkin, & Bhullar, 2020; Wang
et al., 2020; Zhou et al., 2020). The Czech situation is unique because of the relatively
quick reactions of decision-makers, who imposed severe restrictions immediately
during the first two weeks of the epidemic. After March 1, 2020, when the first three
patients were positively diagnosed with COVID-19, strict measures were imposed: a
prohibition on visits to social facilities and hospitals (March 9); the total closure of the
national borders (March 13); the closing of all shops, with the exceptions of food and
other indispensable items (March 14); areal curfews, with the exception of ways from
home to work and back (March 16); and the obligation of everyone to wear surgical or
homemade masks covering the mouth and nose (March 19). Despite the objections
expressed even by some epidemiologists regarding the strictness of these measures,
the reproduction number (R0) fell below 1.5 after March 29 and reached 1 by April 8,
2020 (Seznam.cz, 2020). At the end of March, 2020, the decrease of R0 was also
accompanied by a partial decrease of fear and pessimism in the general public (Figure
1; see also Ahorsu et al., 2020; Harper, Satchell, Fido, & Latzman, 2020; Soraci et al.,
2020). Several insights regarding psychological trauma, emotional responses, and
distress in the Czech population are already available from the first public surveys (for
an overview of the impacts on global mental health, see, e.g., Torales, O’Higgins,
Castaldelli-Maia, & Ventriglio, 2020). A public representative survey of discrete
emotional reactions related to the COVID-19 epidemic was conducted on March 19
20, 2020 (Behavio Labs, 2020). Participants (N = 1,000; 490 males and 510 females)
were asked which emotions they felt at the time of the COVID-19 epidemic.
Participants could indicate more than one option. A total of 370 participants (37%; 33%
males and 67% females) indicated fear, 160 participants (16%; 58% males and 42%
females) indicated anger, and 50 participants (5%; 31% males and 69% females)
indicated hopelessness. Interestingly, a large proportion of the population, 390
participants in all, did not show any substantial psychological trauma and reported that
they felt relatively fine (60% males and 40% females), and 260 participants reported
that they felt the challenge (57% males and 43% females; Figure 2). The data showed
that fear was the most frequent emotional response among females (n = 249; 49%),
while “I feel fine” was the most frequent response among males (n = 235; 48%).
Figure 1 Development of the fear and pessimism in the general public
(Source: European National Panels and Seznam.cz)
Another survey focused on fear and optimism/pessimism in five European
countries (European National Panels, 2020). The reactions of Czechs ranked highest
in the rate of optimism relating to combatting the pandemic in comparison to Slovakia,
Bulgaria, Hungary, and Poland. A representative sample of 3,200 participants aged
15+ participated in the Czech survey. An index of optimism/pessimism (see Figure
1) was constructed from the participants’ responses to three questions, such as “How
do you think the COVID-19 disease situation caused by the new type of coronavirus
SARS-CoV-2 will develop?” rated on a 0–10 rating scale (0 = I am very pessimistic, 10
= I am very optimistic). In the same survey, fear of COVID-19 was measured on the
same sample. An index of fear (see Figure 1) was constructed from the participants’
responses to three questions, such as “How concerned are you about the health effects
of COVID-19 disease caused by the new type of coronavirus SARS-CoV-2 on you
personally?” rated on a 0–10 rating scale (0 = not concerned at all, 10 = very
concerned). Both surveys were repeated seven times to monitor development over
time (see Figure 1). Furthermore, the main sources of fear were surveyed on April 26,
2020 (N = 3,200; European National Panels, 2020). Participants rated individual
sources of fear on a 010 rating scale. The most-rated source of fear was represented
by a fear of price increases (mean rate = 7.65), followed by a fear of falling earnings
(mean rate = 5.74), someone close losing a job (mean rate = 5.72), the unavailability
of health care (mean rate = 5.34; see also health anxiety in Asmundson & Taylor,
2020), the loss of one’s own job (mean rate = 4.49), and the fear of an insufficient food
supply (mean rate = 3.95; European National Panels, 2020).
In another survey (STEM, 2020) conducted between April 23 and 25, 2020, a
total of 626 participants (62%) of a representative sample (N = 1,008) stated that they
are coping with the restrictions “relatively without problems,” 336 participants (33.3%)
are coping “with smaller problems,” 38 participants (3.8%) are coping “with big
problems,” and 8 participants (0.8%) are coping “with very big problems.”
Figure 2 Discrete emotional responses related to the COVID-19 epidemic in the
Czech Republic (Source: Behavio Labs)
Helpful and Unhelpful Factors Impacting Mental Health
At the beginning of March, 2020, stressful information presented in the media
created an unjustifiably pessimistic picture of the COVID-19 outbreak and contributed
to the psychological traumatization of the Czech population, especially among older
adults. Older adults were the most affected part of the population because of their
isolation and their very limited opportunity to share their worries and emotions with
others. In an effort to reach a broader audience, the Czech mass media published
hundreds of articles involving stories of patients from the nonvulnerable part of the
world population who were infected by COVID-19 and had died or had rare or
extremely uncommon serious health outcomes. Most of these media messages were
presented in a highly emotional manner, which contributed to intensifying traumatic
feelings, fears, anxieties, and distress during the first weeks of the COVID-19 outbreak
(see also Dong & Zheng, 2020).
In reaction to this situation, the chairman of the Czech Senior Council negotiated
several supportive activities with the Czech government, namely home delivery for
older adults, special shopping hours for older adults in supermarkets, the establishing
of help lines, and also the launching of a new TV channel with an anti-stress broadcast
targeted to older viewers. At the same time, many civic activities were started, for
example, an initiative called “Scientists Against Melancholy,” in which Czech scientists
posted short supportive messages to the general public on an online social network.
Interestingly, strong collective feelings of solidarity accompanied the
subsequent weeks of the COVID-19 outbreak in Czech society. People began to
behave very thoughtfully toward each other. Because there was a lack of surgical
masks on the market, many people started to make facemasks themselves. Moreover,
people who were able to produce homemade masks provided them to those who could
not make them on their own.
The Organization of Health Care
In anticipation of an explosive increase in the number of people infected by
COVID-19, several hospitals modified selected departments to become specialized for
care of patients suffering from COVID-19. Importantly, the health care service faced a
problem with a lack of surgical masks and hygiene material. Several supplies of this
material were arranged by the government. Also, many private and civic organizations
spontaneously joined and offered their help to finance or support public health care
because of the COVID-19 outbreak. A very influential nongovernmental project even
developed a plan for quick local production of lung ventilators for a hypothetical future
lack of such ventilation units (https://covidhacks.org/). This project immediately
acquired public support and collected 370,000 EUR in one day through a public
Internet fund-raising campaign. In the subsequent weeks, a functional prototype was
developed and the technology is now waiting for certification.
Health care for anxiety, depression, and posttraumatic stress was mostly
organized by national organizations for psychotherapy, by clinical psychologists
working in hospitals, and by civic and nonprofit organizations. Many call centers were
set up to provide immediate help for people experiencing distress, anxiety, and fear.
Similar to other countries (Greenberg, Docherty, Gnanapragasam, & Wessely,
2020; Kang et al., 2020; Shah, Chaudhari, Kamrai, Lail, & Patel, 2020), health care
professionals face extreme psychological distress due to the recent crises.
Conclusions
The present study contributes to a better understanding of the variety of fears
and traumatic emotional responses that are accompanying the outbreak of the COVID-
19 pandemic. Schimmenti, Billieux, and Starcevic (2020) provided preliminary
theoretical categories of fear experienced during the COVID-19 pandemic: fear of/for
the body, fear of/for significant others, fear of knowing/not knowing, and fear of taking
action/inaction. However, this classification was not based on any empirical findings.
The empirical evidence presented in the present study redefines this preliminary
classification and shows the most frequent categories of fear that emerged as
responses to the COVID-19 pandemic to be: (a) fear of the negative impact on
household finances, (b) fear of the negative impact on the household finances of
significant others, (c) fear of the unavailability of health care, and (d) fear of an
insufficient food supply.
Furthermore, the communication used by the Czech mass media during the
outbreak of the COVID-19 epidemic is a representative example of a traumatizing form
of media communication during an epidemic. The anxious emotional tone of the
messages and the presentation of selectively chosen “bad ending stories” contributed
to the psychological traumatization of the Czech population during the COVID-19
outbreak. This form of communication was motivated by an effort to reach the broadest
audience possible. The behavior of the Czech media demonstrates the highly sensitive
nature of media communication during times of unprecedented crises and the key role
of journalists and media officials in influencing the well-being of the general public. In
this regard, Horesh and Brown (2020) suggested that the governments should provide
clear guidelines and talking points for the media to use when speaking to a very
anxious and potentially traumatized public. Future studies should also discuss the
augmented role of ethics in media communication during times of unprecedented
crises like the COVID-19 pandemic.
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Objectives. Fear of the new coronavirus, as an emotional response to a pandemic situation that has plagued the world since early 2020, has many implications for the behaviour and psychological experiences of the population. To measure the fear of coronavirus a 7-item Fear of COVID-19 Scale (FCV-19S) was developed, now successfully used in more than 20 countries around the world. This study deals with the verification of psychometric characteristics of the Slovak version of FCV-19S, focusing on its factor structure, measurement invariance with respect to gender, reliability in terms of internal consistency, and convergent validity based on structural equation modeling (SEM) and based on the relationship to related constructs of anxiety, depression, and stress. Sample and settings. Data were collected online (N=744; aged 17–78) during the ongoing coronavirus pandemic in Slovakia. Along with FCV-19S, World Health Organization-Five Well-Being Index, Perceived Stress Scale, and Coronavirus Anxiety Scale were administered to the respondents. Results. The results of the confirmatory factor analysis supported the two-factor structure of the instrument with two subscales, Emotional and Physiological Symptoms. The FCV-19S has proven to be a gender-invariant tool, so it can be used to compare fear experiences in men and women. The results further indicate good internal consistency and convergent validity of the Slovak version of the scale. Limitations. Measurement invariance of FCV-19S across age, education or ethnic groups was not tested in the present study. The stability of the scores over time was also not examined due to the cross-sectional design. The study is limited by online data collection and convenience sampling method.
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The COVID-19 pandemic has wreaked havoc globally. Besides devastating physical health consequences, the mental health consequences are dire as well and are predicted to have a long-term impact for some individuals and communities and society as a whole. Specific keywords were entered into various popular databases at three points in time (June 2020, April 2021, and February 2022). Articles about COVID-19 that focused on mental health and/or discussed improving resilience/coping were reviewed by the authors. A total of 119 publications were included. The pandemic is certainly a chronic stressor for many people, and some may be traumatized in the aftermath which may lead to stress-related disorders. The psychological impacts of this stress and trauma are reported and findings presented around three key themes: mental health impact, impact in the workplace, and improving resilience. In addition, particularly vulnerable populations are discussed and some of the violence and inequities they might face. Resilience literature offers keys to promoting positive mental wellbeing during and after the pandemic. Being able to effectively respond to the heterogeneity of specific situations while building resilience is addressed. Prevention, preparedness, Psychological First Aid training, and trauma informed practice can all contribute to building resilience and promoting peri/post-traumatic growth at all levels of society. This narrative review provides an overview of the literature on mental health and resilience in the context of the COVID-19 pandemic. The authors propose that, through the use of the accumulated empirical knowledge on resilience, we can mitigate many of the most damaging outcomes. Implications for mental health professionals, policy suggestions, and future research directions are explored.
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Objective To examine the psychological effects on clinicians of working to manage novel viral outbreaks, and successful measures to manage stress and psychological distress. Design Rapid review and meta-analysis. Data sources Cochrane Central Register of Controlled Trials, PubMed/Medline, PsycInfo, Scopus, Web of Science, Embase, and Google Scholar, searched up to late March 2020. Eligibility criteria for study selection Any study that described the psychological reactions of healthcare staff working with patients in an outbreak of any emerging virus in any clinical setting, irrespective of any comparison with other clinicians or the general population. Results 59 papers met the inclusion criteria: 37 were of severe acute respiratory syndrome (SARS), eight of coronavirus disease 2019 (covid-19), seven of Middle East respiratory syndrome (MERS), three each of Ebola virus disease and influenza A virus subtype H1N1, and one of influenza A virus subtype H7N9. Of the 38 studies that compared psychological outcomes of healthcare workers in direct contact with affected patients, 25 contained data that could be combined in a pairwise meta-analysis comparing healthcare workers at high and low risk of exposure. Compared with lower risk controls, staff in contact with affected patients had greater levels of both acute or post-traumatic stress (odds ratio 1.71, 95% confidence interval 1.28 to 2.29) and psychological distress (1.74, 1.50 to 2.03), with similar results for continuous outcomes. These findings were the same as in the other studies not included in the meta-analysis. Risk factors for psychological distress included being younger, being more junior, being the parents of dependent children, or having an infected family member. Longer quarantine, lack of practical support, and stigma also contributed. Clear communication, access to adequate personal protection, adequate rest, and both practical and psychological support were associated with reduced morbidity. Conclusions Effective interventions are available to help mitigate the psychological distress experienced by staff caring for patients in an emerging disease outbreak. These interventions were similar despite the wide range of settings and types of outbreaks covered in this review, and thus could be applicable to the current covid-19 outbreak.
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Background The advent of COVID-19 worldwide has led to consequences for people’s health, both physical and psychological, such as fear and anxiety. This is the case in Italy, one of the countries most affected by the pandemic. Given the heightened fear concerning COVID-19 in Italy., the present study analyzed the psychometric properties of the Italian version of the Fear of COVID-19 Scale (FCV-19S).Methods The sample comprised 250 Italian participants who were administered Italian versions of the FCV-19S, the Hospital Anxiety and Depression Scale (HADS), and the Severity Measure for Specific Phobia–Adult (SMSP-A). Several psychometric tests were performed to investigate the validity and reliability of the test including confirmatory factor analysis.ResultsAnalysis of the data showed satisfactory psychometric characteristics and confirmed the scale’s unidimensional properties. The seven FCV-19S items had acceptable correlations with the test total (from .443 to .784). Furthermore, the loadings on the factor were significant and strong (from .684 to .897). The internal consistency was very good (α = .871). Construct validity for the FCV-19S was supported by significant and positive correlations with the HADS (r=.649) and SMSP-A (r=.703).Conclusions The Italian version of the Fear of COVID-19 Scale is valid and reliable in assessing fear of COVID-19 among the general Italian population.
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Psychological health problems, especially emotional disorders, are common among adolescents. The epidemiology of emotional disorders is greatly influenced by stressful events. This study sought to assess the prevalence rate and socio-demographic correlates of depressive and anxiety symptoms among Chinese adolescents affected by the outbreak of COVID-19. We conducted a cross-sectional study among Chinese students aged 12–18 years during the COVID-19 epidemic period. An online survey was used to conduct rapid assessment. A total of 8079 participants were involved in the study. An online survey was used to collect demographic data, assess students’ awareness of COVID-19, and assess depressive and anxiety symptoms with the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) questionnaire, respectively. The prevalence of depressive symptoms, anxiety symptoms, and a combination of depressive and anxiety symptoms was 43.7%, 37.4%, and 31.3%, respectively, among Chinese high school students during the COVID-19 outbreak. Multivariable logistic regression analysis revealed that female gender was the higher risk factor for depressive and anxiety symptoms. In terms of grades, senior high school was a risk factor for depressive and anxiety symptoms; the higher the grade, the greater the prevalence of depressive and anxiety symptoms. Our findings show there is a high prevalence of psychological health problems among adolescents, which are negatively associated with the level of awareness of COVID-19. These findings suggest that the government needs to pay more attention to psychological health among adolescents while combating COVID-19.
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In the current context of the global pandemic of coronavirus disease-2019 (COVID-19), health professionals are working with social scientists to inform government policy on how to slow the spread of the virus. An increasing amount of social scientific research has looked at the role of public message framing, for instance, but few studies have thus far examined the role of individual differences in emotional and personality-based variables in predicting virus-mitigating behaviors. In this study, we recruited a large international community sample (N = 324) to complete measures of self-perceived risk of contracting COVID-19, fear of the virus, moral foundations, political orientation, and behavior change in response to the pandemic. Consistently, the only predictor of positive behavior change (e.g., social distancing, improved hand hygiene) was fear of COVID-19, with no effect of politically relevant variables. We discuss these data in relation to the potentially functional nature of fear in global health crises.
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The purposes of this study was to assess the youth mental health after the coronavirus disease 19 (COVID-19) occurred in China two weeks later, and to investigate factors of mental health among youth groups. A cross-sectional study was conducted two weeks after the occurrence of COVID-19 in China. A total of 584 youth enrolled in this study and completed the question about cognitive status of COVID-19, the General Health Questionnaire(GHQ-12), the PTSD Checklist-Civilian Version (PCL-C) and the Negative coping styles scale. Univariate analysis and univariate logistic regression were used to evaluate the effect of COVID-19 on youth mental health. The results of this cross-sectional study suggest that nearly 40.4% the sampled youth were found to be prone to psychological problems and 14.4% the sampled youth with Post-traumatic stress disorder (PTSD) symptoms. Univariate logistic regression revealed that youth mental health was significantly related to being less educated (OR = 8.71, 95%CI:1.97–38.43), being the enterprise employee (OR = 2.36, 95%CI:1.09–5.09), suffering from the PTSD symptom (OR = 1.05, 95%CI:1.03–1.07) and using negative coping styles (OR = 1.03, 95%CI:1.00–1.07). Results of this study suggest that nearly 40.4% of the youth group had a tendency to have psychological problems. Thus, this was a remarkable evidence that infectious diseases, such as COVID-19, may have an immense influence on youth mental health. Therefor, local governments should develop effective psychological interventions for youth groups, moreover, it is important to consider the educational level and occupation of the youth during the interventions.
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BACKGROUND At the end of 2019, the COVID-19 outbreak began in Wuhan, Hubei, China, and spread rapidly to the whole country within 1 month. This new epidemic caused a great mental reaction among the public. This study aimed to assess and compare the prevalence and associated factors of anxiety and depression among the public affected by quarantine and those unaffected during the COVID-19 outbreak in southwestern China in early Feb. 2020. MATERIAL AND METHODS Data were collected using the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) administered to 1593 respondents aged 18 years and above. The respondents were grouped as 'affected group' and 'unaffected group' on the basis of whether they or their families/colleagues/classmates/neighbors had been quarantined. RESULTS Among 1593 participants, the prevalence of anxiety and depression was approximately 8.3% and 14.6%, respectively, and the prevalence in the affected group (12.9%, 22.4%) was significantly higher than that in the unaffected group (6.7%, 11.9%). Lower average household income, lower education level, having a higher self-evaluated level of knowledge, being more worried about being infected, having no psychological support, greater property damage, and lower self-perceived health condition were significant associated with higher scores on the SAS and SDS. People living in Chongqing had higher SAS and SDS scores than those living in Yunnan Province. CONCLUSIONS The prevalence of anxiety and depression of the affected group are higher than in the unaffected group during the COVID-19 outbreak in southwestern China in early Feb. 2020. The government should focus more on providing economic and medical support to improve the general population's mental state.
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The newly identified novel coronavirus, COVID-19, was first reported in Wuhan, China, in late 2019. The COVID-19 virus is now known to belong to the same family as SARS and Middle East respiratory syndrome coronavirus (MERS-CoV), which are zoonotic infections thought to have originated from snakes, bats, and pangolins at the Wuhan wet markets (Ji et al. 2020). The virus has rapidly spread across the globe leading to many infected people and multiple deaths (Wang et al. 2020); especially of the elderly and vulnerable (Centers for Disease Control and Prevention 2020). While efforts to control and limit the spread of the pandemic in the community are quite straight forward to follow, it seems that prejudice and fear have jeopardized the response efforts (Ren et al. 2020). In fact, the COVID-19 pandemic has already unleashed panic, as evidenced by the empty toilet paper shelves in stores, resulted in accusations against people of Asian races (Malta et al. 2020), and impacted people’s decisions to seek help when early symptoms arise (Ren et al. 2020). In this editorial, we discuss the issues related to the occurrence of fear, panic, and discrimination, analyse the causes of these phenomena, and identify practical solutions for addressing mental health issues related to this pandemic for both public and healthcare professionals.
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In this article, we argue that fear experiences during the COVID-19 pandemic are organized on the psychological level around four interrelated dialectical domains, namely (1) fear of the body/fear for the body, (2) fear of significant others/fear for significant others, (3) fear of not knowing/fear of knowing, and (4) fear of taking action/fear of inaction. These domains represent the bodily, interpersonal, cognitive, and behavioural features of fear, respectively. We propose ways of addressing these fears and minimising their impact by improving appraisal of the body, fostering attachment security, improving emotion regulation, adopting acceptance and promoting responsibility.
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An infection of novel coronavirus (COVID-19) that originated from Wuhan city of China in December 2019 converted rapidly into pandemic by March 11, 2020. To date, the number of confirmed cases and deaths has risen exponentially in more than 200 countries, with an estimated crude mortality ratio of at least over 2%. The unpreparedness to tackle the unprecedented situation of coronavirus has contributed to the rising number of cases, which has generated an immense sense of fear and anxiety amongst the public. It has further resulted in the inadequacy and unavailability of essential medical supplies, physicians, and healthcare workers (HCW). Although the chief focus is on minimizing transmission through prevention, combating infection, and saving lives by ramping up the development of treatment and vaccines, very little attention is on the critical issue of physician burnout, resident burnout, and the psychological well-being of HCW. Until now, no significant steps have been taken by the authorities to minimize the COVID-19 specific contributing factors for burnout. The COVID-19 has posed strain on the entire healthcare system already, and it is vital to remediate the issue of physician and resident burnout urgently with concrete actions to avoid subsequent potential short-term and long-term adverse implications.
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Background: The current outbreak of COVID-19 coronavirus infection among humans in Wuhan (China) and its spreading around the globe is heavily impacting on the global health and mental health. Despite all resources employed to counteract the spreading of the virus, additional global strategies are needed to handle the related mental health issues. Methods: Published articles concerning mental health related to the COVID-19 outbreak and other previous global infections have been considered and reviewed. Comments: This outbreak is leading to additional health problems such as stress, anxiety, depressive symptoms, insomnia, denial, anger and fear globally. Collective concerns influence daily behaviors, economy, prevention strategies and decision-making from policy makers, health organizations and medical centers, which can weaken strategies of COVID-19 control and lead to more morbidity and mental health needs at global level.