Tanya Lewis: Hi, and welcome to COVID, Quickly, a Scientific American podcast series!
Josh Fischman: This is your fast-track update on the COVID pandemic. We bring you up to speed on the science behind the most urgent questions about the virus and the disease. We demystify the research and help you understand what it really means.
Lewis: I’m Tanya Lewis.
Fischman: I’m Josh Fischman.
Lewis: And we’re Scientific American’s senior health editors. Today we’re going to talk about an oncoming wave of disabling grief that could hit lots of people.
Fischman: And we’ll try to unconfuse you about the complicated new mask-wearing guidelines from the CDC.
Lewis: This is a sad story, but it’s important. People who have lost loved ones to COVID are at high risk for a mental health problem called “prolonged grief disorder.” How is that different from normal mourning?
Fischman: Well, it’s paralyzing. Tanya, this is a high level of mental anguish that keeps people from leaving their homes, taking care of their families, holding down a job. It’s a recognized syndrome that can go on for a year or more without letup.
Ordinarily, after losing someone close, you can be anguished, and then you start to function again in time. But people with prolonged grief describe their lives as simply waiting to die.
The scary thing is that it looks like there will be a huge number of these people because of COVID. Katie Harmon Courage, one of our SciAm.com contributors, crunched some numbers in a story now on our Web site. About 5 to 10 percent of bereaved people get this condition. There are almost 600,000 COVID dead in the U.S., and each one leaves behind about nine close mourners, research shows. This means there could be a quarter million to a half million people disabled by grief in the coming months.
Mental health specialists say COVID deaths make bereaved people particularly prone to this problem. The deaths are often sudden. Those left behind are cut off from normal mourning rituals, says Katherine Shear, a psychiatrist at Columbia University. Plus travel and activity restrictions make it hard to make connections and rebuild lives. Add on economic hardship and general anxiety—and you’ve got a real problem.
There are already signs the pandemic triggers this disorder. Research published earlier this year found indications of prolonged grief in nearly 38 percent of pandemic-bereaved individuals in China. That’s more than triple the typical rate. The disorder can also exacerbate suicidality and substance misuse.
Lewis: Can people get help for this condition?
Fischman: That could be really tough. We are not ready for something this big, in terms of mental health resources. Grief disorder is usually treated with months of therapy. It works. But we don’t have therapists. There are about 30 psychologists and fewer than 16 psychiatrists per 100,000 people in the U.S. Numbers are even lower in poor communities that have suffered the most deaths during the pandemic. People in such areas, who tend to be people of color, often can’t afford insurance to cover mental health treatment.
There aren’t easy answers. Experts say that a safe return to mourning rituals—vaccinated or masked—could help. So could relieving other pandemic stresses, like getting evicted or going hungry. That relief gives a grieving family a chance to deal with the loss of a parent. And the Biden administration has promised $2.5 billion to aid state mental health services. But I don’t know if that money will bolster the grief counseling needed here.
The CDC recently issued new guidelines saying that vaccinated people no longer need to wear a mask or social distance in most indoor or outdoor settings, with a few exceptions, like hospitals. What do you make of the guidelines, and are you ready to ditch your mask?
Lewis: The new guidelines came as a surprise to many public health experts and to the public. Just a couple weeks ago, the CDC was saying that vaccinated people needed to wear masks indoors and in crowded outdoor settings. So it felt a bit like whiplash.
Some accused the CDC of caving to public pressure, but the CDC says its new guidelines are based purely on the evidence that the vaccines are extremely good at not just preventing people from getting infected but also from transmitting the virus to others. Still, some experts say the guidance was premature. As Angela Rasmussen, a virologist at Canada’s University of Saskatchewan, pointed out in a recent article in Slate, it’s not so much the science they object to—the vaccines really do protect people—it’s the way that science is being communicated.
The biggest problem is that there’s no way to know if someone who’s not wearing a mask has been vaccinated or not. It’s basically an honor code. And that could leave unvaccinated people—including young children—or immunocompromised people vulnerable to getting COVID. Plus, it makes it virtually impossible for businesses to enforce mask guidelines, which could make essential workers feel unsafe. And we’re already seeing some places that are getting rid of their mask mandates even though more than half the country is still unvaccinated.
Fischman: Tanya, you asked our SciAm colleagues—most of whom are now fully vaccinated—about if, when and where they were going to keep wearing their masks. What did you hear?
Lewis: Many told me that they were happy to ditch their masks outside in uncrowded areas—one even said she felt “near giddy.” But they were planning to keep them on indoors in places like grocery stores or public transit. They wanted to set an example of protecting others and also protecting their children or loved ones who are unvaccinated. Others said they were happy to comply with state or local guidelines but were ready to stop wearing masks in situations the CDC says are safe—especially the people who wear glasses, who were constantly having to fight the fog.
Personally, I’ve been happy to take my mask off when I’m outside, away from other people. But I plan on keeping my mask on when I’m in most indoor settings with strangers—at least until more people are vaccinated and the number of COVID cases is much lower. What about you, Josh?
Fischman: I keep mine in my pocket, and I put it on when I run into crowds—indoors or outside.
Lewis: Sounds reasonable. For my part, it’s not that I think the vaccine won’t protect me (although no vaccine is 100 percent effective)—it’s more that, given that so many people are unvaccinated, I don’t want to make people guess whether or not I am. It’s not a huge inconvenience to wear one, and if it helps model behavior that keeps others safe, I’m happy to keep it on.
Now you’re up to speed. Thanks for joining us.
Fischman: Come back in two weeks for the next episode of COVID, Quickly! And check out SciAm.com for updated and in-depth COVID news.
[The above text is a transcript of this podcast.]
If you do need help, if you or someone you know is struggling or having thoughts of suicide, there are places to turn. Call the National Suicide Prevention Lifeline at 1-800-273-8255, or contact the Crisis Text Line by texting TALK to 741741.
The Discussion, an online publication covering the current research study.