Prof Renata Schoeman: How to deal with the stress of a COVID-19 diagnosis

The current news coverage on the global COVID-19 pandemic is more or less inescapable. The emotional impact of drastic changes to your way of life can be overwhelming. These include the dynamics that accompany extended stay-at-home periods, self-isolation and a possible period of quarantine as well as the general uncertainty, fear, frustration, boredom and loneliness that all South Africans feel at the moment.

Overall, the COVID-19 pandemic has taken us all into uncharted territory. People feel frightened and isolated, and for most people are greatly uncertain of the future.

However, for someone who has acquired the COVID-19 virus, there are several additional stresses, strains and worries to deal with.

These can include:

• Fear of the possible health outcomes you might face
• Worry over whether you can cope with the illness on your own when you self-isolate
• The general effects of self-isolation
• Dealing with any possible stigma that may be directed at you or your family as a result of your diagnosis
• A fear of possible long-term health complications
• Concerns for the safety and health of your immediate family
• Worries caused by possible financial insecurity and what the future may hold.

Here are some ways to regain perspective on the situation and to help you get through this pandemic.

Is it normal to be very worried about COVID-19?

Yes, absolutely. People are feeling vulnerable and overwhelmed right now, not just by their drastically changed way of life and their sudden social isolation, but also by the threat of possibly becoming ill. At present there seems to be little escape from news about the spreading of the COVID-19 virus, and the rising death toll. We, however, tend to focus on the negative. It’s therefore key to remember that the vast majority of people recover from this illness.

People are worried about whether they will cope if they have COVID-19 and whether they will have enough supplies to get them through their time of quarantine at home. They are worried about whether there will be medical attention available if they needed it and whether they will be able to afford medicine and treatment. And they are worried about possibly dying from COVID-19, and for the safety of those around them.

These are all huge concerns, and added to these is the stigma around the illness: the possibility that others might react with fear when they learn of a person who has – or even has had and recovered from – COVID-19. Their fear of contracting the COVID-19 virus can lead them to post negative comments online or share these directly with the affected person or their family, worsening their sense of social isolation.

• COVID-19 does not discriminate. Let’s prevent stigma that could cause a surge in disease.
• Stigma: I am one of the first South Africans to contract COVID-19

What are people's main concerns about self-isolation?

The notion of self-isolation is new for just about everyone. It is completely natural for people to worry about whether they can cope, emotionally, with being cut off from many of their normal activities and support structures. Loneliness is already an issue for many people in our society. For those living on their own, the prospect of very limited or no direct face-to-face contact with anyone for possibly weeks or months is especially daunting.

A general concern is being able to provide and care for oneself and the family, not just financially, but also in accessing and maintaining a supply of household necessities and medicines. Many people do not have the financial reserves to see them through a period in which they cannot work.

Most people are also used to relying on the emotional and physical support of those around them when they are ill. Now, if you have acquired COVID-19, you are expected to keep a distance from loved ones – for the very sake of their health. That brings its own stresses. Illness, and an illness possibly being severe, can be frightening to face on your own.

The prolonged nature of the COVID-19 pandemic, and its widespread effects can cause many people grief symptoms, such as denial, anger and bargaining. For some people, this can lead to depression or post-traumatic stress disorder, especially for people who are already struggling with stress and anxiety.

Dealing with the COVID-19 pandemic or finding out you have the disease can also cause those who have problems with substance abuse (tobacco, alcohol, drugs) to turn towards these coping mechanisms even more.

Why do I worry so much about the future?

We like to feel that we are in control of our immediate world and right now, that is not really possible. This pandemic has changed our world and we do not know what the future holds. It is normal to be worried, because nobody has definitive answers on what to expect over the coming weeks and months.

Everyone wonders about the long-term impact of this pandemic on their health, their healthcare providers, the economy, their way of life and their state of mind.

We need to remember that we are in this together and that we all now have an unprecedented opportunity to re-evaluate what really matters to us.

Here are ways to cope while recovering from COVID-19

• It is our natural instinct to want to protect those closest to us – and even more so if we have acquired COVID-19 and we fear passing it onto them. Right now, the best you can do is to stay calm, follow your healthcare provider’s instructions and regulations exactly, and focus on your recovery.
• If possible, self-isolate in a part of the house where you can access a separate bedroom and bathroom. If this is not possible, make sure you take every preventive measure to curb the spread of illness to others in your home. 
• Make sure you have enough provisions of items such as food, medicine and hand sanitiser to last you a couple of weeks while you are in self-isolation. But remember: don’t panic buy.
• Follow the Centers for Disease Control and Prevention’s guidelines on Caring for someone who is sick with COVID-19, at home. Keep informed but don't waste your energy on rumours and lies. It is essential to not let yourself be sidetracked by fake news and alarmist reports on social media. Stick to the reliable news sources such as the World Health Organization and the Centers for Disease Control and our National Department of Health’s dedicated COVID-19 website. Remember that sharing accurate information about COVID-19 helps to make those dealing with a COVID-19 diagnosis feel less stressed and it lets you connect with them in a positive way.
• Avoid joining or sharing content from WhatsApp groups where you don't really know other people well enough to understand their credibility or motivation in sharing information related to COVID-19.
• Help your family to feel your support and share updates on your progress by staying in regular, virtual contact with them. Connecting with others, and talking with people you trust about your concerns and how you feel, will also help you to get through your recovery period.
• If you have elderly relatives, offer to do their shopping online for them and have it delivered to their home – also letting those who want to do so, to pay you by electronic transfer into your account.
• It is crucial to stick to a regular routine as far as you can. This is comforting not only to you but also to those around you.
• Remember that everyone responds differently in times of stress. Those who are at higher risk of severe illness if they contract COVID-19 may be more concerned and will need greater support from their healthcare provider. People who are elderly, pregnant, are cancer patients or survivors, who have high-risk children to take care of, or who have pre-existing medical conditions (such as HIV or TB, diabetes, chronic respiratory disease, cancer and heart disease) are especially worried, as they seem to fit the profile of those worst affected by the COVID-19 virus.
• People with pre-existing mental health conditions should continue with their treatment and be aware of new or worsening symptoms. 
• Depending on how well you feel, you can try to continue to work from home while recovering from COVID-19 if you want.
• Also make sure you continue to eat healthily and get enough sleep to support your recovery.
• Manage any guilt you may feel over not being able to share in the responsibility to care for and provide for your loved ones while you are ill.

Keep perspective about your chances of recovery

Many of us are focusing on worst-case scenarios at the moment.

The truth is that 95% of the people who contract COVID-19 will have relatively mild symptoms from which they will fully recover. Studies show that about 3.4% of all people who contract COVID-19 will die from the illness. We need to hang onto that and focus on hope rather than on despair. We need to see things in context and to focus on the large numbers of people who recover.

Coming out of self-isolation or quarantine, recovered from COVID-19

Everyone will feel differently after coming out of any period of illness, and out of self-isolation or quarantine for COVID-19. Mixed emotions are expected – and will include relief but also possibly fear and stress about your health and any further illness, as well as your ability to make up for lost time at work or in the family.

Your response depends on:

• How sick you felt and how much of a toll the episode of COVID-19 has taken on you in the short- and long term
• How quickly you can return to your normal family and professional responsibilities
• The impact of your bout of illness on your work and ability to earn an income, and how much you will need to rebuild
• Where you recovered (whether at home or in a healthcare facility) and how much support you had while ill, which can leave you feeling at peace or with a sense of trauma over your access to healthcare
• Your sense of having felt a degree of control over your situation despite the unknowns – were you able to recuperate in a safe place, and access food, medicine and support? If not, you may feel particular fear over further illness and your vulnerability
• How you feel physically and mentally now that you are no longer contagious
• Your concern over the risk of re-infection, which may cause long-term fear
• The degree to which loved ones and your social and professional community accept your return into contact with others
• Possible frustration because friends or loved ones have unfounded fears of contracting the disease from you even though you have been determined not to be contagious.

Remember to be vigilant about your emotional health as well as your physical health. Pause to think about how you are coping now that you have recovered. If you feel you need support to deal with your new reality, then be sure to ask for help.

All medical information found on this website including content, graphics and images, is for educational and informational objectives only. Discovery Health publishes this content to help to protect and empower all South Africans by promoting a better understanding of COVID-19.