Understand how the second wave could affect mental health

For business owners, leaders and employees, welcoming in the new year may not feel as natural as it has in the past.

President Cyril Ramaphosa's first weekly letter for 2021 (sent on 18 January) clearly defined the context we are currently all waking up to: "The first two weeks of the year have been difficult for all South Africans. The coronavirus pandemic has gotten worse, with new infections increasing far faster and far higher than before. Hospitals have been under great strain as more people have needed medical attention."

"Along with many other countries the world over, South Africa finds itself in the grip of a second wave of COVID-19 infection," says Nonkululeko (Nonku) Pitje, Head of Employee Health Solutions at Discovery. "It's critical that leaders and managers within organisations are equipped with the tools to help employees and to ensure their own mental wellbeing during the trying times ahead."

The second wave could be followed by further waves

In President Ramaphosa's first letter he also said: "While most economic sectors have been able to operate again for several months, it will take some time for the economy to recover and for lost jobs to be restored. As the new year starts, many families are still feeling the effects of the pandemic on their lives and livelihoods." He adds: "For South Africa, as for most countries around the world, the year 2021 will be extremely challenging. The second wave of COVID-19 infections may well be followed by further waves, which will threaten both the health of our people and the recovery of our economy."

Nonku adds: "It is to be expected that the pressures defined by the second wave of COVID-19 infection and threats of further waves of infection will leave employees and leaders at risk of everything from stress to anxiety, depression, loneliness or isolation, also irritability, helplessness or more."

"Our people are understandably concerned for their health and the health of loved ones. Many people are also facing financial difficulties, struggling to cope with the demands of working from home and running a home with home-schooling perhaps on the go, struggling to adapt to changes in their personal circumstances, and even grieving the loss of a loved one or multiple loved ones to COVID-19."

"At the same time, the need to ensure business continuity productivity is critical, particularly in light of the economic pressures businesses currently face."

What could your employees be going through right now? The rise of pre-TSD?

We're early into 2021 and research into mental health will surely emerge in the coming months. "However, in 2020 a good amount of research was done in South Africa and across the world, looking into employee mental health.

In October 2020 a study by Afriforte and the WorkWell research unit at the North-West University (NWU), in conjunction SADAG and Mindful Revolution, investigated the psychological effects of the lockdown. A survey conducted among 1656 employees showed that 46% of respondents were experiencing, very high levels of psychological distress attributed to social distancing measures, the disruption of routines and usual activities, loneliness, depression and even substance abuse.

The findings suggest this is linked to "Pre-Traumatic Stress Disorder" (Pre-TSD). Pre-TSD refers to, "a syndrome involving involuntary intrusive images and flash forwards of haunting events that could be experienced during major disruptions such as COVID-19," explained Afriforte's Prof Ina Rothmann. Pre-TSD could be attributed to a host of symptoms displayed during the epidemic and lockdown episodes.

"Symptoms of Pre-TSD include mood swings, a short temper, forgetfulness, constant worrying, insecurity, a loss of objectivity and an inability to focus or concentrate amongst a host of others. What differentiates Pre-TSD from the more commonly known Post Traumatic Stress Disorder (PTSD), is that Pre-TSD occurs during a traumatic or disruptive event because individuals anticipate trauma and experience flashforwards of traumatic events.

PTSD follows a traumatic event resulting in flashbacks related to the traumatic event experienced. "Although Pre-TSD is not a recognised psychiatric diagnosis, it is based on and founded in scientific knowledge conducted with soldiers which indicated that Pre-TSD predicts the development of PTSD and depressive disorders in future. Understanding Pre-TSD can be key in addressing mental health issues associated with the COVID-19 epidemic.

Prof Rothmann also explained that Pre-TSD can also lead to a variety of physical symptoms.

"Frequent headaches, nausea, heartburn, eating problems, heart palpitations, sleep problems and muscle pains and aches are all symptoms that cause individuals to feel chronically stressed and generally unwell at both a psychological and physical level. In short, the severity of Pre-TSD on our well-being during this unprecedented period of flux must be addressed if society is to return to normal."

Other research into employee mental health conducted in 2020

In April 2020, at the start of South Africa's lockdown period, the South African Depression and Anxiety Group (SADAG) conducted an online survey (1214 respondents) asking participants about their home life and mental health before and after lockdown.

The main challenges experienced during the first phase of lockdown included:

1. 55% Anxiety and Panic
2. 46% Financial stress and pressure
3. 40% Depression
4. 30% Poor family relations
5. 12% Feelings of suicide
6. 6% Substance abuse

"COVID-19 and the lockdown has affected many South Africans, and it has had a serious impact on people living with a mental health issue often making their symptoms more heightened. SADAG has been receiving calls from people with no history of anxiety or depression who are feeling overwhelmed, anxious and stressed", says SADAG's Operations Director Cassey Chambers in relation to the survey.

• Read SADAG's May 2020 guidelines "Mental health for business and the world of work"

Abroad, research done by Employee Benefits and released in September 2020, found that up to one third (29%) of British employers were concerned that the COVID-19 pandemic was having a negative impact on employees, with 36% worried about the health and safety of employees during the pandemic. At the same time a third of employees surveyed worried about their mental wellbeing with even more (42%) concerned about losing their jobs.

Now is the time to put renewed focus onto supporting employee wellbeing

"Employers have a duty to care for their employees' mental health and ensure it is protected at all times," adds Nonku, "and in particular during very challenging times such as those currently underway. Whether teams are working from home, back in the office or on an extended leave of absence, now is the time to put a particular focus on processes and platforms that support employee wellbeing."

"Employee assistance programmes have a valuable role to play in the current context," she adds. "For example, Discovery Healthy Company exists to offers employees various levels of interventions, from prevention and education to episodic or ongoing management across physical, emotional and financial wellbeing, as well as legal support."

"We have multi-skilled Healthy Company Coaches who are trained to provide support and advice across all four dimensions of wellbeing. We have also developed a range of tools and programmes to support employees on their wellbeing journey and are adapting these tools on an ongoing basis to meet current needs."