# Helping Give Away Psychological Science/Coping with Outbreaks of Infectious Disease

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This page organizes resources and general information about coping with outbreaks of infectious disease, such as flu season as well as the current COVID-19 pandemic. Outbreaks of infectious disease, such as pandemics, can lead to increases in anxiety and other mental health symptoms for many people. It is therefore important to have accurate information about how to protect your mental and physical health during such an event, as well as information about how to care about those around you. We have another page focused specifically on the COVID-19 pandemic. There are also a variety of other teaching resources about COVID-19.
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The following sections contain general information that may be useful during a pandemic, as well as resources pertaining specific ongoing crises.

# General Health-Related Information Sources

* US Centers for Disease Control and Prevention (CDC)
** The CDC is the leading national public health institute in the United States
** The CDC website contains up-to-date information about the spread of infectious diseases in the United States and abroad, as well as resources for how to protect you and your loved ones from illness.
* World Health Organization (WHO)
** The WHO is a specialized agency of the United Nations.
** The WHO has many pages and resources translated and available in multiple languages, including Spanish, French, Arabic, Chinese, and Russian. Look at the tabs at the top right of pages to see if other languages are available.
** The WHO website contains general information about worldwide health topics, as well as information about ongoing emergencies.

# Mental Health Resources

Many people feel some degree of anxiety when thinking about the outbreak of infectious diseases. The resources in this section may be helpful for reducing these worries.

## Self Care

The CDC provides some resources for self-care during an epidemic:
Everyone reacts differently to stressful situations. How you respond to the outbreak can depend on your background, the things that make you different from other people, and the community you live in.

### People who may respond more strongly to the stress of a crisis include

* Older people and people with chronic diseases who are at higher risk for COVID-19
* Children and teens
* People who are helping with the response to COVID-19, like doctors and other health care providers, or first responders
* People who have mental health conditions including problems with substance use

### Stress during an infectious disease outbreak can include

* Fear and worry about your own health and the health of your loved ones
* Changes in sleep or eating patterns
* Difficulty sleeping or concentrating
* Worsening of chronic health problems
* Increased use of alcohol, tobacco, or other drugs

### Things you can do to support yourself

* Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting.
* Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
* Make time to unwind. Try to do some other activities you enjoy.
* Connect with others. Talk with people you trust about your concerns and how you are feeling.
Call your healthcare provider if stress gets in the way of your daily activities for several days in a row.

## Coping with Anxiety

The American Psychological Association provides the following 5 tips for people coping with anxiety related to the 2019-nCoV virus outbreak:

### Keep things in perspective

Take a deep breath, and remember that the number of confirmed infections in the U.S. is extremely low compared to number of people in the country. The fact that there is a great deal of news coverage on this issue does not necessarily mean that it presents any threat to you or your family. There are other things that are statistically more likely to be dangerous (such as car accidents) that are not getting major news attention.

### Get the facts

It is helpful to adopt a more clinical and curious approach as you follow news reports about the virus. To that end, you will want to find a credible source you can trust. The U.S. Centers for Disease Control and Prevention has webpage dedicated to information on the coronavirus outbreak. You may also find useful information from local or state public health agencies or even your family physician. We have gathered a lot of these together on a page for the corona virus/COVID-19 here.

### Communicate with your children

Discuss the news coverage of the coronavirus with honest and age-appropriate information. Parents can also help allay distress by focusing children on routines and schedules. Remember that children will observe your behaviors and emotions for cues on how to manage their own feelings during this time.

### Keep connected

Maintaining social networks can foster a sense of normality and provide valuable outlets for sharing feelings and relieving stress. Feel free to share useful information you find on governmental websites with your friends and family. It will help them deal with their own anxiety.

### Seek additional help

Individuals who feel an overwhelming nervousness, a lingering sadness, or other prolonged reactions that adversely affect their job performance or interpersonal relationships should consult with a trained and experienced mental health professional. Psychologists and other appropriate mental health providers can help people deal with extreme stress. These professionals work with individuals to help them find constructive ways to manage adversity.

## Coping with Obsessive-Compulsive Disorder (OCD) or Germ Phobia

The news can feel stressful or overwhelming. It can be even harder to keep in perspective if we already were anxious, and especially if we were anxious or obsessed about germs. It is a challenge to balance realistic steps for safety versus doing things to keep a sense of control and progress dealing with anxiety. The following tips come from Shala Nicely, LPC, Kimberley Quinlan, LMFT, and Reid Wilson, PhD:

### News

It’s tempting to check news constantly to see how the situation is developing. To combat compulsive checking, restrict your news intake to a frequency and duration that works for you. For instance, you might only check once a day for a maximum of 5 minutes, or once a week you might watch the evening news, or you might decide not to check news at all. Do whatever is most useful for you (and not for OCD).

### Travel

If you’re planning to travel to a region affected by the virus, identify dates by which you need to make travel decisions and whether travel providers might waive change fees. It’s likely that the information you’ll need to make decisions will be information released just prior to your decision-making dates. Therefore, give yourself permission not to constantly check the news or ask others’ opinions to try to “figure out” which way the situation will go, as frequent checking and reassurance seeking can cause more anxiety without an increase in useful information.
If it seems like OCD is trying to make your decisions and you’re travelling with someone whom you trust who doesn’t have OCD, you could observe how that person is making decisions and try to follow their lead. While your travel companions may also have anxiety, if they don’t have OCD, they are going to be more likely to make decisions based on current facts, not on OCD “what ifs?”

### Contamination concerns

Many people in OCD treatment are trying to reduce compulsive cleaning rituals, and those in recovery may have handwashing and other cleanliness routines that are less stringent than the average American because they are trying to keep contamination compulsions in check. However, because of the present situation, give yourself permission to follow current guidelines being recommended by authorities such as the World Health Organization (WHO) or the Centers for Disease Control and Prevention (CDC).
The CDC and the WHO have the knowledge to be making these recommendations. OCD, no matter what it says, does not. Your goal is to restrict yourself to following valid recommendations (again, that counts out OCD). For instance, you could wash your hands as directed by the CDC/WHO but no more than that. OCD isn’t going to like this, so following the recommendations becomes your exposure and response prevention (ERP) exercise. Further, the feeling of dirtiness/grossness/contamination may still linger even after you’ve done the recommended wash, giving you an opportunity to practice allowing those feelings to be there without doing compulsions.
Here’s a way to frame these exercises to keep this whole situation in perspective. If you were a medical professional who had contamination OCD, you would still follow your profession’s procedures for germ prevention, even if you were in OCD treatment. But to keep your OCD in check, you’d want to do no more than what your profession says you’re supposed to do. Medical professionals with OCD work to manage this every day, and we’re joining them while valid authorities tell us these protective measures are necessary.

### Self-compassion

Recognize that if you’re anxious about coronavirus, that’s normal and you’re not alone. The situation is making many people fearful, even people who don’t have OCD. Allow yourself to feel anxious and realize that your anxiety might not go away while the situation is still unfolding.
Be compassionate with yourself if you’re experiencing an increase in OCD symptoms. It’s not your fault! Do what you can to keep your compulsions in check without trying to be perfect. If you need support, schedule a booster session with your therapist or reach out to a support group like the International OCD Foundation’s My OCD Community.

### You can do this!

The coronavirus situation is scary because there’s so much about it that’s uncertain. But if you’ve done ERP for OCD, you have above average skills in managing uncertainty and anxiety. You’re actually more prepared to handle all the unknowns than people who haven’t done ERP. While you may be scared and OCD may act up, remember that when it comes to anxiety and uncertainty, you’ve got this!

## Locating mental health care

Sources for locating mental health care services, whether they be virtual or in-person, include:
* Psychology Today
* Better Help (Virtual Therapy)
* The American Psychological Association's psychologist locator
* For low-cost services or services accepting medicare/medicaid, one may call 211
* National Suicide Prevention Lifeline: or chat online

# Incident-Specific Information

The following section contains information specific to specific national or international health crises, organized by name.

## COVID-19

On January 30, 2020, the WHO declared an outbreak of a novel coronavirus designated SARS-CoV-2 (also known as 2019-nCoV). The disease caused by the virus has been named COVID-19. The epicenter of the outbreak was the city of Wuhan, in the Hubei Province of China, though cases now have been reported worldwide. The Johns Hopkins Bloomberg School of Public Health has an interactive tracking site, showing updated information about cases around the world.

### Helpful Links
#### CDC:

* General Info on COVID-19
* Who is at higher risk of getting very sick.
* How COVID-19 Spreads

#### WHO:

* Advice for the public (includes short videos and simple, downloadable graphics; available in multiple languages, including Spanish)
* World Health Organization statement on 2019-nCoV
* Questions and Answers (Q&A) about coronaviruses and COVID-19
* Situation Reports

#### IFRC:

* Information about the IFRC's efforts to combat COVID-19 including background information about the virus and its spread worldwide
APA:
* Podcast about Coronavirus Anxiety
* Johns Hopkins University: The hospital is maintaining a coronavirus resource page with daily status reports and information about how to protect yourself from the virus
* USA Today: article about airlines waiving change fees; many hotels, vacation rentals, and other companies are also offering a lot more flexibility in canceling or rescheduling travel.

###### Infographics

COVID-19 general tips, information, and resources

# References

* ↑ https://www.cdc.gov/coronavirus/2019-ncov/prepare/managing-stress-anxiety.html
* ↑ media:Tip_Sheet_-_OCD_Coronavirus_Concerns.pdf
* ↑ https://www.cdc.gov/coronavirus/2019-nCoV/summary.html