Pradipna Raj Panta

The COVID-19 pandemic has had a major impact on our lives. Many of us are encountering challenges that can be stressful, overwhelming and cause strong emotions in adults and children. Public health measures, such as physical distancing, lockdown and other prohibitory orders, are necessary to break the chain of coronavirus transmission, but they can make us feel isolated and lonely and can increase stress and anxiety. Research proved that this pandemic has been a unique stressor and is having profound mental health consequences that have affected communities all over the world. Concerns have been expressed that, at their most extreme, these consequences could manifest as increased suicide rates.

Where We Were A Year Ago
Nepal is undergoing a severe second wave of the pandemic. But Nepal prepared well for the pandemic in the last year. The hundred and twenty days lockdown in 2020 drastically declined the number of cases that needed hospitalization and treatment enough that they would not cross the limits of the medical capacity of the nation.
Fortunately, this preparation gave the space to manage the first wave in 2020, as overall mortality rates were very low(less than 1 per cent) compare to other nation of the world and people felt safer through strict self-regulation. But even in those good days, the people reported feeling more agitated, more stressed, more restless, more sleepless.
According to the Nepal Police record, 20 people committed suicide each day. This was a huge increase from 12 each day they recorded in 2019. The results of some non-governmental organization research were that alcohol and cannabis habit had increased in lockdown.
But a year ago, however, there was also hope.
The number of Covid cases also began to decline drastically after October and there was a reduction in hospital utilization rate. Vaccination began at the beginning of 2021 through the courtesy of neighbours and WHO, and this led to the expectation that Nepal would be able to vaccinate its health professionals, and the most vulnerable, senior citizen by the summer, so even if the second wave hit, it would not be severe and our health system would be well equipped, suffice to treat every patient. Furthermore, the experience of a pandemic would allow us to slow down, be more mindful, and more time to reflect. Many people have learnt and started working from home. For some working from home, would enable them to work in more creative and environmentally friendly ways.
So, a year on, our vaccination program was disturbed simply because Nepal was not able to procure vaccine for several reasons and the authority and health stakeholders were not able to study the emergence of new variants quickly enough. So when this wave began, from a preparedness point of view, Nepal was, in some ways unprepared than it was towards the end of last year.
As of writing this article, more than 5,657 people have died and nearly half-million infections have been confirmed. Horrifying images of our hospitals are circulating in the country. There aren't enough ventilators, we hear; not enough PCR test; not enough generosity.

Way Ahead
Experts are using huge datasets to track the impact that pandemic control measures have had on people mental health. Although the country-specific picture has yet to be clear, the scientist started to see a global surge in depression. In Nepal, the overall impression of mental health problems is looking rather bleak.
From Anxiety, depression, eating problems, Obsessive-Compulsive Disorder(OCD), personality disorders, bipolar disorder, Post Traumatic Stress Disorder(PTSD), Psychosis to Self-harm and suicidal feelings, the list is quite long and giving details of all is beyond the scope of this article.
Undoubtedly, the rise in mental health problem is not surprising given that the coronavirus has posed many challenges to many of us. Many people live under stress due to lack of work, some other people feel overworked. Many people do not have the resources to cope with the stress of Covid 19.
This may include content and materials such as access to smart technology, social such as a few family members or friends and cognitive or biological (eg, inability to engage in physical exercise, or participate in activities or routines) resources. The government should assess the availability of resources and consider how resource scarcity can be mitigated for a given individual and family.
But according to research mental health mainly stems from fear of death and lack of confidence. Experts believe that this wave of Covid is not the last. Therefore, the intensity of the next wave is likely to occur soon. That's why we are in dire need of vaccine. Vaccination is a key strategy to boost people's confidence and reduce the severity of disease and ultimately the transmission rate. So the government needs to immediately plan a vaccine and ensure safe working for all. Furthermore, we must design our health care system for effective monitoring of triage patients, ensuring an effective supply of the inputs that the hospitals need to treat patients effectively, and if we can collectively practice Covid safe public health measures, the subsequence waves we face can be managed.

Non-Pharmacological Approaches
Moreover, the government and clinicians should recognise the importance of non -pharmacological approaches, which are more result-oriented than pharmacotherapy in the treatment of chronic stress, anxiety and prolonged grief. Such approaches include promoting physical activity and greater engagement in spirituality and yoga as appropriate. These approaches have also been shown to enhance coping, promote resilience, and reduce loneliness.
Also, by taking care of yourself, you can be better prepared to take care of others. It is especially important to stay connected with your friends and family at the time of lockdown. Helping others deal with stress through a phone call or video chat can help you and your loved ones feel less lonely or isolated.
However, people's mental health experiences will be very personal for everyone, and there are many ways it may be affected during the pandemic. And remember that everything I say or people like me who have degrees in Clinical and Behavioral Psychology says, tips or counselling can work for different people at different times. So try only what you feel comfortable with. And try not to put too much pressure on yourself if nothing seems possible right now.

(Panta is a freelance writer)