The evidence from recent surveys asking people about their emotions during the pandemic is not convincing one way or the other either, experts said. One reason is that these surveys often do not make distinctions between people in the thick of the action — front-line workers, in this case — and everyone else. Millions of Americans have been juggling Zoom cocktail hours with Netflix binges: a time-management challenge, perhaps, but not one that has been linked to prolonged trauma.
Moreover, psychological distress usually takes time to consolidate into the kind of persistent condition that drives people to seek treatment, revealing a diagnosable psychiatric disorder. Generalized anxiety disorder, for instance, is defined in part by excessive anxiety for at least six months. Post-traumatic stress requires, first, experiencing a life-threatening event, either personally; through a loved one; or up close, like witnessing deaths in an intensive care unit. Nightmares and other reverberations of the trauma are common, but these typically must persist for at least three months to qualify for the full diagnosis of a chronic condition.
“There are a number of surveys out there, and I think they are all useful, to some extent,” said Emma Beth McGinty, an associate professor in the Johns Hopkins Bloomberg School of Public Health. “But they’re using a mishmash of measures of symptoms of depression and anxiety, and not a validated psychiatric instrument,” or questionnaire.
The best American survey to date, posted early this month by JAMA and led by Dr. McGinty, administered a standard, widely studied psychiatric questionnaire online to a nationally representative sample of 1,468 adults. It found that 14 percent of people had high levels of psychological distress, compared with an average of 4 percent during the pre-Covid era. It found little difference in respondents’ feelings of loneliness, compared to averages before the pandemic.
“The longer people experience these levels of psychological distress, the more likely they are to present with a diagnosis that would benefit from treatment,” Dr. McGinty said in a phone interview. “But the question of whether that’s really going to happen is an open one. We did this in early April, right as the shutdown and stay-at-home orders were implemented, when people were experiencing all this for the first time. One might hypothesize that the stress has eased, we’ve gotten more used to this and the world has opened up a bit.”
Dr. McGinty and her collaborators plan to conduct another such survey later this summer, she said, and possibly one in the fall, to see whether levels of psychological distress change as the epidemic changes shape through the year.
The fear of infection and disruptions caused by the coronavirus, without question, have intensified the distress of many individuals, especially those who have lost regular access to care as a result, or who had pre-existing dread of infections — from obsessive-compulsive disorder, for example.