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COVID19 and SUICIDE
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November 20, 2020

Epidemics undeniably increase the risk factors of suicide: economic hardship, social isolation, fear (of being infected or of spreading infection), and anxiety, but this is too early in the study of the link between COVID19 and suicidality to draw any conclusions.

Past pandemics can give researchers some indication of the effect of global health challenges to mental health and suicidality. Past pandemics include the 1918 flue pandemic, bird flu (1997), Ebola (2014), SARS (2003) and MERS (2012). COVID-19 is the most severe pandemic of the 21st century, on track to having a rising death toll. Beyond causing respiratory distress, COVID-19 may also cause mortality by way of suicide. The pathways by which emerging viral disease outbreaks (EVDOs) and suicide are related are complex and not entirely understood. 

The first comprehensive study of pandemic-induced suicidality was published by the National Center for Biotechnology Information in October 2020.  A team of medical professionals reviewed over 2400 articles in five different journals, selecting nine of these as presenting the most focused analyses of suicide and past pandemics.  Four studies revealed slight but significant increases in suicide rates, mostly among older adults and mostly at the height of the disease. The causes were exactly what early studies of COVID19’s impacts report: quarantine and isolation, plus fear, resulted in suicidal mindsets.

Overall, however, the survey indicated that “we found scarce and weak evidence for an increased risk of deaths by suicide during EVDOs,” yet “Our results inform the need to orient public health policies toward suicide prevention strategies targeting the psychosocial effects of EVDOs.”

Does COVID19 differ from earlier pandemics in ways that might either exacerbate or reduce the stressors that are disease-related and risk factors for suicide? 

  • COVID19 is most commonly compared to the 1918-20 flu epidemic.  This was during the final year of World War I, when millions of soldiers were on the move.  Lockdown and quarantine came earlier, and spread more quickly over a wider global area after the emergence of COVID19.
  • Medical science is able to identify emerging diseases more easily and control outbreaks more quickly than just a decade ago.
  • Hygiene practices are far better in medical facilities, and there is a much greater understanding of how these diseases spread.  In COVID19 for example, the realization that personal protective equipment and simple preventive measures like facial coverings came very early in the pandemic.
  • The time it takes to bring an effective vaccine to the market, and the ability of pharmaceutical companies and governments to distribute the vaccine, has a dramatic effect on the longevity of a virus’s life span.  It was not until 1945, for example, that a flu vaccine was widely available.  The first polio epidemic in the United States was in 1894, and a polio vaccine was not available until 1961.  Compare these periods to the 12 months it may take between the rise of COVID19 and the availability of a vaccine.

These developments all point to a shorter and less impactful pandemic today than in years past, and hopefully reduces the virus’s window of opportunity to inspire suicidal thoughts. But that must not result in complacency.

An interview with a nurse who began practicing in the 1950s and who is an observant of the country’s response to COVID19 noted a societal difference between the polio epidemic and the current pandemic. “…people were scared out of their minds (of polio) and rightfully so. Nobody wanted to go outside. All of the beaches were closed, the pools were closed, and all the movie theaters were closed. Day after day, I'd go into work and inspect all of the iron lungs to make sure none of them had any leaks or problems…”  Like today, there were some who paid no attention to health care, took no advice and remained obstinate throughout the Polio pandemic. But they were rare, and by and large people were unified; the disease never became a political weapon. Those who lived through the polio era will recall the emergence of March of Dimes, when tens of millions of schoolchildren joined together and raised funds to fight polio.

Want to reduce the risk of suicide? Wear a mask. Socially distance.  Wash your hands.

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