Commentary: COVID-19 could worsen depression, divisions in US

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The coronavirus outbreak gathering speed around the world is scary enough. Locally, the announcement Wednesday that California had its first COVID-19 death hammered home. But even after (and assuming) the virus ultimately fades away, whether its overall impact is akin to the average annual global deaths from seasonal flu — ranging from 291,000 to 646,000 people — much less than that, or much worse, the outbreak seems certain to worsen an existing American epidemic: the high levels of mental illness linked to technology and/or extreme isolation.

It also seems likely to deepen divisions nationwide.

Let’s look at technology first.

Smartphones and social media are blamed in nations rich and poor for creating vast alienation and loneliness among the young. Instead of bringing people closer, the ability to quickly connect with others’ lives via Facebook, Instagram or Twitter makes us feel alone in the virtual crowd because everyone else can seem more popular, more clever, more attractive, better off financially or to have happier families.

In her 2017 essay in The Atlantic — “Have Smartphones Destroyed a Generation?” — San Diego State University psychology professor Jean M. Twenge laid out the case that devices and social media had laid waste to the mental health of millions of children from grade school to high school. That same year, University of Pittsburgh physician/researcher Brian E. Primrack and his colleagues established a nexus between social media use and feelings of social isolation among Americans up to age 32. There’s been less academic research into whether social media and smartphones have taken a similar toll on middle-aged and older Americans, but studies show a third of those in that age range also face an epidemic of loneliness with few friendly voices in their lives. Many live alone and have little connection with other adults, their children or co-workers.

So at a time when millions of Americans can go days without having a meaningful personal interaction with another human being, along comes a health threat that authorities say is most easily avoided by not having any such contact. Lengthy isolation is obviously not what U.S. authorities have advised. But from Japan and South Korea closing schools for a month to Switzerland forsaking gatherings of 1,000 or more people to airlines canceling flights to China, Japan, South Korea, Singapore, Iran and parts of Italy, the message seems clear: Large groups of people are risky to be with — so avoid them.

When these admonitions go away, will people return to their old habits? Many probably will. But there is plenty of academic research into epidemics and pandemics and their fallout that suggests some won’t. Large-scale disease outbreaks can promote depression, stigmatization and xenophobia, and can weaken people’s belief in the efficacy of authorities. In other words, they make matters much worse for those who already suffer from or are inclined to alienation and loneliness.

That’s not all. Pandemics also have the potential to turn large segments of the population against each other. When authorities respond to a virulent pandemic, “A unified perception of shared disaster will reduce psychiatric casualties,” David J. Rissmiller wrote in Psychiatric Times magazine in 2007. Or not, he added. “Alternatively, a perceived bias in pandemic resource allocation, such as hospital respirators and beds … will fuel a fractious response that will amplify psychiatric suffering.”

In other words, this is a divisive crisis waiting to happen. In the U.S., there are only 62,000 full-featured mechanical ventilators — and a 2005 federal study showed the nation would need 12 times that many in a mass respiratory-related outbreak. In China, an immense shortage of hospital beds has hindered its response to the COVID-19 epidemic. If it emerges that Chinese President Xi Jinping gave Communist Party big shots and their families much better COVID-19 care, a convulsive reaction is likely. China may have a second cultural revolution that doesn’t turn out as well for Xi as the first one did for Mao Zedong.

If the U.S. has its own epidemic, those who decide who gets ventilators and who gets beds could face enormous blowback from those who don’t and their families. If there is a perception that certain states or regions — or rich people — are favored, watch out. If you thought Americans were already divided and prone to isolation and disillusionment before COVID-19, you haven’t seen anything yet.

Chris Reed is the deputy editorial and opinion editor of The San Diego Union-Tribune. Twitter: @chrisreed99. Email: chris.reed@sduniontribune.com.