Stress, Anxiety and Other Risks of COVID-19

Awareness can save lives.

Posted May 08, 2020

 Josefa Silman by permission
Not Feeling Well
Source: Josefa Silman by permission

We sit at home, practicing social isolation and washing our hands every time we touch anything from the outside. We fear getting infected with the COVID-19 virus, and now—with these efforts—the danger is reduced.

Still, we are not exactly safe; not if we end up with other medical issues that can compel us to take a trip to the emergency room.

What if it's a heart attack?

Should we go to the emergency room and risk getting infected with COVID-19? (Yes, you should. The risk of dying from untreated heart attack is greater than the risk of dying from coronavirus for most people.)

These days, folks might tend to wait more than they should, more than they might have otherwise, hoping their symptoms will go away.

Anxiety and Avoidance:

It may not be a good idea, but people may tend to ignore early signs of disease now. That persistent headache, stomach pain, darkening urine, heart palpitation, blood in the stools can wait until after the pandemic is over. During normal times, people may get alarmed and seek medical advice. But now, the terror of getting infected may override good judgment.

Stress and Major Illness:

Research shows that stress can lead to serious diseases, especially when it is accompanied by a sense of helplessness. Stress was linked to the early onset of type 2 diabetes.

It may even be linked to heart attack, especially if it leads to habits that compromise the heart, such as unhealthy eating, lack of exercise, smoking, and excessive consumption of alcohol. There is a positive link between stress and “broken heart syndrome,” which is a temporary weakening of the heart muscle. Although it is not as fatal as a heart attack, it presents with similar symptoms and can get you out of commission for days or weeks.

Although research about the link between stress and cancer is still inconclusive, other studies have shown that stress can cause a tumor to grow and even metastasize.

Stress can increase inflammation in the body which makes it easier for various diseases to develop, including cancer.

Telemedicine to the Rescue:

There has been a significant increase in the number of deaths and it can’t all be explained by COVID-19. The good news is that increasing numbers of doctors are now practicing telemedicine. You can consult a doctor without leaving your home to assess if you need to go to the hospital, get checked by a doctor, or if you can wait for a while.

Patients suffering from diabetes are particularly vulnerable. With a compromised body, their chances of dying due to the coronavirus are higher than most people. They have to be particularly vigilant to avoid getting hypoglycemic attacks which will necessitate a trip to the hospital.

Anxious People Avoid:

It’s important to remember that even routine visits to your family doctor, which many people will naturally avoid under the current conditions, can be lifesavers. High blood pressure, a dangerous condition, is often discovered during a routine annual checkup. So are breast tumors, lung cancer, and many other life-threatening diseases.

Not all postponement of treatment is because of patients’ avoidance. Hospitals are overwhelmed by COVID-19 and as a result, any treatment that can be postponed is postponed, with potentially detrimental consequences to the patients.

With hospitals almost completely dedicated to fighting COVID-19, it is inevitable that there will be other casualties that do not involve infection. Hospitals encourage patients not to arrive at the ER unless absolutely necessary. They lack resources to treat other patients and they are afraid that the patients may get infected.

For instance, 51 percent of surveyed cancer patients reported that their treatment had been impacted by the coronavirus. Some experienced delays in getting appointments with their doctors, while others experienced delayed access to imaging services required to determine the status of their tumor. There were also reported delays in surgery and access to mental and physical therapies.

Hard Decisions:

This situation is also risky for dogs.

Your dog better not get sick now. Or you will face the dilemma of going to the vet and getting potentially exposed (many vet offices are too small to afford the six-foot social distance recommended by the CDC) or let your dog suffer and potentially die (most dog owners will rather risk it than let their dog die).

Caution, Anxiety, and Hospitals:

Even people who display symptoms of COVID-19 infection delay going to the hospital. Often the symptoms are mild, leading people to believe that perhaps they are not infected or if they are, it’s a mild form of the illness and they are better off weathering it at home. But sometimes they are very wrong. They may have mild symptoms when in fact, they are very sick.

An opinion piece by a physician who spent 10 days in a coronavirus ward warns about the silent nature of pneumonia that develops from the virus infection. Infected people do not recognize the severity of their pneumonia until they develop a fever and other symptoms. By the time they arrive at the hospital, it is too late for some of them.

Currently, elective surgeries have been postponed. It’s obvious that plastic surgery is elective. But the definition of elective surgery has been stretched to include other surgeries. Is lumpectomy an elective surgery? Oncologists claim that there are other protocols to try before going to surgery; chemotherapy can be used first to try to shrink the tumor. But the decision regarding which should be done first is now affected by considerations of coronavirus, rather than what’s best for the patient.

Apparently, induced delivery now falls into the category of elective surgery. In some locals, pregnant women are required to wait for two weeks after the due date in order to be induced. Some babies will be very big by then, leading to cesarean deliveries. Waiting too long endangers pregnant women and their babies.

Take Away:

Hopefully, some of the pressure on hospitals will start abating as the curve of new infections flattens. That should allow them to slowly return to taking care of other patients. But the full return to normal will probably take some time.

In the meantime, the mortality and morbidity that is directly and indirectly associated with coronavirus may soon start to decrease. It’s important not to let fear overwhelm your judgment.

If in doubt, consult with a physician remotely. And try to avoid anxiety and stress. All the methods that worked before are still helpful. Exercise is particularly beneficial since it releases endorphins, which increases the feeling of well being, and improves your general health. Meditation, yoga, and other relaxation techniques are very helpful to many people. Devote your screen time to watching comedies—laughter is a proven medicine for stress.

And remember, this shall pass too.