Resilience, Not Panic, in a Time of Pandemic

We can reasonably quarantine infected individuals, but we should not squander our social and moral capital by quarantining whole communities.

ANXIETY & STRESS

As the pendulum has swung from denial to near-pandemonium about COVID-19 in the US and worldwide, sensible public health strategies to contain the spread of the virus must compete for attention with panic reactions like calling for quarantining people of a particular nationality. Today it is the Chinese, tomorrow perhaps the Italians.

As a psychiatrist, clinical ethicist, and citizen, I struggle with the reality that panic and hysteria spread more easily and quickly, covering more space in less time, than does hope. When hope cannot be offered in the form of a quick fix, there is a natural tendency to plunge into despair, leading often to counterproductive measures. The Internet, through its instant, indiscriminate communication of simplistic, reductive messages, is much better at spreading fear, panic, and hopelessness than at raising hope, which is best fostered by people working together and learning to trust one another.

For an inspiring model of communal hope and resilience under a dire threat to survival, I find myself turning to the Fekalists, the prisoners condemned to be sanitation workers in the Lodz ghetto in Nazi-occupied Poland, my parents among them. The Fekalists, who disposed of human waste and cleaned sewers, had an average life expectancy of six months. Yet, instead of succumbing to despair under the most horrific conditions, they worked with physicians and nurses-also ghetto residents-to prevent an epidemic of typhoid fever from getting out of control. Had they not succeeded, for example, in keeping sewage out of drinking water, the Germans would have liquidated the ghetto.

My father later recalled a Jewish physician who secretly ministered to him after he had been wounded in a resistance raid to obtain vital building materials from a German supply house. “I will die here,” my father said to the older man. “One of us will, but it will be me,” replied the physician. “I do not have any way to treat you, but you are young. If you don’t give up hope, you will survive.” Indeed, the Fekalists did not give up hope. Instead, through solidarity, humor, and song, they helped preserve community morale and became the heart of the Lodz ghetto resistance. Among those who were saved were 14 people who, using the materials obtained in the raid on the supply house, built an underground bunker cemented over a riverbed. My parents married in that bunker.

If the heroes of that imprisoned ghetto could maintain a resilient community without scapegoating, we can do likewise under much more benign conditions. We need not assume that a catastrophic pandemic is at hand, and we must not resort to racist measures like demonizing and shunning an ethnic community. Such panic can easily become a self-fulfilling prophecy, with demoralization and economic chaos cascading into a life-threatening catastrophe. Far better to understand that life goes on and that hope and resilience can be nurtured, even amid cases of illness and death.

Fortunately, the Internet can also serve to convey practical preventive measures for individuals, families, and communities, like those being developed by the Centers for Disease Control and Prevention (CDC). For example, a blogpost by Ian M. Mackay and Katherine E. Arden titled “So you think you’re about to be in a pandemic?” (on the Australian website Virology Down Under) lays out useful recommendations such as staying at least two meters away from visibly sick people, washing hands thoroughly, trying not to touch your face, and stocking up a two-week supply of food and other essential household items. We can reasonably quarantine infected individuals, but we should not squander our social and moral capital by quarantining whole communities.

This article was originally posted on March 3, 2020, and has since been updated. -Ed

Disclosures:

Dr Bursztajn is Co-founder of the Program in Psychiatry and the Law at Harvard Medical School and President of the American Unit of the UNESCO Bioethics Chair (Haifa). He practices clinical and forensic psychiatry in Cambridge, MA.