- During Sars, suicides hit a record high, with elderly cases spiking as quarantine measures disrupted social activity
- This time, let's make mental well-being a priority, help those in quarantine stay connected with loved ones and reach out to the old, weak and disconnected
Hong Kong is facing new challenges as the Year of Rat dawns. In a society still struggling with social unrest amid anti-government protests, the new Wuhan coronavirus outbreak has made the situation worse. With more than 4,500 infections in China alone and at least 106 deaths, the worst, it seems, is yet to come.
The new coronavirus is still very much unchecked and is continuing to spread locally, regionally and globally. Quarantine measures are necessary to contain the disease by reducing contact between those who have been infected and those who are susceptible.
If each infected person can infect at least two others, as is currently estimated, then, according to the epidemic threshold theorem, we need to quarantine at least 50 per cent of the population to ensure the epidemic will die down. If this number " known as the mean reproductive number " is higher, more stringent measures are needed.
The Chinese government has closed down some cities, including Wuhan in Hubei province, cancelled several public and social events, closed public parks and extended the Spring Festival school holidays. These moves are important as they help to reduce the contact rate. Disconnecting the infected and the susceptible helps to break the chain of infection and slow down, if not stop, the spread of the epidemic.
Likewise, Hong Kong's authorities have cancelled many social events, including the festive fireworks display and a football tournament, and closed Ocean Park and Disneyland. Also, visits and volunteer services at hospitals have been stopped, and the government has told civil servants to work from home and urged the private sector to follow suit.
However, it is important not to overlook the community's mental well-being while fighting this epidemic. The disconnection and isolation measures may have the unintended consequence of inducing loneliness, fear and panic in the community, especially for those vulnerable and older.
In 2003, during the severe acute respiratory syndrome (Sars) epidemic, suicides in Hong Kong hit a record high of 18.6 per 100,000, or 1,264 for the year. Of these, there were 60 more suicides by older people than in the previous year.
Our investigation showed that quarantine measures had disrupted mental wellness for some older people in 2003. For example, social and family gatherings, regular health check-ups, food delivery services and elderly centre activities had been cancelled, and no alternatives had been provided. The resulting loneliness and isolation had affected people's mental well-being.
All of Hong Kong suffered, not just because of the city's poor economic performance and high unemployment rate of 8.6 per cent, but also from the fear and panic induced by the epidemic and fake news. Whole communities were cut off as quarantine measures disrupted social gatherings and hospital visits. The sick shunned hospitals for fear of contracting the virus, and many health support services were suspended.
In the midst of this epidemic, we need to be sensitive to those in quarantine and provide alternative means for them to connect with others. Hospitals are high-risk areas but it would be of great benefit if patients could have some support via electronic devices to allow them to stay in contact with their loved ones.
A hotline could also be set up to provide advice and avoid unnecessary admissions, and stop hospital accident and emergency departments from being swamped.
With a lot of our leisure and recreational activities already disrupted, we should make extra efforts to visit family members who need help and support. The government should provide alternative services, whether online, via phone or in other modes, to connect those who have been disconnected.
Fear, anxiety and panic in the midst of any epidemic are not uncommon; we need to manage that. Correct and timely information is the first step. We should not send on to others any unconfirmed news that may cause more, and unnecessary, panic. Everyone can be a good gatekeeper to each other.
Meanwhile, the government needs to be more responsive to concerns within the community and provide timely and correct information to dispel any myths. Above all, we need to be sensitive to the needs of those who have been disconnected, by showing our concern and support.
I salute all the medical and health care workers who are currently risking their lives to help the sick. In such times, we all need to work together to pull through. I have one student who is trapped in Wuhan. According to him, the situation is difficult. There's no doubt that the coronavirus will remain active in our community for a while.
We need to ensure we are well prepared for what lies ahead. That means staying healthy and getting lots of rest while looking out for each other. There will be inconvenience but safety is of the utmost concern.
We also need to appeal to those involved in the social unrest: now is the time to focus our efforts on fighting the epidemic. This is serious and the fatality rate could be high, especially for the vulnerable and weak. Let's give each other a chance.
Paul Yip is director of the Centre for Suicide Research and Prevention and associate dean (research) in the Faculty of Social Sciences at the University of Hong Kong
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