According to two new studies that have reviewed data from 15 countries, pandemic policy measures aimed at controlling rather than eliminating COVID-19 are associated with worse mental health and lower life evaluations. Findings are published in The Lancet.
Study results show that countries that aimed to eliminate community transmission within their borders experienced fewer deaths and equivalent to or better mental health trends compared to countries that aimed to control COVID-19. The mental health impact of lockdowns was much worse for women, especially those living in households with dependent children.
Some countries adopted elimination strategies with zero community transmission targets, while others aimed to slow down transmission through intermittent lockdowns, workplace business, school closings, masking, social distancing and cancellation of public gatherings and public transport. Examples of countries that followed elimination strategies include South Korea and Japan. They implemented early and targeted actions such as international travel restrictions, testing, and contact tracing. These measures resulted in lower levels of infections, thus allowing these regions to opt for more lenient domestic containment strategies. However, countries like France and the UK opted for less prohibitive international travel restrictions. They aimed to control the virus rather than eliminate it through strict and lengthy policy measures, including physical distancing and stay-at-home requirements.
Although it appeared that eliminator countries implemented much harsher strategies than other countries, people within these borders were able to get their freedom back much faster and were able to implement restrictive domestic containment measures compared to mitigator countries.
Also, the mental health impact of these measures was felt disproportionately by different groups. Based on an analysis of eliminator countries (Australia, Japan, Singapore, and South Korea) versus mitigator countries (Canada, Denmark, Finland, France, Germany, Italy, Netherlands, Norway, Spain, Sweden, and the UK), it was observed that there was a stronger link between severe containment policies and lower life evaluation in mitigator countries compared to eliminator countries. Social restrictions and stay-at-home requirements in mitigator countries were associated with greater psychological distress and lower life evaluations. However, school, workplace, public events, public transport closures, and restrictions on domestic travel were not linked to mental health. In addition, the number of consecutive days spent under high or low levels of pandemic restrictions yielded no difference in mental health outcomes.
Stricter policy measures were associated with lower opinions of the government's handling of the pandemic and lower mental health levels. Evaluations of how the government handled the pandemic were more positive in eliminator countries than mitigator countries. The effect of strict policies on reducing deaths was much larger than the one observed for adverse mental health outcomes.
According to study author Dr Rafael Goldszmidt, "Our research demonstrates that in addition to the intensity of the pandemic itself, the type of the pandemic response pursued makes a difference to people's mental health. Mitigation strategies may be associated with worse mental health outcomes, at least in part because containment measures such as long periods of lockdowns and physical distancing can impede social connections. Nevertheless, as stricter policies are proven to be effective at reducing deaths, they may help offset the effects they have on psychological distress and life evaluations."
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