The novel corona virus (SARS-CoV-2) causing COVID was first identified in Wuhan, China, and then spread across many countries through droplet and contact transmission. It has changed the social life of people across the world and has added new isolation measures and quarantine to their life [1]. This isolation is known to affect their mental health due to the loss of a true human connection and surging feelings of stress and anxiety during times of uncertainty.
The public health event it caused has led to delays in starting schools and universities and a switch to online modes of teaching [1]. SARS-CoV-2 virus reached Saudi Arabia in March 2020; a state of alert was declared, slowly leading to nationwide curfew. The Alfaisal University campus was closed in March, online classes resumed shortly, and the closure continued till the end of the spring semester in May 2020.
The impact of COVID-19 worldwide includes not only increased fatality rates but also a wide plethora of both psychological and economic impacts that are now coming to light. The mass fear of COVID-19, termed “Coronaphobia,” along with the forced quarantine, has increased levels of anxiety, hoarding behaviors, and PTSD among the general population [2].
The first association between viral epidemics and psychological distress was made over a 100 years ago during the 1918 Spanish flu pandemic that yielded psychiatric complications [3].
In recent times, COVID-19 has been recognized as a public health emergency and thus far, most papers published on it are focused only on the clinical characteristics of infected patients. However, this pandemic has also demanded people to show phenomenal emotional resilience in the solitude of their homes which can take a toll on their mental health [4].
Negative mental health consequences were observed in medical students as well and can be attributed to isolation from friends and family, experiencing doubts about the disease and having to manage medical school learning during the lockdown [5].
Mental health is affected by a multitude of factors including, but not limited, to our physical health, self-perception, relationships, and social connections. It is therefore inevitable to overlook the impact of a closure of innumerable industries, such as education, finance, entertainment, and service sectors, on the fragile mental health of people belonging to vulnerable subsets of the population.
Furthermore, corona positive patients are now considered a stigma [2]. Internet and social media consumption are fueling safety seeking and hoarding behaviors [6] and affective temperament traits are being recognized in response to the outbreaks. In Italy, anxious, cyclothymic, and depressive temperaments were adopted as modalities of behavior. While anxious behaviors suggested a protective nature, cyclothymic and depressive temperaments indicated worry, negativity, and self-doubt with an enhanced desire for social connection [3].
Other stressors include inadequate supplies, fears of catching the infection, and inadequate information. The most at risk were quarantined medical staff with complaints of increased exhaustion, anxiety, poor concentration, and indecisiveness. In addition, coping mechanisms such as rumination, self-blame, and denying/disengagement were associated with increased psychological complaints [7].
Investigations of the symptoms of psychological determent were described as being very few in the beginning of global alert; people with chronic diseases who were young accounted for more symptoms, and later on there were increased symptoms being detected preceding stay home announcement was given in some countries [8, 9].
On the other hand, a study comparing undergraduate students who had been quarantined found no significant difference in mental health problems when compared to those who had not. Possible reasons include fewer responsibilities, and younger and lesser susceptibility to the infection [7].
Another study demonstrated that medical students believed quarantine did not affect their learning and psychological well-being. Though, some students showed a sense of emotional detachment from friends and family and claimed that this decreased their overall study performance. The main causes of deterioration of mental health were financial losses, fear, frustration, and inadequate information [5].
Overall, stress experienced by young students can be due to the uncertainties of a new learning environment, and the need to adapt to the absence of in-person lectures [8]. Out of town students expressed worry for not only their educational gains but also the safety of their families once they return home [10].
The ongoing COVID-19 pandemic may perhaps leave us all in turmoil to deal with even long after the actual pandemic has culminated. Addressing the issues, it is creating along the way can help mitigate risks for our communities one by one. Coping with stress in a healthy way will make community stronger, it will allow us to combat similar pandemics in the years to come and also allow us right now to provide coping mechanisms for people in social isolation, help address overwhelming media consumption, and improve adherence to guidelines without the associated stress.
All things considered, after the end of quarantine, behavioral changes such as avoidance behaviors and vigilant handwashing were recorded for several months in certain places. Financial loss and increased stigma contributed to the long-term effects of the quarantine on mental health. General education and proper explanations on the rationale of quarantine is thought to reduce this stigma [7].
In contrast to the effect brought about by the social scene, SARS-CoV-2 is presumed to have direct pathological effects too due to it being a multiorgan system damaging virus. It may also infect the brain and trigger the immune system affecting brain function and consequently individual’s psychological health [11].
Through this study, we will be able to determine the impact of the COVID-19 pandemic on the psychological well-being of medical students in Alfaisal University, Riyadh, Saudi Arabia. Formulating this association will better equip us to combat similar consequences in the future if the social isolation continues into the upcoming semester. Furthermore, we will be able to assess the symptoms of post-traumatic stress disorder (PTSD) in the context of COVID-19 among medical students. The IES-R scale [12, 13] used in this study is specifically designed to measure the symptoms of PTSD using three parameters: intrusion, avoidance, and hyperarousal. The presence of these symptoms will help further investigate the specific consequences that were profoundly brought about by the pandemic and guide us toward formulating appropriate timely interventions.
