Pandemic could lead to 75,000 more American 'deaths of despair' from suicide, drugs and alcohol, says study
Increased isolation and anxiety during the coronavirus pandemic could have a "profound effect" on people's mental and physical health, scientists have said repeatedly.
Researchers now warn that in addition to Covid-19, more Americans could lose their lives to "deaths of despair" — that is, deaths due to drug, alcohol and suicide, if measures are not taken immediately.
As many as 75,000 more people could die from drug or alcohol misuse and suicide in the US, along with the thousands of deaths from Covid-19, according to projections by the Well Being Trust (WBT) and the Robert Graham Center for Policy Studies in Family Medicine and Primary Care.
The number of deaths of despair could be even higher if the US fails to take bold action and invest in solutions to address the mental health toll of unemployment, isolation, and uncertainty, caution experts.
The new analysis combined information on deaths of despair from 2018 as a baseline (181,686), projected levels of unemployment from 2020 to 2029, and then estimated the additional annual number of deaths based on economic modeling.
Across nine different scenarios, the additional deaths of despair ranged from 27,644 (quick recovery, the smallest impact of unemployment on deaths of despair) to 154,037 (slow recovery, the greatest impact of unemployment on deaths of despair), with 75,000 being the most likely, says the report.
"If recovery is four times as fast as that of the Great Recession, additional deaths will accumulate over four years compared to 10 years if recovery is the same as that of the Great Recession. When considering the negative impact of isolation and uncertainty the 1.6% multiplier may be more accurate," say researchers in their findings.
"The collective impact of Covid-19 could be devastating. Three factors, already at work, include economic failure with massive unemployment, mandated social isolation for months and possible residual isolation for years, and uncertainty caused by the sudden emergence of a novel, previously unknown microbe," says the team.
"Given the extraordinary uncertainty surrounding the pandemic and its effect on the economy, any projection is imprecise. The goal is to offer a range in the number of additional deaths of despair over the next decade attributable to the rise in unemployment, isolation, and uncertainty," the team explains.
To prevent a disastrous wave of deaths of despair, experts suggest several policy solutions, including figuring out how to ameliorate the effects of unemployment, making access to care easier, and how best to integrate care.
Researchers say that central to many of the problems across communities will be the need to find work as unemployment is an "undeniable risk factor" for suicide and drug misuse as well as a decrease in overall health status.
To this end, policy solutions must focus on providing meaningful work to those who are unemployed, the report recommends. "Service can be a powerful antidote to isolation and despair."
"Covid-19 offers new and unique opportunities to employ a new workforce – whether that be through contact tracing – helping local public health department track the virus – or through community health service where a new corps of community members are employed to provide help to those in the most need," says the study.
Researchers call for policies that support creative opportunities for care delivered at home — virtually or in-person to provide "comfort and safety". The team also recommends bringing mental health and addiction care "into the fabric" of primary and clinical care as well as community settings.
"This requires vision, alignment with a framework, and a method for holding key stakeholders accountable for person-centered outcomes," says the team.
“Undeniably policymakers must place a large focus on mitigating the effects of Covid-19. However, if the country continues to ignore the collateral damage, specifically our nation’s mental health, we will not come out of this stronger," says Benjamin F Miller, chief strategy officer at WBT, in the analysis.
"If we work to put in place healthy community conditions, good healthcare coverage, and inclusive policies, we can improve mental health and well-being," he adds.
In a previous study, researchers had warned that while a rise in symptoms of anxiety and coping responses to stress are expected "during these extraordinary circumstances", there is a risk that "prevalence of clinically relevant numbers of people" with anxiety, depression and engaging in harmful behaviors (such as suicide and self-harm) will increase.
The severe acute respiratory syndrome epidemic in 2003 was associated with a 30% increase in suicide in those aged 65 years and older — around 50% of recovered patients remained anxious, and 29% of healthcare workers experienced probable emotional distress, said the Lancet study.
According to researchers, patients who survived severe and life-threatening illnesses were at risk of post-traumatic stress disorder and depression.
The researchers cautioned that a major adverse consequence of the Covid-19 pandemic is likely to be increased social isolation and loneliness, which are strongly associated with anxiety, depression, self-harm, and suicide attempts across the lifespan.
Tracking loneliness and intervening early are important priorities, the team says. "We need to gather high-quality data rapidly to ascertain the effects of lockdown and social isolation over time. Innovative research is needed to establish ways to mitigate and manage mental health risks and inform interventions under pandemic conditions," they recommended.
As of May 11, more than 1,329,200 coronavirus cases have been reported in the US and over 79,520 have died in the Covid-19 pandemic, according to the Johns Hopkins tracker.