Counseling Practice During Phases of a Pandemic Virus. Mark A. Stebnicki

journal Nature explores what the science says about how COVID-19 will play out in the months and years to come. Scientists indicate that for the pandemic to end, either COVID-19 must be eliminated from the global population (which is near impossible) or between 50% and 80% of the world’s population must build up sufficient immunity through either infections or vaccinations (Scudellari, 2020). Public health officials and infectious disease experts have said it is very likely that COVID-19 will become an endemic disease. Essentially this novel coronavirus will always be present in our environment with possible mutation in the human genome long after the government immunization program ends. If we are fortunate, COVID-19 will be classified as a low-level contagion. Thus, the medical, mental, and public health care systems as well as the world economy will have to learn how to survive this endemic virus.

The challenges in the COVID Generation are unlike any others. It would be naive to imagine that once the COVID-19 vaccines have been distributed and administered to most of the world’s population that a book such as this will no longer be relevant. In fact, rabies still exists today, despite Louis Pasteur’s development of a successful vaccine in 1885. Tetanus (vaccine developed in 1927), measles, mumps, and rubella (1971), hepatitis B (1982), and hepatitis A (1995) all have the potential to be public health crises in certain occupational settings and regions of the world despite the public perception that these diseases have been eradicated. Fortunately, the COVID-19 vaccines on the market have about 72–95% efficacy in treating COVID-19. However, we will need to continue collecting data on those who have been immunized given the new coronavirus variants.

      The good news is that we are in a much better place now than Americans were during the 1918 H1N1 (Spanish flu) pandemic, when approximately 675,000 people in the United States died. The measures available in 1918 to mitigate the spread of a viral contagion were extremely limited. That pandemic predated antibiotics and did not involve epidemiology, highly specialized lab sciences for deciphering the genomes of infectious diseases, or the technology used today by the pharmaceutical industry in the research and development of vaccines. There were no diagnostic tests available to confirm infections and no antiviral medications that could significantly reduce symptoms of the virus. Thus, we have seen improvements coming out of the 20th century and into the 21st. This is evident by advancements in disease surveillance, diagnostic testing, situational awareness, community mitigation science, and a system of public health communication (Jester et al., 2018).

A Pandemic Virus and a Mental Health Crisis

      In the past several years, there has been a resurgence of interest within epidemiology in infectious diseases. Data are available from past pandemics (i.e., severe acute respiratory syndrome coronavirus 2, H1N1 flu, Ebola, Middle East respiratory syndrome, HIV/AIDS) to help guide medical practitioners in disease surveillance, medical evaluation, testing, prediction, preparation, and treatment. However, the same cannot be said of psychology, counseling, and disaster mental health response, which offer few guidelines to inform assessment, prevention, and mental health treatment during phases of a pandemic virus. Hence, the motivation for this unique work in mental health is to identify, recognize, prepare for, prevent, and apply therapeutic strategies for pandemic survivors. It is essential to have resources avail able to address issues related to the medical, physical, psychological, behavioral, and psychosocial impacts of a highly infectious disease in combination with a mental health crisis.

During the early phases of the 2020 COVID-19 pandemic, the refrain repeated in American popular culture was that “we are all in this together.” Also during 2020 were a rise in White nationalism, systemic racism, political divisiveness, the propagation of media-driven conspiracy theories, civil unrest, and economic disintegration, all interacting with this lethal virus to hinder the public health and safety of Americans. To complicate matters even further, there was an ongoing 20-year war on terrorism, cyberattacks on our homeland security infrastructure, and the insurrection at the Capitol on January 6, 2021. Overall, it is my contention that we are not all in this together, because this statement assumes that all persons are living life at the same level of medical, physical, and mental functioning.

      The statement that “we are all in this together” also implies that we all enjoy the same benefits and privileges in terms of socioeconomic status, access to quality health care, jobs, civil rights, as well as adequate support systems and other resources. Thus, we are not all in this together. Many Americans do not recognize the seriousness and lethality of the COVID-19 pandemic based on their questioning of the use of vaccines, wearing masks, social and physical distancing, and other virus hygiene protocols. Instead of “We are all in this together,” I would offer the reframe “We are all our own best support system.” It is only when we can come together in the present moment that good things will unite our communities and regions. Until then, many Americans are surviving at a basic level instead of thriving.

      The medical, physical, psychological, behavioral, psychosocial, and economic impacts of viral contagions have catastrophic impacts on individuals, groups, communities, and cultures. Pandemic viruses mimic other natural disasters, such as floods, hurricanes, tornadoes, wildfires, and earthquakes, all of which also occurred in 2020. However, a pandemic disaster involves other losses, such as the large-scale loss of life, health, jobs, careers, educational opportunities, social and entertainment activities, as well as many other things. This pandemic disaster is not confined to one geographic location. Rather, this viral contagion has had a global impact. All the calamity of 2020 will be etched and mapped into the human consciousness in an infinite number of ways. The result will be a historical trauma that lives in the mind, body, and spirit of humankind, much like the Black Death of the 14th and 17th centuries in Europe and the Spanish flu at the start of the 20th century in America.

The New Anthem for Counseling Practice During a Pandemic Virus

      The number of extraordinary stressful and traumatic events has grown worldwide since 2001. Anyone who watched the January 6, 2021, attack on the U.S. Capitol in Washington, DC, by pro-Trump extremists knows that this September 11th-style attack on the homeland has threatened psychological safety and security in an already tense COVID environment. Fears and anxieties over the war on terrorism; catastrophic natural disasters prompted by climate change; mass shootings in schools and entertainment venues; and the spewing of toxic chemicals by large industries that poison our air, water, and food supply have become integrated with fears and anxieties associated with a pandemic virus that has threatened humankind. Fueling our fears and anxieties are videotaped images that replay on 24-hour news stations and a daily dose of other frightening stories in print and electronic media. Thus, we are surrounded by a daily digest of trauma unfolding in real time. The only breaking news stories missing from this list are a zombie apocalypse or alien invasion. For some, planet Earth does not appear to be a safe place to live.

Today we are singing a new anthem because of the paradigm shift in disaster mental health response. There is a world full of sickness introduced by a highly infectious viral contagion. We are required to reconceptualize how to heal the mind, body, and spirit of individuals, groups, communities, and cultures affected by a new natural disaster: novel coronaviruses. The new normal in mental health is that anxiety and fear of the next pandemic viruses may have become integrated into our psychological and emotional well-being. For some, the idea of a deadly germ in our environment has sparked neurotic thoughts, feelings, and behaviors that have become chronic and persistent patterns leading to mental health issues. Thus, the anxiety and fear we feel around a continually present viral contagion has been integrated into our unconsciousness. Overall, the emerging COVID Generation requires an intensive research agenda to identify, recognize, and explore the unique mental and behavioral health characteristics of individuals, groups, communities, and cultures that have difficulty living optimally. It is paramount that mental health professionals facilitate new meaning and understanding with COVID survivors. Cultivating a perception and attitude of healing the mind, body, and spirit will teach us how we can thrive rather than just survive pandemic disasters.

Foundational Principles of a Pandemic Virus

      Counseling Practice During Phases of a Pandemic Virus is a comprehensive