Infectious diseases have taken more lives in human history than all of the wars combined. Our adaptive defense mechanisms help us survive, but also leave us psychologically vulnerable. Revulsion and disgust are the instinctual responses that force us to turn away foul food. The negative emotions that protect our health, can also easily be projected into mistrust, judgment and blame — which is as contagious as a disease.
Prior to COVID-19, our county’s mental health indicators were worsening. Nearly 8% of adults were severely emotionally distressed and 1 in 10 seniors on Medicare were treated for depression. Those who struggle with depression, anxiety and PTSD may be experiencing a heightened sense of risk right now. While we call on our coping skills to kick in, with diminished social support and mandated isolation some people’s defensive behaviors are triggered like hoarding, lashing out and scapegoating. This could explain (not justify) the national surge in racist aggression and hate crimes against Asians. This is not unlike the intense stigma and discrimination against people living with HIV/AIDS in the early 2000s in China and in the United States when it was called the “gay cancer” in the ’80s.
Public health crises like HIV/AIDS and COVID-19 are the ultimate tests of our values because we are forced to reckon with our inter-dependence despite our instinctual apprehension toward “the other” and our tendency to defend ourselves against threat. Our state and local leaders have championed cooperation and compassion, acknowledging our shared responsibility, and linked fates. We are taking a multi-layered approach to protect lives and livelihoods. In a matter of weeks, we began sheltering our homeless and bolstering safety nets for our most vulnerable. We called on the private, public and nonprofit partners to collaborate on a multi-sector response. All this is propelled by the courage of our first responders and essential workers both in the grocery store and in the hospitals, the immeasurable sacrifices each business owner is forced to make, and the immense generosity of our community members.
Staying home is odd because everything looks the same when literally everything is different. Sheltering in place, we live with the unsettling dichotomy of the familiar appearance of safety in our homes while internally we may be feeling the opposite: dread, grief, panic. Looking ahead, we should prepare to recalibrate our expectations because this will be a marathon more than a sprint. Once the initial shock has lessened, staying home should be acknowledged as an act of bravery, and anything our community can do on top of that will go a long way.
We combat hopelessness by finding the openings within to discover ways to lend our time, skills and resources. Big and small random acts of kindness and generosity will get us through this, such as initiatives like the #MillionMaskChallenge and San Mateo County Strong Fund. We can all smile brighter, pick up the phone to check on our elderly neighbor, have more compassion for ourselves, our loved ones and each other.
Strengthening our community connections while we remain 6 feet apart will require us to channel our positivity to extend even further. Nourishing our collective hope will help us hold our moral center. As we face our mortality and fallibility, the path of solidarity will save our lives and lift our communities. Nature tells us that we must continue to change and reshape ourselves to survive and thrive in times of darkness. Solidarity is the North Star during times of fear and loss. This is the time to lean into our best selves.
Amourence Lee is a member of the San Mateo City Council and has a background in public health and community building. Meredith Bergman, MD, is a practicing California licensed psychiatrist and San Mateo resident.