Being “OK” in the Time of Coronavirus

“Reality hit! I had just returned from the United Kingdom, 3 days before the announcement of the first Kenyan case. However, I had earlier that very day already began my self-quarantine.”

David Muriithi, popularly known as DJ D-Lite explains his reaction and situation when the announcement was made. A day earlier, the Kenyan government had directed all international travellers from “high-risk areas” to self-quarantine. Despite having not specified which countries would be affected by this, Muriithi was not taking any chances. His reason to self-quarantine though, was more than just the government’s directive.

“Prior to that day, I found out that someone had tested positive at a function that I had also attended (in the UK). Even though we were nowhere even close to each other, I took precaution and immediately went into self-quarantine.”

By this time, quarantining was no longer just a precaution or a government directive that Muriithi and all other international travellers had to take. With a first positive case already in the country, this was necessary in containing and controlling what was now a ticking time bomb. At this point, I did not panic and so did a number of people that I asked about this.

A reaction I believe many Kenyans probably had at the time. I mean, it was just one case. But while some of us didn’t exactly panic over it, for others, that announcement alone resulted in a different reaction altogether. The sudden long queues at the supermarkets could tell the story. Reactions aside, each one of us had a reason to be concerned. Why? Because every country that had been reporting an increase in the number of people who had tested positive had their first case, too.

On Sunday 15th March 2020, just two days after the first case was reported, the Government of Kenya would confirm an additional two cases of coronavirus in the country, bringing the number of those who had tested positive to three. Shortly after this update, at about 6.30 pm, my colleagues and I would receive a message from our CEO on our work WhatsApp group.

“Good evening team. As you may have heard, two more cases of COVID -19 have been confirmed. There are also other protocols that have been encouraged, including a work from home policy. As such, save for anyone with pending work assignments, this policy takes effect from Monday, 16th March.”

Besides a few times here and there where I had had to carry some work home, I had never been in this kind of a situation before. Being a journalist, my work ideally requires me to either be at the office or out on the field. But here we were. I wasn’t sure how this was going to work out but I had a week to experience it. I would figure it out. We all would. Or so I thought.

We have to be very sensitive and understand that we are all very vulnerable (right now), not just as a country but also as a people of the world. We have to take extraordinary measures not just on health issues but also in our narrative on how to empower people, especially those who are in vulnerable situations.

As we set ourselves as an organization to work from home, to minimize our movement and heed to the government’s directives to social and physical distance, that same week, Ben* not his real name, a first responder with one of the emergency response service providers, would encounter his first COVID-19 evacuation.

When the call came in, Ben and his team had just completed a long day of sensitization of the public and hospitals in one of the areas in Nairobi. But at this point, the exhaustion he was feeling from that day’s hard work was nothing compared to the fear of the unknown that was ahead of him.

“A cold sweat ran over my back and a thousand questions crossed my mind. What if I get contaminated? I’m I even ready? Do we need police escort? Will the patient be accepted in the facility or hospital that we are headed to?”

This scared him. In his line of duty, as he tells me, he had seen and experienced it all. From hijackings to car accidents, handling of life-threatening diseases and even getting shot at some point. But this kind of evacuation was a first in his entire life, let alone his medical life.

“Some years back, I would have said I am never scared. But right now, I am more scared of being quarantined than anything else,” Ben says.

Life is not as we knew it. Whereas the lives of a DJ, a journalist and first responder may have previously been worlds apart, now they all have a new normal. They are all living in a similar yet very unfamiliar situation. Life under a pandemic. In their stories are important tips that we can all draw some lessons from on how to cope with COVID-19.

Working from home

This was just but a tentative plan, one that would only last for a week as we observed the COVID-19 situation in the country. The optimism was there but little did we know what lay ahead of us. As I write this, it has been over a month of working from home. Being largely introverted, I have managed to stay indoors and not interact with the outside world in the last 45 days. In a normal setting, I would imagine that anyone would stay indoors and be okay. At least in such circumstances, the freedom of movement is there. But today, we are living in absolutely abnormal circumstances.

While I am grateful to still have a job, working from home has not been easy. It has taken me a while to adjust to this new way of doing things and I believe this has probably been the case for other people who have also had to adopt similar changes. Adjustments Dinah, a mental health professional, describes to as “a switch from our normal brain function.”

“Home is meant for rest and rejuvenation and now you are changing that to work and your system will struggle to adapt to that. Every time you have a struggle, you need to reassure yourself that you can make that change.”

She further explains that whenever we experience a change in general and in this case working from home as opposed to the office, we should avoid forcing our systems to adjust to the changes all at once but rather do it small bits. In other words, taking things slow.

“When you allow a system to be so fluid, you are more vulnerable to anxiety. The key thing on adjusting to working from home is having a structure and knowing what works best for you. With time, your system will pick up and it becomes a routine,” Dinah advises.

Quarantine and Isolation

“Being an ambivert this phase has not been too unbearable. Parts of it even welcome,” Muriithi says after I asked him about his quarantine experience.

“I have managed to start a number of tasks that I had put off for ages. And since I could not leave my apartment, I had to rely on a network of kind friends who would call me whenever they were at the supermarket and would shop on my behalf.”

7 days later, his son would then join him in self-quarantine at home after his return from school in the UK. His presence made life a little bearable but with time, the disruption from what used to be his normal life, the isolation from other family members and friends plus an unprecedented time of uncertainty, caught up with him.

“My main fear was brought about by the immediate income loss ahead with no foreseeable let up in sight for months. Fears around rental payments, school fees and living expenses are all currently real fears that have not been resolved yet. The limited movement also did get to me a couple of times. I felt loss of control.”

We are social beings. Confinement or isolation is not something we are used to. Being in the same space for too long, the restrictions on the freedom of movement and the lack of interaction with the outside world can lead up to feelings of loneliness and this negatively impacts on someone’s well-being. For Muriithi, being in quarantine together with his son is one of the reasons that got them through each day. The other was music. Being a DJ, Muriithi took comfort in music as a coping mechanism. He put together a series of DJ mixes and shared them to his followers on social media for 10 days in a row.

“The appreciation from people all over the world was unprecedented and took me by surprise whilst keeping me highly motivated every day. This was my therapy and it worked wonders.”

Meanwhile, in one of the designated government facilities, Newton* (not his real), was also in quarantine. Unlike Muriithi, by the time he landed in the country, the government had already begun mandatory quarantining of all persons flying into the country. The option to self-quarantine at home was no longer available. He had to quarantine in one of the government designated facilities.

“The experience has been challenging with the restricted movement and having to communicate electronically. However, the hotel where I am staying has taken good care of us and the rooms allow for isolation. But I am also tired of the quarantine and want to go back to normal life.”

If any of the stories shared by different people about the state of most quarantine facilities in the country is anything to go by, then being in confinement outside your home is not a situation anyone would like to be in. But Newton was among the lucky ones that ended up in a good facility, where they were not only well taken care of but also received mental health support from counsellors from the Ministry of Health.

“It (psychological support) was okay and helped us not feel alone. We have even done a group session with them,” he says.

Though necessary in the management of COVID-19, the fact is that anyone who ends up in either quarantine or isolation, in addition to the general fear and anxiety that comes with this pandemic, is more likely to experience an even tougher time than the rest of us. If the situation is not well managed, it can lead to a lot of damaging emotions such as the development of lonely feelings, fear, stress, anxiety, among others. Should you be in this situation or in need of information on how to cope during isolation, here are some mental health guidelines from the World Health Organization (WHO) that can be of great help.

Muriithi and his son completed 21 days in self-quarantine and none of them developed any symptoms that would suggest otherwise. A feeling he describes as being a huge relief. And even though they are both in good health, Muriithi says he is still very paranoid about human contact and that he will continue to hibernate until further notice.

Newton, on the other end, completed 16 days in quarantine and was cleared to go home in the second week of April after testing negative for COVID-19 twice.

Stigma and COVID-19

Before Muriithi and Newton shared their experiences with me, for days, I had tried to reach out to a number of people for a chat on how their lives were in different quarantine and isolation centres to no avail. For a majority, sharing about their experiences was not the problem, the fear of stigmatization was.

“When people don’t understand something, it becomes subject to their own interpretation and sometimes it comes in a sense of humour but it causes damage,” says Dinah.

“We have to be very sensitive and understand that we are all very vulnerable (right now), not just as a country but also as a people of the world. We have to take extraordinary measures not just on health issues but also in our narrative on how to empower people, especially those who are in vulnerable situations.”

According to Dinah, there are many reasons why stigma may occur but this is largely attributed to a lack of information. In this case, knowing the facts about COVID-19 and sharing that with others is one of the ways that can help reduce or stop the stigma that comes with being in certain vulnerable situations.

But what does stigmatization look like during these COVID-19 times?

Emergency responders, healthcare workers and helplines

While the rest of the world retreats from normal day to day activities and lays back, the healthcare professions are at the frontline in the fight against COVID-19.

“Since the first case was reported, I have evacuated both suspected and confirmed cases on different occasions,” Ben tells me.

“With COVID-19, the fear is that if you have not donned properly (putting on the full PPE gear) then you are at the risk of getting yourself and your team infected in the line of duty.”

Theirs is a business of saving lives. But even so, their lives too need saving. Now more than ever, their jobs require immense courage and strength – which they have portrayed and exceeded. Their job not only puts them at a greater risk of contracting the virus but also exposes them to emotional turmoil. Seeing the effects of the pandemic first hand can lead to a lot of fear, stress and trauma. Currently, Ben’s work environment has been a hive of activities with a spike in the number of calls coming in on a daily basis in search of support on different issues including COVID-19 evacuations. But as it is right now globally, there is an already overwhelming shortage of essential supplies such as the Personal Protective Gears, leaving them in vulnerable situations in the line of duty. And as the situation continues to unfold, there will be a continued increase in demand on the health care workers, another reason why these challenges need urgent solutions.

In the meantime, the WHO and the Centers for Disease Control and Prevention (CDC) have put together some coping tips and guidelines to help all health workers and emergency responders cope and keep safe (see here and here).

Helpline/hotlines

The helpline/hotlines services available from different organizations/institutions have been very essential, especially those offering mental health-related support. Catherine Wanjiku, a psychologist with NISKIZE, a 24-hour counselling call centre, the first of its kind in East and Central Africa, explains why there has been an increased need for these services:

“The lack of basic needs and inability to make ends meet has burdened a lot of people leading to a lot of fear and trauma. People are now wondering how long the pandemic will take, the fear of the unknown has crept in, there are issues of rent and other unpaid bills, the pay cuts and job losses and the uncertainties about the future. These are just some of the issues people are calling in to seek help and advice on.”

Since the outbreak, she says that they have had a significant increase in the number of people seeking psychological support and guidance at their centre, with a majority ranging from 21-40 years.

“A lot of times when there is a stressful situation like the one we have now, there is a lot of hopelessness. One of the biggest lessons from this pandemic is the realization that things will not always be under our control. But I would encourage people to keep hope alive and to keep reassuring themselves that things will be okay.”

 

“It is important to keep a positive attitude now more than ever but even in doing so, we should also prepare ourselves for any eventualities and trauma especially where COVID-19 is concerned,” she adds.

Conclusion

With the current reality, it can be challenging to think beyond what is going on today let alone imagine what the future holds whether from a personal or societal level. Irrespective of the situation you are in at the moment, remember to be kind to yourself and other people, to relax and live in the moment. But above all, observe the guidelines and measures set in order to avoid contracting the virus and while at it, take care of your physical and mental health.

Below are a few tips that can help you keep mentally healthy during these stressful times:

  • Cultivating a system of calmness by working out and practising simple deep breathing exercises and meditation. Mental wellness and mindfulness apps like Headspace can be a good resource.
  • Staying connected with loved ones virtually (in the case where one is alone) through the various channels of communication available.
  • Avoid an information overload especially on news revolving around the pandemic as this can cause panic, fear and anxiety.
  • Take time to unwind by engaging in activities that you enjoy doing and try to develop and keep up with regular routines.
  • Take care of your body by eating healthy and well-balanced meals.
  • Should you have a pre-existing mental health condition or feel overwhelmed and are struggling to cope, please reach out to your counsellor/therapist or seek help from any of the publicly available services for psychological support.

 

Videos edited by Steve Biko

Graphics by Clement Kumalija

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