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

The fields of psychology and counseling must cultivate new research and training opportunities for mental health and allied helping professionals to work across all age groups and cultures during phases of a pandemic disaster. We must create pandemic identification, prevention, and therapeutic intervention programs. We should never again delay a disaster mental health response as we did during the summer and late fall of 2020. The current and predicted increase in anxiety, depression, posttraumatic stress, and substance use disorders is pervasive across all age groups. The COVID-19 pandemic has spawned an increase in suicidality that is the direct result of untreated, undertreated, and unrecognized mental health symptoms and conditions. Accordingly, the psychology and counseling professions are challenged with recon-ceptualizing disaster mental health programs and services for pandemic survivors using new technology (i.e., telebehavioral health) and other therapeutic interventions yet to be developed and implemented.

We need to cultivate a fighting spirit in the COVID war as we enter the COVID Generation. 1Disaster mental health response throughout phases of the pandemic virus necessitates a high level of empathy and compassion toward individuals, groups, communities, and cultures who are COVID survivors. As a profession, we are challenged to reconceptualize disaster mental health response as we transition throughout phases of a pandemic virus that some experts project will kill up to 700,000 people in the United States. So how serious is it? The U.S. Department of Defense met the Federal Emergency Management Agency’s request during April 2020 to ship 100,000 body bags to aid state and local governments in managing the growing number of COVID-19 fatalities (Entress et al., 2020). It is worrisome that some Americans still do not take coronaviruses seriously by not using good hygiene, rejecting the COVID-19 vaccines, and dismissing the overall positive effects of the federal government’s immunization program on decreasing deaths related to COVID-19 and its mutant variants. The rate of spread of the infection, accompanied by the severe illness, mortality, and mutant variants of COVID-19, has resulted in long-lasting aftereffects that will likely be with us for the next several years.

We have been at war since the start of 2020 with an unseen enemy combatant, COVID-19. New radical insurgencies of coronavirus mutations have emerged as a threat to humanity. One splinter cell first identified as VUI-202012/01 began its assault in England and moved to the United States in January 2021. By February 2021, this variant as well as South African and Brazil variants had spread throughout most states. The problem with these mutant viruses is that they can spread 50–70% times faster than the original COVID-19 virus. Worldwide, other coronavirus variants have been identified also. The enemy we are confronted with is invisible except to virologists, infectious disease specialists, epidemiologists, and public health experts.

The coronaviruses of the 2020–2021 pandemic have left scars within our memories and hearts, with more than 30 million infections and well more than 550,000 COVID-19-related deaths by early 2021. We have COVID fatigue that manifests as serious medical, physical, and mental health concerns. So how long can we sustain both the pandemic virus and mental health crisis in the United States? Now that the vaccine rollout and immunization have begun, we are trying to restore some normalcy and balance to our lives by reopening schools, businesses, the service industry, entertainment venues, and other areas. It is critical that we try and make ordinary sense out of an extraordinary stressful and traumatic event by adjusting and adapting our strategies on the COVID battlefield.

Infectious viruses and diseases have been with us since the beginning of time. They are a naturally occurring phenomenon. They can adapt and survive in a variety of conditions but must have a human and/ or animal host to exist in their virulent and highly contagious state. It may be that viruses inherit the earth (Tyson, 2007). So is there an end in sight to COVID-19? This is much like asking “How long will it take before the sun’s fuel burns out?” It is helpful to understand that there is no beginning or end to a viral contagion.

The 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).

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.