Pandemic Perspectives: Q&A With K. Luan Phan, MD

In light of the coronavirus disease 2019 (COVID-19) pandemic, we are making an effort to speak with psychiatric providers from diverse professional backgrounds and specialties in order to learn more about their response to the current crisis.

We recently interviewed K. Luan Phan, MD, of the department of psychiatry and behavioral health, The Ohio State University, Columbus, Ohio. He is the Charles F. Sinsabaugh Chair in Psychiatry, and an expert in the field of traumatic stress and anxiety.

To share your perspective on the pandemic and the role of psychiatry, please get in touch with us via our submissions page.

What insights can mental healthcare providers offer to the general public during this time?  

Many of the emotions that people feel are very normal and understandable as we are enduring such a new and unpredictable threat. We have had to readjust our lives and our routines substantially and have had so many personal losses, including those of health, safety, jobs, finances, activities, fun, leisure, self care, hobbies, and social gatherings, which are the things that we have turned to, to help us with stress. Because of all this, we feel uncertain, scared, confused, bored, sad, tired, etc. All of these emotions are very normal and we should share our feelings so we can support each other.

How does the “behavioral immune system” play a role in the response to the ongoing COVID-19 pandemic?  

When we are psychologically stressed out and this lasts for long periods like what are feeling now, our body’s immune system actually gets weaker. Our immune system is what helps us fight off infections, but under stress we are actually more susceptible to infections and our ability to heal from injury is also negatively affected.

Behavioral approaches might help us understand responses to the pandemic on an individual level – wearing a mask, remaining isolated, etc. How do we contend with collective responses, including distrust of science and pushes to return to ‘normal’?  

We need to lean on the cognitive approaches. We are best equipped to make decisions and form judgments from acquiring facts and knowledge. Those facts and data come from our public health officials, doctors, and scientists – they are here to inform us and have our health front and center, and we need to listen to them to help guide our actions.

A great burden of stress is being placed on healthcare workers. How do you see this experience altering the healthcare industry and medical landscape?  

Being a medical professional has always been stressful and demanding (physically, cognitively, and emotionally). There are now new stressors in the workplace, from seeing people, including fellow clinicians, get really sick, to being worried about if there is enough personal protective equipment and unintentionally bringing the virus home to families. 

Burnout has been a growing concern that will only be amplified now and in the months to come. That said, all of us entered healthcare to help others, and that passion is more important now than ever. Hopefully, it will engender more understanding about the role of our healthcare professionals on the frontlines, and more young people choose to go into healthcare rather than stay away from it.

Recovery from COVID-19 is an arduous process, and physical challenges may remain afterward. What issues will recovered patients face?  

The infection, particularly if it has caused a protracted and/or complicated physical illness, may have emotional and cognitive consequences. It will be important to stay on top of your mental state by following a rough medical course and checking in with your primary care physician and other healthcare providers.

What lasting psychological effects do you envision the COVID-19 pandemic having? 

The pandemic and its many consequences (physical distancing and social isolation, economic distress, decreased access to community supports, medical illness, etc.) is likely to worsen someone’s depression, anxiety, and addiction if they already had those challenges, and someone vulnerable to these major psychosocial stressors may develop new feelings of such despair.

Many experts predict a major wave of mental health issues in the aftermath of COVID-19, including posttraumatic stress symptoms. How do we distinguish between psychiatric symptoms that may require medical treatment and ordinary human responses to tragedy and adversity?  

The good news is that most people who experience trauma are resilient, in that they bounce back from it without an emotional scar. For those who fall ill though, it is important to track if your emotional states are chronic (last for days and weeks), pervasive (occur throughout the day), difficult to control (you can’t shake it no matter what you try), and/or interfering with your day-to-day roles at work or school, and in your relationships.

Do you have any tips for providers remotely treating their regular patients who may be experiencing exacerbated symptoms during this time? Could you also offer some guidance for providers who are working in hospitals, on the frontlines?  

For providers working remotely, know that you are not alone; try to connect with other colleagues to share your work experience and get support and consultation from each other. For those on the frontlines, know it is okay to be feeling all the new and added stress by caring for patients and to take a break, slow down, and find ways to decompress so that you restore the passion and compassion you started the day with. Also remember why you chose to be in the health field to begin with. Importantly, look out for each other.