Coronavirus in Brazil: mental health in tragedy

This article was exclusively written for The European Sting by Mr. Gustavo Abud Priedols and Ms. Letícia Ribeiro da Cunha, two second-year medical students at the Universidade Estadual de Londrina, located in Londrina, Paraná, Brazil. They are affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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Following the analysis of social psychology, we are currently experiencing what Martín-Baró, a psychologist and philosopher, called “Mental health in tragedy” ¹. The coronavirus arrived in a country in an economic, political, social and humanitarian crisis and whose societal weaknesses have been aggravated by the new health demand. In the case of mental health, there is an even greater precariousness, due to the exceptional issues of social isolation in the country and the inequalities historically existing among Brazilians. Although the prognosis is not the best, it is possible to reduce the burden that mental health in Brazil has become. Several actions are recommended to improve mental health in this period, such as seeking to establish virtual contact with hospitalized relatives, maintaining online contact with family and friends, and avoiding leaving home. Although this is not easy for most residents of Brazilian peripheries, it can still be worked on. It is difficult to ask to keep in touch with patients online when many hospitals do not even have resources for PPE. With that in mind, many states in the federation were inspired by the Italian project “Right to say goodbye” and made it possible to donate tablets to hospitals mainly in the public network, so that these patients with COVID-19 feel connected to family members at home. ²^,³ There is the challenge of staying online in Brazil, because more than 30 million people do not have access to the internet⁴. In contrast, attitudes like that of the National Telecommunications Agency can help. The agency published a letter asking operators to expand broadband and avoid blocking the Internet from defaulting consumers. According to the same letter, debts must be negotiated and the technical stability of the system must be guaranteed.^5,6 In addition, many peripheral residents cannot stay at home, as they depend on informal work for their livelihood. Only 19% of the workers who live in the slums of Brazil have formal employment ties, showing the seriousness of this scenario. The infeasibility of adhering to quarantine intensifies the risks of contamination of the informal worker, which causes fear of contracting or transmitting the disease to family members, but adhering to it may mean not having the money to put food on the table⁷. These contradictions are a potent stressor, affecting the mental health of this population. A measure implemented by the Brazilian government, Emergency Aid, is a bet to help these workers without a formal contract⁸, which can alleviate their concerns regarding basic survival needs, enabling their adherence to quarantine and reducing their emotional overload. The arrival of the pandemic in a country like Brazil, multifaceted and marked by inequalities, makes it impossible for the implementation of social distance to be homogeneous. Thus, the impacts on mental health also acquire particularities according to each social group affected. To lessen this burden, actions such as maintaining online contact with relatives and friends during quarantine, including those who are hospitalized, and spending the pandemic period at home, are possible if adapted to different realities. References [1] Costa PHA. Saúde mental em tempos de crise e pandemia: um diálogo com Martín-Baró. 2020 [cited 2020 apr 20]. Available from: https://www.academia.edu/42682218/Sa%C3%BAde_mental_em_tempos_de_crise_e_pandemia_um_di%C3%A1logo_com_Mart%C3%ADn-Bar%C3%B3. [2] Rocha L. Campanha arrecada tablets para conectar pacientes de coronavírus a familiares. Estado de Minas. 2020 apr 06 [cited 2020 apr 20]; Gerais. Available from: https://www.em.com.br/app/noticia/gerais/2020/04/06/interna_gerais,1136124/campanha-arrecada-tablets-conectar-pacientes-coronavirus-a-familiares.shtml. [3] Colluci C. Hospitais usam tablets e robôs para aproximar pacientes com cornavírus de famílias. Folha de S. Paulo. 2020 apr 06 [cited 2020 apr 20]; Equilíbrio e Saúde. Available from:https://www1.folha.uol.com.br/equilibrioesaude/2020/04/hospitais-usam-tablets-e-robos-para-aproximar-pacientes-com-coronavirus-de-familias.shtml. [4] Costa V. Mais de 30 milhões de brasileiros não têm acesso à internet. Folha de Londrina. 2020 apr 18 [cited 2020 apr 20]; Folha Opinião. Available from: https://www.folhadelondrina.com.br/opiniao/mais-de-30-milhoes-de-brasileiros-nao-tem-acesso-a-internet-2987282e.html. [5] Aquino M. Anatel manda operadoras ampliarem banda larga e abrir o WiFi devido ao COVID-19. Tele.síntese. 2020 mar 15 [cited 2020 apr 20]; Conectados contra a COVID. Available from: http://www.telesintese.com.br/anatel-manda-operadoras-ampliar-banda-larga-e-abrir-o-wi-fi-devido-ao-covid-19/. [6] Brasil. Agência Nacional de Telecomunicações. Ofício n. 80/2020/GPR-ANATEL. Medidas a serem adotadas pelo setor de telecomunicações diante da disseminação da COVID-19. 2020 mar 13 [cited 2020 apr 20]. Available from: http://www.telesintese.com.br/wp-content/uploads/2020/03/OFICIO-ANATEL-MEDIDAS-COVID-19.pdf. [7] Flaeschen H. Coronavírus nas favelas: “É difícil falar sobre perigo quando há naturalização do risco de vida.” Associação Brasileira de Saúde Coletiva. 2020 [cited 2020 apr 21]; Especial Coronavírus. Available from: https://www.abrasco.org.br/site/outras-noticias/saude-da-populacao/coronavirus-nas-favelas-e-dificil-falar-sobre-perigo-quando-ha-naturalizacao-do -risco-de-vida /46098/. [8] Brasil. Caixa Econômica Federal. Auxílio Emergencial do Governo Federal. 2020 [cited 2020 apr 21]. Available from: https://auxilio.caixa.gov.br/#/inicio. About the authors Both authors are second-year medical students at the Universidade Estadual de Londrina, located in Londrina, Paraná, Brazil. Gustavo Abud Priedols comes from a small city in São Paulo. Besides the studies at university, he now teaches art history, his other passion, in a pre-university course. He believes that the arts, and their study, are going to make him a more human doctor, qualified to reduce health inequalities in Brazil and promote biopsychosocial care to all. Letícia Ribeiro da Cunha is affiliated to IFMSA for a little over a year, but that is already a passion. She is local publications and research director of the Local Committee. She loves reading and is interessed in microbiology, infectious diseases and pediatrics.