Research, data and specialists opinion suggesting that unmanaged fear and stress may lead to more infection during pandemics (by affecting the immune system and the behavior that can can impede infection control)
As during the 2003 SARS and 2014 Ebola virus disease outbreaks, generalized fear and fear-induced overreactive behavior were common among the public; both can impede infection control (5,6).
Date: 2020
Source: https://www.ncbi.nlm.nih.gov/pubmed/32202993
Source: https://wwwnc.cdc.gov/eid/article/26/7/20-0407_article
After completing questionnaires assessing degrees of psychological stress, 394 healthy subjects were given nasal drops containing one of five respiratory viruses (rhinovirus type 2, 9, or 14, respiratory syncytial virus, or coronavirus type 229E), and an additional 26 were given saline nasal drops. The subjects were then quarantined and monitored for the development of evidence of infection and symptoms. Clinical colds were defined as clinical symptoms in the presence of an infection verified by the isolation of virus or by an increase in the virus-specific antibody titer.
Psychological stress was associated in a dose-response manner with an increased risk of acute infectious respiratory illness, and this risk was attributable to increased rates of infection rather than to an increased frequency of symptoms after infection. (N Engl J Med 1991; 325:606–12.)
Date: 1991
Source: https://www.nejm.org/doi/full/10.1056/NEJM199108293250903
Source: https://www.ncbi.nlm.nih.gov/pubmed/1713648
Research over the past three to four decades has clearly established that psychological stress affects clinically relevant immune system outcomes, including inflammatory processes, wound healing, and responses to infectious agents and other immune challenges (e.g., vaccinations, autoimmunity, cancer).
“The Impact of Everyday Stressors on the Immune System and Health”
https://link.springer.com/chapter/10.1007/978-3-030-16996-1_6
Risky decision-making in individuals with substance use disorder: A meta-analysis and meta-regression review
The results show that substance use is associated with impaired risky decision-making, indicating that interventions targeting risky decision-making in substance users should be developed for relapse prevention and rehabilitation.
Source: https://link.springer.com/article/10.1007/s00213-020-05506-y
Psychologic stress can induce immune suppression in healthy people. Researches have revealed that psychologic stress can shift Th1 cytokines toward Th2 cytokine and decrease the activity of natural killer (NK) cells. Furthermore, decreased CD4+ to CD8+ T ratio and impaired response to vaccines and low antibodies titer occur in stress (44). As a result, stress can increase the risk for upper respiratory tract infections and relapses of mucosal herpes (23). In a cohort study published in 2018, psychological distress and infectious diseases mortality were assessed in a large population. Results showed that the risk of infectious diseases, especially viral infections, were higher in psychological stress (45).
Date: 14 April 2020
Source: http://abjs.mums.ac.ir/article_15427_1470269b72381ad2be2b27f726f2443a.pdf
The preliminary results reveal adults in locations more affected by COVID-19 had distress, and lower physical and mental health, and life satisfaction.
Source: https://www.sciencedaily.com/releases/2020/04/200408102137.htm
The main findings from this work indicate that … and (3) young adults in this environment seeking clinical verification of their ILI along with laboratory testing report sub-optimal compliance with non-pharmaceutical recommendations for mitigating the spread of influenza.
Stress-related disease emerges, predominantly, out of the fact that we so often activate a physiological system that has evolved for responding to acute physical emergencies, but we turn it on for months on end, worrying about mortgages, relationships, and promotions. (p. 7)
The results of this meta-analysis support this assertion in one sense: Stressors with the temporal parameters of the fight-or-flight situations faced by humans’ evolutionary ancestors elicited potentially beneficial changes in the immune system. The more a stres-sor deviated from those parameters by becoming more chronic, however, the more components of the immune system were affected in a potentially detrimental way.
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/
Research on stressors occurring early (i.e., childhood and adolescence) and late (i.e., aging) in the lifespan have suggested that individuals exposed to chronic stressors (e.g., abuse, caregiving) can exhibit immune dysregulation that may be persistent and severe.
… research into the effects of stress on inflammation in clinical populations has demonstrated that stress exposure can increase the likelihood of developing disease, as well as exacerbating preexisting conditions.
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465119/
World health organization warns of dangerous mistakes people can make during these times of fear and uncertainty
In indoor spaces, routine application of disinfectants to environmental surfaces via spraying or fogging (also known as fumigation or misting) is not recommended. Spraying environmental surfaces in both health care and non-healthcare settings (e.g. patient households) with disinfectants will not be effective and may pose harm to individuals.7-10 If disinfectants are to be applied, manual surface cleaning with detergent and water using applied friction (e.g. brushing, scrubbing) must be performed first to ensure physical removal of organic materials, followed by use of a cloth or wipe which is soaked in the disinfectant. Spraying or fumigation of outdoor spaces (such as streets, sidewalks, walkways or marketplaces), is not recommended to remove or inactivate SARS-CoV-2 or other pathogens. Streets and sidewalks are not considered as routes of infection for COVID-19. Moreover, disinfectants are inactivated by dirt and debris, and it is not feasible to manually clean and remove all organic matter from such spaces. Even in the absence of organic matter, chemical spraying is unlikely to adequately cover all surfaces for the duration of the required contact time to inactivate pathogens. Spraying individuals with disinfectants (such as in a tunnel, cabinet, or chamber) is not recommended under any circumstances. This practice could be physically and psychologically harmful and would not reduce an infected person’s ability to spread the virus through droplets or contact. The toxic effect of spraying with chemicals such as chlorine on individuals can lead to eye and skin irritation, bronchospasm due to inhalation, and potentially gastrointestinal effects such as nausea and vomiting.9, 11
A famous 1997 experiment led by neuroscientist Antoine Bechara showed what happens to people who struggle to generate and process negative emotion. Patients with damage to the ventromedial prefrontal cortex and people without brain impairments performed a gambling task. In the task, participants pick cards from four card decks, with each one drawn revealing either a financial gain or a loss. Some of the decks are bad bets for the player, overall, offering big rewards on some cards (win $100) but even bigger penalties on others (lose $1,000). Other decks are good bets: If drawn from consistently, participants win money over time. Bechara and colleagues found that brain-damaged patients with a deficit in processing negative emotions make dumb bets: They tend to draw from the bad decks until they go broke. Non-patients, on the other hand, develop a stress response to the bad decks and learn to avoid them. Their negative emotion wasn’t corrupting their decisionmaking—it was guiding it.
A much more recent study, published in 2016, demonstrated the specific role of fear in this same process. The researchers used the same gambling task as Bechara, comparing patients with traumatic brain injuries to non-patients. The latter made a bit more money from the cards, and they were also better able to recognize fearful expressions in a set of photographs. In fact, the two abilities—for gambling and understanding fear—appeared to be correlated. Other work on clinical populations who struggle to generate or experience fear show similar impairments in their understanding of risk.
What these sorts of studies indicate is that fear can aid decisionmaking.
Source: https://www.wired.com/story/the-only-thing-we-have-to-fear-is-fearing-fear-itself/
Source: https://www.sciencedirect.com/science/article/abs/pii/S0749597899928388
Source: https://psycnet.apa.org/record/2001-07168-011
Source: https://science.sciencemag.org/content/275/5304/1293
Source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0166995
Other studies on the topic: