As the world confronts the coronavirus pandemic, similar to PTSD, we need to be mindful of the lasting impact of an invisible ailment.
By David Cummings
Residents in American cities are struggling with coronavirus, a pandemic we know doesn’t discriminate. It targets the young and old. Race and socioeconomic status be damned. What we can’t afford is to expect this virus to go away over time and not leave a devastating impact. COVID-19 is a natural disaster and like hurricanes or massive earthquakes, it will create and leave overwhelming destruction. Government models estimate anywhere from 100,000 to 200,000 people could die from COVID-19. We don’t know what the final number will be. We do know the death toll will slow. The images of helpless doctors, first-responders in masks and protective gear, and crowded hospital emergency rooms will cease, but what about the pain and suffering? When will the aftereffects of the scariest virus of our time begin to show its impact? After spending eight years working in the space of trauma, and specifically Post Traumatic Stress Disorder, I’m afraid the coronavirus has the potential to lead to a massive rise in PTSD across the USA.
In urban America, PTSD and trauma are like stop lights, consistent, and everywhere. One of the many lingering effects of the triangle of unemployment, weak education systems, and inadequate healthcare is the rise of PTSD. If we’re not careful and don’t plan accordingly, coronavirus could lead to a similar surge in PTSD. It will not be veterans returning from a war, a mass shooting, or frightening accidents. From New York to Chicago, Atlanta, Dallas, and Los Angeles, this pandemic is eating up communities. Urban and suburban.
It’s times like these when thoughtful government intervention will be required. Private and public agencies need to work collaboratively. Funding will be needed to provide research and mental support. Government officials, politicians on both sides of the aisle, and administrative organizations like the Centers for Disease Control and Prevention (CDC) should support and work with organizations, institutions, and foundations now to establish corrective measures and systems to be in place once we get a handle on COVID-19. We can’t wait for the pandemic to end before we begin to take steps. We can’t repeat the same mistakes made with PTSD. Following a surge of soldiers returning home from military conflicts since 1992, PTSD’s association with veterans nullified research detailing how children living in high-crime urban neighborhoods exhibited higher rates of PTSD than soldiers deployed for combat in Iraq and Afghanistan. A 2012 Congressional briefing by Dr. Howard Spivak of the CDC revealed those figures. We can’t repeat similar blindness. The impact of COVID19 can’t be associated exclusively with a distinct region, age, or population.
Similar to how the CDC started providing local organizations with information and access to government funding to look into PTSD’s impact on urban neighborhoods, we need to be forward-thinking and start planning now on how to address the trauma that’s going to follow COVID-19. Northern California has the road map for how to take on the lasting impact of the coronavirus. It begins with research, identifying weaknesses, and offering sensible solutions. That’s how the area approached the challenge of PTSD’s effect on local children.
Palo Alto, California, is far from a war zone. The wealthy enclave 35 miles south of San Francisco is a unique blend of academia and entrepreneurship. Stanford University represents the education portion and the venture capitalists, who made the city the birthplace of Silicon Valley, represent the business portion. Dr. Hilit Kletter is a clinical instructor at Stanford’s Early Life Stress Research Program. She and some colleagues examined PTSD’s impact on children in the East Palo Alto School District. Working with 13 schools comprised of mostly low-income students, Dr. Kletter said they discovered an alarming rate of students with symptoms of PTSD. Another Stanford study of 700 children treated at a primary care clinic in the Bayview-Hunter’s Point section of San Francisco showed that 30 percent had symptoms of PTSD. These symptoms showed behavior problems such as hyperactivity and difficulty reasoning. The diagnosis from school teachers and nurses was attention deficit hyperactivity disorder (ADHD). Dr. Kletter surmised that these officials were not equipped to diagnose the difference in symptoms between ADHD and PTSD. While they have similar signs, they require different treatments. Children with PTSD need psychotherapy, not medication. But diagnosing children can be difficult.
Kletter gave an example of a young preschool student who witnessed a shooting that seriously injured an individual. The child may not be able to understand the permanence of what happened, but the real worry is the loss of safety the child feels. The child begins to wonder who will take care of them, who will keep them safe and protect them? It’s not just one shooting, but multiple traumatic events over time that lead to devastating results not easily identifiable, especially for someone like a classroom teacher not trained to observe and diagnose PTSD. The findings come out in different ways. Kletter said PTSD is very much a developmental disorderand the symptoms come out in the way children play or interact. The actions of children with PTSD may be misinterpreted and they can be labeled oppositional defiant. In other words, children have triggers cause them to act out or feel like they did when they witnessed a traumatic event. When this happens in the classroom or on the playground, it’s considered a behavior problem.
Teachers or administrators rarely wonder if the student is acting out because they saw mommy and daddy fight at home the night before. Kletter’s research brought problems like that to the surface. To support the children, her team set up a contact person for each school. The idea was to produce consistent dialogue for children and families and the establishment of family screenings. “The treatment was very effective,” Dr. Kletter said. “We saw a reduction in a variety of ways right away, from the caregiver’s anxiety and depression to the student’s behavior.”
The combination of experimentation, recognizing the difference in vulnerabilities, and proposing cognizant resolutions was a mixture that worked. There can be a similar correlation and result for coronavirus in communities across America. Think about it for a moment. If we begin to compare PTSD to COVID-19 now, maybe we have a chance to prepare communities to deal with COVID-19’s lasting impact. COVID-19 is not a mental health disease like PTSD. But similar to PTSD, it is initially an invisible wound that can’t be cured or contained until symptoms are diagnosed. One of the reasons we do not hear any comparisons to PTSD or thoughts about how the after effects of COVID-19 might destroy communities is because of the gut-wrenching accounts of families losing a brother, sister, mother, father, or grandparent. People are losing good friends and co-workers. Not to mention jobs. As the unemployment rate rises and bills escalate, there is going to be a need for people to get help. Not just financially, but mentally and spiritually. The question is, how do we combat the residue of this pandemic when it is over? Especially if we’re not paying attention now.