The world now is struggling to control and overcome a pandemic which has affected the whole world claiming 1524348 lives till now [1]. The first ever case of this novel virus was reported in Wuhan, China in December of 2019. Coronaviruses were not unknown to biologist; these are a group of RNA viruses which are already known to cause disease in mammals and birds [2]. The cause of concern was this novel virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).The rapid rate of spread of the disease crossing countries and continents led to WHO declaring it a pandemic on 11^th March 2020. In an urgent need to contain the spread lockdowns were announced one after the other worldwide. The pandemic not only did unilateral damage to the health of people but the parallel problems that followed remoulded their surroundings and demanded immediate permute from them [3]. Trapping people inside their homes with a constant fear of unknown and uncertainty, shunning the world around them and making their lives fall apart. This brought out the worst of the world. 

Health Care Worker Crisis 

The health care workers all round the world have been working hard day and night as frontline workers for providing the lifesaving heath care services. Doctors live in a constant stress of contracting the disease themselves and transmitting them to other members of their family [4]. According to the data compiled by the Indian Medical Association — which is the largest body of doctors in the country the fatality rate for doctors can be as high as ten times in comparison to general population [5]. Despite them risking their lives they sometimes face uncooperativeness from the patients and their family. Health care workers have been attacked, spat at and even faced verbal abuse. Lack of personal protection kits, pressure of work combined with long working hours, lack of proper rest and sleep is making it more difficult for them.  This combination of stressful situation and accumulated fatigue affects many aspects like personal life, social life and personal care. Outcome is limited or no time for self-wellbeing [6].

Plight of the Underprivileged

According to the UN’s Framework for the Immediate Socio-Economic Response to the COVID 19 Crisis this pandemic is not only a health crisis but its core effect can be seen in economies and societies though the impact will vary from one country to another it will increase destitution and inequity at a worldwide level [7]. The sudden lockdown imposed by the government caused havoc in the millions of migrant workers who have no means to return to their rural home. The fear of the virus, losing their jobs and livelihoods was not enough of the agony as they had to literally walk home suffering in pain and distress. This socioeconomically fragile communities suffered the lack of resources and support. Many lost their lives while walking back home. Those who could make it faced discrimination from their own family members. They were not allowed inside their villages as the people feared contracting the disease. With nowhere to go many migrant suicides came into limelight [8].

Trepidation of the Pandemic

Karestan Koenen, professor of psychiatric epidemiology at the Harvard T.H. Chan School of Public Health explains that when people think that their survival is being threatened, they need to act on things that are in control of them and hence we get extreme reactions. One of the reactions was panic buying. From masks, sanitizers, hand washes to groceries everything went off the shelves so quickly even before they could be restocked [9]. The panic was due to the novelty of the virus, there is no specific treatment, scientists have no history of how it behaves. People are just letting their emotions take over their reasoning. The uncertainty which surrounds the pandemic is the hardest to handle, when there is no information about what exactly will be the impact, how long this is going to stay, how worse the things could get, all of this clubbed together create prodigious panic and enormous anxiety. The minute-to-minute obsession of getting the update on the pandemic is adding to anxiety [10,11]. 

Work from Home Culture

The work from home culture though not new to society has never been practiced at such massive scale. Though it has got some advantages but when we see the bigger picture it is destroying personal lives of people. Since one is assumed to be at home all the time there are no specific boundaries set for working hours. Personal life and personal time has been spoiled by the invasion of management of corporate sectors. Many companies fired people on petty issues, with lesser number of employees the companies are still able to maintain their profit output. Corporate sectors are prompting this culture as they are able to prevent many overhead expenses. Salary cut has also been observed. People in fear of losing their jobs are abiding by the new norms that these sectors are imposing on them. Less tech savvy people are losing their jobs on the grounds of incompatibility. Excessive work load, stress, pressure of adapting to the technology is creating vexation. The homemakers are also facing a lot of stress in lack of any external help and helping kids with their online classes. The frustration of over work and uncertainty of employment status is adding fuel to the fire. Frustration is the crux of all the problems. Even petty issues may lead to quarrel and tensed environment at home.

No Quarantine for Violence 

One of the measures in order to combat the COVID-19 was imposing the lockdowns which would help in containing the spread of the virus. The isolation it brought affected the people devastatingly. It trapped women inside their homes, the place considered to be safe for them. Hence trapping women 24×7 with their abusers. The stress of losing jobs and the salary cuts all were vented out on the women [12]. According to The Hindu there has been an increase in the domestic violence complain in the first four phases of the lockdown than that has been recorded in past 10 years in a similar time period. The data shifts our attention to only the noticeable part of the problem as we already know that 86% of women don’t even share their experience about the domestic abuse they face [13]. These women trapped in the safety of home are expected to manage all the household chores as well as their jobs if they are employed. India being a patriarchal country it is considered that every household work is a women’s responsibility.  If the household has a man who has recently lost a job then it becomes all the more worse. Men who now cannot exert control over their economic security tend to impose it on their spouse. If there is drug abuse in the family the situation deteriorates further. All of these makes women a softer target. The UN has described the worldwide increase in domestic abuse as a "shadow pandemic" alongside Covid-19 [14].

Mental Health Muddle

One of the outcomes of the pandemic was the realization of dearth of mental health services. Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. Emphasized that good mental health is a necessary part of overall wellbeing and health. Isolation, loss of jobs, uncertainty and the frantic helplessness engendered mental health issues as well as aggravated the pre-existing ones. There were cases of increased drug abuse, insomnia, consternation. Covid-19 is known to cause mental and neurological complications some of them being delirium, agitation and even stroke. The pre-existing issues like mental, neurological disorders as well as drug abuse problems can further complicate the situation leading to increased vulnerability to SARS-CoV-2 infection posing risk of severe complications and at worst death. Researches have shown than 10 percent of recovered patients show symptoms like weak memory, body ache, fatigue and delirium for up to 6 months of being Covid-19 negative. In words of Dr.Tedros Adhanom “COVID-19 has interrupted essential mental health services around the world just when they’re needed most. World leaders must move fast and decisively to invest more in life-saving mental health programmes during the pandemic and beyond [15].”

Covid- 19 and Suicides

Country like India with its dense population couldn’t have speculated in advance about the impact of Covid-19. It was complex and devastating. The nexus of the social stratification and divergent communities were affected in ways that it was not easy to anticipate. Along with other collateral issues it brought in forefront the issue of suicides in India. The grim reality is that India's lack of a national response strategy as it relates to mental health and suicide has left a grave and complex problem unaddressed for years [16]. According to a study done to assess the causative factors for suicides due to Covid-19 the maximum cases of suicides were due to fear of contracting the disease, which was followed by financial crisis. Loneliness, Covid-19 work related stress, alcohol withdrawal, trapped due to non-availability of locomotive services, testing positive for Covid-19 were other reasons for the marked elevation in suicide rates [17]. India also saw many celebrity suicides during the pandemic. Mental health requirements of celebrities are different from the general people. They too faced massive challenges in the form of loss of employment, contract cancellation, and inadequacy in maintaining their wealthy lifestyles as well as isolation problems were accountable. Their psychological needs remain unaddressed as they are unwilling to give up their fame combined with absence of anyone to trust upon. These concerns could be the reason for the delay or lack of treatment-seeking behaviour or supportive care despite being aware of the mental health problems [18].

Though the pandemic has evoked a sense of uncertainty, panic and distress all around the world resulting in high rise of all sorts of crime, sudden loss of employment and unexpected pay cuts, mental health issues and consternation in general, the government agencies around the globe are trying their best to fight it back. In the midst of mental health issues as a result of Covid-19 pandemic there is a ray of hope that Vaccines will be available shortly. As per the recent statement of India’s Prime Minister Narendra Modi vaccines will be available to Indian population within few weeks. Even after inoculation by vaccine people will have to wear masks and follow social distancing for a long time. Vaccines from Moderna, Pfizer, AstraZeneca, Janssen and Novavax are in their final stage of clinical trial and will be available to general population in near future. In India, in the first phase vaccines will be given to frontline workers i.e. to the Doctors and Police officials.

Acknowledgment

Authors would like to thank Faculty and Staff of Department of forensic medicine, IMS, BHU for their valuable support as well as print and electronic media for the information source.

Conflict of Interest

No conflict of interest associated with this work.

Funding

This study was funded by UGC.

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