Cite as:  Tiwari, G. K., Rai, P. K., Dwivedi, A., & Ray, B. (2020). The Outbreak of COVID-19: A Narrative Thematic Analysis of the Perceived Psychological distress and health Outcomes [Preprint]. Preprints. https://doi.org/10.22541/au.158955320.05988992

Introduction

           The recent outbreak of COVID-19 has shaken the whole world. Coronavirus disease  (COVID-19) is a respiratory infection caused by the coronavirus that can be transmitted through respiratory droplets and contact routes by droplets particles (>5-10 μm) or droplet nuclei (<5μm) (Li et al., 2020; Liu et al., 2020). This disease causes persons to experience mild to moderate respiratory illness that gets recovered without any special treatment. Older people or those suffering from cardiovascular disease, diabetes, chronic respiratory disease and cancer are more prone to develop this disease (World Health Organization, 2020a). According to the World Health Organization (2020b), the confirmed and death cases caused by COVID-19 on April 23, 2020, are 2, 544, 792 and 175, 694, respectively.
            The pandemic of COVID-19 has resulted in many negative consequences on a mass scale involving physical and mental health, social behaviours and relationships, psychological and emotional functioning. A recent review indicated that many negative psychological consequences are associated with the spread of COVID-19 (Brooks et al., 2020). For instance, the study observed that a pandemic like COVID-19 culminates in acute stress, confusion, anger, restrictions, fear of infection, frustration, boredom, poor supplies of goods and services, insufficient information, loss and stigma (Brooks et al., 2020). It has been argued that the vulnerability of COVID-19 may be dissimilar for different persons depending on their social groups, gender, age and socioeconomic status, occupation, health, education, ethnicity,  history of physical and psychological illness (disabilities, heart problem, diabetes etc.), economic and social conditions, domicile and working conditions (Pan American Health Organization, 2019).
            The consequences of an epidemic involve a set of complex social and psychological processes and these may be very serious if the disease is new, unexpected or very harmful (Strong, 1990). Strong (1990) has argued that the resultant psychological processes are epidemics in themselves that may spread at a fast pace in a variety of forms to individuals and collectives. Epidemic psychology may comprise three types of psycho-social epidemics: fear, explanation and moralization, and the epidemic of action. These may be even more severe when the disease is less well-known (Strong, 1990). These facts may further carry suspicion, insecurity of infection by any method, irrationality, misinformation, panic, stigmatization, avoidance, segregation, abuse and theories of the origin of disease and its effects and metaphysical explanations among educated as well as illiterate people (Weber & Goldmeier, 1983). It has been argued that epidemic psychology originated from the primitive and irrational unconscious emotions that are universal with different forms and consequences (Strong, 1990).
            The ultimate impacts of COVID-19 may be very serious as it has stopped all present human activities across the globe and imposed a sanction on all human interactions. In addition to the disease itself, many negative consequences of the psychological impacts of epidemics have been observed. For example, quarantine has been reported to develop symptoms of acute stress, fatigue, feeling of isolation, anxiety, irritability, insomnia and indecisiveness (Lee et al., 2005; Sprang & Silman, 2013; Wang et al., 2011). Besides, general psychological symptoms (Mihashi et al., 2009), emotional disturbance (Yoon et al., 2016), depression (Hawryluck et al., 2004) and stress (DiGiovanni et al., 2004) are also caused by quarantine and other restraints. Some qualitative studies have also observed confusion (Pan et al., 2005) and anger (Cava et al., 2005) resulting from quarantine.
            It is noticeable from the above discussion that epidemic and its socio-psychological aftermaths lead to a variety of challenges which may catalyze many sorts of psychological distress and poor health outcomes for the affected people. Understanding the dynamics of the psychological distress and negative health outcomes of COVID-19 may be significant for many reasons. The worldwide chaos created after the outbreak of COVID-19 is new, unprecedented and serious as it is the first epidemic which has gripped simultaneously the whole human society for the first time. Previously, epidemics have been limited only to some smaller or larger parts of the world.  Besides, the current poor knowledge about the nature, sources and methods of infections of COVID-19 and its ill-effects has created furore never before. The COVID-19 has caused lockdowns in the majority of the human societies of the world. This sudden worldwide lockdown has paralyzed the economic, social, educational, cultural and familial activities and led people to think nothing than Corona. These multiple negative impacts of the outbreak of the disease may have serious psychological and health consequences for all people. In the backdrop of these observations, the present study attempted to explore the impacts of the outbreak of COVID-19 on the perceived psychological distress and health outcomes of a heterogeneous adult sample through the Narrative Thematic Analysis. This method was chosen for two reasons. First, qualitative methods have been suggested to be appropriate for studying phenomena that are either less explicit or lack a guiding framework for the study (Creswell, 2004). Second, it was not possible to collect data on the impacts of COVID-19 on a large scale through quantitative methods as direct contact with the participants was not possible due to the nationwide lockdown in India.

Methods

            The current study employed a Narrative Thematic Analysis research design that involved a semi-structured interview protocol to collect, process and analyze the data. A heterogeneous sample of 18 participants (age range = 25-56 years, Mean = 36.22, SD = 8.51) was chosen. These belonged to Sagar, Delhi, Varanasi, Prayagraj, Bangalore and Bhopal cities of India. Initially, 45 individuals were contacted through the telephonic calls. Out of these, only 12 males (age range = 25-56 years, Mean = 37.33, SD = 9.54) and 6 females (age range = 28-44 years, Mean = 34.00, SD = 6.10) gave their consent to respond to their experiences and multiple consequences of the outbreak of the COVID-19 for their life. The descriptions of demographic features are presented in Table 1.

Table . Demographic features of the participants