vox--2020-04-16--Exclusive: Amy Klobuchar’s plan to ensure rural areas aren’t devastated by coronavirus

As Congress starts planning its next coronavirus relief package , Sen. Amy Klobuchar ( D-MN ) has shared her new plan for rural America exclusively with Vox .
Though much of the national media focus so far has been on “ hot spots ” like New York City and New Jersey , coronavirus has already hit America ’ s rural communities .
And if it hasn ’ t yet reached a given area , it likely will in the coming weeks and months .
A recent New York Times analysis found that as of April 6 , two-thirds of rural @ @ @ @ @ @ @ case ; the number of cases could continue to rise .
Covid-19 is colliding with a weak health care infrastructure in rural areas with older and lower-income patients who have seen their local hospitals close .
With far fewer resources than cities or suburbs , the 60 million people who live in rural areas could be devastated by coronavirus .
Rural communities are also being hit by the economic ripple effects of the virus ’ s spread .
Some in rural areas have no access to high-speed broadband , which they could use @ @ @ @ @ @ @ , or get their kids logged on to virtual school .
Farmers and ranchers fear the virus could wreak havoc on the food supply chain and their livelihoods .
And people of color , including Native communities , are particularly at risk .
“ We ’ re facing a national crisis — it affects every American , no matter where they live , ” Klobuchar told Vox in a statement .
“ While COVID-19 may be slower to spread to some rural areas , its impact will likely be just as serious , @ @ @ @ @ @ @ like Albany , Georgia and Martin County , Minnesota.
” Klobuchar ’ s plan is expansive .
It includes some proposals like small-business relief , which was in the CARES Act and is part of another small-business loan bill negotiation between Republicans and Democrats .
Other pieces have already been introduced as standalone bills .
But now that the first coronavirus wave seems to be leveling off , the Minnesota senator recognizes a second wave could hit rural America particularly hard and wants her plan included in coronavirus stimulus packages to come .
@ @ @ @ @ @ @ As the coronavirus hit large urban areas like New York City , Detroit , and New Orleans , rural communities didn ’ t see many cases at first .
The lack of dense population might make it seem like these communities don ’ t have as much risk .
But no one ’ s risk is zero .
“ If we believe that the way seasonal flu spreads through the country is likely similar to Covid-19 , the rural eruptions tend to be later and briefer but more impactful than in big urban @ @ @ @ @ @ @ retired neurologist , physician executive , and physician consulting director with the Chartis Group , recently told writer Lois Parshley for Vox .
And when coronavirus does hit , rural areas simply have fewer resources to deal with it .
From 2005 to 2020 , 170 rural hospitals around the country have closed , leaving critical gaps in the rural health care infrastructure .
Physician shortages have followed ; A 2019 poll conducted by NPR , the Robert Wood Johnson Foundation , and the Harvard T.H .
Chan School of Public Health found @ @ @ @ @ @ @ areas said they could not access needed health care — and many said it was because their health care facility was too far away .
Even if these rural areas may not face coronavirus rates like New York City did , the virus could exacerbate some devastating trends .
Klobuchar ’ s proposal is a wide-ranging , four-part plan that takes into account everything from support for rural hospital and medical professionals to relief for farmers , increased rural broadband , and support for local governments .
“ We need to ensure that @ @ @ @ @ @ @ left behind and have the resources they need to respond to this pandemic , ” Klobuchar told Vox .
Here are the main points of her plan .
• Protecting rural hospitals from closing : Well before coronavirus hit , rural areas faced a dire trend of hospitals closing : 170 rural hospitals around the country have closed in the past 15 years , and coronavirus could worsen that trend now that many hospitals have had to cancel elective surgeries and other moneymaking procedures .
Klobuchar wants to expand the $ 100 billion @ @ @ @ @ @ @ for these hospitals , as well as giving them lower interest rates and more time to repay under the Medicare Accelerated Payments Program .
• Temporarily reopening closed rural hospitals : Klobuchar is asking the US Department of Health and Human Services ( HHS ) to explore ways to reopen recently closed hospitals to be overflow facilities for other hospitals dealing with an influx of coronavirus cases .
Much like the Javits Center is serving as a temporary hospital in New York City , recently closed hospitals that were built for this purpose @ @ @ @ @ @ @ is also asking for more assistance for rural health clinics , which are often the main source of health care in rural areas .
• Strengthen the rural health care workforce : Many rural areas have doctor shortages .
Rural areas , on average , have about half as many physicians per capita as urban areas , forcing some people to travel hours to visit their doctor or wait longer to see a physician .
Klobuchar wants HHS to give rural providers maximum flexibility to develop staffing plans in response to the coronavirus @ @ @ @ @ @ @ some hospitals have been asked to help with coronavirus care , it can be harder in rural areas because these specialists sometimes work at different hospitals , which requires shifting personnel across buildings .
Klobuchar also proposes expanding student loan forgiveness for health care and long-term care workers in places with shortages .
• Deliver medical supplies and testing : Regardless of whether they are rural or urban , many hospitals and medical facilities are struggling to get adequate medical supplies and coronavirus tests .
But with increased competition for what is available @ @ @ @ @ @ @ compete .
Klobuchar is asking their needs be considered when equipment and tests are allocated .
• Getting financial relief to farmers : Klobuchar is a senior member of the Senate Agriculture Committee and has been hearing from farmers that prices they ’ re getting for their commodities are starting to fall drastically .
She ’ s proposing getting farmers credit and addressing these low commodity prices by expanding the safety net for farmers .
• Protecting farm workers and food processors : Coronavirus outbreaks at large farms and food processing plants aren @ @ @ @ @ @ @ ; they could also wreak havoc on the food supply chain .
Already , one of the nation ’ s largest pork processing plants in Sioux Falls , South Dakota , shut down after a coronavirus outbreak among employees .
Klobuchar ( like other Democrats in the House and Senate ) is calling for increased Occupational Safety and Health Administration regulations that protect workers on the job for food processing and farm workers , as well as training for these workers in multiple languages , as many are immigrants .
• Keeping the @ @ @ @ @ @ @ proposing a number of other measures like exempting commercial truck drivers from state travel restrictions and providing emergency funding for the nation ’ s ports .
• Increasing SNAP and other food security programs : Klobuchar is echoing a demand from Democratic leaders in the House and Senate — increased funding for food security programs like SNAP , and increased benefits for teenage family members to make sure low-income families and children have enough food .
• Increased funding for small-business loans : A small-business loan fund that was set up by the @ @ @ @ @ @ @ money and is the subject of congressional negotiations between Republicans and Democrats .
Klobuchar is arguing that businesses need increased access to loans and grants but also is calling for increased technical assistance for rural small businesses .
• Expanded access to child care : There ’ s already limited access to child care in rural areas , and the recent closure of schools in many states has exacerbated the problem .
Klobuchar is calling for increased funding for the Child Care and Development Block Grant and increasing subsidies to encourage more rural @ @ @ @ @ @ @ money to operate during coronavirus .
Rural broadband and more funds for state and local programs • Rural broadband : One issue Democrats have long wanted to address as part of a larger infrastructure package is the lack of high-speed broadband internet in many rural areas .
Klobuchar argues that ’ s especially important now , as families must shelter in place and do work and school from home .
It ’ s also essential for unemployed workers trying to apply for benefits from home .
It could take months to develop an @ @ @ @ @ @ @ funding to the E-Rate program , to provide wifi hotspots to students who don ’ t have broadband at home .
• Affordable housing : Klobuchar is pushing for enforcement of a temporary eviction moratorium on properties with federally backed mortgages and calling for increased emergency rental assistance for those in rural areas .
• Supporting the US Postal Service : As the Postal Service suffers from a drop in people sending and receiving mail , Klobuchar and other senators and members of Congress are calling for increased federal support to keep it @ @ @ @ @ @ @ As the coronavirus spreads to rural areas , Congress will likely have to extend more assistance to those areas .
As a senator , former presidential candidate , and potential vice presidential contender , Klobuchar may be in a good position to make the case for helping Americans who live there .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power to save lives .
Our mission has never been more vital @ @ @ @ @ @ @ to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
Please consider making a contribution to Vox today .

As Congress starts planning its next coronavirus relief package, Sen. Amy Klobuchar (D-MN) has shared her new plan for rural America exclusively with Vox.
Though much of the national media focus so far has been on “hot spots” like New York City and New Jersey, coronavirus has already hit America’s rural communities. And if it hasn’t yet reached a given area, it likely will in the coming weeks and months. A recent New York Times analysis found that as of April 6, two-thirds of rural communities have confirmed at least one coronavirus case; the number of cases could continue to rise.
Covid-19 is colliding with a weak health care infrastructure in rural areas with older and lower-income patients who have seen their local hospitals close. With far fewer resources than cities or suburbs, the 60 million people who live in rural areas could be devastated by the coronavirus.
Rural communities are also being hit by the economic ripple effects of the virus’s spread. Some in rural areas have no access to high-speed broadband, which they could use to work remotely, file for unemployment, or get their kids logged on to virtual school. Farmers and ranchers fear the virus could wreak havoc on the food supply chain and their livelihoods. And people of color, including Native communities, are particularly at risk.
“We’re facing a national crisis — it affects every American, no matter where they live,” Klobuchar told Vox in a statement. “While COVID-19 may be slower to spread to some rural areas, its impact will likely be just as serious, as we’ve seen in places like Albany, Georgia, and Martin County, Minnesota.”
Klobuchar’s plan is expansive. It includes some proposals like small-business relief, which was in the CARES Act and is part of another small-business loan bill negotiation between Republicans and Democrats. Other pieces have already been introduced as stand-alone bills. But now that the first coronavirus wave seems to be leveling off, the Minnesota senator recognizes a second wave could hit rural America particularly hard and wants her plan included in coronavirus stimulus packages to come.
Some rural communities are ill-prepared for Covid-19
As the coronavirus hit large urban areas like New York City, Detroit, and New Orleans, rural communities didn’t see many cases at first.
The lack of dense population might make it seem like these communities don’t have as much risk. But no one’s risk is zero.
“If we believe that the way seasonal flu spreads through the country is likely similar to Covid-19, the rural eruptions tend to be later and briefer but more impactful than in big urban areas,” Roger Ray, a retired neurologist, physician executive, and physician consulting director with the Chartis Group, recently told writer Lois Parshley for Vox.
And when the coronavirus does hit, rural areas simply have fewer resources to deal with it. From 2005 to 2020, 170 rural hospitals around the country closed, leaving critical gaps in the rural health care infrastructure. Physician shortages have followed; a 2019 poll conducted by NPR, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health found a quarter of people living in rural areas said they could not access needed health care — and many said it was because their health care facility was too far away.
Per Parshley:
More than half of counties in America have no hospital ICU beds, posing a particular risk for the more than 7 million people over the age of 60 living in those places, who are at higher risk of severe cases of Covid-19. In February, the Chartis Group released a study showing that more than 450 rural hospitals are vulnerable to closure. “If you’re vulnerable enough to risk losing the ability of making payroll, how valuable can you be to the community in crisis?” Ray asks.
Even if these rural areas may not face coronavirus rates like New York City did, the virus could exacerbate some devastating trends.
What’s in Klobuchar’s new plan
Klobuchar’s proposal is a wide-ranging, four-part plan that takes into account everything from support for rural hospital and medical professionals to relief for farmers, increased rural broadband, and support for local governments.
“We need to ensure that all communities across rural America are not left behind and have the resources they need to respond to this pandemic,” Klobuchar told Vox.
Here are the main points of her plan.
Bolstering rural health care
Protecting rural hospitals from closing: Well before the coronavirus hit, rural areas faced a dire trend of hospitals closing: 170 rural hospitals around the country have closed in the past 15 years, and coronavirus could worsen that trend now that many hospitals have had to cancel elective surgeries and other moneymaking procedures. Klobuchar wants to expand the $100 billion Public Health and Social Services Emergency Fund for these hospitals, as well as giving them lower interest rates and more time to repay under the Medicare Accelerated Payments Program.
Well before the coronavirus hit, rural areas faced a dire trend of hospitals closing: 170 rural hospitals around the country have closed in the past 15 years, and coronavirus could worsen that trend now that many hospitals have had to cancel elective surgeries and other moneymaking procedures. Klobuchar wants to expand the $100 billion Public Health and Social Services Emergency Fund for these hospitals, as well as giving them lower interest rates and more time to repay under the Medicare Accelerated Payments Program. Temporarily reopening closed rural hospitals: Klobuchar is asking the US Department of Health and Human Services (HHS) to explore ways to reopen recently closed hospitals to be overflow facilities for other hospitals dealing with an influx of coronavirus cases. Much like the Javits Center is serving as a temporary hospital in New York City, recently closed hospitals could be used if needed. Klobuchar is also asking for more assistance for rural health clinics, which are often the main source of health care in rural areas.
Klobuchar is asking the US Department of Health and Human Services (HHS) to explore ways to reopen recently closed hospitals to be overflow facilities for other hospitals dealing with an influx of coronavirus cases. Much like the Javits Center is serving as a temporary hospital in New York City, recently closed hospitals could be used if needed. Klobuchar is also asking for more assistance for rural health clinics, which are often the main source of health care in rural areas. Strengthen the rural health care workforce: Many rural areas have doctor shortages. Rural areas, on average, have about half as many physicians per capita as urban areas, forcing some people to travel hours to visit their doctor or wait longer to see a physician. Klobuchar wants HHS to give rural providers maximum flexibility to develop staffing plans in response to the coronavirus. For instance, where specialists in some hospitals have been asked to help with coronavirus care, it can be harder in rural areas because these specialists sometimes work at different hospitals, which requires shifting personnel across buildings. Klobuchar also proposes expanding student loan forgiveness for health care and long-term care workers in places with shortages.
Many rural areas have doctor shortages. Rural areas, on average, have about half as many physicians per capita as urban areas, forcing some people to travel hours to visit their doctor or wait longer to see a physician. Klobuchar wants HHS to give rural providers maximum flexibility to develop staffing plans in response to the coronavirus. For instance, where specialists in some hospitals have been asked to help with coronavirus care, it can be harder in rural areas because these specialists sometimes work at different hospitals, which requires shifting personnel across buildings. Klobuchar also proposes expanding student loan forgiveness for health care and long-term care workers in places with shortages. Deliver medical supplies and testing: Regardless of whether they are rural or urban, many hospitals and medical facilities are struggling to get adequate medical supplies and coronavirus tests. But with increased competition for what is available, rural providers have less money to compete. Klobuchar is asking their needs be considered when equipment and tests are allocated.
Addressing coronavirus’s impact on agriculture
Getting financial relief to farmers: Klobuchar is a senior member of the Senate Agriculture Committee and has been hearing from farmers that prices they’re getting for their commodities are starting to fall drastically. She’s proposing getting farmers credit and addressing these low commodity prices by expanding the safety net for farmers.
Klobuchar is a senior member of the Senate Agriculture Committee and has been hearing from farmers that prices they’re getting for their commodities are starting to fall drastically. She’s proposing getting farmers credit and addressing these low commodity prices by expanding the safety net for farmers. Protecting farm workers and food processors: Coronavirus outbreaks at large farms and food processing plants aren’t just worrisome for public health; they could also wreak havoc on the food supply chain. Already, one of the nation’s largest pork processing plants in Sioux Falls, South Dakota, shut down after a coronavirus outbreak among employees. Klobuchar (like other Democrats in the House and Senate) is calling for increased Occupational Safety and Health Administration regulations that protect workers on the job for food processing and farm workers, as well as training for these workers in multiple languages, as many are immigrants.
Coronavirus outbreaks at large farms and food processing plants aren’t just worrisome for public health; they could also wreak havoc on the food supply chain. Already, one of the nation’s largest pork processing plants in Sioux Falls, South Dakota, shut down after a coronavirus outbreak among employees. Klobuchar (like other Democrats in the House and Senate) is calling for increased Occupational Safety and Health Administration regulations that protect workers on the job for food processing and farm workers, as well as training for these workers in multiple languages, as many are immigrants. Keeping the food supply chain running: Klobuchar is proposing a number of other measures like exempting commercial truck drivers from state travel restrictions and providing emergency funding for the nation’s ports.
Klobuchar is proposing a number of other measures like exempting commercial truck drivers from state travel restrictions and providing emergency funding for the nation’s ports. Increasing SNAP and other food security programs: Klobuchar is echoing a demand from Democratic leaders in the House and Senate — increased funding for food security programs like SNAP and increased benefits for teenage family members to make sure low-income families and children have enough food.
Support for small businesses
Increased funding for small-business loans: A small-business loan fund that was set up by the CARES Act is already running out of money and is the subject of congressional negotiations between Republicans and Democrats. Klobuchar is arguing that businesses need increased access to loans and grants but also is calling for increased technical assistance for rural small businesses.
A small-business loan fund that was set up by the CARES Act is already running out of money and is the subject of congressional negotiations between Republicans and Democrats. Klobuchar is arguing that businesses need increased access to loans and grants but also is calling for increased technical assistance for rural small businesses. Expanded access to child care: There’s already limited access to child care in rural areas, and the recent closure of schools in many states has exacerbated the problem. Klobuchar is calling for increased funding for the Child Care and Development Block Grant and increasing subsidies to encourage more rural child care centers to open and have money to operate during coronavirus.
Rural broadband and more funds for state and local programs
Rural broadband: One issue Democrats have long wanted to address as part of a larger infrastructure package is the lack of high-speed broadband internet in many rural areas. Klobuchar argues that’s especially important now, as families must shelter in place and do work and school from home. It’s also essential for unemployed workers trying to apply for benefits from home. It could take months to develop an infrastructure program, so Klobuchar proposes additional funding to the E-Rate program to provide wifi hotspots to students who don’t have broadband at home.
One issue Democrats have long wanted to address as part of a larger infrastructure package is the lack of high-speed broadband internet in many rural areas. Klobuchar argues that’s especially important now, as families must shelter in place and do work and school from home. It’s also essential for unemployed workers trying to apply for benefits from home. It could take months to develop an infrastructure program, so Klobuchar proposes additional funding to the E-Rate program to provide wifi hotspots to students who don’t have broadband at home. Affordable housing: Klobuchar is pushing for enforcement of a temporary eviction moratorium on properties with federally backed mortgages and calling for increased emergency rental assistance for those in rural areas.
Klobuchar is pushing for enforcement of a temporary eviction moratorium on properties with federally backed mortgages and calling for increased emergency rental assistance for those in rural areas. Supporting the US Postal Service: As the Postal Service suffers from a drop in people sending and receiving mail, Klobuchar and other senators and members of Congress are calling for increased federal support to keep it going as an essential public service.
As the coronavirus spreads to rural areas, Congress will likely have to extend more assistance to those areas. As a senator, former presidential candidate, and potential vice presidential contender, Klobuchar may be in a good position to make the case for helping Americans who live there.


vox--2020-04-16--“Take this day by day”: Advice from 5 people around the world in isolation

Over the past few weeks , at least a third of the world ’ s population — including all of India , El Salvador , and most US states — have gone into lockdown .
Their lives have been marked by ambient anxiety about paying rent and staying healthy , a newfound passion for baking , and — at times — boredom .
Few people are equipped to deal with long-term isolation like this .
But while much of the world has only just begun home quarantine , residents of China , Hong Kong , South Korea , Italy , @ @ @ @ @ @ @ isolation for multiple months now , some since mid-January .
Meanwhile , some immunocompromised Americans have also self-isolated for months to protect themselves .
Take it from these folks : While adjusting to a new at-home routine can be incredibly challenging , there are ways to make it work .
Vox spoke with people from across the world who ’ ve been isolating for months .
For those in other countries , many of their anxieties felt different from those facing most Americans , about 12 to 13 percent of which are currently @ @ @ @ @ @ @ has frozen layoffs , and South Korea boasts labor laws that make it hard for companies to fire people in large numbers .
In much of China , life looked close to normal as far back as late February .
Those sorts of protections are not available to the same degree in countries like the U.S .
So it makes sense that the people we talked to discussed playing word-of-the-day games with their kids , streaming live stand-up comedy sessions , and launching Zoom book clubs to pass the time .
But they @ @ @ @ @ @ @ navigating child care and giving yourself space to mess up — Covid-19 is an unprecedented event in our lives , and there ’ s no one right or wrong way to handle it .
Interviews have been condensed and edited for clarity .
Miguel Xia , 25 , a recent graduate currently in Hangzhou , China Socially isolating since late January , but restrictions have eased up .
I was first quarantined just a day after the Lunar New Year when I was in Qingtian .
On January 25 , my family noticed @ @ @ @ @ @ @ and a few people suited up in protective clothing .
Turns out a lady living on the third floor had come back from Wuhan and had developed symptoms .
When the whole town was eventually put in lockdown , each house was given six passes to go out and get essentials .
Each pass allowed a person to leave the neighborhood and go to the nearest supermarkets and back .
I chose to let my family use the passes since they really wanted to go out to walk .
Time lost all meaning @ @ @ @ @ @ @ am and waking up at 2 pm .
I napped a lot , mostly to pass the time .
We watched TV and kept up with the news , occasionally playing cards or mahjong .
We ’ d play board games for a few hours , then watch TV , then cook .
The problem is , I actually live in Portugal .
I just graduated with an engineering degree and went back to visit my family in Qingtian , outside Hangzhou .
My plan was to go back to Portugal in February @ @ @ @ @ @ @ or England .
But obviously that didn ’ t pan out .
Around that time , Europe announced that they ’ re going to cancel all inbound flights from outside of the continent .
At the moment , I ’ ve started to look for potential jobs in China .
I ’ m worried because I don ’ t have any friends here , and my Chinese language level is like a 6-year-old .
As someone who is still looking for work , my advice for quarantine is to do all the things @ @ @ @ @ @ @ had the time or energy .
Organize your home , clean , practice a new language , call those old friends that you haven ’ t talked to in ages .
They might also be in quarantine and be bored as hell , and it ’ s a good way to feel that everyone is in it together .
I ’ m a believer that mental health is affected by physical activity .
Do something at home to work up a sweat , get the heart rate going .
Get as much sun @ @ @ @ @ @ @ Fresh air , too .
And unlike me , try to keep a normal daily schedule .
I ’ m not as anxious as I could be about staying here because , in a way , China is a second home .
But ultimately , it ’ s helped me most to accept my situation .
I ’ ve pretty much decided that for the time being , I ’ m just going to stay here and look for an English-teaching job .
I don ’ t know when I can go home @ @ @ @ @ @ @ helps me take this day by day .
“ I think about three things I ’ m grateful for .
It sounds really hokey , but after about a month I noticed that I sort of coaxed my brain into a more positive space.
” Nora , 25 , an educator based in Beijing ( currently in San Jose , California ) Has been socially isolating since late January .
Quarantine measures started in late January in Beijing , around the same time as Chinese New Year .
I mostly stayed calm during @ @ @ @ @ @ @ used to being really busy , and it was nice to have some time to myself .
I wrote , read , and did some painting , but I didn ’ t force myself to do anything .
At night , I would go to my friend ’ s bar , which was closed to the public , and play games with him and a couple of other people .
This was safe to do in Beijing because of the vast infrastructure that could be easily devoted solely to combating the spread of @ @ @ @ @ @ @ public transport or enter certain public spaces , you have to wear a mask and not be running a fever .
A security guard would usually take my temperature when I entered or left my residential compound or went to the store or got on the subway .
Helping others in my circle of friends take care of their mental health felt really good .
When I felt worn down after about a month , my friends took care of me .
We really banded together and created our own small community where @ @ @ @ @ @ @ , or things we could do safely or via Zoom or WeChat calls .
However , I ’ m now stranded in the US indefinitely because of visa issues .
China has closed its borders temporarily to foreign nationals and I ’ m in the Bay Area .
Since people here don ’ t usually wear a mask and there ’ s less enforcement of directives , I find that I ’ m much more worried about actually getting the virus here than I was in Beijing , although I don ’ t @ @ @ @ @ @ @ all .
I stay inside much more , and unless I need to go to the consulate or to go on a walk , I try not to leave my friend ’ s house whom I ’ m staying with .
Truthfully , I ’ m really worn down after about nine or 10 weeks of this , to the point that even my panic feels blunted .
But what ’ s been helpful for me is to set up a sort of skeleton of a schedule , and then if I deviate @ @ @ @ @ @ @ really punish myself for it .
I make sure to stay hydrated by drinking lots of hot water with lemon ; the minor prep that goes into it keeps me grounded .
My friend I ’ m staying with started a quarantine book club — we ’ re going to have a meeting on Zoom in a couple of days .
I paint a lot more , and I listen to music to process my emotions .
Last year , before this virus , I started doing this thing where once a day @ @ @ @ @ @ @ m grateful for .
It sounds really hokey , but after about a month , I noticed that I sort of coaxed my brain into a more positive space .
I still do it now and I think it ’ s been really helpful even despite my anxiety and a deeper preoccupation with illness and death .
Once a day , I try to set aside some time to think about at least two people I know and think about what I appreciate and miss about them .
Sometimes I tell them as @ @ @ @ @ @ @ .
When and if I get to see my friends again , I will hug them very , very tightly , provided it ’ s safe to .
“ My biggest piece of advice is to give yourself grace and just keep telling yourself this is not normal .
This is a pandemic.
” The weekend quarantine started , late February , there was a big Carnevale party .
It ’ s a giant street party , shoulder to shoulder , and then the next day we essentially went on lockdown .
The @ @ @ @ @ @ @ t open , but some restaurants were .
My kids still had swim lessons , but they were trying to social distance at the pool .
It was these ridiculous half-measures .
Finally , we were put on lockdown , which honestly was a relief .
I think everyone was , in a way , like , “ Okay , let ’ s get this moving .
Let ’ s work on fixing this together.
” Now I have good days and bad days .
My kids are 3 and 6 , so @ @ @ @ @ @ @ They take a lot of attention .
It ’ s exhausting .
My dream wasn ’ t to be a stay-at-home mom or a homeschooling mom .
I don ’ t feel like I ’ m the best to give advice on “ Try these six crafts.
” Sometimes it can feel pretty overwhelming .
Yesterday my 3-year-old emptied every single puzzle and the entire house into a laundry basket , like a puzzle soup .
It ’ s just like that all day long .
Meanwhile , I had been trying really @ @ @ @ @ @ @ speed with her Italian first-grade schoolwork , but now it looks like the kids won ’ t be returning to school this school year , so my drive to keep up with her reading and writing in Italian is getting less and less .
When I am looking for things to do or seeing what these other people are doing , I can start comparing myself and then I ’ m like , “ Oh , why am I not great at managing my kids ?
” and , “ Why are my @ @ @ @ @ @ @ I think that is just not helpful .
If anything , my biggest piece of advice is to give yourself grace and just keep telling yourself this is not normal .
This is a pandemic .
Yes , we want to educate our kids .
Yes , we want to keep them stimulated .
We don ’ t want them to watch too much on screens .
But at the same time , you have to keep yourself mentally healthy .
You can ’ t beat yourself up .
“ I ’ m @ @ @ @ @ @ @ responding with fear .
Sitting with the change until it makes sense.
” Charis Hill , an activist and the co-creator of # HighRiskCovid19 in Sacramento , California Has been socially isolating since early March I have Ankylosing spondylitis , and I ’ m immunocompromised because of the medication .
I was very nervous toward the end of February about leaving my house .
By the first week of March , I finally quit all of that and started staying home except for emergencies .
Living with a chronic disease , I ’ @ @ @ @ @ @ @ of anxiety in my daily life .
Chronic disease teaches you to adjust rapidly to new trauma .
I ’ m professionally disabled , so I receive money from the Social Security Administration every month .
Not enough to live on , but it is a constant .
Day to day , I ’ m intentionally not reading the news , not reading clinical research studies , because that ’ s not going to change how I live right now .
Knowing more at this point isn ’ t going to change the @ @ @ @ @ @ @ daily self-care .
I need to eat , I need to sleep , I need to survive .
Because of my chronic disease , I adapt in my normal life regardless of whether there ’ s a pandemic .
So , with each new symptom in my body , I adapt to it .
I think I ’ m approaching the pandemic in that same way , where I ’ m just allowing things to change instead of responding with fear .
Sitting with the change until it makes sense .
I ’ @ @ @ @ @ @ @ “ Okay , you need to rest now , ” or , “ It ’ s time to go outside and look at your plants.
” But I ’ m also thinking about the future .
When I ’ m going to have a potluck again or how I ’ m going to celebrate with people when they can be together again .
Looking ahead in that way is helping a lot .
I ’ m even welcoming a stray cat into my house .
It ’ s stressful , but it ’ @ @ @ @ @ @ @ making me focus on nurturing a new thing .
One way to adapt is to develop a new passion and give yourself permission to explore things that you never gave yourself permission to do before .
“ We make events out of everything .
Our kids are becoming real members of the household with their new chores and responsibilities.
” Jenna Pallio , an elementary art teacher in Milan , Italy Has been socially isolating since early March I haven ’ t left my apartment in weeks .
My husband goes grocery shopping @ @ @ @ @ @ @ , and waits in line for one hour , sometimes two .
I have two small children .
Luckily we have balconies , so we just go out on the balcony .
But they haven ’ t been out of the house in weeks , either .
I teach art , so I ’ m preparing video lessons and then I have one daughter who ’ s in kindergarten , so she has a program every day that her teacher sent her .
I ’ m not that worried about losing my job @ @ @ @ @ @ @ international school so I feel pretty secure in that .
I do expect budget and pay cuts , but I think we will be okay .
[ Italy also has a freeze on laying off workers . ]
I ’ m finding things I never thought would give me satisfaction now do .
Like pizza night on Fridays are a huge deal .
Or household chores that I hate .
Because I ’ ve been home , I ’ m enjoying taking more time cooking and cleaning and organizing things , and also @ @ @ @ @ @ @ the same time .
We make events out of everything .
Our kids are becoming real members of the household with their new chores and responsibilities .
We tell them they are “ helpers , ” such as a lunch helper or a dinner helper .
They started to mop our balconies and they love it .
We started doing “ word of the day.
” We ’ re making up games and jokes and routines to lighten up the day and make it fun for everyone .
Last night we literally , @ @ @ @ @ @ @ and lip-synced songs together .
I know it sounds crazy , but I feel so connected with my family and I do feel like we ’ re making memories .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power to save lives .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than @ @ @ @ @ @ @ explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
Please consider making a contribution to Vox today .

Over the past few weeks, at least a third of the world’s population — including all of India, El Salvador, and most US states — have gone into lockdown. Their lives have been marked by ambient anxiety about paying rent and staying healthy, a newfound passion for baking, and — at times — boredom.
Few people are equipped to deal with long-term isolation like this. But while much of the world has only just begun home quarantine, residents of China, Hong Kong, South Korea, Italy, and elsewhere have faced movement restrictions and isolation for multiple months now, some since mid-January. Meanwhile, some immunocompromised Americans have also self-isolated for months to protect themselves. Take it from these folks: While adjusting to a new at-home routine can be incredibly challenging, there are ways to make it work.
Vox spoke with people from across the world who’ve been isolating for months. For those in other countries, many of their anxieties felt different from those facing most Americans, about 12 to 13 percent of which are currently unemployed. Italy, for instance, has frozen layoffs, and South Korea boasts labor laws that make it hard for companies to fire people in large numbers. In much of China, life looked close to normal as far back as late February. Those sorts of protections are not available to the same degree in countries like the U.S.
So it makes sense that the people we talked to discussed playing word-of-the-day games with their kids, streaming live stand-up comedy sessions, and launching Zoom book clubs to pass the time. But they also spoke of the constant struggle of navigating child care and giving yourself space to mess up — Covid-19 is an unprecedented event in our lives, and there’s no one right or wrong way to handle it.
Interviews have been condensed and edited for clarity.
“Take this day by day”
Miguel Xia, 25, a recent graduate currently in Hangzhou, China
Socially isolating since late January, but restrictions have eased up.
I was first quarantined just a day after the Lunar New Year when I was in Qingtian. On January 25, my family noticed an ambulance outside of our apartment building and a few people suited up in protective clothing. Turns out a lady living on the third floor had come back from Wuhan and had developed symptoms.
When the whole town was eventually put in lockdown, each house was given six passes to go out and get essentials. Each pass allowed a person to leave the neighborhood and go to the nearest supermarkets and back. I chose to let my family use the passes since they really wanted to go out to walk.
Time lost all meaning. I soon started sleeping at 6 am and waking up at 2 pm. I napped a lot, mostly to pass the time. We watched TV and kept up with the news, occasionally playing cards or mahjong. We’d play board games for a few hours, then watch TV, then cook.
The problem is, I actually live in Portugal. I just graduated with an engineering degree and went back to visit my family in Qingtian, outside Hangzhou. My plan was to go back to Portugal in February and then look for jobs in Germany or England. But obviously that didn’t pan out. Around that time, Europe announced that they’re going to cancel all inbound flights from outside of the continent. At the moment, I’ve started to look for potential jobs in China. I’m worried because I don’t have any friends here, and my Chinese language level is like a 6-year-old.
As someone who is still looking for work, my advice for quarantine is to do all the things that you needed to do but never had the time or energy. Organize your home, clean, practice a new language, call those old friends that you haven’t talked to in ages. They might also be in quarantine and be bored as hell, and it’s a good way to feel that everyone is in it together.
I’m a believer that mental health is affected by physical activity. Do something at home to work up a sweat, get the heart rate going. Get as much sun by the window as you can. Fresh air, too. And unlike me, try to keep a normal daily schedule.
I’m not as anxious as I could be about staying here because, in a way, China is a second home. But ultimately, it’s helped me most to accept my situation. I’ve pretty much decided that for the time being, I’m just going to stay here and look for an English-teaching job. I don’t know when I can go home. But focusing on the new reality helps me take this day by day.
“I think about three things I’m grateful for. It sounds really hokey, but after about a month I noticed that I sort of coaxed my brain into a more positive space.”
Nora, 25, an educator based in Beijing (currently in San Jose, California)
Has been socially isolating since late January.
Quarantine measures started in late January in Beijing, around the same time as Chinese New Year. I mostly stayed calm during the first few weeks.
I was used to being really busy, and it was nice to have some time to myself. I wrote, read, and did some painting, but I didn’t force myself to do anything. At night, I would go to my friend’s bar, which was closed to the public, and play games with him and a couple of other people. This was safe to do in Beijing because of the vast infrastructure that could be easily devoted solely to combating the spread of the virus. In order to ride public transport or enter certain public spaces, you have to wear a mask and not be running a fever. A security guard would usually take my temperature when I entered or left my residential compound or went to the store or got on the subway.
Helping others in my circle of friends take care of their mental health felt really good. When I felt worn down after about a month, my friends took care of me. We really banded together and created our own small community where we scheduled coworking days, small outings, or things we could do safely or via Zoom or WeChat calls.
However, I’m now stranded in the US indefinitely because of visa issues. China has closed its borders temporarily to foreign nationals and I’m in the Bay Area. Since people here don’t usually wear a mask and there’s less enforcement of directives, I find that I’m much more worried about actually getting the virus here than I was in Beijing, although I don’t advocate this approach for the US at all. I stay inside much more, and unless I need to go to the consulate or to go on a walk, I try not to leave my friend’s house whom I’m staying with.
Truthfully, I’m really worn down after about nine or 10 weeks of this, to the point that even my panic feels blunted. But what’s been helpful for me is to set up a sort of skeleton of a schedule, and then if I deviate from it, I don’t really punish myself for it.
I make sure to stay hydrated by drinking lots of hot water with lemon; the minor prep that goes into it keeps me grounded. My friend I’m staying with started a quarantine book club — we’re going to have a meeting on Zoom in a couple of days. I paint a lot more, and I listen to music to process my emotions.
Last year, before this virus, I started doing this thing where once a day I think about three things I’m grateful for. It sounds really hokey, but after about a month, I noticed that I sort of coaxed my brain into a more positive space. I still do it now and I think it’s been really helpful even despite my anxiety and a deeper preoccupation with illness and death. Once a day, I try to set aside some time to think about at least two people I know and think about what I appreciate and miss about them. Sometimes I tell them as much, sometimes I don’t. When and if I get to see my friends again, I will hug them very, very tightly, provided it’s safe to.
“My biggest piece of advice is to give yourself grace and just keep telling yourself this is not normal. This is a pandemic.”
Julie Cohen, a freelance writer in Sacile, Italy
Socially isolating since late February.
The weekend quarantine started, late February, there was a big Carnevale party. It’s a giant street party, shoulder to shoulder, and then the next day we essentially went on lockdown.
The first two weeks, school wasn’t open, but some restaurants were. My kids still had swim lessons, but they were trying to social distance at the pool. It was these ridiculous half-measures.
Finally, we were put on lockdown, which honestly was a relief. I think everyone was, in a way, like, “Okay, let’s get this moving. Let’s work on fixing this together.”
Now I have good days and bad days. My kids are 3 and 6, so they’re not easy ages. They take a lot of attention. It’s exhausting. My dream wasn’t to be a stay-at-home mom or a homeschooling mom. I don’t feel like I’m the best to give advice on “Try these six crafts.” Sometimes it can feel pretty overwhelming. Yesterday my 3-year-old emptied every single puzzle in the entire house into a laundry basket, like a puzzle soup. It’s just like that all day long.
Meanwhile, I had been trying really hard to keep my daughter up to speed with her Italian first-grade schoolwork, but now it looks like the kids won’t be returning to school this school year, so my drive to keep up with her reading and writing in Italian is getting less and less.
When I am looking for things to do or seeing what these other people are doing, I can start comparing myself and then I’m like, “Oh, why am I not great at managing my kids?” and, “Why are my kids not as independent?”
But I think that is just not helpful. If anything, my biggest piece of advice is to give yourself grace and just keep telling yourself this is not normal. This is a pandemic. Yes, we want to educate our kids. Yes, we want to keep them stimulated. We don’t want them to watch too much on screens. But at the same time, you have to keep yourself mentally healthy. You can’t beat yourself up.
“I’m just allowing things to change instead of responding with fear. Sitting with the change until it makes sense.”
Charis Hill, an activist and the co-creator of #HighRiskCovid19 in Sacramento, California
Has been socially isolating since early March
I have Ankylosing spondylitis, and I’m immunocompromised because of the medication. I was very nervous toward the end of February about leaving my house. By the first week of March, I finally quit all of that and started staying home except for emergencies.
Living with a chronic disease, I’m used to having a certain level of anxiety in my daily life. Chronic disease teaches you to adjust rapidly to new trauma. I’m professionally disabled, so I receive money from the Social Security Administration every month. Not enough to live on, but it is a constant.
Day to day, I’m intentionally not reading the news, not reading clinical research studies, because that’s not going to change how I live right now. Knowing more at this point isn’t going to change the fact that I need to do my daily self-care. I need to eat, I need to sleep, I need to survive.
Because of my chronic disease, I adapt in my normal life regardless of whether there’s a pandemic. So, with each new symptom in my body, I adapt to it. I think I’m approaching the pandemic in that same way, where I’m just allowing things to change instead of responding with fear. Sitting with the change until it makes sense.
I’m letting my anxiety tell me, “Okay, you need to rest now,” or, “It’s time to go outside and look at your plants.” But I’m also thinking about the future. When I’m going to have a potluck again or how I’m going to celebrate with people when they can be together again. Looking ahead in that way is helping a lot.
I’m even welcoming a stray cat into my house. It’s stressful, but it’s also good because it’s making me focus on nurturing a new thing. One way to adapt is to develop a new passion and give yourself permission to explore things that you never gave yourself permission to do before.
“We make events out of everything. Our kids are becoming real members of the household with their new chores and responsibilities.”
Jenna Pallio, an elementary art teacher in Milan, Italy
Has been socially isolating since early March
I haven’t left my apartment in weeks. My husband goes grocery shopping once a week, wearing a mask, and waits in line for one hour, sometimes two. I have two small children. Luckily we have balconies, so we just go out on the balcony. But they haven’t been out of the house in weeks, either.
I teach art, so I’m preparing video lessons and then I have one daughter who’s in kindergarten, so she has a program every day that her teacher sent her. I’m not that worried about losing my job because I am a teacher at an international school so I feel pretty secure in that. I do expect budget and pay cuts, but I think we will be okay. [Italy also has a freeze on laying off workers.]
I’m finding things I never thought would give me satisfaction now do. Like pizza night on Fridays are a huge deal. Or household chores that I hate. Because I’ve been home, I’m enjoying taking more time cooking and cleaning and organizing things, and also being okay with a huge mess at the same time.
We make events out of everything. Our kids are becoming real members of the household with their new chores and responsibilities. We tell them they are “helpers,” such as a lunch helper or a dinner helper. They started to mop our balconies and they love it.
We started doing “word of the day.” We’re making up games and jokes and routines to lighten up the day and make it fun for everyone. Last night we literally, like, drew faces on our chins and lip-synced songs together. I know it sounds crazy, but I feel so connected with my family and I do feel like we’re making memories.


vox--2020-04-16--Coronavirus is causing a mental health crisis. Here’s how to fight it.

Austin Hollinger has been dealing with depression and post-traumatic stress disorder for several years , ever since he was bullied at school .
Now 19 , he relies a lot on his friends to help him feel better day to day .
Hollinger is disabled and doesn ’ t drive , so his friends would often come to him .
But with Alabama , where he lives , under a shelter-in-place order , most of them aren ’ t able to visit anymore .
“ I ’ ve been very isolated , ” he said , “ which is not @ @ @ @ @ @ @ a message many mental health experts have been sending in recent weeks , as millions of Americans face not just the spread of a new and dangerous virus , but also the measures necessary to stem that spread , which can cut people off from friends , family , therapists , and others who could ordinarily support them through difficult times .
As weeks of distancing turn into months , many people are experiencing a greater and greater sense of isolation .
They ’ re also dealing with the uncertainty of when and @ @ @ @ @ @ @ fear of getting infected , the economic crisis that has cost millions of Americans their jobs , and the inconsistent messaging about the virus from authority figures .
“ All aspects of life are affected ” by the pandemic , said Arash Javanbakht , a psychiatrist and trauma specialist .
“ It was like one day , everything changed.
” And many are concerned that the painful changes brought about by the coronavirus pandemic will cause a spike in mental health problems that could persist long after the most immediate threat of the @ @ @ @ @ @ @ been the case with other major disasters , like Hurricane Katrina , said Lisa Meredith , a senior behavioral scientist at the Rand Corporation think tank who has studied disaster preparedness .
“ It ’ s not just during the event , ” she said .
“ People will be stressed afterward.
” Among people who contract Covid-19 and need to be hospitalized , experts expect to see high levels of post-traumatic stress disorder and depression .
Experts are also concerned about health care workers who are on the front lines battling the @ @ @ @ @ @ @ to keep them safe .
A recent study of health care workers treating Covid-19 patients in China has already confirmed some of these concerns , finding considerable rates of anxiety , insomnia , and depressive symptoms .
As Laura Hawryluck , an associate professor of critical care medicine at the University of Toronto , told Vox , “ health care workers are people too.
” And while the current crisis is stressful for everyone , people who already have conditions like anxiety or depression may be especially at risk , psychologists say .
@ @ @ @ @ @ @ example , “ any new stressor can make it worse , ” Javanbakht said .
It ’ s possible to mitigate some of these effects now if those affected have access to treatment , mental health experts say .
But that will require an expansion of telemedicine to make sure people can get therapy safely while socially distancing .
And it will require policymakers and society as a whole to take the psychological impact of the pandemic , not just its threats to physical health , seriously .
The stress and isolation of @ @ @ @ @ @ @ toll on Americans ’ mental health It ’ s safe to say that billions of people around the world are in a stressful situation right now .
For many , life changed nearly overnight , with little time to prepare , Javanbakht noted .
Some are now trying to work from home while caring for children .
Others have been laid off or furloughed and may be worried about how they will pay their bills .
Meanwhile , people are getting a lot of contradictory information about the virus and the measures needed @ @ @ @ @ @ @ While President Trump may say one thing , public health officials may say another .
“ It ’ s confusing and stressing , ” Javanbakht said .
Feeling powerless in the face of such a widespread threat is common and real .
“ When we are dealing with a difficult situation , the more control we have , the less stressed we are , ” Javanbakht said .
But for many people right now , “ the only control we have is to sit at home.
” The fact that many people are @ @ @ @ @ @ @ ones in person only makes the situation worse .
“ Social distancing is really hard on people , and it ’ s especially taking its toll on people who are isolated at home alone , ” Meredith said .
“ Loneliness can be a big source of stress.
” Even under more normal circumstances , prolonged loneliness can contribute to depression and anxiety , as well as to physical health problems .
One 2016 study , for example , found that being lonely was associated with an increased risk of stroke and heart @ @ @ @ @ @ @ of loneliness could be magnified by the stress of living during a pandemic .
For people who are social distancing right now , “ there is a high risk that they ’ re going to become more anxious , much more depressed , and it ’ s going to have longer-term effects , ” Rima Styra , an associate professor of psychiatry at the University of Toronto , told Vox .
Overall , a lot of people around the world are experiencing a dip in mental well-being .
Factors from “ looming severe @ @ @ @ @ @ @ imposition of unfamiliar public health measures that infringe on personal freedoms ” are likely to increase emotional distress during this time , psychiatry professors Betty Pfefferbaum and Carol S. North wrote in a paper published this week in the New England Journal of Medicine .
Still , while many people may experience greater feelings of anxiousness in the pandemic than usual , most who experience such distress will likely not develop a clinical mental health condition .
“ After disasters , most people are resilient and do not succumb to psychopathology , ” @ @ @ @ @ @ @ , some people find new strengths.
” But the pandemic does have the potential to trigger or worsen clinical conditions like anxiety and depression .
And experts say that some groups of people are at especially high risk .
Health care workers , people who get sick , and those with existing mental health conditions could be especially at risk One such group is Covid-19 patients themselves .
Patients can experience delirium and agitation as a result of the virus , said Hawryluck , who has treated people with the disease .
Being @ @ @ @ @ @ @ a ventilator , which requires medication that can increase confusion , can add to this effect .
“ We know that survivors from intensive care do have a lot of psychological symptoms ” that match conditions from depression to PTSD , Hawryluck said .
“ I think it ’ s going to be higher in this population just based on what we ’ re already seeing.
” In addition to patients , health care workers are also at risk of the most serious mental health effects of the pandemic .
“ We share @ @ @ @ @ @ @ as anyone right now , Hawryluck said — and health care workers may even be more fearful because they have seen the full extent of what the virus can do at its worst .
They also must deal with the prospect of losing patients , and the task of delivering terrible news to families — often by phone , because the family members of Covid-19 patients are typically not allowed to visit hospitals .
On top of that , they face their own risk of infection because of shortages of protective equipment .
@ @ @ @ @ @ @ , “ they ’ re still going home and self-isolating in the way everybody else is , so they have all of that impact as well , ” Hawryluck said .
Some health care workers are even more isolated than others , staying in hotels or even in their cars to avoid infecting family members .
The combined impact of these stressors could lead to mental health diagnoses and , in the long term , could cause people to leave the health care field , Hawryluck said : “ I think , unfortunately @ @ @ @ @ @ @ not necessarily want to continue in their career.
” A third group that could face added risk is those who had mental health conditions before the pandemic began .
People with addiction , for example , may not be able to meet with their support groups or get access to medication-assisted treatment during this time , Meredith said .
People with conditions like anxiety , depression , schizophrenia , or PTSD may find their symptoms worsened by the stress of living during a pandemic , Javanbakht said .
That ’ s doubly true @ @ @ @ @ @ @ diagnosis gets Covid-19 .
“ We all need to be conscious of how scary it is for somebody to need to be admitted to hospital who ’ s got underlying mental health issues , ” Styra , who has treated patients with the disease , told Vox .
Even after they recover from the virus , “ people with underlying illnesses are going to need a lot more help from their psychiatrists and their mental health teams , ” she said .
Experts say without a major policy response , the mental health @ @ @ @ @ @ @ after the crisis has passed Some mental health service providers are already seeing an uptick in people reaching out during the pandemic .
Crisis counselors at the California-based nonprofit Didi Hirsch Mental Health Services , for example , got 1,800 calls related to Covid-19 in March , up from just 20 in February , according to the Los Angeles Times .
And experts fear that , for some , the mental health impact of the crisis could last even after the pandemic — or , at least , its current phase — has @ @ @ @ @ @ @ , people in New Orleans who had been affected by the storm reported trouble going to work during hurricane season due to reactivated trauma , Meredith said .
The SARS epidemic in 2003 also led to high rates of PTSD and depression among patients who had contracted the disease , Styra said .
And research in Sierra Leone has found that people affected by the Ebola epidemic experienced high rates of depression , anxiety , and PTSD symptoms as well .
However , there are public health and policy measures that can help @ @ @ @ @ @ @ — and insurance coverage of — telemedicine for mental health care .
Many insurance providers have begun covering telemedicine during this time , and the Trump administration has announced that Medicare will expand such coverage to help reduce the need for seniors to travel to health care facilities where they could be exposed to the virus .
But coverage for telemedicine should continue long after the immediate crisis has passed , many say .
“ A lot of our patients have to drive 50 , 60 , 80 miles to get to a @ @ @ @ @ @ @ ” Javanbakht said , an especially difficult task for low-income patients without reliable transportation or child care .
State and local governments are also recognizing the importance of offering remote mental health support .
New York has announced an initiative to provide free phone or video chat support to people dealing with the mental health impact of the crisis , with more than 6,000 psychiatrists , psychologists , and other clinicians volunteering their time .
“ We talk about the economic consequences , but we also need to talk about the social consequences @ @ @ @ @ @ @ when he announced the program in March .
“ But the stress , the anxiety , the emotions that are provoked by this crisis are truly significant , and people are struggling with the emotions as much as they are struggling with the economics.
” Also crucial for mitigating the mental health effects of this crisis — and the next — is simple preparedness , Meredith said .
For hospitals , having appropriate plans in place for allocating resources and housing patients isn ’ t just about caring for people ’ s physical @ @ @ @ @ @ @ the mental health of everyone involved .
And leaders should be trained in how to communicate with the public about the risks of the virus and other threats .
For people in power , being transparent and empathetic — “ showing the public that you ’ re in it with them ” — can help reduce the stress ordinary people feel during a time like this , Meredith said .
And while they aren ’ t a substitute for mental health treatment , there are things people can do to feel better during @ @ @ @ @ @ @ important when possible , Javanbakht said .
One of his patients , he noted , has begun taking walks with her husband when she would ordinarily be driving to or from work .
“ They call it commute time , ” he said .
For those who have the time and energy , learning a new skill like gardening can also have a psychological impact .
“ For a lot of us , our sense of productivity and purpose is decreased , ” Javanbakht said .
“ That ’ s a way of @ @ @ @ @ @ @ important to maintain social relationships as much as possible using phone calls , FaceTime , and other remote communication .
For that reason , Javanbakht prefers the term “ physical distancing ” rather than social distancing to describe how people should behave right now .
“ We can be physically distanced and socially very connected , ” he said .
Living under a shelter-in-place order , Hollinger has been staying in touch with his friends by text and phone when he can .
“ They ’ ve been as supportive as possible , @ @ @ @ @ @ @ he ’ s also been continuing to record music , releasing a single in April and trying to finish an album .
“ I have so much material over the past three months , ” he said .
While he and others are finding ways to be creative amid the pandemic , millions of Americans remain in a state of extreme uncertainty , unsure when , if ever , they can resume their normal lives .
That can take a psychological toll .
But a positive change since the days of SARS is @ @ @ @ @ @ @ crisis is getting a lot of attention , Hawryluck said — not just from experts and policymakers but also from the media , with widespread discussions and tips for coping with stress .
“ At least this time , ” she said , “ people are talking about it.
” Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power to save lives .
Our mission has never been more vital than it @ @ @ @ @ @ @ you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
Please consider making a contribution to Vox today .

Austin Hollinger has been dealing with depression and post-traumatic stress disorder for several years, ever since he was bullied at school. Now 19, he relies a lot on his friends to help him feel better day to day.
Hollinger is disabled and doesn’t drive, so his friends would often come to him. But with Alabama, where he lives, under a shelter-in-place order, most of them aren’t able to visit anymore.
“I’ve been very isolated,” he said, “which is not good for anyone.”
It’s a message many mental health experts have been sending in recent weeks, as millions of Americans face not just the spread of a new and dangerous virus, but also the measures necessary to stem that spread, which can cut people off from friends, family, therapists, and others who could ordinarily support them through difficult times.
As weeks of distancing turn into months, many people are experiencing a greater and greater sense of isolation. They’re also dealing with the uncertainty of when and how the pandemic will end, the fear of getting infected, the economic crisis that has cost millions of Americans their jobs, and the inconsistent messaging about the virus from authority figures.
“All aspects of life are affected” by the pandemic, said Arash Javanbakht, a trauma specialist and assistant professor of psychiatry at Wayne State University. “It was like one day, everything changed.”
And many are concerned that the painful changes brought about by the coronavirus pandemic will cause a spike in mental health problems that could persist long after the most immediate threat of the virus is over. That’s been the case with other major disasters, like Hurricane Katrina, said Lisa Meredith, a senior behavioral scientist at the Rand Corporation think tank who has studied disaster preparedness. “It’s not just during the event,” she said. “People will be stressed afterward.”
Among people who contract Covid-19 and need to be hospitalized, experts expect to see high levels of post-traumatic stress disorder and depression. Experts are also concerned about health care workers who are on the front lines battling the virus, sometimes without the appropriate equipment to keep them safe. A recent study of health care workers treating Covid-19 patients in China has already confirmed some of these concerns, finding considerable rates of anxiety, insomnia, and depressive symptoms. As Laura Hawryluck, an associate professor of critical care medicine at the University of Toronto, told Vox, “health care workers are people too.”
And while the current crisis is stressful for everyone, people who already have conditions like anxiety or depression may be especially at risk, psychologists say. For people with anxiety disorders, for example, “any new stressor can make it worse,” Javanbakht said.
It’s possible to mitigate some of these effects now if those affected have access to treatment, mental health experts say. But that will require an expansion of telemedicine to make sure people can get therapy safely while socially distancing. And it will require policymakers and society as a whole to take the psychological impact of the pandemic, not just its threats to physical health, seriously.
The stress and isolation of living in a pandemic are taking their toll on Americans’ mental health
It’s safe to say that billions of people around the world are in a stressful situation right now. For many, life changed nearly overnight, with little time to prepare, Javanbakht noted. Some are now trying to work from home while caring for children. Others have been laid off or furloughed and may be worried about how they will pay their bills.
Meanwhile, people are getting a lot of contradictory information about the virus and the measures needed to combat it, Javanbakht said. While President Trump may say one thing, public health officials may say another. “It’s confusing and stressing,” Javanbakht said.
Feeling powerless in the face of such a widespread threat is common and real. “When we are dealing with a difficult situation, the more control we have, the less stressed we are,” Javanbakht said. But for many people right now, “the only control we have is to sit at home.”
The fact that many people are unable to see their friends and loved ones in person only makes the situation worse. “Social distancing is really hard on people, and it’s especially taking its toll on people who are isolated at home alone,” Meredith said. “Loneliness can be a big source of stress.”
Even under more normal circumstances, prolonged loneliness can contribute to depression and anxiety, as well as to physical health problems. One 2016 study, for example, found that being lonely was associated with an increased risk of stroke and heart disease. Today, the ordinary risks of loneliness could be magnified by the stress of living during a pandemic. For people who are social distancing right now, “there is a high risk that they’re going to become more anxious, much more depressed, and it’s going to have longer-term effects,” Rima Styra, an associate professor of psychiatry at the University of Toronto, told Vox.
Overall, a lot of people around the world are experiencing a dip in mental well-being. Factors from “looming severe shortages of resources” to the “imposition of unfamiliar public health measures that infringe on personal freedoms” are likely to increase emotional distress during this time, psychiatry professors Betty Pfefferbaum and Carol S. North wrote in a paper published this week in the New England Journal of Medicine.
Still, while many people may experience greater feelings of anxiousness in the pandemic than usual, most who experience such distress will likely not develop a clinical mental health condition. “After disasters, most people are resilient and do not succumb to psychopathology,” Pfefferbaum and North wrote. “Indeed, some people find new strengths.”
But the pandemic does have the potential to trigger or worsen clinical conditions like anxiety and depression. And experts say that some groups of people are at especially high risk.
Health care workers, people who get sick, and those with existing mental health conditions could be especially at risk
One such group is Covid-19 patients themselves. Patients can experience delirium and agitation as a result of the virus, said Hawryluck, who has treated people with the disease. Being in an intensive care unit and using a ventilator, which requires medication that can increase confusion, can add to this effect. “We know that survivors from intensive care do have a lot of psychological symptoms” that match conditions from depression to PTSD, Hawryluck said. “I think it’s going to be higher in this population just based on what we’re already seeing.”
In addition to patients, health care workers are also at risk of the most serious mental health effects of the pandemic. “We share a lot of the same fears” as anyone right now, Hawryluck said — and health care workers may even be more fearful because they have seen the full extent of what the virus can do at its worst. They also must deal with the prospect of losing patients, and the task of delivering terrible news to families — often by phone, because the family members of Covid-19 patients are typically not allowed to visit hospitals.
On top of that, they face their own risk of infection because of shortages of protective equipment. And at the end of the day, “they’re still going home and self-isolating in the way everybody else is, so they have all of that impact as well,” Hawryluck said. Some health care workers are even more isolated than others, staying in hotels or even in their cars to avoid infecting family members.
The combined impact of these stressors could lead to mental health diagnoses and, in the long term, could cause people to leave the health care field, Hawryluck said: “I think, unfortunately, a lot of people will probably not necessarily want to continue in their career.”
A third group that could face added risk is those who had mental health conditions before the pandemic began. People with addiction, for example, may not be able to meet with their support groups or get access to medication-assisted treatment during this time, Meredith said. People with conditions like anxiety, depression, schizophrenia, or PTSD may find their symptoms worsened by the stress of living during a pandemic, Javanbakht said.
That’s doubly true if someone with an existing mental health diagnosis gets Covid-19. “We all need to be conscious of how scary it is for somebody to need to be admitted to hospital who’s got underlying mental health issues,” Styra, who has treated patients with the disease, told Vox. Even after they recover from the virus, “people with underlying illnesses are going to need a lot more help from their psychiatrists and their mental health teams,” she said.
Experts say without a major policy response, the mental health effects of the pandemic could linger long after the crisis has passed
Some mental health service providers are already seeing an uptick in people reaching out during the pandemic. Crisis counselors at the California-based nonprofit Didi Hirsch Mental Health Services, for example, got 1,800 calls related to Covid-19 in March, up from just 20 in February, according to the Los Angeles Times.
And experts fear that, for some, the mental health impact of the crisis could last even after the pandemic — or, at least, its current phase — has passed. Even years after Hurricane Katrina, people in New Orleans who had been affected by the storm reported trouble going to work during hurricane season due to reactivated trauma, Meredith said. The SARS epidemic in 2003 also led to high rates of PTSD and depression among patients who had contracted the disease, Styra said. And research in Sierra Leone has found that people affected by the Ebola epidemic experienced high rates of depression, anxiety, and PTSD symptoms as well.
However, there are public health and policy measures that can help. One is more widespread access to — and insurance coverage of — telemedicine for mental health care. Many insurance providers have begun covering telemedicine during this time, and the Trump administration has announced that Medicare will expand such coverage to help reduce the need for seniors to travel to health care facilities where they could be exposed to the virus.
But coverage for telemedicine should continue long after the immediate crisis has passed, many say. “A lot of our patients have to drive 50, 60, 80 miles to get to a psychiatrist or a therapist for care,” Javanbakht said, an especially difficult task for low-income patients without reliable transportation or child care.
State and local governments are also recognizing the importance of offering remote mental health support. New York has announced an initiative to provide free phone or video chat support to people dealing with the mental health impact of the crisis, with more than 6,000 psychiatrists, psychologists, and other clinicians volunteering their time.
“We talk about the economic consequences, but we also need to talk about the social consequences,” Gov. Andrew Cuomo said when he announced the program in March. “But the stress, the anxiety, the emotions that are provoked by this crisis are truly significant, and people are struggling with the emotions as much as they are struggling with the economics.”
Also crucial for mitigating the mental health effects of this crisis — and the next — is simple preparedness, Meredith said. For hospitals, having appropriate plans in place for allocating resources and housing patients isn’t just about caring for people’s physical illnesses — it also helps to protect the mental health of everyone involved. And leaders should be trained in how to communicate with the public about the risks of the virus and other threats. For people in power, being transparent and empathetic — “showing the public that you’re in it with them” — can help reduce the stress ordinary people feel during a time like this, Meredith said.
And while they aren’t a substitute for mental health treatment, there are things people can do to feel better during this time. Keeping to routines is important when possible, Javanbakht said. One of his patients, he noted, has begun taking walks with her husband when she would ordinarily be driving to or from work. “They call it commute time,” he said.
For those who have the time and energy, learning a new skill like gardening can also have a psychological impact. “For a lot of us, our sense of productivity and purpose is decreased,” Javanbakht said. “That’s a way of staying productive.”
It’s also important to maintain social relationships as much as possible using phone calls, FaceTime, and other remote communication. For that reason, Javanbakht prefers the term “physical distancing” rather than social distancing to describe how people should behave right now. “We can be physically distanced and socially very connected,” he said.
Living under a shelter-in-place order, Hollinger has been staying in touch with his friends by text and phone when he can. “They’ve been as supportive as possible,” he said.
A songwriter, he’s also been continuing to record music, releasing a single in April and trying to finish an album. “I have so much material over the past three months,” he said.
While he and others are finding ways to be creative amid the pandemic, millions of Americans remain in a state of extreme uncertainty, unsure when, if ever, they can resume their normal lives. That can take a psychological toll.
But a positive change since the days of SARS is that the mental health impact of the crisis is getting a lot of attention, Hawryluck said — not just from experts and policymakers but also from the media, with widespread discussions and tips for coping with stress. “At least this time,” she said, “people are talking about it.”