The COVID-19 pandemic has resulted in disruptions on the individual and societal experiences of death, dying, and bereavement for the United States and its people. A wave of grief is flowing through individuals, families, and communities in addition to losses associated with cultural norms, rituals, and social practices related to death and mourning, further elevating the complications of grief (Mayland et al, 2020). This sudden rise in mortality, due to COVID-19 becoming a leading cause of death worldwide, can potentially yield concerns regarding population health that are tied to grief and social support reductions (Ashton et al, 2020). According to data published by the Centers for Disease Control and Prevention (CDC), the total deaths due to coronavirus in the United States has now reached 734,752 as of October 26 (CDC, 2021). Given that the pandemic first became a recognizable health threat in March of 2020, this rapid loss of life marks an unprecedented moment for the American public. The COVID-19 pandemic has raised divisive partisan debates on the best course of action in terms of reopening the country, which became a major talking point during the 2020 presidential election. Furthermore, some Americans are more eager to reopen, perhaps without considering the health consequences on the greater population. What most of the general public neglects to consider is that behind every COVID-19 statistic is a distinct individual that suddenly—and oftentimes painfully—died, leaving many family and friends to grieve in their absence. One study published in Proceedings of the National Academy of Sciences found that roughly nine Americans experience some form of grief for every one person that dies from COVID-19 (Ashton et al, 2020). These statistics show that more care should be provided for those currently grieving a loved one.
Theoretical Background of Grief
Grief is a natural response to the loss of a loved one. While grief can be universal, it is important to recognize that individual experiences of grief vary (Mayo Clinic, 2020). For many, grief is a very overwhelming emotion that can impair their daily life. Processing the pain after the loss of a loved one can take months and even years to do . It is ideal that individuals eventually come to terms with their loss by finding meaningful ways to adapt to the new normal (Psychology Today, 2020).
Academic literature and discussion regarding grief is often built on the work of Swiss psychiatrist Kübler-Ross who first introduced her five stage grief model in her book On Death and Dying (1969). Using the Kübler-Ross Model, grief can be defined by five distinct stages: denial, anger, bargaining, depression, acceptance (Kübler-Ross, 1969). These five stages of grief are understood by many professionals as the most commonly observed experiences in a grieving population (Gregory, 2020). In the context of COVID-19, denial can be seen in statements of disbelief in medical facts. Anger can appear in the form of blaming the government for its handlings of lockdowns, masks, and allocation of resources. In bargaining, an individual attempts to make the situation better by believing everything will be okay if they follow COVID-19 safety guidelines. Despair is the feeling of hopelessness in regards to the pandemic. Finally, acceptance is when one truly allows themselves to acknowledge the reality of their loss. It is important to realize that these stages are fluid so individual experiences may vary (Gregory, 2020). Grief is very individualized and unpredictable from a clinical perspective (Psychology Today, 2020). However, it is generally understood that this is the basic grieving process that most people go through.
Another widely recognized phenomenon worth acknowledging is complicated grief, also referred to as persistent complex bereavement disorder. This phenomenon is characterized by long-term and severe painful emotions due to an individual experiencing trouble in recovering from loss of and resuming normal life (Mortazaviet et al., 2020). Due to stay at home orders, some may be experiencing this more due to being isolated from their loved ones. Additionally, given the safety precautions necessary to combat COVID-19, many seriously infected individuals end up dying alone which can increase the likelihood of mental health complications due to family members never being able to say goodbye to their loved ones or have a proper funeral (Mortazavi et al, 2020). Signs of complicated grief include, but are not limited to, having trouble carrying out normal routines, isolating from others and withdrawing from social activities, and experiencing depression, deep sadness, guilt or self-blame (Psychology Today, 2020).
Experiences of Grief During the Pandemic
The COVID-19 pandemic has impacted numerous groups of people and it is important to consider all demographics (i.e age, occupation, race etc.) to effectively address grief in communities. This is because various factors (e.g health care access; educational, income, and wealth gaps; housing etc.) contribute to increased risk of getting COVID-19, which potentially leads to more frequent manifestations of grief and perhaps even a lower ability to effectively cope due to differences in the extent of grief management resources available to various groups.
The CDC estimates that eight out of 10 deaths in the U.S. from coronavirus have been in people 65 and older (CDC, 2020). Additionally, CDC officials estimated that 6% to 29% of people 85 and older that get COVID-19 will require intensive care. Health experts from John Hopkins University explain that this is because older adults are more likely to already have long-term health problems that put them at higher risk (Maragakis, 2020). It is important to note that people’s immune systems tend to weaken due to aging which makes it much harder for their bodies to be able to effectively fight off infections. In particular, lung tissue tends to become less elastic with age which is why COVID-19 in particular, a respiratory disease, is so dangerous for the older population (Maragakis, 2020).
One study published in Proceedings of National Academy of Sciences found that roughly nine Americans are suffering from grief for every one person that dies from COVID-19 (Ashton et al., 2020). The study was conducted by a team of sociologists at Pennsylvania State University by examining previously collected data on kinship profiles of families in conjunction with data on the age patterns of COVID-19 deaths. The researchers were then able to use their statistics to conceptualize what they called the “bereavement multiplier” which attempts to estimate “the average number of individuals who will experience the death of a close relative (defined as a grandparent, parent, sibling, spouse, or child) for each COVID-19 death” (Ashton et al., 2020 pg. 17698) When looking at particular age groups and utilizing the bereavement multiplier, the study found that for every 100,000 Americans who die of COVID-19, roughly 120,000 to 140,000 young people (ages 10 to 29) will experience a family member’s death. Experiencing grief at a young age can be a considerable risk factor given that individual development occurs at this point in time in young people’s lives (Mayo Clinic, 2020).
The COVID-19 pandemic has also put a strain on frontline health care workers. One study found that frontline health care workers had 12-times higher risk of testing positive for COVID-19 compared with the general population (Long et al., 2020). In addition to higher risks of transmission, frontline healthcare workers are found to be experiencing psychological and physical symptoms of grief in response to patient suffering and death (Cabarkapa et al, 2020). This suggests that the extent of grief is not just limited to immediate family and friends. The COVID-19 pandemic has put considerable strains on healthcare workers, and it's important to address this to maintain stability in the healthcare infrastructure.
Studies have also shown that low-socioeconomic and minority communities have much different outcomes in regards COVID-19 as opposed to other demographic groups (Koma et al., 2020). Reports estimate that Black Americans are around three times more likely than White Americans to contract COVID-19, are six times more likely to be hospitalized due to complications from the illness, and are two times more likely than White Americans to die from COVID-19 (Wezerk, 2020). In particular, in Kent County, Michigan, Black and Latinx residents roughly make up 63 percent of total infections despite making up only 20 percent of the county’s population (Oppel et al., 2020). An article from New York Times revealed that public health officials and elected leaders in Michigan were not sure why Black and Latinx residents in certain counties were more adversely affected than in other parts of the country (Oppel, 2020). However, what these statistics do suggest is that there are many health disparities and health inequalities in regards to COVID-19.
The COVID-19 pandemic has also negatively affected essential workers which encompasses jobs like hospital staff, workers, and grocery clerks. According to the U.S Department of Homeland Security, “essential workers are those who conduct a range of operations and services that are typically essential to continue critical infrastructure operations'' (NCSL, 2020). COVID-19 revealed how much society relies on the sacrifices essential workers make. Because of the nature of their work, essential workers are more likely to get infected from COVID-19 (The Lancet, 2020). The loss of jobs and even life, can signal both economic and emotional challenges for families. Managing grief is already difficult, but having to worry about issues like finances in an ongoing recession, makes the grief process more difficult for families. Pre COVID-19 research has shown that grief in children can become a hindrance to development, causing anxiety and depression. The loss of a loved one can greatly impact a child’s behavior due to various changes in family dynamics (Black, 1998).
It is undeniable that the COVID-19 pandemic has greatly changed many of the ways that Americans connect with and support each other. The lockdown and stay in place orders have led many to feel isolated, fatigued, and stressed. In regards to coping with grief, it is paramount to consider new ways to maintain and make meaningful connections so that both individuals and communities can thrive despite the challenges that COVID-19 brings.
Conclusion
The COVID-19 pandemic has resulted in insurmountable losses for the United States and its people. Some losses are more tangible than others such as the loss of jobs, graduations, and weddings. Over the course of the pandemic, many Americans have been left confused, outraged, and anxiously eager to reopen the country at the first possible opportunity without taking into consideration the possible cost of human life. Regardless of one’s personal opinions on the controversies of COVID-19, it is paramount to understand that behind every COVID-19 statistic, is a unique individual.
There seems to be less attention being paid to personal losses of loved ones due to the majority of Americans being too focused on the politics and economics of the pandemic. Perhaps instead of spending time worrying and arguing about all the controversy surrounding COVID-19, the nation should try to show love and empathy to those that are currently grieving the loss of a loved one.
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