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A friend of a person who died of COVID-19 grieves at a crematorium in Jammu, India Image Credit: AP

These days I often feel restless. The knot of foreboding in the stomach seldom subsides and the mind is constantly running on top gear — hyper and edgy yet there is nowhere to go, all roads are a dead end.

Sitting down doesn’t ease anything, there is a nagging feeling that I am missing something — that there must be more that I can do, someone else that I can at least try and help. Unfortunately, my success rate is not very high.

Most of us are merely mediators, amplifying anguished tweets, passing on any ICU bed opening or oxygen cylinder availability but for a son who sent that distress plea as his mother gasps for breath on the road between one hospital and another, it is the not the journey that counts.

And yet, as we try and go beyond being merely bystanders, there is not much hope we can offer. Civil society abandoned by a government working their connections, resources and hearts on social media and offline but still staring, heart to mouth as the only children’s hospital in the capital declares it has oxygen left for barely an hour.

A nation overwhelmed

Everything is changing by the minute — loss, hope, anger, disbelief — there are more range of emotions today than our ability to identify them. There is one that many have still not internalised, because they are either trying to breathe through the fog or are trying to not get consumed by the grief. We are overwhelmed — survivors, care givers, families, — and this emotion is the one that could take us down.

Where do we go from here? Our grief is not an island, but it is a stark reality that this virus also emphasises loneliness. You are left alone with your thoughts and fear. The dead are left alone at the crematorium. The survivors left without a closure

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In 2020 we still had hope, the vaccine was the light at the end of the tunnel. We were convinced that in 2021 we would be able to dismiss the preceding year as just a blip. Instead, five months into this year, there could not be any more bleakness. Hope has vanished.

Every phone call is dreaded, a message almost always brings some more bad news, and we don’t know where the next loss will come from, but it will happen. Coming out of this collective sense of loss will not be easy.

A 35- year- old doctor killed himself last week, at least 6-7 of his patients were dying daily. It is not just his family that is mourning him though.

The sense and smell of death- whether it is the image of a man ferrying his dead wife on a cycle or in the lifelong scars two children will bear as they watched their father’s body being dumped along with nine others in a cremation van — is so overpowering that you don’t have to be at a hospital to know we are all drowning, some physically, others mentally.

But our inability to process this omnipresent grief, knowingly or inadvertently is not a talk for another day. Counsellors are warning that once we have counted our dead, it could be the turn to count the living dead.

Says clinical psychologist and author Sonali Gupta, “as a therapist what I am seeing clients experience is a consistent anticipatory anxiety about either they, their parents/partner or children contracting the virus.

A collective trauma and grief

A lot of people are experiencing grief, inability to sleep, a consistent feeling of being wired along with feeling traumatised and helpless about what’s happening and deeply scared. Trauma and grief are impacting us in a big way.”

Panic, anxiety, acute sadness, sleepless nights- it is now the new normal whether it is those who have recovered from the virus- they live in fear because countless around them didn’t make it- or those who have escaped it.

Psychiatrist Dr Harish Shetty narrates the episode of a 44- year- old woman who learnt of her husband’s passing only after being discharged from hospital and now spends the days at home wishing she had died instead. “This is a common refrain among a large number of survivors in this pandemic.

I also saw this while working during the 1993 Latur earthquake and later the Kandla cyclone. This guilt may persist for long if not treated.”

This ‘survivor’s guilt’- a term used to describe the emotions of those surviving a trauma dates as far back as the Holocaust survivors. Today, it is manifesting in those who didn’t get sick or those who got away lightly while many around them have gasped for breath.

These sentiments could manifest into PTSD or post-traumatic stress disorder in a large chunk of the population, warn experts. Mayo Clinic defines PTSD as “a mental health condition that is triggered by a terrifying event- either experiencing it or witnessing it.

Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.” What we are living through today more than fits the bill.

The doctor who committed suicide was not the only one going through unimaginable angst, many health care workers fear their colleagues are on edge. Dr Shetty also narrates the story of a surgeon who survived the first wave but is now suffering from nightmares of the COVID ICU.

Exposed to death

“He sees bodies being taken away, people in PPEs and wakes up with a startle. He is also affected by images and thoughts of the entire experience which is intruding and causing anxiety and loss of sleep. This is PTSD, seen among victims who have had a longer stay, health care workers and those who have been exposed to a lot of death,” adds the psychiatrist.

A look back at past pandemics will reveal that we can expect mental health to be collateral damage. The number of suicides increased in the US after the 1918 Spanish flu, both the MERS outbreak in 2015 and Ebola a year earlier also reported a ‘high contagion of fear.’

Experts globally are warning of an increased dependence on alcohol and substance abuse as a COVID coping mechanism. But in India with less than 1% of the total health budget allocated for mental health it will be hard to break the discomfort that any talk of mental health brings. In the meantime, people are Googling to figure out whether their increased heartbeat is a COVID symptom or a panic attack.

Some days I debate taking a break from social media — maybe I am not that strong to keep scrolling through a timeline of realism and condolences or maybe silently the despair is triggering many others like me. But the thought of helping even one person keeps bringing me back. Perhaps this is also survivor’s guilt.

Last year we were the generation with a dual responsibility — to carry both the elders and the kids through to the other side. This year more than the elders and the children, our age-group has been ravaged.

All those calls for positivity will have to wait another day, right now it is only about survival, protecting the children and getting some oxygen. Someday we will all re-evaluate the simple joys of a hug.

But there is a process. For now, we are in autopilot — mourning, not ready to face our pain — the elders who would have survived if there was no COVID, children who would not have been left orphans.

A friend who recently recovered, while his young daughter is still sick tells me in desolation, “I cannot see so much suffering around and be helpless. What pains me is that the government is doing anything. It is a free for all. People helping each other. We are walking the deathly hallows.”

Where do we go from here? Our grief is not an island, but it is a stark reality that this virus also emphasises loneliness. You are left alone with your thoughts and fear. The dead are left alone at the crematorium. The survivors left without a closure.