OUTBREAK’S IMPACT ON PEOPLE AND THEIR RESPONSES
In a broad aspect of viral outbreaks, it is impossible to predict the extent of mortality and morbidity accurately, that will be caused by a newly emerged pathogenic virus. Considering the current situation of the world environment, viral outbreaks may affect animals or humans [3,9], without causing extensive fatalities, however, their psychological impacts can be serious such as anxiety, insomnia, panic behavior, fear, and hopelessness. In some cases viral outbreaks infect thousands of people, cause hundreds to thousands of fatalities and spread around the globe [1,3,10,11], thereby affecting millions of people to induce anxiety, panic behavior, and other related psychiatric disorders. To cope with such outbreaks and epidemics, the health care authorities should have affective plans, which must consider psychological health [3,10,12]. Unlike the infected individuals, the responses of uninfected individuals are expected to be mild, however, these reactions become worse by rumors spread by media and social networks [13-15]. In the outbreak caused by 2019-nCoV in Wuhan, China, the reactions of the people could be quite severe as compared to the outbreaks of SARS and MERS [3,11] (and references S1-S3 in the Online Supplementary Document; other supplementary references are indicated by letter S in brackets).
Interventions by health care authorities have consisted of equivocal recommendations for the prevention of viral infections (S4). For instance, some of the infected individuals were advised to stay isolated inside homes rather than hospitals, which may increase the stress burden on family members due to the fear of getting infected. The scarcity of preventive measurements such as gloves, masks, and headcovers during the massive lockdown in China may induce further stress in the general population. To mitigate the negative outcomes, interventions for the general population must be informed by these recommendations; information about viral outbreak and possible impact, individual risk, outcomes of negative health behaviors, identifying place and time of risk in advance to take specific measurements, public awareness regarding necessary actions to prevent the spread of viral infections. Furthermore, people must be provided with follow-up information during and after control of the outbreak.