This is one of the last homework essay submitted in my final university year. Accidentally re-discover it in one computer folder. Hope you will like it.
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Date: 10 -5-2003
Topic: The impact of the outbreak of SARS on my psychological health: A personal diary.
Why are you so scared?” This is the question that has existed in my mind since the outbreak of SARS, a mysterious disease at first which has sparked “irrational” anxieties in the general public. And no matter how often, with what force our public health officials has assured us that we should not panic in the face of SARS outbreak, their message is bound to fall on skeptical ears. In the following, I am going to reveal some of my personal reflections on SARS aroused panic in the public.
Yes, it is certain that SARS outbreak is unique in recent history on its rapidity in transmission, its concentration in health care settings and the large number of health care workers (i.e. nurses and doctors) who have been infected, but we are also sure that it is not highly infectious for causal contact (Poutanen et al., 2003). The transmission of SARS is mainly by respiratory droplets, not airborne spread. Considering that the highest number of infections in one day in HK is around 80, which accounts for (80/ 6,700,000[1]) 1 in every 83,750 people, thus the chance of getting infected is still very low, except you are working or living in some “high-risk” places like hospital. Therefore, as healthy individuals should we be so scared, after we have done enough safety precautions like wearing masks and hand washing? It appears that our fears are inordinately disproportionate to the actual risks,
The perception of personal danger is mainly exacerbated by some uncertainties towards the disease, and by intense media coverage of the outbreak and its effect. Once the disease has been reported for more than 1 cause; with day-to-day addition of symptoms from more severe ones like acute respiratory distress syndrome to relatively mild symptoms such as fever, vomiting and myalgia; a rapid spread to around 30 countries within 2 months; an increase in mortality rate from 4.8% in April to 9.6% to May; everyone feels uncertain about the current situation about the disease and becomes more attended to everyday updating from the news reporting. The fear brought about by the SARS outbreak in Amoy Garden, where the transmission route for a rapid transmission is unknown for a period, has further heightened by the media for the disease’s mystery. For any kind of invasion of our internal workings, where we have no absolutely control, presents the biggest perceived of danger of all. According to Allan (2003), our faith in the ability in science to answer all questions, and give us the power to control our environment, leaves us rudderless when it becomes apparent this faith has misplaced. Therefore a risk for which there is no scientific explanation or solution, as with SARS, shakes the foundation of our belief system, and produces our fear.
An interview with my flatmates who are studying in HKU medicine has expressed their worries about their personal safety and about transmitting disease with family members. As there were past cases of CU medical students getting infected with SARS during the bedside teaching, their worries are not unreasonable. With such a great burden on the medical students in face of the SARS outbreak, they have quite different reactions in dealing with it. While majority has signed up in the student union to strongly request for class suspension, some CU medical students has voluntarily gone to help rescuing SARS patients in the Shatin Wale’s Hospital. Some has shared jokes to ease their tension; others have mentioned that they have seriously considered to put themselves in quarantine within the flat and not to go home. One would be very surprised by the contrasting behaviours above shown by different medical students. In fact, their behaviours can be well explained by the cognitive model of stress and coping of Lazarus and Folkman (1984), recently revised (Folkmann, 1997).
There are 2 processes at the heart of this model, namely appraisal and coping. Appraisal refers to the individual evaluation of the personal significance in a specific event and the adequacy of the individual resources for coping. It influences emotions and subsequent coping. Copings are the thoughts and behaviours a persons use to relieve emotion impact of stress (emotion-focused coping) and manage the threatening problems or events (problem-focused coping). Coping influences the outcome of the situation and the individual appraisal of it (See diagram 1). Referring back to the above different reactions shown by the medical students, for those who appraise the outbreak of SARS as a threat and a harm to themselves, thus they immediately go to sign up for class suspension; those who are afraid of transmitting this disease to their family, they perhaps would consider themselves as a potential threat to their family and hence think of putting themselves in quarantine within the flat; others treating the SARS as not only a threat to the society but also a challenge to themselves might thus go to the hospital voluntarily to help rescuing SARS patients. All of these are good examples of problem-focused coping. Among the medical students, sharing jokes become a common useful way to ease their intense tension (emotion-focused coping).
Topic: The impact of the outbreak of SARS on my psychological health: A personal diary.
Why are you so scared?” This is the question that has existed in my mind since the outbreak of SARS, a mysterious disease at first which has sparked “irrational” anxieties in the general public. And no matter how often, with what force our public health officials has assured us that we should not panic in the face of SARS outbreak, their message is bound to fall on skeptical ears. In the following, I am going to reveal some of my personal reflections on SARS aroused panic in the public.
Yes, it is certain that SARS outbreak is unique in recent history on its rapidity in transmission, its concentration in health care settings and the large number of health care workers (i.e. nurses and doctors) who have been infected, but we are also sure that it is not highly infectious for causal contact (Poutanen et al., 2003). The transmission of SARS is mainly by respiratory droplets, not airborne spread. Considering that the highest number of infections in one day in HK is around 80, which accounts for (80/ 6,700,000[1]) 1 in every 83,750 people, thus the chance of getting infected is still very low, except you are working or living in some “high-risk” places like hospital. Therefore, as healthy individuals should we be so scared, after we have done enough safety precautions like wearing masks and hand washing? It appears that our fears are inordinately disproportionate to the actual risks,
The perception of personal danger is mainly exacerbated by some uncertainties towards the disease, and by intense media coverage of the outbreak and its effect. Once the disease has been reported for more than 1 cause; with day-to-day addition of symptoms from more severe ones like acute respiratory distress syndrome to relatively mild symptoms such as fever, vomiting and myalgia; a rapid spread to around 30 countries within 2 months; an increase in mortality rate from 4.8% in April to 9.6% to May; everyone feels uncertain about the current situation about the disease and becomes more attended to everyday updating from the news reporting. The fear brought about by the SARS outbreak in Amoy Garden, where the transmission route for a rapid transmission is unknown for a period, has further heightened by the media for the disease’s mystery. For any kind of invasion of our internal workings, where we have no absolutely control, presents the biggest perceived of danger of all. According to Allan (2003), our faith in the ability in science to answer all questions, and give us the power to control our environment, leaves us rudderless when it becomes apparent this faith has misplaced. Therefore a risk for which there is no scientific explanation or solution, as with SARS, shakes the foundation of our belief system, and produces our fear.
An interview with my flatmates who are studying in HKU medicine has expressed their worries about their personal safety and about transmitting disease with family members. As there were past cases of CU medical students getting infected with SARS during the bedside teaching, their worries are not unreasonable. With such a great burden on the medical students in face of the SARS outbreak, they have quite different reactions in dealing with it. While majority has signed up in the student union to strongly request for class suspension, some CU medical students has voluntarily gone to help rescuing SARS patients in the Shatin Wale’s Hospital. Some has shared jokes to ease their tension; others have mentioned that they have seriously considered to put themselves in quarantine within the flat and not to go home. One would be very surprised by the contrasting behaviours above shown by different medical students. In fact, their behaviours can be well explained by the cognitive model of stress and coping of Lazarus and Folkman (1984), recently revised (Folkmann, 1997).
There are 2 processes at the heart of this model, namely appraisal and coping. Appraisal refers to the individual evaluation of the personal significance in a specific event and the adequacy of the individual resources for coping. It influences emotions and subsequent coping. Copings are the thoughts and behaviours a persons use to relieve emotion impact of stress (emotion-focused coping) and manage the threatening problems or events (problem-focused coping). Coping influences the outcome of the situation and the individual appraisal of it (See diagram 1). Referring back to the above different reactions shown by the medical students, for those who appraise the outbreak of SARS as a threat and a harm to themselves, thus they immediately go to sign up for class suspension; those who are afraid of transmitting this disease to their family, they perhaps would consider themselves as a potential threat to their family and hence think of putting themselves in quarantine within the flat; others treating the SARS as not only a threat to the society but also a challenge to themselves might thus go to the hospital voluntarily to help rescuing SARS patients. All of these are good examples of problem-focused coping. Among the medical students, sharing jokes become a common useful way to ease their intense tension (emotion-focused coping).
Figure 1: The Cognitive Model of Stress and Coping
Personally, SARS outbreak has not created a large impact upon my psychological well-being. Instead, my only surprise was how the general public respond fearfully to the outbreak. Yes, SARS is scary. But the appropriate attitude towards SARS is prudence, not panic. We should learn as much as we can about the SARS virus, avoid high-risk encounters and attend to any possible symptoms, clean up and disinfect our living environment. Some HK officials reappraise the SARS situation as having provided benefits of getting HK people to hold together to fight against the disease, with improved relationships with and concerns about each other. However, perhaps these reappraisals are just the cognitive reframing process (Park and Folkman, 1997) that we use to sustain a sense of psychological well-being during unfavorable circumstances. The correct way for us to live peacefully into the future, is to take active actions to gain more facts about the disease, to develop experience in treating SARS and keep ourselves healthy in both psychologically and physically, and certainly, not to be panic.
Allan R.G. (2003) SARS and the fear factor. Maclean’s 116 (16): 37.
Lazarus R. S. & Folkman, S. (1984) Stress, Appraisal and Coping. Springer, New York.
Folkman, S. (1997) Positive psychological states and coping with severe stress. Soc. Sci Med. 45, 1207 – 1221.
Park, C. L. & Folkman, S. (1997) The role of meaning in the context of stress and coping. Gen. Rev. Psychol. 2, 115 – 144.
Poutanen SM, Low DE, Henry B, Finkelstein S, Rose D, Green K, et al. (2003) Identification of severe acute respiratory syndrome in Canada [online]. N Engl J Med. Available: content.nejm.org/cgi/reprint/NEJMoa030634v3 (posted 2003 Mar 31; accessed 2003 Apr 22).
[1] According to 2001 census, HK population is around 6,700,000.
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