Pandemics are inflection points in history — that is, events which profoundly transform society by directly impacting each individual in some way. The Black Death was a catalyst for a scientific renaissance; the polio pandemic added fuel to the burgeoning cause of disability rights activism; and, on a smaller scale, Philadelphia's yellow fever epidemic in 1793 highlighted simmering political tensions in the early American republic.
Now, both experts and everyday people attest to at least one big social shift caused by the COVID-19 pandemic: A lingering and profound sense of anxiety over our health.
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"If there's something that COVID has taught me is that life is awfully fragile and a random virus can change your life completely," Evelyn Ott, a tattoo artist at Soul Canvas Ink who lives in the Washington, D.C. area, told Salon by email. "Not only financially, but also physically and emotionally. What scared me the most about getting sick, from anything really, is just how expensive healthcare is. My aunt got sick and had huge bills for random things in the hospital. It was crazy."
"[F]or a minority of children and young people, this health-related fear may become particularly distressing. It may interfere substantially with their functioning and persist over time."
Ott recalled observing COVID-19 wreaking medical and financial hardships on the lives of the people close to her, reflecting sadly on "how family members you thought loved you can tend to shun you because you are dealing with bills and hardship they don't want to get involved in. It was sad how easy it is for people to abandon the sick."
"I got to see this a lot during the pandemic," Ott added. "I really don't want to get sick from anything, because I'm scared of seeing how many people do not actually care about me."
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Heather Von St. James is a 53-year-old mother of one in Minnesota who has an additional reason for developing health anxiety as a result of COVID-19 — she is a cancer survivor, and thus she is at much higher risk were she to contract COVID-19.
"I'm a survivor of a rare cancer called mesothelioma and live life with one lung," Von St. James wrote to Salon. "I'm generally cautious because a simple cold can put me in the hospital with breathing problems. With COVID? Getting sick with anything makes going to the ER scary. I don't want to be exposed to COVID while waiting to be seen for something else like bronchitis or heart issues. I've already been told that COVID may be a death sentence for me, so getting sick with anything scares me."
Von St. James said that she is always careful to mask up when she goes out. "I've survived this terminal cancer for 16 years, and I'll be damned if I'm going to let a virus take me out," she added.
"In the middle of the pandemic it is perfectly reasonable for people experiencing these symptoms to attribute them to coronavirus infection, but what happens later? COVID‐19 is not going to disappear suddenly."
Ott and Von St. James are not alone in feeling a sense of health anxiety from the pandemic. Anyone who has been aware of their surroundings since the start of 2020 knows that this sense of dread has been all-present. It is related to hypochondriasis, the clinical term for when people become hyper-focused on potential health problems.
Dr. Peter Tyrer of the Imperial College London's Division of Psychiatry wrote in the journal World Psychiatry that COVID anxiety differs from traditional hypochondriasis in that it is based on rational concerns. After all, there is a global pandemic that has claimed millions of lives and shut down society. Yet as with any anxiety, even those based in reality, there is a question as the degree to which people take their potentially legitimate health concerns.
"In the middle of the pandemic it is perfectly reasonable for people experiencing these symptoms to attribute them to coronavirus infection," Tyrer writes. "But what happens later? COVID‐19 is not going to disappear suddenly. There will be a long period, possibly extending over several years, in which there will still be the danger of infection — and this is when pathological COVID anxiety will occur."
One group of people that will be particularly impacted: The youth, for whom the pandemic will have shaped their most formative years.
"This will take generations to get past," Dr. David Reiss, a psychiatrist in private practice and expert in mental fitness evaluations, told Salon last year. "And that's because at every stage of development, things have been disrupted, whether you're talking about my two-year-old grandchild who somehow has to understand seeing family members in masks, to four- and five-year-old kids who are just starting to socialize, to adolescents who can't socialize, and all through different stages of life."
Other research has found that these disruptions have, unsurprisingly, led to heightened health anxiety.
"In the context of a global pandemic, some degree of health-related fear is normal and adaptive," explained authors of a 2020 article in the journal Behavioural and Cognitive Therapy. "However, for a minority of children and young people, this health-related fear may become particularly distressing. It may interfere substantially with their functioning and persist over time, in a way that we recognize in [health anxiety]."
There are other, perhaps even more significant, unanswered questions when it comes to the intersection of COVID-19 and mass health anxiety. Now that the restrictions prompted by the pandemic are being gradually rolled back, how will people who struggle with health anxiety cope with the adjustments?
"Braving the pandemic when masks were mandatory, tests were free, and lockdown was an option when infection rates climbed too high, was difficult, but manageable," writes health anxiety sufferer Jenny Medlicott in the British newspaper. "Now, with the restrictions scrapped, for those of us with anxiety, it can feel like the worry has spiralled into freefall."
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