The novel Coronavirus Disease 2019 (COVID-19) became a pandemic on 11 March. COVID-19 did not only cause a life crisis, but also psychological stress: tension, anxiety, fear, and despair among the affected populations. How to help individuals navigate reactions to traumatic stress and get out of the psychological crisis has become a public concern that needs to be discussed on time. The psychological health concerns caused by the COVID-19 pandemic have been discussed in this letter.

Anti-pandemic steps of self-quarantine and social-distancing were employed to curb the spread of COVID-19, but ultimately triggered a certain degree of side-effect: anger and anxiety in the general public. In particular, front-line medical emergency workers and COVID-19 patients were more vulnerable to developing psychiatric disorders. Despite public knowledge, there is a degree of anxiety that affects the quality of life during pandemics, including quarantine times. A national survey recorded that, under the threat of COVID-19, the prevalence of psychological distress is up to 35% among the general population in China [1]. The lack of evidence-based science and medical knowledge of the population can be difficult to differentiate from speculation and rumor that can induce fear and anxiety in large populations [2]. The amount of activity and workload for certain occupations decreased due to quarantine and self-isolation during the outbreak of COVID-19, resulting in a lack of usual social activities that would contribute to stress and isolation [3–5]. When previously working people are forced to stay at home for a long time, their income decreases, resulting in anxiety [6,7]. In another large sample, a cross-sectional survey of 1,257 health workers in China during the COVID-19 pandemic, more than 70% recorded anxiety, with 50% reported depression and 34% reported insomnia [8]. Sustained psychological distress and inadequate sleep can affect the physiological stress response system of the body, leading to a further risk to health [9].

Attentive interventions for psychological disorders should be made available to everyone during pandemics. Possible approaches to support the mental well-being of people during COVID-19 may include telepsychiatry, adequate assessment, and referral for mental health issues; physical exercises, self-monitoring health education, and general prevention measures against COVID-19 infection. WHO recommends that people in isolation during the COVID-19 pandemic should strive to follow strategies to remain connected with family and friends and maintain social networks, follow a regular daily routine, pay attention to one's needs and emotions, participate in healthy activities and avoid rumors that may lead to anxiety and stress [10]. Health education should be paired with psychological counseling for disadvantaged people. An integrated multidisciplinary approach is required to address the prevailing psychological issues among people during the COVID-19 pandemic.

1. Qiu JY, Shen B, Zhao M, Wang Z, Xie B, et al. “A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: Implications and policy recommendations.” General Psychiatry 33(2020).
2. Tan SS, Goonawardene N. “Internet health information seeking and the patient-physician relationship: A systematic review.” J Med Internet Res 19(2017): e9.
3. Chen L, Huang D, Mou X, Chen Y, Gong Y, et al. “Investigation of quality of life and relevant influence factors in patients awaiting lung transplantation.” J Thorac Dis 3(2011): 244–2
4. Thomas SL, Randle M, Bestman A, Pitt H, Bowe SJ, et al. “Public attitudes towards gambling product harm and harm reduction strategies: An online study of 16–88 year olds in Victoria, Australia.” Harm Reduct J 14(2017):
5. Xia Y, Ma Z. “Social integration, perceived stress, locus of control, and psychological wellbeing among Chinese emerging adult migrants: A conditional process analysis.” J Affect Disord 267(2020): 9-
6. Li J, Liu L, Sun Y, Fan W, Li Mei, et al. “Exposure to money modulates neural responses to outcome evaluations involving social reward.” Soc Cogn Affect Neurosci 15(2020): 111-121.
7. Piccolo M, Milos G, Bluemel S, Schumacher S, Muller-Pfeiffer C, et al. “Food vs. money? Effects of hunger on mood and behavioral reactivity to reward in anorexia nervosa.” Appetite 134(2019): 26-33
8. Lai J, Ma S, Wang Y, Cai Z, Hu J, et al. “Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 3(2020):
9. Chang B. Can hospitalization be hazardous to your health? A nosocomial based stress model for hospitalization. Gen Hosp Psychiatry 60 (2019): 83-89.
10. https://www.bmj.com/content/369/bmj.m1904