Suicides amongst people who are in quarantine in connection with COVID-19 and those isolated in hospitals following mild symptoms have been on the rise in the State.
The psychological issues such as stress, depression and anxiety experienced by those in quarantine have been well documented. But a sudden increase in suicides wherein the individual later turns out to have been COVID-19 positive has raised the possibility that the neurological complications caused by the SARS-CoV 2-virus, resulting in an altered mental status and encephalopathy, could be triggering these suicides.
Those in distress or having suicidal tendencies could seek help and counselling by calling any of the helpline numbers given here .
Detailed clinical studies would be required to establish a link between COVID-19 and the acute altered mental status in patients. But neurological manifestations of COVID-19 in patients, which is increasingly being recognised globally, certainly warrants more attention.
Encephalopathy has been described as a “a pathobiological process in the brain that usually develops over hours to days and can manifest as changed personality, behaviour, cognition or consciousness.”
A recent study in The Lancet Neurology has reported the neurological manifestations in 901 COVID-19 patients, some of which may be considered as direct effects of the virus on the nervous system.
The Lancet Psychiatry has also recently reported the data from the U.K. national registry of 125 patients with COVID-19 and neurological or psychiatric disease reported over a three-week period,wherein 31% patients had altered mental status, which included 16 with encephalopathy and 23 with a neuropsychiatric diagnosis.
Exact data unavailable
The Health Department does not have the exact number of persons who have committed suicide in the State while in COVID-19-related quarantine or isolation. It does not have the number of cases wherein those who committed suicide tested positive for COVID-19 either.
Apparently, suicide figures are reported by the State Crime Records Bureau while the COVID-19 statistics alone go to the Health Department.
Even though the Health Department has a well- established system in place for lending psycho-social support to those in quarantine and isolation, there have been issues of delayed reporting in recent times wherein the counsellors could not reach across to the quarantined person on time.
The suicide rate in Kerala is estimated to be 21.5 per lakh population. Having put some 12 lakh people through quarantine so far, it is only natural that the State’s statistics would reflect amongst this group, goes one argument.
“Depression that persists for a few weeks has been noted in many viral infections and it is possible that it is not different in the case of COVID-19 also. Loneliness, frustration, the stigma attached to COVID-19 and anxieties over the loss of livelihood haunt many of these patients and those in isolation. They would need daily monitoring of their mental status, continued psycho-social interactions and support from the family to save them from going over the brink,” says P.S. Kiran, State Nodal Officer for Mental Health.
Doctors treating COVID-19 patients say that while they have not yet observed any obvious neurological issues in these patients, irritability and adjustment disorder are seen commonly in most of them.
“Neurological manifestations of COVID-19 or its sequelae in patients require detailed study. It is very much possible that there is a link between COVID-19 and encephalopathy in patients. Recovery is possible through continued care and support,” says Thomas Iype, Head of Neurology, Government Medical College Hospital, Thiruvananthapuram.
(Kerala suicide prevention helpline: DISHA - 1056, 0471-2552056)