The Complete Beginner's Guide to Understanding Coronaphobias

 Cronaphobia

Alisha Arora, Amrit Kumar Jha, & Sitanshu Sekhar Das

Source - Asian Journal of Psychiatry

1.  Introduction

In the COVID-19 pandemic, as in other pandemics, fear, anxiety, and worries have been the major psychological consequences (Roy et al., 2020; Tandon, 2020a; Xiang et al., 2020). COVID-19 related fear, mortality rates, unemployment, protective strategies have become the most searched topics in Google search history (Charlton, 2020; Sullivan, 2020). Researchers have used the expressions “fear of COVID-19” (Ahorsu et al., 2020; Mertens et al., 2020) and ‘coronaphobia’ (Asmundson and Taylor, 2020) to indicate the fear of contracting COVID-19. Now that there is unanimity that COVID-19 is an endemic (BBC, 2020b; Kissler et al., 2020) and living with the coronavirus with constant precautions becomes the new normal, fear may become more pronounced (Tanner, 2020). COVID-19 affects all spheres of life and the risk factors are more unique, numerous, and diverse than in other pandemics. Therefore, fear may extend beyond falling ill or dying due to contracting the virus and evoke other fears such as that of economic adversity (Yoon, 2020) and infecting others. This paper attempts to postulate the contents and antecedents of coronaphobia, identify the associated risk factors and the underlying mechanisms of its development which might inform policy decisions and healthcare activities.

2. Conceptualizing coronaphobia

A phobia is an anxiety disorder characterized by a persistent, excessive, unrealistic fear of an object, person, animal, activity, or situation. Phobia makes people avoid the triggers of fear; when such avoidance is not possible, it causes anxiety and distress (American Psychiatric Association, 2013). A search in the Scopus database using the keywords "COVID-19" and "Coronavirus" with "fear", "anxiety/anxious", "uncertainty", "worry/worries/worried", "phobia", "public place" and "public transport" resulted in 499 studies after excluding studies with no abstract or in a language other than English. Various components and outcomes of COVID-19 fear have been reported such as functional impairment leading to hopelessness, suicidal ideation, and coping deficits (Lee, 2020), fatal cognitions leading to the association of COVID-19 with a terminal end (Dubey et al., 2020; Goyal et al., 2020), and anxiety and depression while coping with the ‘new normal’ (Cao et al., 2020; Chakraborty and Chatterjee, 2020; Haleem et al., 2020, Huang and Zhao, 2020).
Based on a review of these studies, we define coronaphobia as an excessive triggered response of fear of contracting the virus causing COVID-19, leading to accompanied excessive concern over physiological symptoms, significant stress about personal and occupational loss, increased reassurance and safety-seeking behaviors, and avoidance of public places and situations, causing marked impairment in daily life functioning. The triggers involve situations or people involving the probability of virus contraction, such as meeting people, leaving the house, traveling, reading the updates or news, falling ill, or going to work outside.

The definition implies three essential components (Figure 1 ), which reinforces the process of fear:

 I.   Physiological: The fight or flight response of fear is triggered, on being exposed to an antecedent event. Constant worry can cause symptoms such as palpitations, tremors, difficulty in breathing, dizziness, change in appetite, and sleep (Wang et al., 2020).

 II. Cognitive: Fear of virus would involve a preoccupation with the threat provoking cognitions (Chakraborty and Chatterjee, 2020), e.g. ‘I will die if I contract the virus, ‘I will not be able to go to my job and will be unemployed’; ‘My family is in danger and they may die’. The cognitions may further trigger emotional responses, like sadness, guilt, and anger.

  III.  Behavioral: In order to prevent the consequences, individuals engage in avoidance behaviors. There is marked fear of using public transportation, touching any surface, being at open places (markets, beaches, stadiums) and at enclosed places (hotels, shopping malls, movie theatres, indoor stadiums), attending any public gatherings, and standing in the queue (Tanner, 2020). The individual fears and/or avoids situations like meeting people or overindulges in health-related safety behaviors (like washing hands). Reassurance behaviors such as constantly checking body vitals, confirming the absence of illness, self-medicating, or rechecking sanitation perpetuate fear (Li et al., 2020), leading to phobia. Besides, the zoonotic origin of the virus (Andersen et al., 2020), may further lead to the fear of having exotic meat-based food. Though the fear is realistic, it can disturb the overall quality of the everyday functioning of the individual.