“Water running along a pavement will readily seep into every crack; so, too, did the unchecked coronavirus seep into every fault line in the modern world.” So wrote Ed Yong in his August 4, 2020, Atlantic article on “How the Pandemic Defeated America.” At that time, the US was nearing 150,000 lives lost due to COVID-19. Now, five months later, the US death toll has nearly tripled, with over 420,000 lives lost to date.
Yet the nation’s health challenges extend beyond lives lost. Mental health is also a growing challenge—a pandemic within the pandemic, if you will. A recent survey of 3,334 physicians from 24 countries by Sermo, a medical social media platform, found 86 percent of doctors who responded believe that mental health and depression will be the biggest non-COVID-19 public health issue after the pandemic. Increased violence, spousal and child abuse, suicide, and increased opioid abuse are other major areas of apprehension.
Substance use and mental health are deeply interconnected—and these intersect with matters of economic, racial, health, and criminal justice. A Kaiser Family Foundation poll during mid-July found 53 percent of adults in the US reported negative mental health effects connected to the coronavirus. These effects took many forms, such as difficulty sleeping, increased alcohol and substance use, and eating disorders, as well as a worsening of prior chronic conditions.
An alarming recent report from the Centers for Disease Control and Prevention (CDC) found 81,230 people died of drug overdoses between May 2019 and May 2020, a record loss for a single year. Prior to COVID-19 overdoses related to substances such as fentanyl were on the rise, yet the pandemic increased the risk of overdose by affecting systems of service for those being treated for addiction and access to healthcare and support systems. Increased isolation, heightened anxiety and depression, and socioeconomic and emotional hardship are further risk factors.
The global concerns reflected in the Sermo findings are even more concerning when we take into account a September 2020 report from the nonprofit Well Being Trust (WBT). The WBT report projected various scenarios of recovery, which affect “deaths of despair,” defined as drug and alcohol use and suicide. By investigating trends of unemployment, isolation, and the state of supportive services across the US during COVID-19, the report estimated a range of deaths of despair from 27,644—if there is quick comprehensive action taken—to 154,037 additional lives lost if the recovery efforts or slow and poorly rolled out.
These fault lines cannot be remedied overnight. Yet, a new foundation of recovery, service, and care might be modeled on those nations that aim to uphold “the right to health” as defined in the 1966 United Nations treaty, The International Covenant on Economic, Social and Cultural Rights (ICESR). The United States signed ICESR in 1977, yet it has not ratified the treaty, which defines a broad array of equity issues like the right to housing, healthcare, education, labor, and many more as basic human rights. Unlike the US, in Canada healthcare is seen as a