The Effects of COVID-19 on Mental Health of the Society: A Dynamic Approach in Iran

Introduction On March 11, 2020, the World Health Organization (WHO) declared the outbreak of a new coronavirus disease, COVID-19, to be a pandemic (1) and called for countries to take urgent and aggressive action (2). The world was faced with a new crisis that not only involved the health sector but also several other sectors.2 Confirmed COVID19 cases have exceeded 4.5 million globally, with confirmed deaths going over 283 000, according to the latest official figures derived from official WHO data on May 13, 2020 (3). The Islamic Republic of Iran announced its first COVID-19 positive case on February 20, 2020 (4). The stressful atmosphere observed in societies previously infected by the virus also gradually reached Iran, and in most of the cities, it was even more intense than the real stress related to the virulence of the disease (5). Paying attention to the mental health of societies struck by a crisis has been shown to be one of the fundamental aspects of crisis management programs worldwide (6-8). The Islamic Republic of Iran has more than 2 decades of experience in providing psychosocial support in disasters. Lessons learned from the management of mental health issues in emergencies, especially during the COVID-19 pandemic, revealed to us that in order to efficiently respond to the mental health needs of a society at different stages of a crisis, a dynamic approach has to be adopted. The rapid spread of the novel coronavirus has brought about a great deal of stress, anxiety, and fear to all societies. These emotions can be considered normal regarding the fact that people are being faced with an unstable, unpredictable and ambiguous situation. Nevertheless, severe and prolonged anxiety may lead to psychological distress, and this in turn will lead to malfunctioning in daily living. High stress levels have been shown to weaken the human immunity system, and therefore lead to vulnerability towards viral infections (9). Stress may also lead to maladaptive behavior. At this point, the Ministry of Health and Medical Education (MOH) of Iran became preoccupied with developing strategies to reach a comprehensive solution for properly addressing the quickly-spreading stress and tension across the society. The mental health staff of the pri-