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Monday, April 19, 2021

In world’s longest lockdown, processing grief is a lonely and lingering struggle

Kristine Joy Patag (Philstar.com) – March 17, 2021

MANILA, Philippines — Thirty-one-year-old marketing professional Stef Reyes was still grappling with the loss of her father when her only brother contracted COVID-19 barely two months later.

Stef rushed her father to the hospital in May 2020 after she and her mother found him half conscious and having difficulty breathing. Shortly after, she had to return to the hospital, that time to get treatment for her brother who had contracted the coronavirus.

By then, hospitals were hitting full capacity and Stef had to go make several phone calls to find a nearby hospital that could accommodate her brother.

“Losing a loved one months ago and facing the thought of possibly losing someone due to lack of hospital beds for COVID patients led to sleepless nights and countless panic attacks,” she added.

After nearly a year of grieving, Stef is still unsure if the wounds of losing her father have healed. The coronavirus pandemic hitting too close to Stef’s home and the continued rise of confirmed COVID-19 cases have only compounded her anxiety over death.

Quarantine protocols

To arrest the spread of the coronavirus, the government in mid-March last year placed Luzon under Enhanced Community Quarantine, keeping millions of Filipinos confined to their homes.

Stef lost her father on May 31, more than two months into the lockdown. The family was at home when her mother woke her and told her of an emergency: Her father was in bed, barely conscious and was having trouble breathing.

She shared they rushed him to the nearby hospital in Angono, Rizal for first aid. Her father was not considered a suspected COVID-19 case at the time, and the hospital was not a COVID-19 referral facility, which allowed them to be with him in the emergency room.

“To be honest, given the gravity and the suddenness of the situation, the thought of potentially having COVID patients in the area was the least of my concerns during that time — thankfully, there were none,” she told Philstar.com.

Since the pandemic, hospitals have set up appointment systems, usually online, for consultations, while tele-medicine or virtual consultations also continue. They have also limited the number of companions a patient can have.

By June 1, when Stef’s family was getting ready to bury her father, Rizal province shifted to looser protocols under General Community Quarantine. Under GCQ, mass gatherings are prohibited, while religious gatherings of no more than ten people were allowed.

Setf said close friends and family were allowed to visit, although visits were limited by restrictions on public transport.

“We were quite strict in limiting the crowd inside the chapel, observing social distancing, and even giving face masks to people who attended the wake as my mom is a senior citizen and is considered high-risk,” she said.

The lockdowns in early 2020 may have also affected the late registration of deaths. The Philippine Statistics Authority in a report in March recorded the highest number of late registrations of deaths, or those whose deaths were registered more 30 days after, for March and April 2020 deaths.

In March, 6,540 deaths were registered late, which is six times more than the 1,067 recorded in the same month in 2019. For April, 6,017 late death registrations were recorded, nearly five times more than the 1,249 in April 2019.

National Statistician Dennis Mapa noted that the spike in late registrations may be due to quarantine measures implemented during those months.

Funerals without hugs

Being in the world’s longest lockdown also means no reunions even among family members. In the past, Filipino Christmas holidays were marked with gatherings, with children lining up to the elderly to receiving blessings through “mano.” But the 2020 holidays were quiet: No caroling, no parties.

Thirty-one-year-old government worker Alice* comes from a tightly-knit family that celebrates holidays and milestones together, with relatives flying in from other provinces and even from abroad.

In 2020, they made do with virtual gatherings. This still allowed them to be together to welcome the New Year despite being miles apart.

In the morning, they learned an uncle who had joined the virtual celebration from Mindanao passed away just hours into 2021.

“We learned about it through phone calls and family group chats… We could’ve been with him that time, had it not been for the lockdown restrictions, as we usually spend the holidays together,” she said.

Alice told Philstar.com that they had to wait for her uncle’s daughter to arrive from abroad, secure requirements for entry into the country and finish her mandatory quarantine before they could lay their uncle to rest.

She was able to pay respect to her relatives who passed away, but only remotely. “One of the cousins subscribed to a premium account of a videoconferencing service just so all family members and loved ones can witness and participate in the daily novena and memorial service,'” Alice said.

“Because of the pandemic, we weren’t able to see and hug each other in grief, comfort or want of physical interaction.”

A study from the US National Library of Medicine National Institutes of Health noted concerns among researchers that the pandemic may hamper a person’s grief process, due to COVID-19 deaths that may be sudden or due to difficulties such as changes in death rituals and difficulties in receiving social support.

Grief researchers Maarten Eisma and Aerien Tamminga found that there was no significant difference in general grief severity before and during the pandemic but “people who experienced a recent loss during the pandemic had higher grief levels than people who experienced a recent loss before the pandemic.”

“Because acute grief is a strong predictor of future disturbed grief, this lends support to predictions that the pandemic will eventually lead to a higher prevalence of grief disorders,” they said.

Among those disorders, complicated grief, according to the Mayo Clinic, involves “feelings of loss [that] are debilitating and don’t improve even after time passes.”

It adds: “In complicated grief, painful emotions are so long lasting and severe that you have trouble recovering from the loss and resuming your own life.” 

‘Pandemic stole my grief process’

Alice said the loss of her uncle may not have completely sunk in yet. They have not seen their other relatives for a long time and seeing them again is still uncertain.

“I’m not sure if their deaths have completely dawned upon us (seeing is believing), but upon introspection, it’s either my personal grief went as swift as their passing or with all that’s happening these days, my brain is rejecting the idea that they’re now gone,” Alice said.

Stef also admitted difficulty in healing. She identifies herself as an extrovert who draws strength from her close friends, but she has not seen them in a year, even when she was mourning her late father.

“Personally, I can say that the pandemic has stolen my grieving process,” she said.

“To be honest, given the gravity and the suddenness of the situation, the thought of potentially having COVID patients in the area was the least of my concerns during that time — thankfully, there were none,” she told Philstar.com.

Since the pandemic, hospitals have set up appointment systems, usually online, for consultations, while tele-medicine or virtual consultations also continue. They have also limited the number of companions a patient can have.

By June 1, when Stef’s family was getting ready to bury her father, Rizal province shifted to looser protocols under General Community Quarantine. Under GCQ, mass gatherings are prohibited, while religious gatherings of no more than ten people were allowed.

Setf said close friends and family were allowed to visit, although visits were limited by restrictions on public transport.

“We were quite strict in limiting the crowd inside the chapel, observing social distancing, and even giving face masks to people who attended the wake as my mom is a senior citizen and is considered high-risk,” she said.

The lockdowns in early 2020 may have also affected the late registration of deaths. The Philippine Statistics Authority in a report in March recorded the highest number of late registrations of deaths, or those whose deaths were registered more 30 days after, for March and April 2020 deaths.

In March, 6,540 deaths were registered late, which is six times more than the 1,067 recorded in the same month in 2019. For April, 6,017 late death registrations were recorded, nearly five times more than the 1,249 in April 2019.

National Statistician Dennis Mapa noted that the spike in late registrations may be due to quarantine measures implemented during those months.

Funerals without hugs

Being in the world’s longest lockdown also means no reunions even among family members. In the past, Filipino Christmas holidays were marked with gatherings, with children lining up to the elderly to receiving blessings through “mano.” But the 2020 holidays were quiet: No caroling, no parties.

Thirty-one-year-old government worker Alice* comes from a tightly-knit family that celebrates holidays and milestones together, with relatives flying in from other provinces and even from abroad.

In 2020, they made do with virtual gatherings. This still allowed them to be together to welcome the New Year despite being miles apart.

In the morning, they learned an uncle who had joined the virtual celebration from Mindanao passed away just hours into 2021.

“We learned about it through phone calls and family group chats… We could’ve been with him that time, had it not been for the lockdown restrictions, as we usually spend the holidays together,” she said.

Alice told Philstar.com that they had to wait for her uncle’s daughter to arrive from abroad, secure requirements for entry into the country and finish her mandatory quarantine before they could lay their uncle to rest.

She was able to pay respect to her relatives who passed away, but only remotely. “One of the cousins subscribed to a premium account of a videoconferencing service just so all family members and loved ones can witness and participate in the daily novena and memorial service,'” Alice said.

“Because of the pandemic, we weren’t able to see and hug each other in grief, comfort or want of physical interaction.”

A study from the US National Library of Medicine National Institutes of Health noted concerns among researchers that the pandemic may hamper a person’s grief process, due to COVID-19 deaths that may be sudden or due to difficulties such as changes in death rituals and difficulties in receiving social support.

Grief researchers Maarten Eisma and Aerien Tamminga found that there was no significant difference in general grief severity before and during the pandemic but “people who experienced a recent loss during the pandemic had higher grief levels than people who experienced a recent loss before the pandemic.”

“Because acute grief is a strong predictor of future disturbed grief, this lends support to predictions that the pandemic will eventually lead to a higher prevalence of grief disorders,” they said.

Among those disorders, complicated grief, according to the Mayo Clinic, involves “feelings of loss [that] are debilitating and don’t improve even after time passes.”

It adds: “In complicated grief, painful emotions are so long lasting and severe that you have trouble recovering from the loss and resuming your own life.” 

‘Pandemic stole my grief process’

Alice said the loss of her uncle may not have completely sunk in yet. They have not seen their other relatives for a long time and seeing them again is still uncertain.

“I’m not sure if their deaths have completely dawned upon us (seeing is believing), but upon introspection, it’s either my personal grief went as swift as their passing or with all that’s happening these days, my brain is rejecting the idea that they’re now gone,” Alice said.

Stef also admitted difficulty in healing. She identifies herself as an extrovert who draws strength from her close friends, but she has not seen them in a year, even when she was mourning her late father.

“Personally, I can say that the pandemic has stolen my grieving process,” she said.

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