key: cord-0906875-gdefrz2p
authors: Banerjee, Debanjan; Rao, TS Sathyanarayana; Kallivayalil, Roy Abraham; Javed, Afzal
title: Revisiting ‘The Plague’ by Camus: Shaping the ‘Social Absurdity’ of the COVID-19 Pandemic
date: 2020-07-08
journal: Asian J Psychiatr
DOI: 10.1016/j.ajp.2020.102291
sha: 741465f4856d0eacdb8851a138151907dc4cbaed
doc_id: 906875
cord_uid: gdefrz2p

COVID-19 has emerged as a global health threat. The catastrophic reaction to a pandemic in spite of knowing the deadly outcomes, has been referred to as the 'social absurdity’. Such reaction creates a negativistic outlook with regard to the infection, thus contributing to chaos and preventing containment. In this article, the current pandemic of COVID-19 is revisited through the lens of Camus' ‘La Peste, 1947’. The philosophical roots of social ‘absurdity’ during a pandemic are critically discussed in the context of death anxiety. Subsequently, ways of reshaping it are highlighted, borrowing from the theories of existentialism and positive psychology.

When the world welcomed 2020 like any other new year, we knew little of what awaited us in the next few months. Originating in the Hunan province of China towards the end of last year, the novel coronavirus (SARS-CoV-2) causing Coronavirus disease 2019 (COVID-19) has already gripped human life by its reigns during the first few months. The COVID-19 pandemic has affected more than ten million globally, claiming the lives of almost five lakhs so far (World Health Organization Situation Report 163, as on 1 st July 2020), the numbers rising as we speak. Besides public health infrastructure, the virus has ripped through global economy, travel, national and international policies. Starting from various cities locking down their borders to small-scale set-ups crashing and thousands losing their livelihood, agitation has been soaring over need for testing and treatment. Masks and sanitizers have become the rarest commodities and various fake products are on the rise. Besides the infection, people are also falling prey to faulty treatments, false assurances and plethora of misinformation (Garrett, 2020) . in that sense is a 'digital pandemic' in which the 'tension and chaos' spread faster than the virus itself. Beyond just public health, psychosocial discourse related to the outbreak is on rise. Keeping the same in background, the authors were encouraged by the personal reflections of the Editor of this journal where he calls for a global action on mental health during the ongoing pandemic . Furthermore in the subsequent editorial, he stresses on "opportunity amidst tragedy and uncertainty" highlighting the need to understand the ongoing pandemic in varied socio-cultural contexts (Tandon, 2020b) . Hence, the authors attempt to glance at COVID-19 through a different lens.

J o u r n a l P r e -p r o o f definitive cure, have we really developed a practical and rational psychological reaction to COVID-19? In his classic of 1947, the Plague (La Peste), Camus speaks about an infection that destroys more than half of a town's population. Referring to the classical 'black death' or the Bubonic plague, he aptly mentions that "pestilences" keep repeating themselves, but the world still reacts to them with surprise. Considered to be one of the greatest of its times, 'The Plague' back in those days sets the human behavioural pattern at times of a pandemic. It mentions that "habits tend to get lost initially and they start returning when the infection ceases" (Camus, 2012) . In psychoanalytic terms it might be considered to be the inevitable 'Thanatos instinct' that disturbs the 'normative obvious' while existentialism points towards the 'eternal truth of death' transforming the habitual life into that of absurdity. In both cases, it is the susceptibility of a civilization to sudden extermination just as many species in the past have met their detrimental fate (Felman, 2013) . This intense 'fear of end' while knowing the very obvious has been the basis of human absurdity during the time of pandemics. Existentialism further proposes this absurdity to rise out of the conflict between constant search for meaning in life versus the apparent 'nothingness' of the universe (Thompson, 1995) . Like reaction to grief, the reaction to such a biological disaster is also individualized, leading to various forms of denial, anger, frustration, dissociation, somatization and sublimation. In fact, the altruistic records mentioned in the Decameron written about the times of bubonic plague, have later been interpreted as healthier forms of defence during such 'pestilences' (Marafioti, 2005) .

Zooming out of the philosophical underpinnings, the threat is indeed true: we do have an illness that has affected the whole of world! Stress is but the norm at the times of pandemics but the world has an exaggerated response of mass-hysteria, fear of uncertainty and isolation as billions are locked down in an attempt to contain the outbreak. This is the 'storm of absurdity' which J o u r n a l P r e -p r o o f COVID-19 has taken the world into. In the midst of statistics about the number of cases, fatalities and recoveries, this important 'psycho-social' construct is largely neglected, as it subtly affects the society at a large, deeply impacting our quality of life and thoughts for months to come. Historians have inferred from past such infections, that they almost always unfold as 'social dramas'. The response pattern described by epidemiologists has been repetitive: denial and ignorance, recognition of the crisis, attempts to blame and explain, and finally the loss and resolution (Phillips, 2004) . Camus in 'The Plague' wisely draws similar connotations saying that knowledge, beliefs and memories are the true offshoots that one wins after the war between plague and life is fought. In simpler terms, the obvious chaos attempts to stabilize the society which has been alternatively termed as 'Creation's theory of conservation' according to some philosophers (Hanson, 2020) . While the human civilization is scattered and isolated due to the virus, many rare species of birds and animals are again seen to surface, plants living longer and air becoming clearer. This has been termed as 'reverse chaos' in one of the recent articles in the Guardian (The Guardian, Comments, as on 8 April 2020).

Can a thematic analysis of this psycho-social behaviour be then attempted: using an anthropological point of view? Besides denial, chaos, blame, stigmatization, loneliness and depression the other prevalent theme is the 'over-the-edge' fear of contamination, that is much beyond the usual precautionary measures of social distancing, hand and respiratory hygiene.

This leads to significant hoarding of protective medical devices, toilet paper, soaps and sanitizers. The 'socio-cultural lines' also tend to get marked as the mental health needs range from the luxury of 'loneliness in isolation' for the socially affluent individuals to basic living amenities and self-dignity for the homeless and migrant workers. The higher socio-economic class continues to have higher 'acute death anxiety', knowing well that COVID-19 is not a fatal J o u r n a l P r e -p r o o f infection. As mentioned in disaster management literature, 'mortality salience' is inversely proportional to the social class structure (Västfjäll, 2014) . This 'survival of the fittest' often leads to public chaos, violence, increase in poverty and unemployment and eventually increase in criminality and aggression that can impact public health much more than the virus itself. To reiterate, in the words of Hongchen (2006) , the human species has not yet obtained a rational response to its 'impending mortality'. Finally, going back to Camus, humans bury this 'social drama of the plague' deep in their unconscious as a response to resolution of each pandemic.

This social drama during pandemics or epidemics gives rise to the panic-laden psycho-social reactions at a large, referred to as the 'absurdity of the plague' (Hongchen, 2006) .

The biggest threat for an unknown infection that is extremely contagious, is its uncertainty till an effective medication develops. Especially so, when it spreads so fast across the world. It serves as a pervasive reminder of our 'end', which can be disturbing. This often leads to 'deathdenying' behaviours that influence the global scenario. These can be competition for healthcare, discrimination, 'othering' and mutual blaming which can strain international and interracial relations. Likewise COVID-19 has given rise to conspiracy theories against certain countries related to the origin of the virus, with the debate ongoing. Similar behaviours have been noticed in the past too. Anti-Jew sentiments during the Bubonic Plague of 14 th century, the 'Spanish Flu' being a misnomer even though the virus did not originate in Spain, anti-Asian remarks during the SARS pandemic and racial discrimination during the Ebola outbreak in Africa: all are examples of desperate needs for 'scapegoating' to explain the uncertainty (Hays, 2005) . Similarly during COVID-19 blame against China was rampant, WHO was accused of being 'lacklustre' and in various South-East Asian and European countries stigma is prevalent against people with Mongoloid features irrespective of their origins (Jones, 2020) . As the J o u r n a l P r e -p r o o f current pandemic spreads out its claws globally, these panic-inducing reports have become all the more viral.

The Novel coronavirus has ironically hijacked our daily life and communication, more than the respiratory system. It becomes difficult and confusing for the general public to be bombarded with plethora of data being updated every day. Similarly discordant messages are prevalent about the lifespan of the virus, the presumed duration of the pandemic, routes of infection, safety precautions, dietary habits and the necessary period of lockdown. Not one day has passed in last two months, on which every source of media has not debated or argued about one or more of these aspects, ultimately with an ambiguous solution in the end. The penetration of this effect is now even more as social media is the primary 'consumption' of people stranded at homes. This confusion and a 'constant threat of mortality' increases the 'absurdity' during a pandemic and hence panic-stricken behaviour (Ingram, 2016) . The mutual blame will eventually further divide us socio-politically only to be affected by another wave of infection or a new pandemic some days later. Stigma and marginalization will increase the pre-existing ageism, social stratification and hate that will proceed beyond this outbreak.

This 'death anxiety' has been a topic of extensive research. It is defined as an innate driving force behind the human motives in life, that influences various aspects of behaviour and interaction (Neimeyer and Van Brunt, 1995) . Based on the Terror Management Theory (TMT) by Greenberg et al. (1986) , increased death terror during global threats shape society and acculturate the world. Examples of such 'death reminders' are fundamentalist beliefs and terrorism, substance abuse, attachment security threats, economic competition, aggression for dominance and wars. With the prevalent instability during COVID-19, it might seem that the J o u r n a l P r e -p r o o f 'death threat' is higher this time, hence contributing to the increased chaos and adverse effects on social health.

To borrow a quote from the movie Contagion (Shamberg, Sher and Jacobs, 2011, 0:45:20) , directed by Steven Soderbergh, "We tend to admire more during the times of such crisis, only to evolve beyond it…".

Human resilience is remarkable and history is the greatest proof of it. Many psychological theories talk about making peace with the 'inevitable death', a technique hard to master. The 'absurd behaviour' can be modified into a rational one in the face of stress, loss, suffering and death (Tomer, 1992) . The 'death threat' need not always be perceived as morbid.

Resilience and acceptance can help convert our behaviour towards positivism, flexibility and personal growth. New interpretations of the crisis can improve functioning and quality of life at times of such adversities. Based on disaster management research, lessons are always learnt after each crisis and the resultant optimism needs to be incorporated both into the psyche and at a broader level, the policy making. Sadly this is often not implemented (Vernberg et al., 2016) . It needs another large-scale threat to make the world realize that its vulnerable and bring back the primal fear, that stays concealed in the vague delusion of invulnerability. Even in the face of COVID-19, if the mandates of global health agencies, precautionary measures of distancing are followed and behavioural responses organized, situations will start to improve.

Self-care can foster care for others, exercise can promote health and mindfulness can help us reflect on our own selves. Social adherence helps taking care of the marginalized population, fosters growth and prevents stigma (Murphy et al., 1987) . Based on positive psychology research, 'death threat' during a disaster can also lead to new avenues and goals like creativity, J o u r n a l P r e -p r o o f generativity, solving existential questions (purpose of life), higher standards and personal growth oriented behaviour (Wong and Tomer, 2011) : all of which are for the 'healthier change'.

Difficult times also tend to increase our harmony with the nature. Practically not idealistically, there is a need to 'share' the Earth with other species instead of usurping their space. Expanded understandings of our existence can help build new opportunities at such times. A conscious attempt to accept the stress, live through the uncertainty, refrain from indulgence in social media and prevent unhealthy behaviours like hoarding, blaming or stigmatizing can lead the way forward. There needs to be a fine but firm balance between 'unrealistic optimism' and 'panic-driven fear of extermination'. That helps buffer the 'death anxiety' for an 'inclusive social growth'. In the words of Furer and Walker (2008) , this anxiety can serve to modify the cognitions more towards self-sustenance and self-consciousness. The possible negative outcomes of this crisis can be used to find 'positive paths' ahead. Ultimately COVID-19 has stranded us all together, with more time for our families and ourselves, time that was long due.

People can engage in lost hobbies, revise forgotten skills and nurture strained relationships.

The social extravaganza of any celebration can be converted into true enjoyment and bonds can be mended. Even the nature has modified itself to be cleaner and purer in just few months as unnecessary human movement has got restricted. All these might have seemed idealistic last

year, but a microscopic virus was all that was needed to turn these into a reality.

The renowned sculptor Bernini once said, "Where there is death, there is a new meaning."

Many of his great arts depict fragility yet rejuvenation of life (Perlove, 1995) . Sublimating our death fears through a new meaning has also been the basis of logotherapy, when Frankl details J o u r n a l P r e -p r o o f

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