COVID-19 has caused more than 894,000 deaths to date (1) and left several million people mourning since the virus was first reported in December 2019.(2)
Globally, health and social systems are facing an unprecedented challenge: supporting those who are grieving, while continuing to treat those infected and preventing the virus from spreading exponentially. It is also a time of great uncertainty, as the consequences and course of the disease are not yet clearly defined.
Grief and bereavement during a pandemic remain complex due to public-health measures aimed at reducing the spread of the virus and protecting vulnerable people.(3) Physical distancing requirements mean that funerals are limited and those who have lost loved ones may have to grieve alone. The inability to say goodbye, the loss of social and community networks, living in confinement, and all the other social and economic impacts of the pandemic may exacerbate the grieving process.
In recent months, people have voiced their concerns that the COVID-19 pandemic is depriving people of the possibility of grieving.(4) A Canadian coalition has also called for a national strategy to better support grief and bereavement which are currently "distorted" by the pandemic.(5)
What strategies could help to deal with mass grief and bereavement? What programs and services could be put forward during a pandemic?
What research tells us
A recent rapid review of 12 articles examined service delivered in the context of mass grief and bereavement following natural disasters or man-made disasters (for example, oil spills, transportation accidents, or terrorist attacks), but also following pandemics.(6) Although these events differ from the current pandemic, there have similar characteristics: the sudden and massive loss of human life, the lack of access to relatives after death and disruption to customary funeral rituals, job losses, social disruption, as well as intense media coverage of the events and their consequences.
None of the studies reviewed provide strong evidence on the effectiveness of programs and services in supporting mass grief and bereavement. However, relevant measures in the context of COVID-19 have been identified:
- a highly coordinated, proactive and multi-pronged approach to providing support to bereaved populations while avoiding promoting formal intervention with people who demonstrate resilience;
- information and practical advice provided through multiple channels from the onset of the crisis, then moving to an open and centralized communication channel in the longer term;
- an integrated local approach aimed both at raising awareness of support services and at communicating with people who are grieving (especially those living in rural and remote regions);
- specific training for front-line workers on grieving and bereavement experiences, funeral rituals that must be changed and the effects of the intense media coverage during the pandemic;
- psycho-educational approaches that focus on understanding reactions to loss, normalizing grief, improving family and social relationships and promoting individual coping skills;
- risk assessments that take into account the impact of COVID-19 on other roles in life such as social isolation and unemployment to identify people likely to experience complicated grief and bereavement or to develop a mental health problem (or exacerbate pre-existing mental health problems); and
- culturally sensitive approaches (that is, focused on the cultural needs of individuals, or that take into account the cultural and linguistic barriers of minority groups who are overrepresented in COVID-19 death rates).
But until national strategies to support mass grief and bereavement are adopted, some programs and services exist to support you. Crisis Services Canada provides a list of crisis and counselling centers across the country (including local bereavement support groups). These centers are there to help you.