Rwanda, like many countries is now under mandatory lockdown, a measure that is crucial to minimise the spread of the COVID-19 pandemic.

According to Dr Sabin Nsanzimana, an epidemiologist who is the Director-General of Rwanda Biomedical Centre (RBC), "staying home, nowadays, is the most effective proven intervention that reduces COVID-19 spread.”

People are required to stay home and practice social distancing, among others, to avoid spreading the viral disease further.

By Friday April 10, the total number of people who were being treated for COVID-19 was 118 - including seven who recovered earlier.

But what impact does staying home have on people’s health and wellbeing considering that research shows that being sedentary is bad for your physical and mental health?

Dr Leon Mutesa, a professor of human genetics at the College of Medicine and Health Sciences, University of Rwanda, told The New Times that the impact of staying at home in this crisis varies.

Worsening of mental health conditions

The impact of the lockdown on the population’s health, he explains, is that during this stressful situation caused by the outbreak, people can develop some mental health and behavioural problems. One such problem is anxiety and fear.

Dr Mutesa says, "Adults are the majority to experience this effect but can transmit such behaviour to their children. This fear and worry are about their own health and of loved ones.”

Other mental health and behavioural problems, he adds, are; changes in sleep or eating patterns; difficulty in sleeping or concentrating; worsening of chronic health problems; and "worsening of mental health conditions.”

There is also the risk of increased use and or abuse of alcohol, tobacco or other drugs, among other problems.

On Thursday April 9, Dr Elke Van Hoof, a professor in health psychology and primary care psychology at the Vrije Universiteit Brussel, in Brussels, Belgium, published an article arguing that taking action now can mitigate the toxic effects of COVID-19 lockdowns.

Dr Van Hoof, a clinical psychologist and an authority in the fields of stress, burn-out and trauma, highlighted that with some 2.6 billion people around the world in some kind of lockdown, "we are conducting arguably the largest psychological experiment ever.”

This, she added, will result in a secondary epidemic of burnouts and stress-related absenteeism in the latter half of 2020.

Ida Jooste, Global Health Media Adviser, Internews, an international non-profit media development organisation, told The New Times that national public health advisories should indeed also put emphasis on what people can do to stay physically and mentally healthy during this lockdown.

Jooste says, "Mental health impacts should also be acknowledged; from bereavement to fears and anxieties about the future and the hundreds of changes in our lives. Many people will feel depressed and anxious.”

Jooste said The Carter Center, a non-governmental, not-for-profit organisation founded by former U.S. President Jimmy Carter, has put together resources about this issue.

The NGO’s mental health journalism fellows have reported extensively on the mental health impact of pandemic.

Jooste says: "The first steps for addressing mental health could be simply to equip oneself with more knowledge that it is normal to feel anxious, then enquire about support available.”

Take care of your body, connect with family

Dr Mutesa says there are ways one can cope with the stress.

"Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting,” he says.

"Take care of your body; take deep breaths, stretch, or meditate; try to eat healthy, well-balanced meals; exercise regularly at home and maintain working hours and sleep as if you are not in lockdown. Avoid alcohol and drugs.”

Make enough time to be with your family members, he adds.

"Interact and use imagination for creativity of new ways of living, education for children, socialisation, projects and so on. Make time to unwind. Try to do some other activities you enjoy. Connect with others. Talk with people you trust about your concerns and how you are feeling.”

Facts, not fake news, help reduce stress

In addition, Mutesa says, know the facts to help reduce stress.

Dr Mutesa advises that sharing facts about COVID-19, and understanding the risk to yourself and the people you care about can make an outbreak less stressful.

"When you share accurate info about COVID-19, you can help make people feel less stressed and make a connection with them.”

Call 112

And for those who need mental healthcare services, says Dr Yvonne Kayiteshonga, Mental Health Division Manager at RBC, "we are in all public healthcare facilities throughout the country.”

"For additional support, please call toll free number 112 or call community health workers, health care providers at your nearest health post or health centre.

"The toll free number 112 was communicated for Kwibuka26 (commemoration of the 1994 Genocide against the Tutsi). Toll free number 114 is saturated by calls related to COVID-19. But the operators for both lines are trained in mental health and have the information about the evacuation plan.

On another note, she advises journalists, "do not refer to people with the disease as ‘COVID-19 cases’ or ‘victims’, ‘COVID-19 families’ or the ‘diseased’.

"They are ‘people who have COVID-19’, ‘people who are being treated for COVID-19’, ‘people who are recovering from COVID-19’, and after recovering from COVID-19, their life will go on with their jobs, families and loved ones.”

"It is important to separate a person from having an identity defined by COVID-19 to reduce stigma.”

Don’t forget the children

Finally, Dr Mutesa says, ways to support your child during this period also matter.

The idea is that during this period of uncertainty, what children need most is to feel loved and protected.

Talk with your child about COVID-19, he advises.

"Answer questions and share evidence and facts about COVID-19 in a way that your child or teen can understand. Avoid creating fear. Reassure your children and teens that they are safe. Share with them how you manage or deal with your own stress,” he says.

"Limit your family exposure to news coverage; especially fake news. Try to keep up with regular routine activities.”

As schools are closed, Dr Mutesa says, create a schedule for learning activities at home, relaxing and fun activities.

"Try to be a role model; take breaks from your work, get plenty of sleep, exercise and eat well. Connect with your friends and family members via social media or phones.”

For Jooste, testing is another important piece of the jigsaw puzzle.

Jooste says: "I think the fact that we follow the rising numbers in each and every country distracts us from the fact that these are not the exact figures. They merely represent the positive cases among those tested.”

Very many people who may have the virus and have only mild symptoms or no symptoms have not been tested, she notes, either because they are not aware they may be at risk or testing may not be available.

"Thus, instead of being fixed on figures, we should all play a role to encourage more awareness of the importance of testing.”