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7.C: COVID-19 Impact on Emerging and Established Adulthood

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    Long Haulers:

    While most people who are infected with COVID-19 completely recover within a couple of weeks, some individuals, "COVID long-haulers" experience lingering symptoms even after the acute symptoms of the infection have disappeared (Berg, 2021). This means, if tested, such individuals would now be testing negative for COVID-19, but are still experiencing debilitating effects (John Hopkins Medicine, 2021). According to one study, 72% of COVID long-haulers are between 30 and 70 years of age, and are more likely to be women (Huang et al., 2021). In addition, the Huang study found that 32% of long-haulers were initially asymptomatic, and months later started to show symptoms. This is consistent with the anecdotal evidence of medical personnel. Below are some of the more common long-term symptoms.

    • Neurological Symptoms: Some of the more common symptoms for COVID long-haulers include cognitive impairment, sometimes referred to as brain fog, "a term used to describe the feeling of being mentally slow, fuzzy, or spaced out" (Berg, 2021, para. 18). The cause of this impairment is still an active area of study (John Hopkins Medicine, 2021).
    • Psychological Symptoms: Anxiety, depression, or post-traumatic stress are other common symptoms (Berg, 2021). Periods of isolation during the lockdown or in the ICU, stress from financial difficulties, job loss, or death of loved ones can complicate an individual's recovery from illness.
    • Lung and Heart Problems: COVID long-haulers may continue to experience shortness of breath, and may require ongoing oxygen treatment for weeks or even months due to lung damage (John Hopkins Medicine, 2021). Sixty percent of people who recover from COVID-19 initially show signs of heart inflammation, even in those with mild COVID-19 symptoms or no prior health issues. This inflammation can lead to a rapid heart rate and shortness of breath, common symptoms in longhaulers.
    • Other long-term effects: Many long-haulers experience a general level of fatigue. In addition, COVID-19 can produce kidney issues, diabetes, or a worsening of preexisting kidney or diabetes problems (Berg, 2021). About 25% of people with COVID-19 who experience a loss of sense of smell and/or taste, will see an improvement in a couple of weeks, while most of the remaining patients will recover in a about a year (John Hopkins Medicine, 2021).

    One intervention that has improved the health of long-haulers has been the introduction of the COVID-19 vaccine. Since the start of vaccinations, 30–40% of those individuals with lingering symptoms have identified improvements after receiving their shot (Leventis Lourgos, 2021). Theories as to why improvements may be occurring include that the vaccine may be stopping a harmful immune response, that it resets their immune system, or that the vaccine helps the immune system fight off residual amounts of the virus remaining in the body. Unfortunately, not all long-haulers exhibited improve health after the vaccine, and the reason why some benefited while others did not is not known. Regardless of the efficacy, all long-haulers are encouraged to become vaccinated with the possibility that their symptoms will improve.

    Weight Gain:

    Shut at home with stockpiles of food, binge watching TV and playing video games, people jokingly referred to the lockdown as "Quarantine 15", referring to the likely weight gain (Rabin, 2021). Just how much weight did people gain during the pandemic? Lin et al. (2021) studied 269 individuals from February 1 to June 1, 2020 and noted a steady increase of 0.6 pounds every 10 days, irrespective of where they lived, or prior health issues. This meant that people gained about \(1 \frac{1}{2}\) to \(2\) pounds every month their state was in lockdown. As the United States is only slowly returning to pre-COVID activity, it may be some time before people stop this steady weight gain.

    Mental Health:

    As the pandemic continued, concerns regarding Americans' mental health became as important as their physical health. According to results obtained from a national survey completed by the Census Bureau in January 2021, 41.1% of adults in America reported symptoms of depression or anxiety (Panchal et al., 2021). In contrast, only 11% of adults reported these symptoms between January and June 2019 (see Figure \(\PageIndex{1}\)). Adverse symptoms included difficulty sleeping, eating issues, increased substance use, and worsening chronic health conditions.

    Graph of the average share of adults reporting anxiety and/or depressive disorder symptoms, with values of 11.0% between January and June of 2019 according to NHIS and 41.4% in January 2021 according to the Household Pulse Survey.
    Figure \(\PageIndex{1}\). Image source.

    Specific populations identified deteriorating mental health more than other groups. For young adults, the closure of colleges and loss of income were significant risk factors for poorer mental health (Panchal et al., 2021). The percentage of adults aged 18–24 years identifying mental health issues was the highest among all ages, at 56.2%. Prior to the pandemic, young adults were already at a higher risk than other ages and were not receiving treatment. The pandemic only increased their symptoms. Working age adults who experienced job or income loss had greater symptoms of mental health disorders than those not experiencing losses (53% vs. 32%).

    Also reporting higher rates of anxiety and depression were parents of children under the age of 18, especially mothers (Panchal et al., 2021). Additionally, communities of color identified poorer mental health. Black and Hispanic communities experienced significantly higher rates of coronavirus cases and death adding to the stress of the pandemic. Black parents were also more likely to identify negative effects on their children's education compared to White parents. Lastly, essential workers, including health care providers, store employees, mail and package delivery personnel, transportation workers, and cleaning personnel, also identified poorer mental health. These essential workers were at an increased risk of contracting COVID-19, while earning less wages than other workers.

    Substance Use Disorders:

    Since the beginning of the pandemic, an increased number of Americans reported starting to use, or increasing their use of, psychoactive substances to deal with the stress and emotions related to COVID-19 (Abramson, 2021). Factors contributing to the increased use include stress from the loss of wages, loneliness, general anxiety about COVID-19, and a lack of healthy alternatives due to pandemic restrictions. Additionally, clinics and community-based programs for those with substance use disorders closed making it more difficult for people to receive treatment. Overdoses also increased since the start of the pandemic, with an 18% increase in the early months of the pandemic compared to the same months the previous year. When individuals use drugs alone, they are also more likely to die as no one is there to call for help. Additionally, those with substance-use disorders are more likely to develop COVID-19, and they experience worse outcomes, including greater hospitalizations and deaths (Cahan, 2021).

    Telepsychology:

    To help those with mental health and substance use disorders during the stay-at-home orders caused by the pandemic, an increase in telepsychology/telehealth emerged. Medicare, Medicaid, and private insurance companies increased reimbursing mental health clinicians for delivering services via phones and videoconferencing (Abrams, 2020). Providing mental health care remotely to those who were isolated, lacked child care, or lacked transportation had already been well established, and research indicates that telepsychology is effective in treating depression, anxiety, PTSD, and substance use disorders. Consequently, when the pandemic occurred, clinicians increased their use of telepsychology for current clients and expanded its use for new ones. A study of 2619 licensed psychologists found that only 7% of their therapy involved telepsychology before the pandemic, while 85.5% involved telepsychology during the pandemic (Pierce et al., 2021). In fact, 67.32% of psychologists indicated that they conducted all of their clinical work with telepsychology, and post pandemic, the psychologists indicated that they would continue to perform 35% of their clinical work via telepsychology. Given the positive research outcomes and frequency of use, increased levels of telepsychology are expected in the future.

    Domestic Violence:

    As the United States passed shelter-in-place directives, many advocates for women and children warned that we might face a second pandemic: domestic violence (Kofman & Garfan, 2020). Prior research revealed that during states of emergency, such as natural disasters, war and civil unrest, and health crises, the rates of domestic violence increases (Anastario et al., 2009). One month after the lockdowns, nine major metropolitan cities in the U.S. reported between a 20% and 30% increase in domestic violence calls (Tolan, 2020). Similar statistics occurred worldwide. When the Chinese government locked down cities in Hubei Province, the outbreak's epicenter, there was a surge in calls to helplines dedicated to combating domestic and sexual violence against women (Taub, 2020). Taub also reported that the emergency number for domestic violence support in Spain received 18% more calls in the first two-weeks of their lockdown, and that the French police reported a 30% increase in domestic violence calls. With shelters effectively closed off as a source of refuge for the victims of domestic violence, many had to shelter in place with their abusers until governments heeded the call for action. Taub (2020) reported that Spain and France started to use hotels to house those fleeing their abusers, and Britain granted victims the right to leave home during the lockdown.

    Emerging Adults Living with Parents:

    According to the data collected by the Pew Research Center, the percentage of 18- to 29-year-olds living with their parents was at an all-time high in July 2020 at 52%, surpassing the previous peak during the Great Depression (Fry et al., 2020). The number of emerging adults living with their parents grew for men and women, metropolitan and rural residents, and all major racial and ethnic groups. In past decades, White emerging adults were less likely than Asian, Black and Hispanic emerging adults to live with their parents. With the pandemic, the number of White emerging adults living with their parent(s) actually grew more than for other racial and ethnic groups. In July 2020, more than half of Hispanic (58%) and Black (55%) emerging adults lived with their parents, compared with about half of White (49%) and Asian (51%) emerging adults. Reasons given for returning home by these emerging adults included their college campus had closed, they suffered a job loss, and/or they experienced other financial reasons.

    Work:

    World-wide COVID-19 produced 4 times as many job losses as did the 2009 recession (International Labour Organization (ILO), 2021). According to ILO, there was an 8.8% drop in working hours in comparison to the last quarter of 2019 , the equivalent of the loss of 255 million full-time jobs world-wide. In the United States, unemployment in April 2020 jumped to rates not seen since the Great Depression, and a year later was still over 6% (Center on Budget and Policy Priorities, 2021). World-wide, the hardest hit were young workers, women, the self-employed, and low- and medium-skilled workers (ILO, 2021). However, positive job growth was found among higher-skilled workers, such as those in the tech industries.

    Gender Gap in Job Losses:

    During a recession, men tend to experience greater job losses than do women (Gupta, 2020). The recent recession created by COVID-19 has been dubbed the "she-cession" (Boesch & Phadke, 2021) as it has proven to be the exception. The industries that were the hardest hit, that is, hospitality, childcare, and education, are dominated by female employees. In addition, many women left the workforce, or reduced their hours, because of the need to take care of their children when schools closed. Overall, women lost 5.4 million jobs, nearly 1 million jobs more than men (Boesch & Phadke, 2021). Throughout the pandemic, Hispanic, Black, and Asian women experienced greater unemployment than White women.


    This page titled 7.C: COVID-19 Impact on Emerging and Established Adulthood is shared under a CC BY-NC-SA 4.0 license and was authored, remixed, and/or curated by Martha Lally and Suzanne Valentine-French via source content that was edited to the style and standards of the LibreTexts platform.