The Psychosocial impacts of COVID-19 pandemic on Australian-based West Africans who survived the 2014–16 Ebola epidemic

Thesis Abstract Introduction: Studies on the impact of the COVID-19 pandemic in Australia concentrate on a broad range of impacts such as income, social cohesiveness, wellbeing, and psychological distress in the general population of Australia rather than on specific migrant communities such as West Africans who survived the 2014-16 EVD epidemic. The diverse socio-cultural backgrounds and prior experiences of traumatic events e.g. war, political upheaval, and infectious disease outbreaks may influence responses to adverse events. Therefore, a study of the psychosocial impacts of the COVID-19 pandemic on this community is needed to provide a nuanced understanding of the needs of communities that carry a heavy load of prior trauma. This study focuses on the psychosocial impacts of COVID-19 pandemic among survivors of the 2014-16 West African Ebola epidemic who reside in Victoria, Australia. The 2014-16 EVD epidemic is one of the worst infectious disease outbreaks that caused widespread deaths before the COVID-19 pandemic. Similarly, the COVID-19 pandemic caused widespread illness, deaths and socioeconomic devastation of people globally. These events negatively impacted many people and reportedly increased psychosocial tension such as fear, nightmares, stress levels, altered sleep patterns and elevated risk of mental health deteoration among vulnerable groups such as those with a history of mental health problems. Participants in this study were recruited through nonrandomised purposive sampling techniques to explore the knowledge base of this special cohort which is knowledgeable on the phenomenon of interest. This cohort include 36 participants; majority of whom are women provided rich qualitative and quantitative data. Data was collected in two phases which include, semi-structured interviews which were done with 9 participants who were derived from the 36 volunteer participants. This phase produced qualitative data that covered all seven objectives listed below. Like the qualitative interview phase, the online survey phase collects data that dwells on the seven research objectives. Additionally, open ended qualitative questions were included in the survey. The survey collected sociodemographic data from the participants, which culminated in a peer review publication. Three data sets which include textual data from the survey, data from the semi structured interviews and the quantitative numerical data were analysed, triangulated and merged for results and findings. As the immediate social, economic and health impacts of COVID-19 pandemic in Victoria, Australia are known, its psychosocial impact in the long term especially on West African Victorian resident who survived the largest EVD epidemic is yet to be fully understood. Literature search shows paucity of this information, and this led to the interest in determining the psychosocial impacts of this social phenomenon among survivors of these events through the following objectives. Objective: The study explores the psychosocial impacts of the COVID-19 pandemic on West Africans who survived the 2014–16 EVD epidemic and are residing in Victoria, Australia. Specific objectives focused on how people previously living in West Africa who experienced the EVD epidemic, now living in Victoria, Australia report: (I) their previous trauma experiences, (II) their strongest memory of events during the Ebola epidemic and COVID-19 pandemic (III) the influence that surviving the EVD has had on their lives since the epidemic, (IV) the social supports available during the EVD epidemic, and social supports available during the COVID-19 pandemic, (V) the coping strategies used to manage during the EVD epidemic, and the strategies now used to cope during the COVID-19 pandemic, (VI) their current level of psychological distress and (VII) their current level of life satisfaction? Methods: To assess these objectives, a mixed methods study utilised an online- based survey questionnaire to collect data. Following this, semi-structured interviews were conducted among those individuals who volunteered after completing the online survey. This study recruited West African migrants who were over the age of 18 years, living in Victoria and resided in an Ebola outbreak-affected country in West Africa during 2014–16 epidemic. Participants were recruited through a non-randomised purposive sampling and completed an online questionnaire comprising demographic data; Trauma History Screen (THS); Oslo Social Support Scale (OSSS-3); Brief COPE (28); the Kessler Psychological Distress Scale (K-6); Life Satisfaction measure; and two short-answer questions. Participants were also invited to participate in a second phase, in which semi-structured Zoom or phone interviews were conducted for more nuanced data that would enrich the findings. Results: A total of 68 persons in Victoria, Australia initially subscribed to the online survey, out of which 36 qualified for inclusion and 9 of the 36 participated in qualitative interviews. Fifty three percent of the 36 were women and majority of the participants were 18–40 years. Fifteen papers that covered demographic characteristics of participants, raw qualitative interview data, and seven covering the research questions (RQs) resulted from the study. Widespread illness and death followed by hardship and trauma were recounted by participants. Family was a major source of social support for them, which enhanced coping strategies during the 2014–16 EVD epidemic in West Africa. Alternatively, government support played a major role in alleviating the socioeconomic pain in Australia, seemingly to better effect by comparison with West Africa. Awakening the 2014–16 EVD experience during the COVID-19 pandemic elevated psychological distress. Nevertheless, most participants reported resilient coping strategies built on past experiences during the 2014–16 EVD epidemic. Participants were more satisfied with life during the COVID-19 pandemic in Australia than during the 2014–16 EVD epidemic in West Africa. Conclusion: Findings showed that past events traumatised participants and there were more illnesses during the COVID-19, but more deaths occurred during the EVD period. They utilised past coping strategies during the COVID-19 pandemic, and they positively highlighted government support in Victoria, Australia. Considering the scale of infectious disease emergence and re-emergence and the psychosocial impacts of these events, further studies are needed to explore the long term effects of such events. Furthermore, adapted and culture sensitive infection prevention and control methods are required to ameliorate the negative impacts of these events. It is further recommended that community programs should be implemented to locate and encourage traumatised and distressed survivors of these events and other disasters to seek healthcare treatments.