There are several reasons why vaccines are not trusted, including religious and political reasons. This is exasperated by the misinformation that is spread wildly about the science behind vaccines, and the validity of such claims. Ultimately, it all boils down to how much government entities and other community leaders can propel misinformation about vaccines, and the fact that decisions about vaccines might affect the community at large.

Medical Objections Against Vaccinations

A study conducted by Andrew Wakefield in 1998 linked autism to the measles, mumps, and rubella (MMR) vaccine. It was later discredited and retracted, however, this study is still referenced as a reason to not vaccinate children, or has at least kept the idea prevalent. People often believe that vaccines are more harmful than the diseases they might prevent because of their side effects. The same sentiment is being referenced to in recent objections about a coronavirus vaccine. Pharmaceutical companies and governments are moving at record speeds to come up with a vaccine for the coronavirus. However, this is also fuelling uncertainty and hesitancy about vaccines.

The common folk is worried about compromising quality in the race for a vaccine, and some experts agree: Oksana Pyzik, who is a senior teaching fellow at the University College London School of Pharmacy says, “The fact that it’s being crunched into such a short period has been a cause for concern”. There is also a large mistrust of big pharmacy companies at play here along with a general mistrust against science and experts. People believe that the science that is provided in support of vaccines is either falsified for profit or can be proven incorrect in the future. In the case of the coronavirus vaccine, trials are being conducted one after the other without time to properly gauge the implications of the previous trial. Vaccine development can take decades; hence it is only natural that there are doubts about the safety of a coronavirus vaccine developed in less than a year.

Religious and Political Objections

Vaccines can also bring religious objections – the MMR vaccine and the rubella vaccine had been previously derived from fetal tissue. Opposition to abortion present in religions such as Hinduism, Islamism and Jewism can translate into opposition to vaccines. Religious reasons such as these are brought into play when we consider the fact that schools grant exemptions to children based on religious grounds. Schools might continue to do so even when a coronavirus vaccine comes into being, which can be a concern for overall public safety if parents want to send unvaccinated children to school citing religious objections.

Objections to a vaccine are often part of a bigger picture which includes discourse on government intervention. Opinions on a vaccine can vary along party lines, with 81% of Democrats and only 51% of Republicans keen to get vaccinated in the United States. Certain people can value individual liberty and not want the government to intervene in vaccination-related decisions, which is why Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases since 1984 said that the United States will not make a coronavirus vaccine mandatory. The idea that vaccination is increasingly becoming compulsory in order to attend school is, in turn, fuelling the anti-vaccination sentiments. People valuing freedom are interpreting this as an infringement of their rights. A study titled “The psychological roots of anti-vaccination attitudes: A 24-nation investigation” found that there is a correlation between anti-vaccination sentiments and “reactance” which is described as “the tendency for people to have a low tolerance for impingements on their freedoms”. 

Coronavirus Vaccines and Future Steps

Dr Anthony Fauci has also said that a vaccine taken by only two-thirds of the public would not create the herd immunity we want – in order for economies to get back up and running. In uncertain times such as these, one of the ways to vaccinate people is to either have governments make vaccinations mandatory. Dr Fauci’s previous comment about mandatory vaccination being unlikely in the United States could be indicative of an approach many countries could take. In such a scenario, it is important that there are discussions and discourse regarding vaccine safety. 

People often do not rely solely on doctors for medical advice, or at least have different sources than can influence their medical decisions. There needs to be a coming together of leaders in the community – religious leaders, celebrities and politicians – in order to combat misinformation and to encourage people to get vaccinated. Secondly, it is important to address religious concerns. Though most religious organizations do not actively oppose vaccination, there is sometimes opposition to vaccination in certain religions. Religious leaders could be instrumental in combating vaccine hesitancy – against coronavirus and other preventable diseases. 

Such a sentiment on discourse about vaccines is best represented by Dr Mike Ryan’s quote. Dr Ryan, who is executive director of World Health Organisation’s health emergencies programme, said that people need to be allowed to have conversations about vaccines – “It’s not a one-way street. It’s not about shoving things down people’s throats. It’s about having a proper discussion, good information, good discussion on this and people will make up their own minds,” he was quoted saying.

Properly publishing information on how vaccines are developed and how safe they are can quell medical objections to vaccines. Propelling rumours and misinformation is important – despite the sped-up process, vaccines are still going through required checks and tests before being made available to the public. Moreover, data from trials is being verified from other sources too. People often have worries about the authenticity of medical equipment. For example, the WHO says that 1 in 10 medical products are either fake or below a certain standard. This is all a part of the mistrust people have of “big pharma”, and even the government. Conspiracy theories have cropped up saying the government might inject microchips in the vaccines. Such rumours increase vaccine hesitancy and need to be combated by emphasising the importance of vaccines in public safety.

Conclusion

All efforts and resources including medical personnel, money and infrastructure that is being put into the development of a coronavirus vaccine will be in vain if people refuse to get vaccinated if and when a vaccine becomes available. Making the vaccine mandatory is something a lot of countries might be unable to do. In this situation debunking conspiracy theories and having trust in public safety experts and doctors is crucial. In fact, it is important to trust medical experts in all matters related to vaccines. Even the WHO has included vaccine hesitancy in its list of top 10 global health threats and that goes on to show how important it is for discourse to happen on the importance and safety of vaccines. 

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“Health is the core of human development”

– Gro Harlem Brundtland

Economy and health are inseparable. Healthy people can live a prosperous life leading to more productivity, saving and investment, boosting economic growth and development. When an economy is interrupted by an unusual happening, economic effects follow up. Morbidity rate – the percentage of people infected, mortality rate- death rate, duration of the pandemic’s existence, number of workweeks lost, level of inequality during and after pandemic are some of the variables which can be used to estimate the economic effects of the pandemic.

Effects on supply

At the very initial stage when the disease starts spreading it creates panic among workers and there are possibilities for the rise in the rate of absenteeism. When the situation turns worse and the government intervenes by preventive and curative actions through lockdown and quarantine then it leads to loss of working weeks, shut down of businesses and industries at least till the restrictions are eased. Even after industries resume its functions, there will be a restriction on the number of workers, possibilities of workers getting affected by the disease or being deceased or laid off. This will not only affect a separate industry but there will be a break in the supply chain due to the breakdown of linkages– the flow of intermediate inputs in production. In the present time where many countries have trade liberalization, international flow of goods and services may also get severely affected. Businesses will hesitate to make an investment. Tourism, aviation, automotive, real estate, manufacturing industries of non-essential commodities may face loss while health care product industries, E-commerce may become some of the potential gainers at least for a short term.

Effects on wage

The Black Death of the 14^th century wiped out a quarter of Western Europe’s population, had economic effects like a drop in GDP, hike in the price of basic commodities and hit in the agriculture sector. But on the perspective of income, some thought to have positive or no effect on income per capita at least in France and England. Even 1918 influenza has had a positive impact on income per capita in the US. 

In a simple economic model, when the supply of labour is reduced in the manufacturing sector, initially there will be an increase in the marginal product of labour and capital per worker, increasing the real wage for a short term. The same way in a research it was found that over the period of 1914 to 1919 there was a greater increase in the manufacturing wage growth in the cities and states of the United States where influenza mortalities were greater. This may be possible only in short term but in the long run, fall in demand, loss of skilled workers, political pressure to control the wage, higher mobility of workers, reduction in human capital may result in equalization of wage. There is no clear view on both short and long term effects, as it depends on various circumstances.

Effects on demand

The anxiety created by the pandemic situation may result in loss of consumer confidence, people may hand back to spend. The economic cost may rise irrespective of whether the morbidity and mortality rate is high or low. The anxiety created during SARS (2003) outbreak which relatively had low mortality rate led to the economic cost of over 11 billion dollars in the areas where tourism and business were affected. The precautionary measures to avoid the spread of disease may isolate people from other activities like going to gymnasium, theatre, hotels etc. There may be effects on savings too.

Poverty and Inequality

Generally, the most vulnerable section, prone to diseases, is the poor due to lack of good sanitation, health care facilities and insufficient nutritious food. Even if the pandemic affects people indiscriminately the degree of an economic burden to be borne by the poor will be more.  During the lockdown, they have to face a hard time as most of their lives depend on day to day wages. Poor people may not have life insurance due to non-affordability or lack of information/awareness, in such a case if the principal earning person dies in that family the economic situation of that family will become worse and it will prolong until another person from the family enters into the working population with sufficient income. Education may become a distant dream, as the unfavourable economic situation may force them to send their children to work than to school, but education is one of the significant factors for the development of an individual as well as the economy a whole. 

The historians noted an improvement in economic equality after Black Death of 14^th century but currently, the pandemic situation which we are facing is quite different, now technology has taken lead. Right from health care services to education to work, for time being, is dependent on the internet. In the case of education students who cannot afford to electronic devices with internet connections or from remote rural areas will be set back. Half of the world’s population does not have access to the internet. If the gender gap prevails in access to the internet then it will increase the disparity between men and women. According to research, nearly 15% of the workforce on an average from 35 advanced and emerging countries, among 189 member countries of IMF is unable to do their works remotely. Even when vaccines are developed, distributional inequality may arise both within and between countries. Not only during its existence but even after COVID-19 vanishes a fear emerges that it may have an impact on inequality in different ways.

Loss of life can never be comparable at any cost.  

“Hope is important because it can make the present moment less difficult to bear. If we believe that tomorrow will be better, we can bear a hardship today.”

 -Thich Nhat Hanh

Even when Spanish flu led to the death of nearly 3-5% of the population and having a severe impact on the economy by increasing the unemployment and poverty, history shows that humankind with resilience fought back and got recovered soon. There is a greater chance of being flexible to the unforeseen circumstances to bounce back to normality. Fiscal and monetary measures used by the government, funds from international organizations, improvement in public health, infrastructure, education, cooperation by the people, love and compassion for others, giving a helping hand to the needy and most importantly faith in healing to have a better future will definitely lead us to recovery.

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Symptoms

Conditions such as anxiety, depression, panic attacks, lucid dreams, phobia, insomnia affect our mental health. Overthinking plays a very huge part when we talk about mental health. Many people tend to think too much about the situations which will probably never happen. People don’t have control over how much they overthink. There are many solutions to overthinking if you search it up on the internet but, in reality, it’s not very elementary. You can experience these conditions at any point of your life, no matter the age, sex or ethnicity. Some people can be more prone to depression than others because of well, life situations, peer pressure, sexual identity and whatnot.

According to a study by WHO, half of all mental health conditions start by 14 years of age. Adolescents are at greater risk of mental health conditions due to their stigma, discrimination or exclusion, or lack of support from their parents/friends. As per the same study by WHO, suicide is the third leading cause of death in older adolescents because of mental illness and lack of access to help/therapy. There is a growing consensus that healthy development during childhood contributes to good mental health.

Lancet’s Study

Lancet has found the efficacy of “brief lay counsellor delivered, problem-solving intervention’’ for mental health problems in adolescents from government schools in Delhi. This is for adolescents who can’t afford to pay for therapy sessions. The premium for Adolescents (PRIDE) is a six-year research programme dedicated to making psychosocial interventions for improving the mental health of adolescents in India. “The study established that with limited resources and counselling intervention, we can give practical tools to adolescents to manage and deal with their mental health issues. This also makes mental health treatment accessible to those from underprivileged sections of society,” says Dr Kanika Malik, a clinical psychologist. The programme is going really well and is pretty successful. More than 250 adolescents were enrolled for the programme between August and December in 2018. For the treatment, they made a problem-solving booklet in a comic format to keep up with the interest of the adolescents. The book has many chapters which teach the kids to deal with domestic problems. This is very important because domestic life can be a major source of stress for the students and they don’t have the resources to tackle these situations but the comic book gives them tools to work through them. Not only did they distribute the booklets but also hired and trained the members of the community to counsel students.

According to a study by the lancet, more than 99% of adolescents and children with mental health problems remain undiagnosed in India. If these students receive proper treatment right now, they are less likely to suffer from serious mental health conditions in the later stage of their life. The initiative that lancet took for these adolescents is exceptional. 

Vulnerable Teens 

Another problem that students face while growing up is whether or not they should tell their parents about what they are going through. Adolescence is a very crucial period in our lives. Your decision-making power is not the best at this age. Parents are also requested to listen to their kids, to understand them, to tell them that it’s normal to feel this way. Many kids have abusive parents which makes it even more difficult for them to go through the illness. 

Look out for yourself and other people

 Mental illness is a very serious condition and it should not be neglected. Your brain is just as important as your heart and other body parts. It can only handle so much. Also, we should not forget the fact that we are in the middle of a pandemic right now and this COVID situation is not helping. This is for all the parents, if your kid is struggling, love him/her. This is for all the people who have friends with mental illness, support your friends.

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Over the years, not only has the United Nations solved conflicts but has also catered to humanitarian crises, a number of which have been successful. The Polio Eradication Initiative led by WHO in India has been one of the most effective health campaigns carried out by WHO. In 2009, India had the highest number of polio cases in the world. This public health emergency was especially challenging to tackle due to India’s population density, poverty rate and poor sanitation. Given the rising cases of polio and the challenges the Indian government was faced with, the WHO’s intervention in 2010 made a lasting impact. 

 In the procedure of eliminating Polio, the WHO introduced bivalent oral polio vaccines, the implementation of which was excellently supported by the Indian government. The prompt response to this led to a nationwide inoculation drive and polio vaccines became a must and were being heavily implemented in every state through micro-planning. Despite the complexities of reaching out to every section of the society in a diverse country like India and refusal of getting vaccinated the UN subsidiary in amalgamation with the Indian government led to a sharp fall in the numbers of reported polio cases. 

Although the UN has made crucial contributions towards the betterment of certain aspects, it has, however, failed to prevent war in some instances and has had counterproductive peacekeeping missions. The Democratic Republic of Congo has been victim to the UN’s inefficiency and sub-par performance during the peacekeeping mission set out by the UN for the DRC. 

In 1999 the UN started operation MONUC and sent peacekeeping forces to Congo due to its civil war and the rising threat to human rights it posed. The Congolese Civil War gained traction from its neighbouring states, but the most vital role was played by the Rwandan Army. to counter the same Congo and the UN pledged to remove insurgents in return for the withdrawal of Rwandan troops. In spite of this Rwanda did not comply since they felt the pledge was not upheld and went on to order the UN to withdraw its peacekeeping forces. 

Shockingly, the UN complied and withdrew its forces from the region. Resultantly, the Rwandan Army’s militaristic involvement in Congo increased and caches of weapons in the DRC were found in the following year. Rooting from the UN’s very explicit inaction and resistance towards changing the status quo, this mission by the United Nations is considered one of the most consequential and colossal failures of the organisation. 

Regardless of its performance, the UN has undoubtedly played a key role in shaping world order and contributing to changing the balance of power. Over the years IGO’s have become a platform for states to posture themselves in the international arena and flex their muscles. While the realist beliefs refute the importance of non-state actors and any means of power that is not militaristic or economic in nature, there has been a steady growth in the investments made in the United Nations due to its magnitude. 

China being one of the most prominent states to visibly express their interest in investing and following through has definitely added to its soft power and sphere of influence. China is now the second-largest contributor in financial investments in the form of troops to the UN amongst G77 countries. In 2015 Xi Jinping pledged to supply 8,000 peacekeepers and after withholding that pledge, they committed to a 10 year $1 billion China-UN Peace and Development Fund for peacekeeping operations.

China’s sudden involvement and constant support towards the UN, financially, is no coincidence. By gradually becoming a salient aspect of the mechanism and functioning of the United Nations, China has gained an upper hand in all the conflicts and human rights violations attached to it. Taiwan’s position as a state and not being recognised as a nation-state by the United Nations, now seems far from happening due to the UN’s dependency on China for financial aid. 

2020 being the UN’s 75th anniversary and still being a major stakeholder in the system of states and their functioning, the aforementioned arguments and cases are a pure reflection of the United Nations work over the years and paints a clear picture of its performance and potential actions in the future. 

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In India, as reported by the National Mental Health Survey (NMHS) 2015-16, nearly 15% of Indian adults require interceding for mental health issues and at least one in twenty Indians suffer from depression. According to the recent WHO report India is the 6^th most depressed country with 258,000 reported suicides in the year 2012. The report also mentions that around 80% of Indians don’t seek treatment after getting diagnosed with depression, mostly because of the stigmatization of mental health in Indian society.

Reasons for Depression:

• Hormonal changes in the brain of a human being.
• A person who always thinks negatively or perceives the conditions with a pessimist approach more likely faces stress loneliness and anxiety.
• Some people who constantly experience violence, hatred, abuse, poverty, and relationship disputes easily tend to fall in depression.
• Sometimes genetics plays a major role in making a person vulnerable to depression as it runs from the parents to their children and affects them without external causes.

Symptoms of Depression:

• Fluctuating body weight
• Energy loss or fatigue
• Feeling irritated or agitated
• Finding oneself guilty and worthless
• The feeling of being left out
• Reduced concentration power
• Lowering interest and pleasure in activities and works.
• Suicidal thoughts or constant thoughts about self-harm

Present Scenario

Normally, people in the midst of lockdown have confined themselves in their houses which might be necessary for the amelioration of the nation but when it comes to the mental health of an individual, without any medical treatments or personal measures being taken many people are going through major repercussions like depression, anxiety, frustration, fear, etc. and these sort of feelings within a person has resulted in the upsurge of activities like domestic violence and suicide attempts. Usually, people tend to find solutions for such problems through an intense consumption of alcohol and drugs but improper awareness, the looming threat of a pandemic, fear of joblessness, and lack of medical facilities available in hospitals have caused amplification of this issue.

Confirming to the Ministry of Health and Family Welfare, India requires around 13,000 psychiatrists. An ideal ratio to be attained is 1 psychiatrist for 8000 patients but at present, we have 3500 psychiatrists which are about 1 for 2 lakh or 200,000 people. Regarding clinical psychologists, we need 20,000 but we have only 1000 working clinical psychologists. Though we are doing much well in the manufacturing, supply, and export of PPE kits yet it’s a need of the hour to fill this gap between the patients and the doctors required for mental health treatments by the government.

Social media has become an alternative way of living a life for us where due to loneliness people have presumed social networking sites as a second world. We have already witnessed cases of suicides due to a lesser number of likes and public views on social media handles of a person. Current so-called modern communication tools have resulted in remoteness from personal/physical engagements and gatherings.

Due to lockdown, we have started utilizing video calling tools that are leading towards a virtual life rather than a real one. Though it must be helping us in the continuation of our regular schedules it has now led to such disorders and has started affecting humans both mentally as well as physically. A human is called a social being but soon this sentence will reverberate as a fantasy and unfortunately, in the end, these social beings will find themselves as introverts.

Medical Treatments and Therapies for Depression

Though it is one of the most lethal disorders, it can be treated which must be done as soon as the illness gets diagnosed. The general method for getting it treated is with medications and psychotherapy or with the combination of both. When these solutions don’t work electroconvulsive therapy and brain stimulation therapies are the options that are mostly explored.

Considering the medications, anti-depressants are the most recommended medicines to treat depression which may improve the brain’s way of using certain chemicals that manages the mood and stress of an individual. They may usually take 2 to 4 weeks to deliver some positive results. Such kinds of prescriptions should never be taken without the counsel of a trusted doctor because an over-dosage or mistakes in the courses of intake of an antidepressant can cause serious side effects.

Psychotherapy is another option which is also termed as ‘talk therapy’ or ‘counselling’. It can help to reduce the symptoms of depression. Methods such as interpersonal therapy (IPT), cognitive-behavioural therapy (CBT), and problem-solving therapy are the approaches for the treatment of depression.

If the above mentioned medical treatments don’t give expected results then electroconvulsive therapy (ECT) plays a major role in the treatment of depression. The treatment includes continuous sessions which may be thrice a week for almost two to four weeks but may cause few side effects like confusion or memory loss. However, now due to the advancement in the method of ECT, it has become safer and more effective for the patients. The procedure though is not painful and a patient is put under anaesthesia. There are many more methods to treat this mental disorder which are being studied by the researchers and the doctors and soon may be utilized for the better and more accurate treatment of the illness.

Yoga to Overcome Depression

Yoga alone should never be considered as a treatment for depression but should complement with proper medication and other options after proper consultation with the doctors. Regular yoga will definitely help a person to overcome stress and will give strength to think optimistically and makes a person optimistic. Yoga includes asanas, pranayamas, and also yoga philosophies.

Yoga Asanas:

• Dhanurasana (Bow Pose)
• Janu Shirsasana (One-Legged Forward Bend)
• Setu Bhadasana (Bridge Pose)
• Matsyasana (Fish Pose)
• Pashchimottanasana (Two Legged Forward Bend)
• Hastapadasana (Standing Forward Bend)
• Marjariasana (Cat Scratch)
• Adho Mukha Svanasana (Downward Facing Dog)
• Sirsasana (Headstand)
• Shavasana (Corpse Pose)

These asanas help in releasing the tension and negativity from the systems of the body.

Pranayamas to relieve anxiety:

• Kapal Bhati Pranayama
• Nadi Shodha Pranayama
• Bhastrika Pranayama
• Bhramari Pranayama

These pranayamas are done by focusing or putting attention on the breath to relax and free the mind and erase thoughts that procreates anxiety or depression.

Meditation is the method that should be followed daily because when a person gets too anxious regarding a threat or for varied reasons the muscles of a body get tense and the body starts sweating and scientific research has proven that meditation can significantly reduce the level of stress hormones.

The ancient yoga philosophies mention about two important principles of yoga, ‘yamas’ and ‘niyamas’. According to this principle, niyama teaches about the value of containment whereas the Aprigraha principle guides us in overcoming greediness which has always remained a reason for anxiety. Another principle called the Shahucha principle glorifies the cleanliness of the body and mind. These principles also mention healthy eating habits and a proper lifestyle for a perfect livelihood.

Lastly, praying to the god and keeping positive group of company around ourselves can keep our faces smiling and can breed peace and joy in our lives.

Conclusion

The recent committing of suicide by a well-known actor Sushant Singh Rajput has left us astonished and where depression is said to be the reason for the unfortunate step he took. These problems can simply get solved by sharing our feelings with the near and the dear ones and consulting trained professionals in due time. Unfortunately, the lockdown has kept few people away from their close relatives and friends even then suicide should never be a choice because “suicide does not end the probabilities of life getting worse but it eliminates the possibilities of it ever getting any better.”

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