Fear of infection. Lonely. Worried about good health.

As the coronavirus spreads across borders in the early stages of the pandemic, calls to the global helpline show that from China to Lebanon, from Finland to Slovenia, the damage to mental health is surprisingly similar.

An analysis of 8 million helplines in 19 countries/regions published Wednesday in the journal Nature reveals the collective response to an unprecedented period of uncertainty.

The caller’s concerns centered on the fear of infection, loneliness, and physical health. Compared to before the pandemic, phone calls related to relationship issues, financial issues, and suicide-related issues are generally less common.

Researchers in Switzerland and Germany checked helplines in 14 European countries, the United States, China, Hong Kong, Israel, and Lebanon. These include suicide prevention hotlines and hotlines for crisis counselling.

Marius Brulhart, professor of economics at the University of Lausanne and lead author of the study, said: “We are shocked at how similar the pattern of calls to helplines in various countries is broadly similar.”

Researchers gathered country-specific data in the first 12 weeks of the 2020 pandemic and found that the call volume peaked in six weeks, an increase of 35% over the same period in 2019.

The researchers also analyzed data from the two largest helplines in France and Germany in the spring of 2021. The call patterns in these two countries have changed as infections and government restrictions have risen and fallen, and the concerns raised are similar to those in the early stages of the pandemic.

Due to fear, loneliness, and suicidal thoughts or behaviors, strict blockades and social distancing measures are associated with more calls. Researchers say the government’s financial support for unemployed workers and companies that have lost customers has the opposite effect, “alleviating pain and mental health problems.”

Harvard mental health researcher Karestan Koenen said that the model of linking reduced phone calls with government assistance is an important gain for policymakers.

She said that in many countries, analyzing helpline data is “a very creative way of assessing mental health in a pandemic.” Koenen pointed out that in the United States, crisis helplines have been vigorously promoted throughout the pandemic, which may have expanded their use.

Judith Buss of the Bloomberg School of Public Health at Johns Hopkins University said that the concerns raised on the phone echoed the findings of investigations that showed that the pandemic has caused damage to mental health.

“The idea that fear is part of the early manifestations is both research and logical,” Bass said. The virus “is an unknown number, no one has experienced it before.”

Ass pointed out that the study does not include developing countries, such as countries in Africa that have experienced Ebola and other disease outbreaks. She said that the response of people in these countries to the early stages of the COVID-19 pandemic may be different from the countries in the analysis.

Nonetheless, the study shows how common helplines are around the world, Bass said, and there are many more of these hotlines than the countries included in the study.

Bruhart said the methods used in the research to manage the data make them useful for academic research.