War in the COVID-19 era: Mental health concerns in Armenia and Nagorno-Karabakh
Christopher Markosian, Christopher M. Layne, Varduhi Petrosyan, Shant Shekherdimian, Cheryl A. Kennedy, Vahe Khachadourian
Abstract
Given its pervasiveness, severity, and complex and lasting impacts, the COVID-19 pandemic is in many respects the worst global epidemic in over 100 years. Apart from the devastating direct health effects of the viral infection, other aspects of the pandemic – including fear of transmission, consequences of interventions to reduce transmission, massive economic strain, societal disruption, and loss of family and friends – undoubtedly impact mental health in a complex manner (Brooks et al., 2020; Moreno et al., 2020; Pfefferbaum & North, 2020). Considering the newfound challenges imposed by the rapid global spread of the virus, the Secretary-General of the United Nations called for the cessation of all armed conflicts in March 2020 (Guterres, 2020). The damaging effects of war exposure on mental health are well-documented (Barber, 2009; Murthy & Lakshminarayana, 2006; Summerfield, 2000). However, the ramifications for mental well-being of both a global pandemic and war are unknown, including additive and potentially synergistic effects of these two constellations of stressors on mental health disorders (Layne et al., 2010). Despite the call for a global ceasefire, many populations across the world remained susceptible to conflict during the pandemic. It is a sobering fact that the peoples of Armenia and Nagorno-Karabakh (also known as Artsakh) have been experiencing extremes of both war and COVID-19 during the past few months.