Protecting our collective physical health has been Canadians’ top priority for nearly seven weeks, as we hunker down at home or take to the front lines to battle COVID-19 together.

But the realities of a pandemic — the loss of life, the financial hit, the isolation — can also take a toll on our mental health.

A poll released earlier this week by Angus Reid Institute, which surveyed 1,900 respondents, showed half of Canadians reported their mental health has worsened in the last six weeks, with 10 per cent of respondents reporting their mental health has worsened “a lot.”

“Part of the issue is just when you think you’ve adapted to this, something comes up,” said Dr. Laura Hawryluck, a critical care physician at University Health Network and associate professor of critical care at the University of Toronto. “Like, for example, something really simple like you want to cook something and then you realize that you’re missing an ingredient, and you realize what’s going to be involved in getting that ingredient, if the stores even have it. Things that you’ve really taken for granted, that you wouldn’t even think twice about and now every time that kind of moment comes up you re-experience the loss of life as it was all over again.”

Hawryluck and her colleague, Rima Styra, a psychiatrist at University Health Network and associate professor of psychiatry at the University of Toronto, have observed different emotional stages of the pandemic, some of which Canadians have already or are currently navigating.

And, they say, there are more difficult stages to come, even as the pandemic curve itself flattens and the country considers opening its doors once again.

Here’s a look at the psychology of the pandemic in five stages.

Denial

Denial began before Canada was hit by coronavirus, as we started hearing about this new, emerging pathogen and watched it ravage other countries, like China and Italy.

“It was a serious situation, but we were going to manage all of this,” said Styra. “We had been through (severe acute respiratory syndrome) in Toronto so we thought we had kind of lived through this in the past, we were successful in doing so; we tried to minimize the impact that we though might occur in Toronto.

“SARS was very different, though, from COVID-19.”

Control

When it became clear that coronavirus would touch Canadians, people searched for ways to feel in control, ways to protect themselves. Toilet paper, hand sanitizer and medicine flew off the shelves, as people haphazardly began preparing makeshift survival kits.

“We had a lot of anxiety going on, so we did the kind of things that we think would help us. There was all this rushing to Purell and basic needs and, as anxiety grew, we really started hoarding,” said Styra. “That’s a negative thing, as well.”

Social and physical distancing, which continue today, also gave people the sense that they had a handle on the virus.

“It was going to protect us, that was so important for us,” Styra said.

Uncertainty

As time wears on and reality has now set in, fear, worry and anxiety grow. Things people thought would mitigate the risk might be working, but illness and death tolls continue; financial struggles and isolation persist. So-called “normalcy” seems out of reach.

Those feelings may only grow as provinces open their doors. For vulnerable members of the population in particular, lessening restrictions may be terrifying, Styra said.

Fear is an appropriate, normal response to the unknown, said Hawryluck, who works in the intensive care unit at Toronto Western Hospital. It is how people handle fear that will be crucial to their mental well-being.

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“It’s OK to be afraid in many ways but … the fear that paralyzes you from living, it’s not good,” she said. “It’s understanding that yes, we are going to experience this and different people are going to experience it to different degrees for different reasons, but what we do with that fear then becomes really important.”

Loss

Loss will also hit people in different ways at different times, said Hawryluck.

She expects the loss of normalcy could become more difficult to accept as we open our doors to a changed world.

“I don’t think that people are necessarily emotionally prepared for it to not go back to normal,” she said.

The bigger loss is the loss of lives. Families and communities who have lost a loved one may not have been able to say goodbye or mourn the way they wanted to. Hawryluck worries the deaths will hit all over again when lockdown restrictions are lifted.

“I worry that those people will be somewhat lost as everybody is coming out and emerging … They’re going to need support that other people won’t need and we need to be attuned to that to be able to help everybody” she said. “That motto of not leaving everyone behind as we navigate this next stage is going to be something that we all need to remember.”

Understanding

There will be a choice to make as we continue to manage the outbreak about what we can learn from this pandemic. In critical care, Hawryluck sees people demonstrate love, courage and gratitude every day. She hopes people try to carry that forward in their daily lives.

“If, as a society, we learn this from COVID, we will be better,” she said. “There will be something that comes from all the decimation, what it has done to us.”

Innovations, preparedness and how we treat each other are all things to come out of this time that we can be grateful for.

That gratitude may help us heal mentally, said Styra.

“We’re going to have to focus more on the positives than the negatives, which is easier said, of course, than done.”