Duelo Covid-19
This phenomenon is worldwide and experts call it: duel deprived of rights. (Photo: EFE)

More than 2.9 million people have died around the world due to the Covid-19 pandemic. We’re dealing with death and loss in unconventional ways. Experts call the phenomenon “disenfranchised grief”, which means our right to say goodbye at a funeral, to carry out our rituals, and to take time to say farewell has been taken away.

How can we mourn during the health emergency? How can we accept loss when, in many cases, there were no goodbyes? Expert Alejandro Domínguez Rodríguez, together with his team, seeks to help the population answer these questions via the Duelo Covid (Covid Grief) platform.

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How does the Duelo Covid platform work?

The website is aimed at anyone who’s lost a loved one or someone close to them in the last six months, and who hasn’t had suicidal thoughts or attempted suicide. It’s free and easy to navigate.

“The platform won’t be enough for those people who’ve been grieving for more than six months or for those who have some of the symptoms of complicated grief, but it will refer them to free hotlines that operate 24 hours a day, seven days a week,” says Alejandro Domínguez, a Doctor of Psychology from the University of Valencia, Spain, who runs the program.

“The project originated because we’re seeing abnormal levels of anxiety, depression, and sleep. We started with Salud Mental Covid (Covid Mental Health), but users told us that a psychological program focused on grief was needed, so Duelo Covid was born,” he explains.

The platform’s goal is to prevent complicated grief disorder, which requires more specialized care. There are modules on the website with exercises and questionnaires to determine what stage each person is at.

“The idea of these programs and efforts is that once Covid-19 is under control, it doesn’t continue to have an effect on society and on health,” says Domínguez Rodríguez.

Duelo Covid is an inter-institutional and interdisciplinary effort, involving mental health professionals with clinical experience, engineers, developers, and designers.

It has the support of researchers from the National Autonomous University of Mexico (UNAM), the Valencian International University, the Autonomous University of Ciudad Juárez, and the University of Buenos Aires.

The program has been created to provide free, professional care to anyone who’s suffering a loss, even if it’s not specifically from Covid-19.

You only need an email address to access the program. It doesn’t have to include your name.

“The website is hosted on the cloud. All the data is encrypted and secured. It’s confidential. It complies with the highest standards of data security and has various security certifications,” explains Joabian Alvaréz Silva, architect and manager of the platform.

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What is complicated grief?

Due to the regulations to avoid infections, hospital visits are restricted, so not everyone has been able to say goodbye to their loved ones. Many were taken by surprise. Some were only able to say goodbye through a cellphone camera.

Funerals as we knew them are no longer held. There is often no body present or only the ashes. Vigils can’t be held because the red alert level prevents gatherings.

“The rituals that we’ve built around death are strategies (in most cases) to help us with the process of assimilating the loss. These rituals have been modified or suspended because of the pandemic, which in general makes it more difficult to process the emotions related to grief,” explains thanatologist Farith Zambrano Medina.

This change in the way we say goodbye to our loved ones has triggered complicated grief, a disorder that concerns mental health experts.

For his part, psychologist Alejandro Domínguez explains that complicated grief disorder is very serious and affects various aspects of physical health. These are people with the following characteristics who’ve been grieving for more than six months:

Depression

Suicidal thoughts and behavior

Anxiety

Post-traumatic stress

Significant sleep disorders

Difficulty coping with everyday tasks, maintaining relationships, and doing their jobs in the long term.

“It’s as if we suddenly see reality through lenses with a filter that makes the colors turn dull. Some describe it as a sense of disconnection to present reality,” explains Farith Zambrano, a Tec de Monterrey graduate.

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Follow-up from Duelo Covid

The intervention of Duelo Covid is designed to last 36 days. It follows the same logic as medication, i.e. we don’t take a bottle of pills to get better faster. It requires time and metering out the doses.

“All the content on the website is based on scientific evidence. We’ve seen improvements after this intervention,” says Domínguez.

The 12 modules are designed to help people who’ve experienced a loss. The content is structured as follows:

Module 1. Explains grief and its stages.

Module 2. Helps to identify people’s emotions and needs during the stages of grief.

Module 3. Prepares people to go through and face pain.

Module 4. Assesses concerns.

Module 5. Disenfranchised grief due to Covid.

Module 6.  Strategies for saying goodbye to our loved ones.

Modules 7 to 10. Resuming life, self-care, support networks, setting goals, avoiding relapses.

Grieving is a normal process for dealing with the losses that we suffer. “It’s a process of emotional acceptance that we all go through every time we suffer a significant loss,” says thanatologist Farith.

But we need help from an expert in order to face this process, especially because the grieving process has been affected by the pandemic.

“You don’t overcome grief by avoiding thinking about the loss. All that causes is a rebound effect. It comes back stronger,” Domínguez warns.

Here are the requirements for registering on the Duelo Covid website:

An email address

Read the informed consent form.

Complete a survey if you provide consent. The survey helps you know what progress you’ve made before and after intervention.

Begin the 12 modules of grief. Each module is designed to last three days. In total, the intervention lasts 36 days.

At the end, users answer another survey that allows them to evaluate their progress.

The other pandemic

The World Health Organization (WHO) has warned that the next pandemic will be a mental health pandemic and has urged governments not to neglect psychological care.

This organization says that fear, worry, and stress are normal responses when we’re faced with uncertainty or the unknown or situations of change or crisis.

So, it’s normal and understandable for people to experience these feelings in the context of the Covid-19 pandemic.