"I want to break free” - the famous lyric from Queen`s song seems appropriate for today’s times, when everyone wants to escape the restrictions that were enforced with the COVID-19 pandemic. Looking back, the alarming spread of SARS-CoV-2 infection has induced fear and panic among people. The fear of getting sick with the "unknown virus” made us self-isolate at home, and be very careful about hand hygiene and interactions with others. Since March 2020, face masks have become an essential part of our lives, together with hand hygiene products. The initial months of the pandemic have been marked by a significant disruption of the availability of these products on the market, which, in turn, exponentially increased people’s fears.

But as the months passed and SARS-CoV-2 became better known, opponents of the restrictions began to emerge, and the mask became a means of "suppressing people’s freedom”. In a personal study (unpublished data), Romanian adults’ fear of contracting COVID-19 has dropped in one year since the start of the pandemic from 79.4% to 24.9%. Why these paradigm shifts – from desperately seeking to procure masks to wanting to get rid of them, or from fear of the disease to underestimating SARS-CoV-2 infection?

Overall, the COVID-19 pandemic has produced major changes globally at all levels, but it has also caused major changes at the individual psycho-emotional level. "The fear of coronavirus is changing our psychology" wrote David Robson for the BBC in April 2020.¹Subsequent studies have shown that the pandemic has led to an increase in the incidence of depression and anxiety,^2-7 emotional disorders,⁸mood disorders,^6,7 stress⁷ and insomnia.^3,5Lockdown, social isolation, alarming news, fear of the unknown contributed to the psychological impact of the pandemic.

In this context, there were opponents of the measures taken by governments to contain the pandemic⁹and many of the measures began to be disliked by the population. The mask was a main topic of discussion, its wearing becoming a sign of fear. But numerous studies have shown that the mask played a crucial role in limiting the transmission of SARS-CoV-2 infection, and not only.^10-12 The lockdown and non-pharmaceutical measures put in place played a key role in limiting the exponential increase in the number of COVID-19 cases that could have blocked healthcare systems and increased mortality. At the same time, these measures also played an important role in modifying the circulation of other seasonal viruses. Thus, during the years 2020-2021 the circulation of influenza viruses was almost non-existent and infections with other respiratory viruses such as respiratory syncytial virus, common coronaviruses, metapneumovirus or parainfluenza viruses were rarely identified.¹³

What happened after the relaxation of restrictions? The sudden relaxation of restrictions, without public awareness of the positive role that non-pharmaceutical measures had played, has led to a high circulation of influenza viruses in the spring of 2022.¹⁴In addition, hospital emergency departments have been overrun with patients with acute respiratory or digestive illnesses.

After these two years of the pandemic, we need to summarize the lessons we have learned. Although, we as humans try to forget everything we didn’t like, we cannot hide the fact that the pandemic taught us what was already known but not practiced properly: prevention measures are essential and safe to limit viral infections. Simply washing our hands and wearing a mask protects us and those around us. The extremes and exaggerations are not good, but we must find the balance and intelligence to apply these measures when the epidemiological situation demands it.

David Robson. 2020. The fear of coronavirus is changing our psychology. Accessed on: 26 April 2022. Available at: https://www.bbc.com/future/article/20200401-covid-19-how-fear-of-coronavirus-is-changing-our-psychology.
2. Chen F, Zheng D, Liu J, Gong Y, Guan Z, Lou D. Depression and anxiety among adolescents during COVID-19: a cross-sectional study. Brain Behav Immun. 2020;88:36-8.
https://doi.org/10.1016/j.bbi.2020.05.061
3. Deng J, Zhou F, Hou W, et al. The prevalence of depression, anxiety, and sleep disturbances in COVID-19 patients: a meta-analysis. Ann N Y Acad Sci. 2021;1486:90-111.
https://doi.org/10.1111/nyas.14506
4. Daly M, Robinson E. Depression and anxiety during COVID-19. Lancet. 2022;399:518.
https://doi.org/10.1016/S0140-6736(22)00187-8
5. Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-07.
https://doi.org/10.1016/j.bbi.2020.05.026
6. Vorspan F, Amarsy R, Etain B. May confusion be a misleading initial clinical presentation of COVID-19 in individuals with mood disorders? Psychiatry Res. 2021;297:113710.
https://doi.org/10.1016/j.psychres.2021.113710
7. Rogers JP, Chesney E, Oliver D, et al. Psychiatric and neuropsychiatric presentations
associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry. 2020;7:611-27.
https://doi.org/10.1016/S2215-0366(20)30203-0
8. Hwang H, Hur WM, Shin Y. Emotional exhaustion among the South Korean workforce before and after COVID-19. Psychol Psychother. 2021;94:371-81.
https://doi.org/10.1111/papt.12309
9. Chen CWS, Fan TH. Public opinion concerning governments’ response to the COVID-19 pandemic. PLoS One. 2022;17:e0260062.
https://doi.org/10.1371/journal.pone.0260062
10. Cheng Y, Ma N, Witt C, et al. Face masks effectively limit the probability of SARS-CoV-2 transmission. Science. 2021;372:1439-43.
https://doi.org/10.1126/science.abg6296