The Coronavirus disease 2019 (COVID-19) is an illness caused by a novel coronavirus which is associated with severe acute respiratory syndrome coronavirus.

According to Belam, Boseley and Devlin (2020), this virus leads to pneumonia-like symptoms which include coughs, fever, breathing difficulties and other associated symptoms.

The novel coronavirus was first identified amid an outbreak of respiratory illness cases in Wuhan City, Hubei Province, China.

In view of this, many started tagging it as the “China virus”. There were other claims that the virus infects certain groups of people or population and many more.

Given this, the name COVID-19 (Coronavirus disease 2019) was chosen to avoid stigmatizing the virus' origins in terms of populations, geography, or animal associations.COVID-19 was initially reported to the World Health Organisation (WHO) on December 31, 2019 (CDC-China, 2019).

On January 30, 2020, the WHO declared the COVID-19 outbreak a global health emergency (Ramzy & McNeil, 2020).

Finally on March 11, 2020, WHO declared COVID-19 a global pandemic (The New York Times, 13th March 2020).

Undoubtedly, COVID-19 is a new infectious disease, and there is inadequate information concerning the risk factors associated with it.

However, based on clinical expertise and reports currently available across the world, it is clear that older adults and people of all age groups who have severe underlying medical conditions might be at higher risk for severe illness from COVID-19 (CDC, 2020).

As reported by experts, these underlying medical conditions include but are not limited to diabetes, chronic lung disease, cancer, immune deficiencies, as well as liver and kidney diseases.

When the information reached the general public that older adults and people with severe underlying medical conditions were the most vulnerable, most young people felt invulnerable and seemed less scared or concerned.

Subsequent disturbing reports of young and otherwise “healthy” people falling seriously ill with COVID-19 and dying especially in New York City, however, changed the narrative of indifference among the youth albeit slightly.

As of 7th April 2020, there had been 12 deaths of people between the ages of 19 to 44, who had no reported underlying medical conditions. Eleven per cent of more than 19,000 hospitalized patients were reported as persons within ages 26 to 44.

It has been widely established through medical findings that immune system functionality declines with age and that older people report more underlying medical conditions which also appear to be risk factors for severe COVID-19 (Montecino-Rodriguez et al., 2013).

The alarming rate of deaths among the elderly population and other persons with severe underlying medical conditions is understandable. However, the baffling issue is the rate at which medically healthy people are also falling seriously ill with COVID-19 and dying out of it. Why is it so? There is no one reason for this happening.

Conversely, this study is hunched on the premise that mid-life crises and inappropriate ways of handling the stressors associated with it, is a precursor to COVID-19 illness and deaths among the medically healthy people. These people are medically healthy but maybe facing psychological issues and stressors emanating from a mid-life crisis.

Issues with Midlife Crisis

Midlife crisis is a term used to describe a period of dramatic self-doubt, intense intrinsic frustration and self-pity that is typically felt in the "middle years" of life (40-60), as people sense failure in their developmental tasks, the passing of youth and the imminence of old age without great wealth and good health. Sometimes, transitions experienced in these years, such as ageing in general, the decline in physical abilities, hormonal imbalance, the death of parents, or children leaving home, can trigger such a crisis in an individual.

The result may be a desire to make significant changes in core aspects of day to day life or situation, such as in career, marriage, finance, academic life or romantic relationships. For other people, a middle-age crisis may present itself as a time of regrets. Some people may regret not choosing a different career path or not creating a life they once dreamed about living.

For some individuals, the midlife period may be a time of immense reflection. They might look back over their years and question what their lives might have been like if they had taken a different path. In totality, these situations interfere with the smooth running of individuals as they may be going through distressing symptoms such as:

* Emotional distress which could impair the ability to sleep or loss of appetite

* Loss of concentration at work which negatively affects the level of work output

* Mood swings affecting healthy relationships, such as increased fighting with a partner or sibling, loss of sexual interest and activities

* Loss of interest in leisure activities and hobbies

* Feelings of pessimism or hopelessness

* Feelings of restlessness, anxiety or irritability

* Loss of interest in activities that you once enjoyed including sex and hobbies

* Thoughts of suicide or attempts at suicide

* Physical symptoms, such as headaches aches or pains.

Unfortunately, these distressing conditions usually do not respond to physical health therapy or medical treatment. When it happens this way, the individual may look good on the outside and for that matter could be considered as medically healthy without an observable medical condition.

However, these individuals may be going through psychological trauma that impairs their immune system, general health and many more, making them vulnerable to infections as well as other illnesses.

Midlife crisis downsizing the immune system

The coronavirus pandemic has turned the world’s attention to the immune system; the body’s defence force against disease-causing bacteria, viruses and other organisms that we touch ingest and inhale every day.

The immune system is a collection of billions of cells that travel through the bloodstream. They move in and out of tissues and organs, defending the body against foreign bodies (antigens) such as bacteria, viruses and cancerous cells. There are two types of lymphocytes: B cells and T cells.

The B cells produce antibodies and release them into the fluid surrounding the body’s cells to destroy invading viruses and bacteria. In cases where the B cells are unable to destroy the invading virus, leaving them to get inside the cell, the T cells quickly lock on to the infected cell, multiply and then destroy it.

In performing these actions, the immune system becomes the body’s multi-level defence network against potentially harmful bacteria, viruses and other organisms.

Medically, people have been educated on how to boost their immune system so they can naturally fight the coronavirus, pending a breakthrough in the search for vaccines.

For instance, we are aware that following general good-health guidelines are the best steps you can take toward naturally keeping your immune system strong and healthy.

We have also been told that every part of our body, including our immune system, functions better when protected from environmental assaults and bolstered by healthy-living strategies such as these:

* Neither smoking nor drinking excessive alcohol

* Avoiding drug and substance abuse

* Eating more fruits and vegetables.

* Exercising regularly.

* Maintaining a healthy weight.

* Getting adequate sleep.

* Take steps to avoid infection, such as washing your hands frequently and cooking meats thoroughly.

* Taking in vitamins etc.

Unfortunately, some of these medical suggestions to boost one’s immune system are the very things that individuals with midlife crisis either fail to do or enjoy doing. For instance, some victims of mid-life crisis take to smoking, drinking excessive alcohol, abusing drugs and other substances, overeating which results in weight gain, inability to sleep, loss of interest in exercising regularly, among others.

They mostly have the perception that doing some of these things will make them forget their problems. Unknowingly to them, they instead break down their immune system and are more likely to contract infectious diseases and even more importantly, more likely to die from them.

Furthermore, the high level of stress that mid-life crisis places on its victims becomes the greatest immune system destroyer. When stressed, the immune system’s ability to fight off antigens is reduced, thus making victims more susceptible to infections. The stress hormone corticosteroid can suppress the effectiveness of the immune system, thus lowering the number of lymphocytes produced.

Stress also produces an increase in blood cholesterol levels through the action of adrenaline and noradrenaline on the release of free fatty acids. This provides a clumping together of cholesterol particles, leading to clots in the blood in the artery walls and constriction of the arteries.

Stress responses increase strain upon the circulatory system due to increased heart rate as well as other mechanisms. Stress can also affect the immune system by raising blood pressure levels, which may then lead to coronary heart disease.

The good news is that short term suppression of the immune system is not dangerous.

However, chronic suppression leaves the body vulnerable to infections and diseases.

To this point, you can bear with me that mid-life crisis, if not dealt with properly and on time, exposes its victims to be more susceptible to the infection itself and make them more likely to suffer severely from COVID-19 and go through more serious complications which may finally result to death.

Redefining the vulnerability of the COVID-19 pandemic

In an attempt to control the infection rate of COVID-19, the WHO issued a number of statements which included a statement on the most vulnerable group prone to COVID-19.

The Organization indicated that evidence to date suggests that two groups of people are at a higher risk of suffering severely from COVID-19.

These are older people (that is people over 60 years old), and those with underlying medical conditions (such as cardiovascular disease, diabetes, chronic respiratory disease, and cancer). The risk of severe ailment gradually increases with age, starting from around 40 years. It is important that adults in this age range protect themselves and in turn protect others that may be more vulnerable

WHO therefore suggested that a healthy lifestyle will make all bodily functions work better, including immunity. Eating healthy diets, with plenty of fruit and vegetables, keeping physically active, quitting smoking, limiting or avoiding alcohol intake, and getting enough sleep, are critical components of a healthy lifestyle.

As much as these measures may be working for the older group and those with medical underlined conditions, these suggestions may not work for individuals who are going through stress and midlife crisis.

Unfortunately, WHO has not yet considered the fact that midlife crisis and any form of intense stressors have the propensity to breakdown the immune system and make its victim prone to COVID-19 infection.

Have you thought of why most healthy health workers are dying of COVID-19? I could presume that they are stressed out with workload, fear of being infected and/or infecting their families. They are depressed about the thousands of dead patients they encounter every day. These stressors might have distorted their immune systems, and for that matter, they could not fight the COVID-19.

It is highly likely that a similar case has been happening to the middle-aged healthy-looking men and women who are dying after being infected with COVID-19. I strongly believe that their immune systems might have been impaired by underlying midlife crises and stressors.

No wonder many healthy middle-aged people are being infected and dying every day in New York, USA. There is indeed a public secret about the stressful nature of living in New York as compared to other States in the USA.

The reality is that, if the prevention of COVID-19 is only about observing the known protocols, then infection rates should have dropped long ago.

People are wearing masks, washing their hands, staying home, among others but still, infection rates and death tolls keep rising.

This should inform the world that there is more to the spread and infection of the COVID-19 pandemic than the known protocols which have been outlined to prevent infection.

If prompt action is not taken, many countries lose their health workers, social workforce and security personnel who are going through a midlife crisis to the mercy of COVID-19.

Recommendations

Deducing from the case raised earlier on possible non-medical underlying conditions to the infection of COVID-19, it is recommended that the WHO will conduct further research into identifying more vulnerable groups susceptible to COVID-19. If vulnerable groups are not properly identified, the consequences of this pandemic will be even more devastating.

Although measures proposed by WHO should be followed, it is recommended that governments find the appropriate ways to support citizenry (especially the frontline health workers), with frequent psychosocial support via counselling and psychotherapy. This will go a long way in helping to reduce the high-stress levels experienced among them in these unnerving times.
This, among other practices, would boost their immune system and keep them safe throughout this pandemic.

Mental health workers (Psychologists, Counselling Psychologists, and Psychotherapists etc.) cannot wait comfortably in their counselling rooms to receive clients.

It is recommended that all mental health workers get on board to provide psychosocial support to the general public, infected persons and the frontline health workers.

Furthermore, the public health education programme on COVID-19 should include awareness creation on the need to prevent emotional instability and the intense stressors emanating from an uncontrollable crisis in mid-life.

Finally, it is recommended to mental health workers in academia to initiate research into the areas of mid-life crisis and COVID-19 attack, stressors and their influence on the immune system, as well as other related areas.

Conclusion

The obvious reality is that everyone is prone to an attack from COVID-19. If you give it a chance, it will enter into your system and the fight against it will depend on your immunity. When the virus gets into your bloodstream, the situation becomes a battle between you and your immune system. It is therefore critical that you stay safe and healthy in areas such as your physical, psychological and spiritual life.