By Mr. Spencer Case, M.S., and Mr. Christian Evans, M.A., M.Div.
June 8, 2020

U.S. Navy photo by Mass Communication Specialist Seaman Zachary C. Bender

Continued Stress of COVID-19

Although we have settled into a new way of life, COVID-19 continues to bring lots of things to worry about, including health concerns and major unwanted life changes. On top of worrying about isolated loved ones and contracting the virus, summer programs for kids have been canceled, getting groceries is challenging, we're still stuck at home, and many remain concerned about layoffs and financial loss.

The Navy, specifically the Navy Center for Combat and Operational Stress Control (NCCOSC), has developed tools which help sailors manage the stressors of deployments and other aspects of military service. These can be applied more broadly to help all of us stay the course through this turbulent time of uncertainty.

What can you do to manage stress for yourself and the people you care about?

Caregiver Occupational Stress First Aid (COSFA) is the Navy's psychological first aid toolkit designed to help you, and the people you lead and care for, manage stress at home and work. COSFA is a flexible, multi-step psychological first aid process used to quickly and accurately assess stress injuries and provide early care. COSFA aims to preserve life, prevent further harm, and promote recovery.

If you or others you know are experiencing difficulties, using these seven COSFA actions, known as the "7 Cs," (seven seas, Navy, get it?) can help mitigate COVID-19 stress:

1. Check refers to assessing for problems using the Navy's "Stress Continuum," (see below) and identifying stressors by writing them down to help develop a clear plan of attack for reducing stress. The stress continuum is a color-coded way to identify the severity of stress responses and outcomes. The continuum comprises four zones: the green "ready" zone, the yellow "reacting" zone, the orange "injured" zone, and the red "ill" zone. Several possible sources of stress injury in the orange zone may be particularly relevant during COVID-19: loss, inner conflict, and wear and tear (accumulation of stress over time).
2. Coordinate with leaders and family members when someone needs assistance.
3. Cover refers to ensuring safety. Reassure others with a sense of psychological safety (e.g., "We're going to get through this"), as well as physical safety when necessary.
4. Calm refers to decreasing physiological arousal by planning for time away from stressors, spending time listening ("here with you") and providing reassurance and encouragement ("We're going to get through this", "You can do it"). Practice relaxation techniques.
5. Connect with family, friends, peers and unit support via phone calls or video chat.
6. Competence refers to restoring function through problem solving and active engagement.
7. Confidence refers to restoring confidence in self and instilling hope.

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Even though service members are trained to prevail when there is no easy path forward, and help each other along the way, anyone can use these concepts to assist in maximizing health and wellness during the pandemic and care for others who may be struggling.

Additional online psychological health resources:

• PHCoE Combat and Operational Stress Control 
• Defense Health Agency free, evidence-based, self-care tools
• Defense Health Agency "Military Meditation Coach" podcast

Mr. Case is a public health analyst at the Psychological Health Center of Excellence. He has a Master of Science in global health.

Mr. Evans is a public health analyst at the Psychological Health Center of Excellence. He has a Master of Arts in economics and a Master of Divinity.