Dealing with grief during the COVID-19 pandemic requires special support. During these difficult times, the work carried out by the Spanish Ministry of Health aims to provide that support.
Written by Javier Barbero, Angélica Bonilla, Pilar Campos, Jara Cubillo, Ana Gil, Tomás Hernández, Ana Koerting, Elena Ruiz, María Terol, Javier Segura.
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The COVID-19 pandemic has substantially impacted health and social wellbeing in Spain. By causing significant morbidity and mortality, the pandemic has put health systems to the test. Moreover, COVID-19 prevention, control and treatment measures have changed the processes through health and disease.
These circumstances posed new challenges to our emotional wellbeing especially during the first wave. Among these challenges, people faced the death of a family member or friend, the last days of their lives, saying farewell, and expressing and working through their grief in traditional ways. It is important that society, health professionals and, of course, public administrations respond to the changed needs of people and their families.
The need for support materials
During the first wave of the pandemic, it became clear that there was a need for materials to support people’s emotional wellbeing. The Ministry developed general informational material about the COVID-19 virus and the measures to contain the virus, such as the staying-at-home rules. Specific publications for children and adolescents were also developed. These materials specifically specifically addressed grief in times of the pandemic.
When loved ones pass away due to COVID-19, various factors may complicate the grief process. Besides the traumatic nature of everything that accompanies death, people may not be able to be with their loved ones to say goodbye and may not be able to come together with other family members and loved ones to support one another and commemorate the person who has passed away.
The Ministry noticed that these circumstances required a different way of grieving and that providing good emotional support in those first moments of grief could be key to preventing more complicated grief later on.
Elaborated materials
To respond to the need for support around grief, the Ministry created a working group of people with different backgrounds. The group included psychologists, family medicine and community health specialists and medical specialists in preventive medicine and public health, as well as specialists in bioethics and grief management who treated people who had just lost loved ones to COVID-19.
Initially, the group created an infographic named Facing grief in the time of coronavirus. The infographic included words from those who had experienced loss. The words were linked to the four tasks to deal with grief:
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- Recognising the traumatic nature of the event
- Accepting the difficulty of accompanying a sick person during their last days.
- Acknowledging the realities of isolation and loneliness during a period when social support is more important than ever.
- Validating the right to remember the loved one that passed away.
The infographic further explained the four tasks, and offered advice and resources to deal with grief.
Subsequently, the Ministry published guidance for professionals to facilitate the use of the infographic.
The loss of a loved one due to COVID-19 impacts all family members, including children. That is why the Ministry developed a similar infographic that explains how adults can support children as well.
Finally, the Ministry developed an infographic for those who were trying to support a family member or friend who is grieving the loss of a loved-one due to the coronavirus, called Support during grief.
Active dissemination of materials
The Directorate General of Public Health (previously the Directorate General of Public Health, Quality and Innovation) recognised the need to actively disseminate these materials. A number of public administrations and organisations whose work touches upon the subject of grief were asked to use and disseminate the infographics, including, among others:
- Official College of Psychologists (COP), Collegiate Medical Organization (OMC) and General Council of Official Colleges of Nursing Graduates
- Spanish Federation of Municipalities and Provinces (FEMP)
- Funeral homes and funeral directors in Madrid and Barcelona
- Associations and networks of compassionate communities
- Patient associations
- Scientific societies
When dealing with grief during the COVID-19 pandemic, people have needed and will continue to need special support. The work carried out by the Ministry of Health aims to facilitate this support in these difficult times.
Javier Barbero Gutiérrez
Doctor in Psychology, Specialist in Clinical Psychology, Master in Bioethics, with experience in Palliative Care. Currently, Councilor for Más Madrid in the Madrid City Council.
Angélica Bonilla Escobar
External Public Health Technician in Ministry of Health of Spain. Medical doctor specialist in Preventive Medicine and Public Health by NHS of Spain. Master in Public Health and Epidemiology by University of Alcala, Spain. Interested in social determinants and inequalities of health.
Pilar Campos Esteban
Pilar is Deputy Director of Health Promotion and Public Health Surveillance at the General Direction of Public Health, Quality and Innovation in the Ministry of Health, Consumer Affairs and Social Welfare.
Pilar is a graduate in Medicine, and a specialist in Family and Community Medicine. She has a Masters Degree in Public Health and Epidemiology, and a Postgraduate qualification in Health Economics.
Jara Cubillo Llanes
Specialist in Family and Community Medicine. Head of Service of the Health Promotion Area of the General Directorate of Public Health of the Ministry of Health Spain. Coordinator of the Working Group "Inequities in health and international health" of the Madrid Society of Family and Community Medicine. Teaching collaborator of the Andalusian School of Public Health.
Ana Gil Luciano
Head of the Health Promotion and Equity Area in the Ministry of Health Spain. She is a graduate in Medicine, and a specialist in Preventive Medicine and Public Health, and has a Master Degree in Public Health and a Master Degree in Health Economics.
Tomás Hernández Fernández
Specialist in Preventive Medicine and Public Health and in Family and Community Medicine. He has worked in the field of public health at the regional, national and international levels, especially in the fields of HIV prevention and addiction.
Ana Koerting de Castro
Degree in Psychology, Master in Sexology, Master in HIV, Master in Infertility and Diploma in Public Health and Gender. She currently works as a external head TRAGSATEC technician in the Secretariat of the National Plan on AIDS of the Ministry of Health and works as a Health Psychologist. She is a professor on the HIV master's degree at the Rey Juan Carlos University of Madrid, a trainer and evaluator of intervention and research projects, and is the author of various publications, research and materials.
Elena Ruiz Peralta
Family and community doctor. Master in Medical Anthropology and International Health. She currently works as a external head technician in the Health Promotion Area of the Ministry of Health where she develops topics related to health equity and the social determinants of health. Member of the Silesia Collective, she has taught courses on Qualitative and Participatory Research.
María Terol Claramonte
Specialist in Preventive Medicine and Public Health and in Family and Community Medicine. Head of Health Promotion of the Ministry of Health. National and regional experience in health promotion, prevention and health equity.
Javier Segura del Pozo
Doctor, vice-president of the Madrid Public Health Association, former head of Prevention and Health Promotion of the city of Madrid (2009-2019), former coordinator of the Madrid City of Care plan, of the healthy neighborhoods strategy and of the network of the Municipal Community Health Centers of Madrid. Visiting professor at various universities and public health schools in Spain and Latin America on health promotion, community health and social inequalities in health.