Dear Editor:

The factors associated with fear during the Covid-19 pandemic in unknown. Thus, this article aimed to briefly describe the main risk factors for collective fear genesis during the COVID-19 pandemic ¹.

The Covid-19 pandemic has caused direct impacts on income due to premature deaths, workplace absenteeism, and productivity reduction ^1,2. It has created a negative supply shock, in which manufacturing productive activity slowed down due to global supply chain disruptions and closures of factories ². Thus, the first factor in creating fear during the Covid-19 pandemic is due to the economic crisis ¹. Furthermore, in addition to the fear of contracting the disease, Covid-19 has caused insecurity in all aspects of life, from the collective to the individual perspective, from the daily functioning of society to changes in interpersonal relationships ³. In a Chinese study with 263 participants, 52.1% of the participants felt horrified and apprehensive due to the pandemic ⁴. A paper published in The Lancet reported that patients infected with Covid-19 (or suspected of being infected) might experience intense emotional and behavioral reactions, such as fear, boredom, loneliness, anxiety, insomnia, and anger ⁵.

It is noteworthy that there is a lack of quality or conflicting information offered to the population as fake news. This “Disinformation pandemic”, whose term was recently nicknamed, is called Infodemia ¹. According to literature data, false information has been disseminated more quickly than Sars-CoV-2 itself. Doubtful or even false data about factors related to virus transmission, incubation period, geographic reach, number of infected people, and real lethality rate lead to population insecurity and fear ⁶.

Thus, emphasis should be given to the development of fear during COVID-19, due to the corruption and poor management of the pandemic by local governments such as Brazil and USA ^7,8. An article published on the New York Times, regarding the exploitation of the pandemic crisis in Latin America, points to the involvement of public officials and businessmen in the overpricing of items of various kinds ⁷. In Ecuador, plastic bags for corps were sold at 13x the real value; in Bolivia, the former Minister of Health awaits trial under house arrest on charges of corruption for paying a fan that costs millions more than the normal rate and that did not even work properly; Peru’s police chief and interior minister resigned after his subordinates bought diluted sanitizer and flimsy face masks for police officers, who then began dying of infections from the virus at alarming rates ⁸.

In Brazil, dozens of people, including businessmen, health secretaries, governors, and mayors have been investigated or responded to overpricing processes, fraud, and other forms of resource misuse that culminated in the collapse of the hospital network and the resulting high number of deaths. The most recent case occurred in Manaus, capital of the Brazilian state of Amazonas, where patients not only accumulated in the corridors due to lack of beds, but also lacked oxygen ⁸. Horror scenes were broadcast by health professionals and residents asking for help, and family members carried oxygen cylinders on their shoulders to save their loved ones that were suffocating.

Therefore, Covid-19 should be seen as an event that is not only biological, but multifactorial. The influence of the environment and factors such as political, social, and economic conditions from the pandemic management by local governments to the economic impact on communities, deserves to be highlighted in the study of the impact on people's mental health ^1-4. Thus, Covid-19 is now considered not only a pandemic, but a syndemia. This term refers to “a set of closely intertwined and mutual enhancing health problems that significantly affect the overall health status of a population within the context of a perpetuating configuration of noxious social conditions” ⁹. Although everyone is susceptible to Sars-CoV-2, the virus does not affect everyone equally, but those with low socioeconomic conditions are the most severely affected.