COVID-19, mental health and religion: an agenda
for future research by Simon Dein , Kate Loewenthal , Christopher Alan Lewis & Kenneth I.
Pargament
We are currently facing a worldwide pandemic of Coronavirus disease 2019 (COVID-19) for
which there is yet no effective treatment or vaccination. This has resulted in the world being
turned “upside-down” where many of our “normal” social behaviours have undergone dramatic changes. As of 3 May 2020, there have been approximately 3,546,758 global cases of
COVID-19, 1137,349 people have recovered from the disease, while there have been 247,312
deaths from the virus (Worldometer, 2020). First identified in Wuhan, China in December
2019, the virus has reached most parts of the world. At the time of writing, the United
States, the United Kingdom, Italy, and Spain have been the four countries worse affected by
the pandemic. At present, there is an almost global lockdown, and social distancing appears
to be having some effect on reducing the prevalence of infection. One aspect of the lockdown
is that places of worship have been temporarily closed and the internet has become the
primary locus of religious activity primary locus of religious activity.
In this brief paper, we ask what are the implications of the COVID-19 pandemic for religion
and mental health? Given that the viral pandemic has existed only for six-months or so, there is
a dearth of empirical research, and currently, there is little information available on this topic.
The evidence base for this paper largely derives from newspaper articles on the internet rather
than scientific empirical studies but indicates what is happening to religious beliefs and practices. Much of the information on the Net pertains to Christianity, which is a central, though not
exclusive, focus of this paper.
When the mental health impact of the COVID-19 pandemic began to be appreciated,
attempts were made to assess this impact (e.g., Ho et al., in press; Van Bavel et al., 2020;
Wang et al., 2020). For example, Wang et al. (2020) reported from a general population
survey in China that 28.8% of those surveyed reported moderate to severe anxiety symptoms,
and 16.5% reported moderate to severe depression symptoms. Classical European literature
does mention the possible roles of religion in responding to and coping with epidemics of contagious illnesses such as the Plague (e.g., Boccaccio, 1353; Camus, 1947; Defoe, 1722; Mann,
1912) but recent work contains negligible mention of religion in responding to and coping
with the COVID-19 pandemic.
Here we examine some factors. First, religious doctrinal responses. Second, religiously
related behaviour. Third, prejudiced attitudes and behaviour towards religious groups.
Fourth, tensions, strains, and conflicts about religious matters.
Religious doctrinal responses
We first describe some Christian responses, including some beliefs that the pandemic is not
merely extraordinary but apocalyptic. Such beliefs may appear in all or most other religious
groups, although a serious conviction that apocalyptic change is imminent may be confined
to a minority of individuals within any faith tradition.
Since it was first written in 95 AD by John of Patmos, the Book of Revelation has deployed to
account for world events in terms of the “end times”. While there is disagreement among scholars as to how the text is to be interpreted, the book spans three genres: Epistolary, the apocalyptic, and the prophetic. Many have taken the text as a literal description of the end
times while others have used it as a revelation of divine will. Revelation describes four horsemen of the Apocalypse who appear when the seven seals are opened. The first symbolises
Christ. The second represents war and bloodshed. The third is identified with famine, and
the fourth is associated with pestilence and death. Some Christians claim that COVID-19 is
proof that the plagues of the book of Revelation, and more specifically, the seven Seals of
Revelation 6:1–8:1, are occurring now and Jesus’ return is imminent. For them, Revelation
has indeed predicted the COVID-19 pandemic. Corona has been associated with the fourth
horseman.
Christian sources on the internet quote a range of biblical sources about the preceding of
the end of time with pestilence. For example, Revelation 6:8 – And I looked, and behold a
pale horse: and his name that sat on him was Death, and Hell followed with him. And
power was given unto them over the fourth part of the earth, to kill with sword, and with
hunger, and with death, and with the beasts of the earth. Matthew 24:7–13 – For nation
shall rise against nation, and kingdom against kingdom: and there shall be famines, and pestilences, and earthquakes, in diverse places. Ezekiel 38:22 – “I will plead against him with pestilence and the blood”.
lence and the blood”.
There is evidence that some religious groups have neglected health preventative measures
for COVID-19 and have, therefore played a role in spreading the virus. For example, a major
source of COVID-19 infection in South Korea has been the Shincheonji church (Rashid, 2020).
It was established by its leader Lee Man Hee in 1984 who is held by his followers to be the
second coming of Christ, the “Promised Pastor” in the Bible and the Messiah (Lincoln, 2017).
The group is known for its aggressive and deceptive proselytising practices and packing its
members tightly in the church during services. Worshipers were instructed to keep their
church affiliation secret. Its leader has promised entry into the “New Heaven and the New
Earth” to its members, who have been declining treatment and preventive measures for
virus infection.
Approximately 60% of the total infections nationwide are held to have originated from the
church (Bostock, 2020). The Koreans were outraged by the fact that church members were told
to continue proselytising even after the outbreak had begun and were taught not to be afraid
of sickness. A 61-year-old female member of the sect was one of the first to be infected and
initially refused to be taken to a hospital to be tested. She attended a number of services
while unwell and was a major source of contagion.
while unwell and was a major source of contagion.
The Seoul city government instructed prosecutors to charge the religious group’s founder
and other senior members of the group with murder, causing harm, and for violating the Infectious Disease and Control Act (Agence France-Presse, 2020). Authorities have blamed the
church for hiding the names of some members and allege that Shincheonji members infected
one another in the southern city of Daegu last month, before spreading through the country. It
has been difficult to locate and screen church members for the COVID-19 virus.
Another group who have not taken preventative measures are Haredi Jews in Israel (Halbfinger, 2020). The Haredim are groups within Orthodox Judaism who strictly adhere to their
interpretation of Jewish law and values and are opposed to modern values and practices.
They strive to limit contact with the outside world except for economic purposes and essential
public interactions. In Israel, many live in poor environments, and overcrowded accommodation and social distancing would be difficult, to say the least. According to the Jewish newspaper The Forward (2020), Haredim constitute about 12.5% of Israel’s population, but,
according to health officials, they make up a third of the country’s COVID-19 cases. In Bnei
Brak, an ultra-Orthodox area outside of Tel Aviv, Israel, approximately 40% of residents may
be infected (Zevloff, 2020). Religious leaders have been blamed for encouraging their followers
to continue life as normal, and some people have continued to congregate for prayer. A funeral
of a Haredi Rabbi in Bnei Brak in March was supposedly attended by 400 followers (Staff, 2020).
Israeli newspapers accuse them of flouting government directives, and they are driven, allegedly, by their religious beliefs that if they pray and study, they can defeat the virus (Halbfinger,
2020). The pandemic for them is a punishment for inadequate religious observance. Could it be
that being cut off from the outside world, they are not exposed to everyday news and therefore
not to blame for their own predicament? However, in the USA it is reported that large numbers
of Haredi Jews recovered from the virus are “flocking” to donate plasma for all current patients
in need: 50% of plasma donations in the USA are reported to be from Haredi Jews (Sharp, 2020).
In a third recent instance, 16,000 Muslim pilgrims came together in Malaysia and, returning
home, spread the COVID-19 to half a dozen countries (Beech, 2020) The worshippers came from
Tablighi Jamaat, the largest Islamic missionary movement in the world. This movement emphasises returning to the way life was lived in the age of the Prophet Muhammad, praying and
eating together in mosques. Despite the public outcry against another large planned religious
event, 8,700 people met in a subsequent gathering, sharing food and crowding together in
tents. One participant said: “None of us have a fear of corona. We are afraid of God”. A
worker employed by the ministry of health said: “All sickness and all health is from God. Whatever happens to us is God’s will”
While the increased prominence of apocalyptic texts and beliefs can offer comfort in the
time of COVID-19, some religious doctrinal responses may have been counter-productive
and have led to spreading of infection, and also to dislike by others towards those holding
to these doctrines. There are many kinds of other religious beliefs that could offer comfort
in relationship to COVID-19 (e.g., beliefs in a loving, protective God, beliefs in an all-knowing,
all-powerful God, beliefs in an afterlife).
Religious behaviour
Passing from doctrinal beliefs, we examine religious behaviour resulting from the pandemic.
The pandemic has affected religious practice in significant ways, including the cancellation
of live religious services, closing religious schools, cancelling pilgrimages and prohibiting
group interactions during festivals and celebrations. Some religious organisations have been
involved in the process of providing disinfectants, ventilators, face shields, gloves and food
to affected areas while others have offered COVID-19 tests to the general public. In the
United States, President Donald Trump declared 15 March 2020 a National Day of Prayer. As
an alternative, churches, mosques and synagogues have provided creative ways of providing
services online through live streaming, radio and television. These lack the communal dimensions of live face to face interactions and for Christians do not provide the opportunity to
partake of the Eucharist. Some Christian denominations have started up drive-in church services in church parking lots. In other instances, Christians deploy online apps for prayer and
daily devotionals. There are reports that hospital chaplaincy services in the UK, which have
been declining in recent years due to funding cuts, are being increased in Coronavirus (Nightingale) hospitals (Rookes, 2020).
gale) hospitals (Rookes, 2020).
Some religious practices have changed. The obligation to observe the custom of abstaining
from eating meat on Fridays during Lent was suspended by some Roman Catholic bishops
during the COVID-19 pandemic, which coincided with Lent in 2020 (Noori, 2020). Episcopal
and Catholic churches have requested that older worshippers remain at home rather than
attending Sunday Mass which is usually required (Parke, 2020). Thousands of Jews prayed
together at the Wailing Wall in Jerusalem on 15 February 2020 to stop the COVID-19 pandemic,
led by Chief Rabbi of Safed, Shmuel Eliyahu. Following a police request on 12 March 2020,
Israel’s chief rabbis David Lau and Yitzhak Yosef instructed observant Jews to stop visiting this holy site, but a few people still continued to pray there. However, even though the government prohibited collective prayer with a minyan (publiс prayer quorum of 10 people or more)
on 30th March, a special exemption was made in order that prayers might continue at the
Wailing Wall thrice daily. For the first time in 2020 Jews celebrated the Passover without
guests and the mosque in Regents Park, London is closed, with Muslims being asked to pray
at home. And Muslims have been instructed to delay Haj and Umrah bookings (Heren, 2020).
There is some compelling evidence for a link between natural disasters and increased manifestations of religiosity (Bentzen, 2019). It is well recognised, however, that prayer is a common
way of dealing with adversity. When catastrophe strikes, people seek closeness to God. Prayer is
one strategy for doing so. Pargament (1996) has asserted that religion can facilitate coping in
situations beyond their control. There is evidence for an intensification of prayer activity during
this pandemic (Coppen, 2020). Searches for “prayer” on Google escalated in April 2020 and has
doubled with every 80,000 new registered cases of COVID-19 (Bentzen, 2020). In our view, this
suggests an increase in the actual number of people praying. Also searches for the terms God,
Allah and Mohammad increased significantly. Bentzen (2020) speculates that the COVID-19
pandemic encouraged religious coping. Given the lockdown and the closure of religious institutions, this might indicate a marked shift from public to private prayer. Pray.com, which calls
itself “the world’s #1 prayer app and website”, has been highly successful in attracting new subscribers and revenue (Heilwell, 2020). A Pew poll (Pew Research Center, 2020) indicated that
55% of Americans had prayed for the pandemic to end. This included 15% of those who
“seldom or never prayed” and 24% of those who endorsed no religious affiliation had
prayed about the virus.
On the other hand, there are data suggesting that in the last four decades there has been a
significant decline in religious affiliation. The 2014 British Social Attitudes Survey (Clements,
2015) indicated that there was a 50% reduction in the number of Anglicans between 1983
and 2014. Between 2001 and 2011, the number of people identifying as Christian in the UK
diminished by 4.1 million. This occurred despite 1.2 million adherents from Eastern Europe
arriving in the UK. Bullivant’s (2019) Mass Exodus examines Catholic attrition in the UK and in
the USA. The author notes that in America, only 15% of those born Catholics report that
they attend Mass weekly; meanwhile, 35% no longer endorse the “Catholic box” on surveys.
In the UK, of those brought up as Catholic, only 13% still attend Mass on a weekly basis, and
37% state that they have “no religion”. He speculates that church attendance will lessen
after the COVID-19 pandemic for three reasons. First, churchgoers both lay and clergy, are
often elderly, are most affected by the virus, and likely to die from it. Second, with the lockdown
immigrants can no longer enter the UK. Many churches are highly dependent upon them for
their congregations to grow. Third, the habit of churchgoing may be abolished, and once gone,
its hard to take up again. A long period of lockdown may well break the habit of church attendance for a sizeable number of attendees
So, what have studies observed to date? A Gallup report states that “the most dramatic
result (of the pandemic in religion) has been the exceedingly quick shift of religious services
from in-person to online worship”. This is an unprecedented move in the history of world religions. The Poll indicated that 19% of Americans responded that their faith has intensified and
only 3% reported that it got worse (Newport, 2020). A Pew Research report in March 2020
describes a change in peoples’ religious habits during the pandemic (Pew Research Center,
2020). Over 50% of respondents stated that they had “prayed for an end to the spread of coronavirus”, “attended religious services in person less frequently”, and “watched religious services online or on TV instead of in person”. Finally, according to Time Magazine, there has
been increasing use of drive-in services in the US following the pandemic (Price, 2020).
This material suggests that many forms of religious activity have changed in response to the
demands of the pandemic. In particular, collective worship has become difficult, online worship
is increasing and while private worship/prayer appears to have been considerably on the
increase.
Prejudice
We turn now to a classic topic in the study of religion, namely prejudice (Burch-Brown & Baker,
2016). We will look at prejudiced beliefs associated with the pandemic, and at behaviours.
There is as yet negligible evidence about the numbers and nature of those prejudiced
against other groups about the causes of the pandemic.
As mentioned above, some Christian and other religious sources have suggested that the
pandemic is a punishment for sin, for example, for gay marriage. American Evangelist Preacher,
Perry Stone sees the COVID-19 outbreak as a “reckoning” on America for abortion and gay marriage (Mantyla, 2020). More moderate faith leaders, however, reject the idea that the pandemic
is a punishment for sin. “God is not interested in humanity perishing but to have eternal life”,
Lightner said. “God did not send his only son to condemn us but to redeem us” (De Jesus,
2020). One empirical study of a sample from the United States, presumably largely Christian,
found people agreeing only to a modest extent (Mn = 1.71 on 0 to 4 Likert scale) with the statement “After thinking about the Coronavirus, I wondered if God was angry with or had abandoned some people” (Lee, 2020, p. 394).
There has been a longstanding tradition in the monotheistic religions of accounting for
illness in terms of sin. Recently fundamentalist Protestants and radicalised Catholics have
taken to the internet to propagate their views that the pandemic is a punishment for a
variety of sins ranging from gay marriage, abortion, blasphemy, environmental pollution,
paganism and witchcraft, women having employment outside the home, and the Pope allegedly not consecrating Russia to the Immaculate Heart. While there have been no empirical
studies of Christian explanations of COVID-19, over the past two months increasing numbers
of reports have appeared on the internet quoting pastors who allege a direct relationship
between sin and the development of COVID-19; the sins usually but not always involve homosexual issues. It is unclear at present how prevalent these views are among Evangelical Christians, how representative these views of the internet pastors are, and indeed some Christians
have cautioned against linking COVID-19 with sin (Valerio & Heugh, 2020).
Some illustrative examples. Franklin Graham is an anti-LGBTQ+ evangelist, missionary and
CEO of the Billy Graham Foundation who is well known for blaming gay people for a “moral
9/11”. He compares LGBTQ+ medical workers to “drunks and drug users”. He asserts that
COVID-19 is caused by the world “turning its back on God”. He publicly stated, “This pandemic,
it’s a result of a fallen world, a world that has turned its back on God” (Duffy, 2020). In another
instance Pastor Rick Wiles, creator of the TruNews streaming channel, claims that COVID-19 has
been “sent” to purge the world of sin, particularly sexual immorality and “filth” on TV. Furthermore, he argues that those who are devoted to Jesus are immune to the virus. He calls for Americans to “get right with God”. In a third case, extreme right pastor, Stephen Anderson quotes
biblical verses prohibiting homosexuality, sodomy and transgender identity (Schlatter, 2010).
He calls himself the leader of the American Christian denomination. He argues that COVID-19
is a consequence of “National disobedience of God’s laws and has called for March to be
Repent of LGBT Sin Month and states that obeying God protects the US against Coronavirus”.
Associated Press (2020) cites a recent Tel Aviv University report that anti-semitic beliefs are
becoming more widespread – as in the past, disasters are blamed on the Jews. Examples of
anti-semitic beliefs include the beliefs that the Jews developed the virus in order to later
gain credit and profit from the vaccine that they will develop. They are alleged to be benefitting from the economic recession associated with the pandemic. Another anti-semitic belief is that
the pandemic is a punishment for Jewish denial of (the divinity of) Jesus. There has been an
18% rise in anti-semitic incidents worldwide since the beginning of the COVID-19 pandemic,
including murders, other physical attacks on Jews, and desecration of synagogues and cemeteries (see Associated Press, 2020).
Other prejudice against religious groups includes anti-Christian persecution which has escalated in some countries like China with its policy of State Atheism. The government made use of
the COVID-19 pandemic to pursue its anti-religious agenda. Xiangbaishu Church in Yixing was
demolished and a Christian Cross from the steeple of a church in Guiyang County was removed.
In the Shandong Province, “officials issued guidance forbidding online preaching, a vital way
for churches to reach congregants amid both persecution and the spread of the virus”
(Parke, 2020).
One conclusion that may be safely drawn, unfortunately, is that prejudice against others is
likely to increase their distress, and in some cases, precipitate mental ill-health.
Religious struggles
Finally, it is important to recognise the potential for major life crises to shake people not only
psychologically, socially, and physically, but religiously and spiritually as well. Religious struggles
– defined as tensions, strains, and conflicts around sacred matters – are not at all unusual over the
lifespan (Exline et al., 2014). Although data on COVID-19 are as yet lacking, other studies have
demonstrated robust links between trauma, such as natural disaster and medical illness, and religious struggles. For example, in a study of a representative sample of adults from the United
States, greater exposure to major life events was tied to higher levels of religious struggles
which were, in turn, related to higher levels of psychological problems (Pomerleau et al., in press).
Religious struggles can take many forms: feelings of anger toward, abandonment or being
punished by God; concerns that a trauma may reflect the work of the devil or demonic forces;
doubts about the truth of one’s religious faith; questions about ultimate meaning and purpose
in life; struggles with living up to one’s moral values; and conflicts with other people about religious issues (Exline et al., 2014). We might expect the COVID-19 pandemic to trigger many of
these profound religious and existential questions. Doehring (2020), for example, speaks to the
moral struggles elicited by COVID-19 among frontline healthcare providers who must wrestle
with the conflict between limited medical resources (e.g., ventilators, oxygen), a flood of
patients, and the injunction to “do no harm”. Other people are likely grappling with ways to
reconcile their beliefs in a loving God with the suffering engendered by the pandemic. And
still, others may find their ultimate purpose in life thrown into question by the virus.
A significant body of research has tied religious struggles to greater distress, psychological
problems, and physical decline, including a greater risk of mortality (e.g., Pargament & Exline,
in press). For example, Vitorino et al. (2018) found that religious struggles among Brazilian hemodialysis patients were associated with greater pain and fatigue and poorer physical functioning.
Another study of end-stage congestive heart failure patients showed that higher levels of religious struggles at baseline were related to more nights of hospitalisation and, marginally,
greater physical impairment three months later (Park et al., 2011). In one of the first studies conducted in relation to COVID-19, Lee (2020) reported that higher levels of struggle with God were
associated with elevated scores on a Coronavirus Anxiety Scale. If these and other studies are any
guide, we should expect a rise in COVID-19 related religious struggles among various religious
groups and subsequent mental health-related problems, including depression, anxiety, PTSD,
and suicidality. Research will be needed that points to factors that may buffer the effects of religious struggles on subsequent health and well-being will (e.g., Abu-Raiya et al., 2016).
Implications for future research
The discussion above raises several specific issues pertaining to religion and mental health.
. How do virtual religious activities impact mental health, and are they as effective as their live
counterparts?
. In what ways do apocalyptic beliefs and other religious beliefs help or hinder coping with
COVID-19?
. What strategies can be used to enhance preventative behaviour in religious groups pertaining to COVID-19?
. What role does prayer and other religious practices play in coping with COVID-19 and how
effective is this strategy?
. To what extent do pandemics like COVID-19 intensify or diminish religious beliefs?
. How can prejudice against others be reduced in the context of the pandemic?
. What factors can cushion the effects of COVID-19 related religious struggles on subsequent
distress, psychological problems, and poorer health?
In conclusion, in this brief paper we have begun to reflect on some of the possible implications of COVID-19 for religion and mental health. Noting that there is exceedingly limited
empirical research on the topic available, we have relied heavily on newspaper and internet
sources. Four general areas of attention were noted: religious doctrinal responses; religiously
related behaviour; prejudiced attitudes and behaviour towards religious groups; and tensions,
strains, and conflicts about religious matters. Some pertinent research questions are presented
to help stimulate research on COVID-19, mental health and religion.
