Dear Editor,
The novel coronavirus 2019 (COVID-19) has expanded rapidly around the world. In addition to physical illness, COVID-19 has affected other aspects of human life in a variety of ways. Because of its high transmission and mortality rate and the absence of effective treatment and vaccine, governments have implemented social distancing, isolation, quarantine, and lockdowns in society. Now the world is facing the third wave of soaring death tolls from COVID-19. It has led to the closure of many businesses, and millions of people have lost their jobs. Financial problems, especially in developing countries, became one of the important consequences of this contagious disease. These conditions, in combination with the psychological burdens of quarantine and lockdown, may cause mental health problems such as fear, stress, anxiety, depression, PTSD, and unresolved grief and suicide (1). Some case-series and report studies of COVID-19-related suicides have been reported in different countries, hitherto (2, 3). One case of COVID-19-related family suicide in Iran has been reported after the death of the father due to COVID-19 (4). Other suicide cases related to COVID-19 have been reported in the media. For instance, a 36-year-old woman in Tehran, the capital city, with no record of personal/family history of psychiatric illness or attempted suicide, committed suicide during the period of quarantine. This suicide happened after two months of her husband's infection with COVID-19. She became depressed and committed suicide by jumping off the sixth floor of a residential building (5). Another case of an 86-year-old man in Tabriz with an unknown psychiatric history was hospitalized due to complications from Covid-19, attempted suicide by jumping from his hospital room (6).
A recent study demonstrated that the loss of jobs due to COVID-19 could lead to between 2,135 and 9,570 suicides per year worldwide (7). According to the Islamic Parliament Research Center, in Iran, the current pandemic will lead to the loss of jobs for 2.9 to 6.4 million people (8). In Iran, a psychological autopsy study reported that unemployment increases the suicide rate by a factor of 6 (9).
Our concern is the future growth of suicide rates, especially in Post-COVID-19 times. Psychological distress, psychiatric disorders, and suicide rates could increase after a crisis such as natural disasters or economic recessions (10, 11). Alongside other studies, which did not show increases in the suicide rate during the COVID-19 pandemic (12), registered data of the Ministry of health indicated that during the first six months since the beginning of COVID-19 in Iran, the rate of suicide and suicide attempts has not increased from the corresponding date of last year. Surprisingly, this trend was on the rise in September 2020 remarkably with unknown reasons thus far (13). Does it mean that the socioeconomic effect of COVID-19 is going to gradually reveal its detrimental effect on the mental health of our society and the increasing rate of suicide? Now we are in the third wave of soaring death tolls from COVID-19, and alongside other countries, partial and total lockdowns may be imposed, with great economic pressure, particularly on deprived people. The health system has to be conscious of and set the stage for all possibilities to trace critical suicidal behavior in real-time and tackle the predictable rate increase of suicidal behaviors.
