“…In a viral pandemic, anxiety, depression, and trauma can be environmentally (eg, exteroceptive) induced in infected and non-infected people alike. 56 , 59 Therefore, psychopathological expression in infected individuals does not ultimately imply the presence of virulent activity but can also result from unconscious and conscious stress induced, for example, by social stigma, individual behavior (eg, substance abuse), experience with invasive medical procedures, long-term isolation and medical segregation, inconsistent information or the awareness of one’s affliction. 1 , 49 , 57 Thus, the frequently observed disease-associated loss of energy (eg, fatigue), diminished interest in one’s environment (eg, anhedonia), and diminished ability to think (eg, brain fog)—symptoms that may lead to the diagnosis of MDD in infected individuals 60 may be reducible to purely biological phenomena (eg, infection-stimulated immunological responses), secondary environmentally induced psychological phenomena (eg, exteroceptive responses) or both.…”