Death and Grief in COVID-19. Grief and Mental Health of relatives in a restrictive situation of supporting end of life and rites. – COVIDEUIL

A mixed quantitative and qualitative methodology was used after obtaining the agreement of the Research Ethics Committee of the University of Strasbourg.
-On the quantitative level, an online survey, by webquestionnaire, collects the traumatic elements of the end of life and then of the death of the close person. As the deaths are not unique, we analyzed up to three deaths during the period. Five validated questionnaires in French allow us to analyze the nature of the trauma, the temporality of the bereavement, the health of the bereaved, and their «post-bereavement growth.
-A semi-directive interview accepted by the bereaved and the analysis of word co-occurrences by the patented ALCESTE software allows the qualitative study, as well as a phenomenological analysis of the discourse.
This project is therefore a prospective cohort study with data collected in three measurement times (T1, T2) over a period of 6 to 13 months (T1 = 3 to 6 months after the loss, T2 = T1+ 6 months, T3 = T1+ 12 months). The comparison between the three measurement times will allow the evaluation of the manifestations of grief and their duration, to identify the possible prolongation of grief and disabling symptomatology.

We have just completed our T1 with 300 subjects. We already have the first statistical analyses on the socio-demographic characteristics of the bereaved.
In the meantime, we have succeeded in bringing our initially French research to the transatlantic and European level.
Quebec has already adapted our web questionnaire and administered it to 900 people (without a qualitative interview), and Belgium, Switzerland, Italy, Greece, Spain, and Mexico are working on translating and adapting our web questionnaire to survey their populations.

We hope that through our international collaboration we will be able to promote the French Covideuil proposal with funding from the ANR.
We will soon propose an article on our French results. In addition, we hope to initiate large cross-cultural research.
Our hypothesis is that, despite significant variations, all funeral rites present human constants. Furthermore, we want to study the effectiveness of attempts to replace these rites.

We bought the domain names Covideuil.fr and Covideuil.eu

6-Bacqué M-F, (2021) The Covid-19 epidemic: an experiment in mourning without rituality? Résonance funéraire. N°172 : 26-30.

5-Bacqué M-F Sani L. Covid-19 : l'expérimentation du deuil sans ritualité. 119e Colloque international du
CPNLF (Congrès de Psychiatrie et de Neurologie de Langue Française) 15-17 September 2021. La Rochelle.

4-Bacqué M-F Accepting not knowing and saying it: a pedagogy of limits. SFAP web-seminar, September 2021.

3-Bacqué M-F The Covid-19 epidemic and the return of repressed death. Lorraine Academy of Sciences. 29 May 2021. Nancy.

2-Bacqué M-F La perte d'un proche en période pandémique. What support? Assises du deuil. 6 April 2021. Paris.

1-Bacqué M-F La mort, le deuil en période épidémique. Conference «Et la mort si on en parlait?« 31 March 2021. Clemont-Ferrand.

In the press:
1. Bacqué, M.-F. (2021). Deuil sous Covid: « Les conséquences psychologiques rejailliront probablement «. Libération. Interview by Cassandre Leray. 4 July. www.liberation.fr/societe/deuil-sous-covid-les-consequences-psychologiques-rejailliront-probablement-20210704_PA5K3U2IABD2NMCAM5JQKIY5UY/
2. Bacqué, M.-F. (2021). Covid-19: How to mourn in times of pandemic? Interview by Marianne Chenou. Grand entretien - France Info - 16 April 2021.
3. Bacqué, M.-F. (2021). «These deaths were not mourned collectively«. For the psychologist Marie-Frédérique Bacqué, a celebration is necessary to overcome the crisis. Interview by Stéphane Mandard. Le Monde, 15 April 2021, 4.
4. Bacqué, M.-F. (2021). Covideuil: What place for mourning during an epidemic? Online article published on 08.02.2021. MESRI. Interview by Marion Riegert. recherchecovid.enseignementsup-recherche.gouv.fr/covideuil-quelle-place-pour-le-deuil-en-periode-d-epidemie-48862
5. Bacqué, M-F. (2021) « Depuis un an, le deuil empêché des familles de victimes du Covid-19 «. Le Monde.fr, 28 March 2021. Interview by Jérémie Lamothe. www.lemonde.fr/planete/article/2021/03/28/depuis-un-an-le-deuil-empeche-des-familles-de-victimes-du-covid-19_6074717_3244.html.

This prospective study is part of the "Ethics and Social Dynamics" theme. It evaluates the effects of the Covid-19 epidemic and confinement on the bereavement of a loved one in France from March 2020. The prohibition, then the drastic restriction of visits and farewell rituals for the sick and the deceased has modified the mourning process for many people encountered in hospitals or consultations. It was not only the Covid-19 patients and their families who were subjected to the restrictions on visits and the expression of the emotional bond but all the sick and the dead of the period. The number of deaths from SARS-CoV-2 according to Santé Publique France (between March 1 and July 20, 2020, there were 30,177 deaths), added to the deceased from other causes, reached in 4 months more than 200,000 deaths. Extrapolating to two mourners per deceased, there are 400,000 people likely to develop a difficult bereavement, due to the limitations of accompaniment and funerals. According to international research and our own, wars, human and natural disasters and epidemics complicate mourning.
Our general research theme is, therefore: did the difficulty of saying goodbye and the impediment to practicing funeral rites during the SARS-CoV-2 epidemic lead to or aggravate true psychopathology of grief?
The urgency of our research lies in the fact that we will analyze the temporality of the affective state of mourning during a quasi-experimental situation of ritual limitation. 500 mourners since March 2020 will be met to seek the aggravation or prolongation of the manifestations of their mourning. The Covid-19 epidemic has anxiety-provoking and traumatic characteristics because people suddenly face the violence of the threat of death for themselves and their loved ones. The media coverage of this global pandemic, the impression of the accumulation of the dead, the uncertainty of treatment, and the difficulty of confinement, further complicate mourning. The dead are mostly people over 70 years of age, males in fragile health. The mourners of the first degree are mostly elderly women. However, women are more sensitive to psychotraumatic aspects, so they will be more likely to present disorders such as prolonged grief, currently discussed in international nosographies (DSM-5 and ICD-11).
If we find a specific reaction of grief during the Covid epidemic, we will also look for phenomena such as the anguish of contamination, the fear of collective deaths, the accumulation of losses, the absence of rituals.
A mixed, quantitative, and qualitative methodology will be set up after agreement with the Research Ethics Committee of the University of Strasbourg.
-On the quantitative level, an online survey will collect the traumatogenic events of the end of life and death of a close relative (TGI-SR and Traumaq).
-A semi-directive interview and the analysis of co-occurrences of words by the patented software ALCESTE will allow the qualitative study of verbatims, as well as a phenomenological analysis of the discourse.
This project is therefore a prospective cohort study whose data are collected in two measurement periods (T1, T2) over 6 to 12 months (T1 = 3 to 6 months after the loss, T2 = T1+ 6 months). The comparison between the two measurement periods will allow the evaluation of the manifestations of grief and their duration, to identify possible prolongation of grief and disabling symptomatology.
Our study will be replicated in several European countries and Quebec thanks to the collaboration with the CIEM (International Centre for Death Studies). The expected results aim to improve the care of families and bereaved persons in public health, psychiatry, or association consultations.