Fear of being infected and its consequences.

Participants reported their fear of going out and being infected with the virus, which has been lingering throughout the pandemic and post-pandemic.

P7 mentioned….“there was also the fear of going out – the fear of going out and catching COVID and all sorts of things. Scared lah* , not really anxiety because the auntie stand(sic) very close to me.“So even you buy toilet paper from Speedmart 99, you come back, I put it on my car and sun it for a while. “(June 2023)

* a local expression used to punctuate speech, with no particular meaning

Similarly P 17 mentioned…..“So after the COVID it really scared me, frightened me and then I start to think about all kind of consequences and yeah. Whether in future the health would (be) threatened and all kinds of thing.” (April 2024)

These narratives illustrates, the psychological impact of COVID-19 extended into anticipatory fear about long-term health consequences. These narratives illustrate how the experience of illness reshaped participants’ outlook on health and ageing; not as isolated events but as disruptions that undermined their sense of safety and future stability.

Even after pandemic restrictions were relaxed, some participants continued to avoid crowded places, such as weddings or religious events. The persistence of these adaptations reflects a recalibrated sense of safety and social engagement.

As P4 described…“So even though later on we are physical in (the) office I also refused to attend the meeting.. I say I go online in the office itself. They give me options ma (local expression)I refused to attend the physical meeting. Even when (the) boss call(s) me

I said,’no, no’ you (have) got five people inside. I stay outside.”(June 2023)

The decision to remain physically distant, even when offered a choice between in-person or virtual attendance, reflects not just caution but a redefined relationship with space and safety, as shared environments are no longer perceived as inherently safe.

Through these lived accounts, it becomes evident that the fear of contagion was not a temporary response but a deeply embedded experience that redefined participants’ interactions with their social world.

Anxiety, worry and stress for self and others falling ill.

Participants described their concerns about them being within the high risk group to based on age alone. This concern extended to elderly parents with pre-existing health conditions and young grandchildren, prompting heightened vigilance and self-imposed restrictions. While they acknowledged their own vulnerability, many participants were more distressed about the possibility of becoming a vector of infection to loved ones.

P1 clarified….. “Not afraid but anxious worried about grandchildren getting it-more worried about family members rather than myself.” (May 2023)

P4 described …..“I feel like I feel bit concerned about my mum therefore cannot go out

We (are) scared because she is elderly in her 80s so I am afraid we might spread the virus if you get it…. because at that time there is (sic) no vaccination.” (July 2023)

The participants were worried about their family, other older people and their health and future. This reflects broader cultural norms of collectivism and filial obligation, particularly prevalent in many Asian societies, where protecting family, especially elders is both a moral duty and a source of identity, where care for others shaped emotional responses and everyday choices.

Feeling stressed and worried were common issues among the participants during the pandemic. They felt this was something new and didn’t have adequate information and guidance to deal with the uncertainty.

P2 mentioned about unknown……“Especially the first lockdown it was something… we had to get used to… never happened before… totally… I didn’t like it. Every day you hear about the news, you know. What you hear on media and on TV, that really made you worried like what’s the world coming to.” (May 2023)

P7 reflected …..“And then at one point in KL, the lockdown was so bad that you cannot even go out again. I think middle of 2021, I realized that that is when I could feel the stress building up.” (June 2023)

The constant state of uncertainty created a sense of confinement and heightened psychological tension, particularly during periods of strict enforcement or when performing essential tasks. This illustrates how repeated lockdowns created cumulative emotional fatigue among the participants. P2’s reference to the unknown highlights how different forms of uncertainty whether aleatory (stemming from the inherent unpredictability of the pandemic) or epistemic (arising from limited knowledge, evolving guidelines and conflicting information) shaped older adults’ risk perceptions. Such uncertainties intensified feelings of anxiety, stress and loss of control over daily life, underscoring how psychological strain was not just about isolation, but also about navigating the ambiguity of a rapidly changing crisis environment.

P2 expressed…..“But when I felt unwell and I went to the doctors clinic that was very very stressful But I had to visit the doctor… I felt if anybody sits next to me… I will get uptight… If anybody coughs I will get uptight. Going to the doctor was very stressful.“(May 2023)

What was once routine became a source of emotional distress. These accounts highlight how the pandemic reshaped everyday environments into spaces of fear, revealing the embodied nature of stress and its link to perceived vulnerability.

Social isolation and emotional well-being.

The participants who experienced illness during the pandemic, whether due to stroke or COVID-19, described profound emotional suffering, not simply from the physical illness but from the isolation that accompanied it.

P9 reflected on the loneliness that accompanied his stroke recovery during the pandemic: ”In fact, what happened was during the,… during the COVID, of course, we have, we advise people not to come and many will stay away. But during my recovery from stroke, I didn’t want visitors because it was very depressing at that time. So depression was more due to my being isolated from a lot of activities that I was very interested in.” (Sept 2023). Here, the absence of visitors and withdrawal from valued activities created a sense of disconnection that compounded the physical vulnerability he was already experiencing. His narrative reveals how recovery, in isolation, became a deeply distressing and disorienting experience.

Similarly, another participant spoke of the emotional aftermath of surviving COVID-19. Although his physical symptoms subsided, a persistent sense of unease and restlessness emerged, accompanied by disrupted sleep and a loss of emotional equilibrium:

P17 stated “So even though I recover from it, but after recovering from it, very soon I went into depression. And then I had to rely on sleeping pills, to sleep, to take and I feel very restless. I mean about one month or two months after recovering, no after three (weeks) or one month after that, I feel (sic) really depressed.” (April 2024)

The enforced isolation sometimes compounded by participants’ own precautionary behaviours led to a profound sense of withdrawal from the world, which impacted participants’ mental health severely illustrating that public health measures extended beyond physical threat of the COVID-19.

Together, these accounts reveal how illness during the pandemic extended beyond the physical body; deepening isolation, disturbing routines, and leaving emotional imprints that lingered long after recovery.

Loss of connections to people.

Participants described feelings of being disconnected with their loved ones, families and friends due to social distancing and travelling restrictions. Some participants had adult children who had migrated overseas and were unable to make their usual annual visits. Regular visits, once a meaningful anchor in their lives, were replaced by video calls, which felt emotionally inadequate.

For example, P18, shared how virtual communication fell short of meeting emotional needs “No, once a year. But during COVID, we were on video call. Or maybe we do WhatsApp video… WhatsApp call. So that was also something which was painful. Not painful, it was we couldn’t meet her. We couldn’t see her. See the children.” (April 2024)

His statement reflects a longing not merely for visual contact, but for physical closeness—holding, touching, and being in the presence of loved ones—essential elements of familial intimacy that were denied.

Similarly P10 mentioned ……”The difficult part is sometimes not so difficult. What I mean is not so difficult. It’s just that you sometimes you have to… like you got somebody to talk to. Sometimes you go to the neighbour there, you chit chat. Maybe sometimes we have tea together. That’s all cut off.” (Jan 2024).

This illustrates how even casual social rituals played a significant role in maintaining emotional well-being. Their disruption revealed how deeply embedded these micro-interactions were in participants’ sense of normalcy and belonging.

The loss was further intensified when major life milestones were missed.

P13 expressed ……”So basically it’s more to... You missed your... I mean being a grandfather, you were not able to enjoy it. Yeah, yeah. That went through. You went through that part. It was a sad life.” (Jan 2024). His use of “sad life” points to a deeper existential pain and loss of intergenerationa connection.

Decline in physical activity.

Participants described a disruption in their physical routines that previously provided structure, wellbeing, and social connection. The fear of infection, even in open spaces, led to self-imposed restrictions that altered their embodied habits and daily rhythms.

P2 mentioned…..“Exercise was out. I used to exercise daily. But even going for morning walks also you felt apprehensive for some reason… Might bump into someone so I felt I will not do my usual routine. So the exercise daily part of my life changed a lot. I tried to exercise at home but myself I didn’t have the discipline.”(May 2023) P17 shared…“Almost two years grounded in the house. But of course I take my walk outside for exercise purpose and all this after a year of lockdown. Even doing exercise, playing with the group taiji was stopped for 2 years… Then I went for one eye checkup and three days later I was infected with COVID.” (April 2024)

These narratives illustrates how physical activity, once a consistent and self-directed aspect of daily life, was disrupted by the pervasive sense of ambient threat, where even eventual re-engagement with physical activity came after long-term confinement. The suspension of group activities such as taiji underscores the dual loss—physical movement and communal interaction. Although walking outdoors is generally safe, the participant’s hesitation reflects the internalization of risk, routine medical visit further reinforces the sense that resuming normalcy carried lingering psychological risk.

These narratives demonstrate how the decline in physical activity was not just behavioural but existential; entangled with fear, loss of routine, and the collapse of embodied freedoms.

Loss of confidence and freedom.

COVID-19 restrictions led to a profound disruption in personal autonomy, especially in relation to mobility and self-reliance. The extended period of immobility caused some participants to experience a decline in self-confidence, particularly in tasks they had once performed routinely, such as driving. These losses were not only practical but deeply symbolic, touching on core aspects of identity, agency, and independence—values that often become even more meaningful in later life, when maintaining autonomy is closely tied to one’s dignity and self-worth.

P6 reflected …….”That life has gone because of the pandemic.Because of the pandemic sort of it made your life too static you know. You were not allowed to move around you were not permitted to go out anywhere, you see. So you become like… on your own. And then after that I told you I became sick. Maybe if I hadn’t fallen sick… after the pandemic I still might have… might have the confidence to drive… to go distant places. I really lost my confidence.“(June 2023) P3 stated……”I use to drive here and there then because of the COVID, I (was) restricted. So is a loss of freedom……….Now I don’t drive…, feel not confident. I only recently about one month (ago), I sold my car.” (May 2023)

Here, driving is not merely a functional activity—it represents a form of independence that promotes agency and fosters well-being The loss of confidence in performing this task marked a deeper shift in self-perception, from being capable and active to being dependent and uncertain. Her remark that “life has gone” suggests an existential sense of disruption, where the past self no longer feels accessible. In the context of older adulthood, selling a car carries more than logistical implications; it is not just a vehicle but a symbol of independence, and letting it go can signify a shift into greater reliance on others and a narrowing of one’s world, potentially impacting people’s self-worth and well-being.

P3 further reflected……“It is not your own house. Only loss, you have you lost your own (house comfort). I lost my freedom in the way (dependent). In the sense, food wise and everything wise is provided for… buy coconut water… buy this buy that … everything buy…The thing is only your freedom.” (May 2023)

Although her physical needs were met, the emotional experience of being cared for without control evoked a deep sense of loss. In older age, when maintaining control over decisions and routines becomes increasingly important for preserving identity and well-being, this feeling of disempowerment was especially difficult.

Loss due to death.

Loss of loved ones during the pandemic was described as emotionally devastating, particularly when public health restrictions disrupted traditional mourning rituals.

P9 described his grief ……“Then my brother also passed away during COVID, not due to COVID, you know, but because of the restrictions. Yes, I was able to pay my respects and come off (leave) immediately. They didn’t want to allow us to stay there too long, you know. So, even the funeral proper, they had it on Zoom. Yeah. because it happened during the COVID MCO* , that was very traumatic because he was the youngest in our family.” (Sept 2023)

* MCO = movement control order

His distress was not solely about death itself but the incomplete grief—being denied the culturally significant acts of communal grieving and physical presence. The phenomenological experience here includes an interrupted mourning process that left a lingering emotional void.

Loss of purpose.

Beyond physical and relational losses, several participants expressed a diminished sense of purpose. The loss of routines, social roles, and opportunities to contribute meaningfully to others left some individuals questioning the value and direction of their lives during the pandemic.

P6 shared how the abrupt halt of social and physical mobility disrupted her sense of direction: “That life has gone because of the pandemic… you become like… on your own” (June 2023)

P2 mentioned……..“I missed going to church. Maybe the social life with my church friends. Yes that part I missed. Because church was also locked down for at least one and half years or something like that.”(May 2023)

Her repetition of “life has gone” indicates not just boredom but existential displacement—a shift from an active contributor to a passive observer. The closure of churches and community groups removed important roles for some participants. As P2 described missing her church involvement, it was not simply about socialising but the loss of embedded roles that gave her identity structure. Beyond this it also limited access to psychological comfort that could have helped participants master the stressful situation, meaning an additional source of support was missing to cope with adversity.

Loss of financial security.

For some participants, the pandemic disrupted not only their routines and relationships but also their financial stability, which posed a significant threat to their sense of self-reliance. The loss of income for some participants made accessing essential items more challenging, with some relying on community support to meet their needs. They expressed a deep sense of helplessness as their income dwindled, leading to significant lifestyle changes. Despite the passage of time, they reported that their income has yet to return to normal. Thus, the pandemic did only impact during the pandemic but had long lasting consequences.

P13 who ran a market stall, described how the six-month closure of the market severely affected his livelihood: “Market business… you can’t open, they closed the market. DBKL* closed the market for six months… six months! So difficult for us to run (meet) daily expenses and all. After about two weeks later when the COVID (outbreak) closed down the market, we started off (again). Then we started doing home delivery. Then after that six months later they opened and come back to normal. But still after the COVID, business was not the same… like this.” (June 2024)

His account reflects a disruption in economic routine, but also the loss of a social role. As a provider and worker, his identity was intertwined with daily business activity. The phrase “business was not the same” points to a lasting impact—not only financially, but in how the participant perceived their ability to recover and resume pre-pandemic life.

P14 who ran a food stall business, reported pawning her jewellery in order to pay her employees’ salaries during the early phase of the pandemic: “Very bad, because I got no (not) much savings. So I went and pawn all my jewels(jewellery). Oh, so financially. To pay all my workers. Pay workers’ mah, give them salaries. I have some problem… a lot.”(Sept 2024)

Her account reveals the emotional toll of having to liquidate personal and symbolic assets, including items that may have held familial or cultural meaning. Jewellery, often a marker of security and tradition in many cultures, was sacrificed to meet obligations—underscoring her sense of responsibility in crisis but also personal loss.

Culturally grounded health practices.

Some participants relied on traditional knowledge and practices to cope and maintain their health. These routines were more than preventive strategies—they represented a source of control, self-efficacy, and identity in uncertain times.

P1 described how he relied on natural remedies and home-prepared food as a preventive health strategy: I follow simple rule don’t eat out try not to eat out – eat home cooked food use good spices in Indian home- I take lot of garlic onion cloves pepper chilli pad I take all of this a lot and every night without fail one glass of hot water with turmeric- not affecting my health- I feel healthy- so keep on doing this follow- nature’s way of helping.” (May 2023)

His detailed routine reflects not only a health practice but a resilient mindset rooted in cultural knowledge and personal conviction. By trusting in “nature’s way,” he enacted a form of control over his health, reaffirming his belief in the body’s ability to withstand external threats through natural means.

Grounding through mindfulness and nature.

Others coped by drawing inward—adapting mentally and emotionally through acceptance, mindfulness, and routines that created stability.

P5 described she adapted to the new normal…..Then after I kind of got used to it I learn to accept it I learn to cope By making sure that I am always next to the window when I am in the room luckily my house has got all windows and then I can spend some time out in the porch so that helps. Of course meditation and that helps.Internet actually saved lot of people because you can get entertainment you can get so many things on internet.” (Jan 2024)

This layered coping approach involved connection to nature, mindfulness, and purposeful use of digital tools. Her response demonstrated psychological flexibility and acceptance—key attributes of behavioural adaptation.

Adapting to connect virtually.

While physical distancing disrupted familial roles and routines, some participants reframed their experiences by using digital platforms to stay connected with loved ones.

P15 expressed …….“Normally we would go and visit the other son in Australia… But during lockdown, we didn’t do anything… Well, thanks to technology… we can still use WhatsApp and also Zoom.”(April 2024)

Similarly P6 was grateful…And very often my friends visit me and they come drive here I go with them and buy whatever I need so I felt I don’t really need the car so let him have it (June 2023)

P6 who previously attended in-person religious classes, described how the shift to online sessions gave her renewed purpose. ”I used to go for my religious classes in the evening. When the MCO came, I couldn’t go for those classes so it left a void in the schedule and later on I am not sure whether the same year or the next year they found Zoom (a video conferencing platform) and they started conducting Zoom classes. I was very happy. Someone came and set up everything so I just follow I just follow… so the password is there, just press (touch screen) on the password and then ok, press and I get into in the class”.(June 2023)

This adaptation illustrates emotional regulation through gratitude and relational continuity, where maintaining emotional connections despite physical separation helped buffer feelings of isolation and loss.

Shopping strategies and food accessibility.

Participants expressed a strong fear of being in crowds due to the risk of contracting the virus. This led them to make significant changes to their daily routines, including minimizing outings and making do with available resources for extended periods.

P19 described how he and his household adjusted the timing of shopping trips to reduce risk: “So during the COVID, take extra precautions and then also … we choose a time choose a

time you know. During the time when there are less people we think when there are less people so it create less problems.” (April 2024)

“we” suggests that decisions were made together, showing that safety was a shared concern. Choosing specific times to go out reflects a careful effort to avoid risk while still keeping some control over daily life

P7 a practising Buddhist, vividly described how her spiritual beliefs supported her mental health “I limit myself … I limit myself. Each time if I go out I make sure I have to get everything and it has to last me for a week or two you know That means I have to stretch my need to go out as much as possible. Of course the fridge become stocked up lah.” (June 2023)

Her efforts to limit outings show how carefully she managed her safety. Keeping the fridge well-stocked wasn’t just practical—it gave her a sense of security and readiness during an uncertain time.

Coping through religious faiths.

Several participants drew strength from their religious and spiritual practices, which provided emotional regulation, structure, and meaning during periods of isolation. Faith was described as both anchor and lens, shaping how participants interpreted and responded to confinement. Through prayer, meditation, or community connection, participants established new norms within constrained environments.

P5 who felt confined by physical restrictions, found comfort in her home’s architectural openness and her spiritual routines:“Then after I kind of got used to it I learn to accept it I learn to cope By making sure that I am always next to the window when I am in the room luckily my house has got all windows (windows on all sides)… and then I can spend some time out in the porch so that helps. Of course meditation and that helps.” (Jan 2024)

Her experience highlights a phenomenological shift from confinement to containment—where her home transforms from a prison to a sanctuary. The window and porch become symbolic thresholds, linking her inner life to the outside world, while meditation offers a way to sustain psychological spaciousness.

P7 mentioned….”I tell some of my Buddhist friends if I had no Dharma I would be cuckoo already. Because the Dharma is like an anchor for us now. Even though we were all locked in quarantine but we still communicated through Zoom, through WhatsApp.” (June 2023)

Her statement underscores the protective and interpretive power of faith, framing Dharma not only as spiritual guidance but as a psychological stabiliser. The use of “anchor” reflects how her belief system grounded her sense of reality during upheaval. Even in physical isolation, virtual communication sustained her community and preserved her sense of shared meaning.

These adaptive behaviours—ranging from altered routines to virtual engagement and spiritual practice—illustrate how older adults actively negotiated safety, connection, and purpose. Rather than passive recipients of care or regulation, participants demonstrated resilience and resourcefulness, adapting their lifeworlds to the realities of the pandemic while maintaining continuity in what mattered most to them.

Negative influence of news on social media.

Many participants expressed concern over the news they encountered on social media. They felt overwhelmed by the constant flow of information on platforms like WhatsApp, which fuelled their anxiety and fear about the spread of the virus.

P2 described how daily exposure to media reports amplified her fears about the state of the world: “Every day you hear about the news you know. What you hear on media and on tv that really made you worried like what’s the world coming to.”(May 2023)

P7 shared how social media, rather than calming her, increased her anxiety symptoms “Ya la (a local expression), you know somebody say something and then you Google. Then you know follow That time… not afraid… until more social media makes me more afraid.” (June 2023)

These narrative shows that the constant flow of grim or alarming news contributed to a broader sense of existential uncertainty. The phrase “what’s the world coming to” indicates not just concern for personal safety but a disruption in her worldview—one in which the future felt unstable and unpredictable. This reaction aligns with the literature on risk communication, where intense media coverage can unintentionally escalate public fear and undermine psychological resilience [21,22]. The shift from “not afraid” to becoming afraid illustrates the cumulative psychological impact of ambiguous or exaggerated digital messaging, particularly when individuals are trying to make sense of rapidly changing circumstances.

Connection through social media.

While Social media could amplify anxiety, participants also acknowledged its important role in fostering connection and maintaining routines. Digital communication became a lifeline to emotional support allowing them to stay connected with family and friends and attend religious virtual gatherings.

P5 expressed appreciation for how technology helped her stay in touch with colleagues from her religious community: “Of course because of internet, because of telephone because of WhatsApp Also because I was work from home at that time I was also connected with my Buddhist society colleague.” (Jan 2024)