It's no secret that the COVID-19 pandemic is a cause for adverse psychological effects, and when thinking of vulnerable demographic groups, the elderly come to mind – many of whom are often Holocaust survivors – as they are a high-risk group, especially being more isolated than other age groups. As the pandemic rages on, with it come health policy guidelines that are reminiscent of various adverse conditions that existed during the Holocaust. Among the adverse effects are prolonged isolation and separation from family members, but particularly the omnipresent risk of contracting an infectious disease. Thus, a new Bar-Ilan University study examined whether exposure to specific adversities would be related to amplified psychological reactions to COVID-19."According to memory-based theories of post-traumatic stress disorder (PTSD), present circumstances akin to past traumatic conditions can trigger involuntary retrieval and reliving of intense trauma-related memories and images," it says.The study set out to determine whether Holocaust survivors would report higher levels of PTSD symptoms, COVID-19 worries and loneliness relative to other elderly populations.Findings from the study showed that many survivors actually fared similarly to other elderly Jews of European descent who did not experience the Holocaust – unless they were exposed to or contracted infectious diseases during the Holocaust."We believed that most Holocaust survivors would manifest increased psychological distress during the pandemic because many of them still cope with PTSD symptoms and other impairments. However, heightened distress was evident mainly in a sub-group of survivors whose lives were endangered by infectious disease during the Holocaust," says Prof. Amit Shrira of the MA Program in Gerontology and the Interdisciplinary Department of Social Sciences at Bar-Ilan University."Most other survivors manifested impressive resilience and were similar in some markers of psychological distress to older adults who were not directly exposed to the Holocaust," he said. Shrira led the study, called "Suffering from infectious diseases during the Holocaust relates to amplified psychological reactions during the COVID-19 pandemic," in collaboration with Maya Frenkel-Yosef from the Nini Czopp Association, which provides social services to Dutch-Israeli Holocaust survivors and their families, and Bar-Ilan University PhD candidate Ruth Maytles.The study, conducted between April 23 and June 17 and published in the Journal of Psychiatric Research, focused on 127 elderly people born before 1945. Participants were divided into three groups: six survivors who reported having contracted infectious diseases, such as tuberculosis or dysentery, during the Holocaust; 70 survivors who reported not having contracted such diseases; and 31 Jews of European descent who did not live in Nazi or pro-Nazi-dominated countries."Survivors with Holocaust-related diseases reported higher COVID-19 worries than both survivors without Holocaust-related diseases and comparisons," the study noted. PTSD and loneliness were more prevalent among survivors who contracted infectious diseases such as tuberculosis and dysentery during the Holocaust relative to older adults who did not experience the Holocaust (38.5% vs. 0% for PTSD; 53.8% vs. 22.6% for loneliness). Moreover, not surprisingly, worries related to COVID-19 were more frequent among survivors who contracted infectious diseases during the Holocaust (46.2%) relative to other survivors (22.1%) or those who were not exposed to the Holocaust (6.5%)."It is possible that COVID-19 experiences reactivated traumatic memories especially among survivors who contracted an illness like tuberculosis or dysentery during the Holocaust, thus rendering exacerbated PTSD symptoms, worries and loneliness," the study noted. "Survivors' greater psychological sensitivity to COVID-19 possibly reflects their increased fear of being sick, losing control and independence, and of course, their fear of death – all of which are linked to similar fears experienced during the war," it added.