One of the biggest challenges for the lunar and Martian settlements during the diablovirus pandemic was mental health. While the isolation produced by travel times served to protect the settlers from physical contagion, it bred a variety of mental issues in the susceptible.
While it is true that space travelers had to undergo rigorous physical and psychological evaluations, these had become steadily less and less severe as space travel became more routine, especially in the case of those going to the Moon. The Expulsions added an additional wrinkle, since Expulsees were rarely rejected for anything but the most gross of medical problems.
As a result, the stress of being aware of the crisis on Earth (thanks to light-speed telecommunications) yet unable to offer any substantial aid even to friends and family built up steadily as news grew worse and worse. Furthermore, when communications began to break down, people were left wondering whether loved ones were not responding to texts and e-mails because their local cell towers and Internet routers were down, or because these individuals had fallen ill with the diablovirus or met with some other misfortune. This information void could often be even worse than knowing that a close friend or family member was ill, even on death’s door.
On the whole, the transient population (individuals who were on short-term assignments and thus had more primary ties with persons on Earth than those in their local community) found the situation more difficult than the long-term and permanent resident population. However, even among the permanent settlers, there were enough people who had maintained strong ties with friends and family on Earth that questions about hose individuals’ well-being was intensely distressing.
This situation was complicated by a culture drawn from the “right stuff” attitudes of the early astronauts and reinforced by the military traditions of the pilot-astronaut community. The pressure to remain stoic in the face of this nightmarish uncertainty was particularly intense for anyone in a position of authority, which could be difficult for civilian science department heads and committee chairs, and particularly for dependents who were increasingly been given permission to accompany personnel in the years leading up to the pandemic.
For many people, the pressure made itself known through dreams. Particularly in settlements that used advanced telemetry in the monitoring apparatus for their life-support systems, it was possible to detect changes in the frequency of REM sleep, and of heart rate, respiration, and skin temperature of residents in sleeping quarters without intrusive sensory apparatus. This data often proved far more accurate in detecting sleep disruptions than self-reporting of nightmares, insomnia or other issues with sleep.
However, medical personnel often had limited options for dealing with these issues. Although sedatives could force the body to sleep, they could not provide normal sleep-rhythm cycles, which could be almost as damaging as the insomnia they were supposed to treat. And while there were drugs that could reduce the severity of nightmares, they did so by disturbing normal REM sleep, which could be as disruptive to mental functioning as the sleep disruptions themselves.
Fortunately, the most severe cases were generally rare. By and large, most Lunans and Martians were able to maintain a satisfactory level of job performance even with the deleterious effects of the stress resultant from the omnipresent threat of the pandemic, both personally in the case of a breach of the quarantine procedures which protected space travel, and more broadly in the potential of civilization breakdown on Earth if too many skilled workers were lost to sustain complex technological civilization.