A third of Covid survivors suffer neurological or mental disorders: Study

‘One in three COVID-19 survivors in a study of more than 230,000 mostly American patients were diagnosed with a brain or psychiatric disorder within six months, suggesting the pandemic could lead to a wave of mental and neurological problems, scientists said.

‘Researchers who conducted the analysis said it was not clear how the virus was linked to psychiatric conditions such as anxiety and depression, but that these were the most common diagnoses among the 14 disorders they looked at.

‘Post-COVID cases of stroke, dementia and other neurological disorders were rarer, the researchers said, but were still significant, especially in those who had severe COVID-19.’

Read here (Reuters, Apr 7, 2021)

Covid-19 & neurological conditions

‘A study published in The Lancet Psychiatry estimates that more than one-third of COVID-19 survivors experienced neurological symptoms within 6 months of their infection. Researchers at the University of Oxford (UK) evaluated medical record data for nearly 250,000 COVID-19 patients and found that 33.62% were diagnosed with a neurological or psychiatric condition in the 6 months following their infection, including 12.84% for whom this was their first such diagnosis. The proportion increased among those who were admitted to an intensive care/treatment unit (ICU/ITU), up to 46.42% and 25.79%, respectively. The most common conditions included anxiety disorders (17.39%), mood disorders (13.66%), substance use disorder (6.58%), insomnia (5.42%), nerve disorders (2.85%), and ischemic stroke (2.10%). The study breaks down each condition by disease severity.’

Read here (The Lancet, April 6, 2021)

Read press release here

Science and society are failing children in the Covid Era

‘In spite of the increasingly polarized debate about school reopenings, community infection rates and prioritization of vaccination, it seems clear that both science and society are failing children. Children have proven uniquely resilient to COVID-19, but many are already suffering lasting educational, mental and physical harms. The greatest harm is falling on the most vulnerable children, and yet we know so little of the true extent and duration of these harms, because relatively little research has focused on them, compared to the research on COVID-19-related spread and mitigation.

‘School closures are a prominent example where following the science is not in itself an answer. These are hard decisions based on ethical and moral considerations for elected officials to make, in ways that acknowledge the evidence on the harms, the requirement for safeguarding and the emerging evidence on COVID-19. Understanding the evidence on the potential trade-offs for children is a critical component of such policies and decisions. It is time science and society elevated this central responsibility.’

Read here (Scientific American, Mar 3, 2021) 

What Covid-19 has done to our well-being, in 12 charts

‘How has Covid-19 and the related shift to WFH affected workers? A group of researchers surveyed HBR readers and others in the fall of 2020 and found that the vast majority reported declines in both general and workplace well-being. The biggest culprits? Mental health struggles, increased job demands, and home-life challenges. A much smaller percentage reported an increase in well-being, attributing it to reduced commutes and business travel and having more time to focus on health.’

Read here (Harvard Business Review, Feb 10, 2021)

The surprising mental toll of Covid

‘You didn't need a crystal ball to forecast that the COVID-19 pandemic would devastate mental health. Illness or fear of illness, social isolation, economic insecurity, disruption of routine and loss of loved ones are known risk factors for depression and anxiety. Now studies have confirmed the predictions. But psychologists say the findings also include surprises about the wide extent of mental distress; the way media consumption exacerbates it; and how badly it has affected young people.

‘For example, a report from the U.S. Centers for Disease Control and Prevention, published in August, found a tripling of anxiety symptoms and a quadrupling of depression among 5,470 adults surveyed compared with a 2019 sample. Similarly, two nationally representative surveys conducted in April, one by researchers at the Boston University School of Public Health and another at Johns Hopkins University, found that the prevalence of depressive symptoms (B.U.) and “serious psychological distress” (Hopkins) were triple the level measured in 2018. “These rates were higher than what we've seen after other large-scale traumas like September 11th, Hurricane Katrina and the Hong Kong unrest,” says Catherine Ettman, lead author of the B.U. study.’

Read here (Scientific American, Dec 1, 2020)

One in 5 Covid-19 survivors will develop mental illness, a new study found—So we asked an expert why

‘Covid-19 is an infectious disease that causes respiratory illness, but its effects can go way beyond that. A large study from Oxford University in the UK found that survivors are at a higher risk of developing mental illness, such as anxiety and depression. They are also more likely to develop dementia, according to the research, which was published in The Lancet Psychiatry on November 9.

‘The researchers analyzed electronic health records of 69 million people in the US, including more than 62,000 people who had COVID-19. They found that 20% of those infected with the coronavirus were diagnosed with a psychiatric disorder within 90 days—about twice as likely as for other groups of patients with other illnesses in the same time frame.’

Read here (Health, Nov 11, 2020)

Will the economic and psychological costs of covid-19 increase suicides? It is too early to say, but the signs are ominous

‘When America’s Centres for Disease Control and Prevention (CDC) carried out a survey this summer, it found that one in ten of the 5,400 respondents had seriously considered suicide in the previous month—about twice as many who had thought of taking their lives in 2018. For young adults, aged 18 to 24, the proportion was an astonishing one in four.

‘The survey, published in August, was one of a growing number of warnings about the toll that the pandemic is taking on the mental health of people. For legions, the coronavirus has upended or outright eliminated work, schooling and religious services. On top of that, lockdowns and other types of social distancing have aggravated loneliness and depression for many.’

Read here (The Economist, Oct 5, 2020)

How people coped in lockdown: Jules Evans

‘What conclusions can we draw from this? Here are some personal suggestions and reflections:

1. Difficult times bring out the best (and sometimes the worst) in people. As Stoic philosopher Epictetus said: ‘Difficulties reveal people’s characters’. Most of us are finding the pandemic incredibly hard, we’re tired, anxious and sometimes feel defeated. But there’s cause for hope too — the emergency is bringing out the best in people, and helping us rediscover what really matters.
2. Doctors and health authorities should be careful not to pathologize the normal and appropriate suffering people feel in hard times, or to immediately prescribe pills for emotional suffering. Anti-depressants can be helpful in the short-term, but they also have side effects and can lead to long-term dependency. Declaring a mental health ‘epidemic’ and saying mental health services are the only solution can create bottlenecks for services that either don’t exist or have long waiting lists.
3. Instead, as well as supporting mental health services, we should also emphasize people’s strengths, assets and natural coping skills, including community approaches like getting to know your neighbours or joining local mutual aid groups. This empowers people rather than making them feel weaker and more dependent on medical experts.
4. For two decades, as part of the ‘politics of well-being’, policy makers have tried to improve people’s happiness in schools, companies and society. There is some evidence this is counter-productive, especially in difficult times. It can make people ashamed of feeling anxiety, anger or grief, even if these emotions are appropriate. Instead of focusing narrowly on happiness, we can help people develop psychological flexibility, and discover what gives them a sense of meaning and purpose, especially in adversity. This could make people more resilient and less prone to ‘the happiness trap’ (ie avoiding activities that make them feel anxious in the short-term).
5. Mental health and flourishing involve all aspects of society, from the economy to the arts to travel and green spaces. Building a flourishing organisation or society means taking a joined-up approach. That joined-up approach needs to come from the top — from the head of state, or the CEO of an organisation, or the head of a school or university.
6. An example of that joined-up approach to flourishing is social prescribing — perhaps 25% of people who go to see their GP (local doctor) don’t have anything physically wrong with them. Instead, they’re mainly suffering from loneliness and disconnection. Under a new NHS programme, the GP can refer them to a ‘link worker’, who then connects them to local community groups (sports, arts, faith and philosophy, and so on). Rather than asking ‘what’s wrong with you’ they can ask ‘what matters to you? What do you value?’
7. The challenge is that we are discovering the importance of these community approaches to flourishing just as the pandemic destroys community infrastructure — shutting down theatres, churches, youth groups, sports facilities and pubs. Yes, online courses have boomed, but we can’t go entirely digital, nor should governments only support big national arts projects. We all need to support local organisations that foster well-being, especially local companies.
8. In an age of emergency, you are only as strong as your community. The fantasy of the invulnerable Stoic individual is just that - a fantasy. We need each other, now more than ever, so the best thing you can do to support your long-term mental health is to invest in your community and in community relationships.

Read here (Jules Evans, Philosophy for Life, Sept 18, 2020)

America is trapped in a pandemic spiral

‘The country is now trapped in an intuition nightmare: Like the spiraling ants [army ants that sometimes walked in circles until they died of hunger and dehydration because they followed pheromone trails of others], Americans are walled in by their own unhelpful instincts, which lead them round and round in self-destructive circles. “The grand challenge now is, how can we adjust our thinking to match the problem before us?” says Lori Peek, a sociologist at the University of Colorado at Boulder who studies disasters. Here, then, are nine errors of intuition that still hamstring the U.S. pandemic response, and a glimpse at the future if they continue unchecked. The time to break free is now. Our pandemic summer is nearly over. Now come fall, the season of preparation, and winter, the season of survival.’

The nine errors:

1. A serial monogamy of solutions
2. False dichotomies
3. The comfort of theatricality
4. Personal blame over systemic fixes
5. The normality trap
6. Magical thinking
7. The complacency of inexperience
8. A reactive rut
9. The habituation of horror

On point 9: ‘The US might stop treating the pandemic as the emergency that it is. Daily tragedy might become ambient noise. The desire for normality might render the unthinkable normal. Like poverty and racism, school shootings and police brutality, mass incarceration and sexual harassment, widespread extinctions and changing climate, COVID-19 might become yet another unacceptable thing that America comes to accept.’

Read here (The Atlantic, Sept 9, 2020)

One-two punch of protests, coronavirus playing havoc with mental health in Hong Kong, study finds

‘Some three-quarters of Hongkongers are harbouring negative thoughts in the aftermath of last year’s social unrest and amid the ongoing coronavirus pandemic, with young people suffering significantly more from post-traumatic stress disorder (PTSD) and depressive symptoms, a new study has found.’

Read here (South China Morning Post, August 6, 2020)

This is not a normal mental-health disaster

‘The full extent of the fallout will not come into focus for some time. Psychological disorders can be slow to develop, and as a result, the Textbook of Disaster Psychiatry, which Morganstein helped write, warns that demand for mental-health care may spike even as a pandemic subsides. “If history is any indicator,” Morganstein says of COVID-19, “we should expect a significant tail of mental-health effects, and those could be extraordinary.” Taylor worries that the virus will cause significant upticks in obsessive-compulsive disorder, agoraphobia, and germaphobia, not to mention possible neuropsychiatric effects, such as chronic fatigue syndrome...

‘In 2013, reflecting on the tenth anniversary of the SARS pandemic, newspapers in Hong Kong described a city scarred by plague. When COVID-19 arrived there seven years later, they did so again. SARS had traumatized that city, but it had also prepared it. Face masks had become commonplace. People used tissues to press elevator buttons. Public spaces were sanitized and resanitized. In New York City, COVID-19 has killed more than 22,600 people; in Hong Kong, a metropolis of nearly the same size, it has killed seven. The city has learned from its scars.’

[Joshua Morganstein is the chair of the American Psychiatric Association’s Committee on the Psychiatric Dimensions of Disaster; Steven Taylor is a psychiatrist at the University of British Columbia and the author of The Psychology of Pandemics]

Read here (The Atlantic, July 7, 2020)

A third of Americans now show signs of clinical anxiety or depression, Census Bureau finds amid coronavirus pandemic

‘When asked questions normally used to screen patients for mental health problems, 24 percent showed clinically significant symptoms of major depressive disorder and 30 percent showed symptoms of generalized anxiety disorder. The findings suggest a huge jump from before the pandemic. For example, on one question about depressed mood, the percentage reporting such symptoms was double that found in a 2014 national survey.’

Read here (Washington Post, May 26, 2020)

Is everyone depressed?

‘For people whose response to the pandemic turns from acute anxiety into general malaise, Jarvis recommends facing the numbness head-on. It’s treatable, and not necessarily with medication. First, she says, create regimens of simple tasks that give structure to the day. The approach is working for Falcone, the acupuncturist. He starts every day with 30 minutes of stretching, no matter what. Then he walks his dog, makes coffee, and sits down to teach massage via Zoom. Deb Hawkins, the tech analyst, sent me a list of things she’s doing to help others and stay busy: She donated money to a couple of worthy causes, and made an appointment to give blood. She has created a small social bubble and signed up for an online ballet class. She says her sense of self is returning.’

Read here (The Atlantic, May 22, 2020)

COVID-19 and the need for action on mental health

‘The report highlights the needs of vulnerable populations, including first responders and front-line healthcare workers, older adults, children, women, and refugees or those in conflict settings. In addition to fear of illness or death and the growing challenges posed by mis- and disinformation, individuals are also experiencing a broad scope of secondary mental health effects, including financial insecurity or social isolation. The report advises that emergency psychosocial support should become more widely available, including remote mental health care. Furthermore, the report calls for prioritizing the protection and promotion of human rights of those with severe mental health conditions, as their needs can often be neglected in major emergencies.’

Download here (United Nations, May 13, 2020)

National action plan for expanding and adapting the healthcare system for the duration of the Covid pandemic

This 24-page report by the Johns Hopkins Center for Health Security offers answers and recommendations related to the following problems, for which there are tractable solutions:

• How can we improve infection prevention in hospitals and maintain a robust supply chain for personal protective equipment (PPE)?
• What approach should we take to restarting deferred healthcare services?
• What financial support is needed for hospitals and healthcare providers?
• How should the healthcare workforce be sustained and augmented?
• How can we provide mental health support for healthcare workers in this crisis?
• How can we provide medical care and sick leave for all people in the United States?
• How can we make telemedicine a new normal?
• How can we reduce the number of undiagnosed infectious diseases in our hospitals?
• How can we better protect emergency medical services (EMS) personnel from infectious diseases?
• How can we better coordinate the healthcare response to COVID and the next pandemic?

Read and download here (Johns Hopkins Center for Health Security, May 5, 2020)

The coronavirus pandemic is pushing America into a mental health crisis

‘Three months into the coronavirus pandemic, America is on the verge of another health crisis, with daily doses of death, isolation and fear generating widespread psychological trauma. Federal agencies and experts warn that a historic wave of mental health problems is approaching: depression, substance abuse, post-traumatic stress disorder and suicide. Just as the initial coronavirus outbreak caught hospitals unprepared, the country’s mental health system — vastly underfunded, fragmented and difficult to access before the pandemic — is even less prepared to handle this coming surge.’

Read here (Washington Post, May 4, 2020)