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COVID-19 disrupting critical mental health services

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A social worker (left) and a psychologist (second from left) give colouring and exercise books to children in eastern Ukraine, during a home visit to meet with the family. © UNICEF/Pavel Zmey

The global pandemic has disrupted critical mental health services in 93 per cent of the countries it surveyed, underscoring the devastating impact of COVID-19 and highlighting an urgent need to scale up funding, the UN World Health Organization (WHO) has said. 

Announcing the findings on Monday, the UN health agency also said that the pandemic has increased the need for the vital services. 

COVID-19 has interrupted essential mental health services around the world just when they’re needed most,” said Tedros Adhanom Ghebreyesus, WHO Director-General, calling on world leaders to “move fast and decisively to invest more in life-saving mental health programmes – during the pandemic and beyond.” 

“Good mental health is absolutely fundamental to overall health and well-being,” he added. 

Bereavement, isolation, loss of income and fear are triggering mental health conditions or exacerbating existing ones. Many people may be facing increased levels of alcohol and drug use, insomnia, and anxiety, according to WHO. 

COVID-19 itself can lead to neurological and mental complications, such as delirium, agitation, and stroke. People with pre-existing mental, neurological or substance use disorders are also more vulnerable to SARS-CoV-2 infection – they may stand a higher risk of severe outcomes and even death. 

Survey findings 

The survey – conducted between June and August 2020, covering 130 countries – evaluated how the provision of mental, neurological and substance use services changed due to COVID-19, the types of services disrupted, and how the countries are adapting. 

It showed that while many countries (70 per cent) adopted telemedicine or teletherapy to overcome disruptions to in-person services, there were significant disparities among them. More than 80 per cent of high-income countries reported deploying such measures to bridge gaps, compared with less than 50 per cent of low-income countries, said WHO. 

Findings also showed that counselling and psychotherapy were disrupted in 67 per cent of the countries, 65 per cent reported impact on critical harm reduction services, and 45 per cent on treatment for opioid dependence.  

More than a third (35 per cent) reported disruptions to emergency interventions, including those for people experiencing prolonged seizures, severe substance use withdrawal syndromes, and delirium, often a sign of a serious underlying medical condition. Three in ten countries also reported disrupted access for medications for mental, neurological and substance use disorders.  

The results were released ahead of the UN health agency’s Big Event for Mental Health – a global online advocacy event on 10 October, which will highlight the need for increased investments in mental health in the wake of COVID-19. 

Ensure resources for essential services  

Recalling its guidance on maintaining essential services – including mental health services – during COVID-19, WHO urged countries to allocate resources to mental health as an integral component of their response and recovery plans.  

According to the survey results, while 89 per cent of countries reported that mental health and psychosocial support is part of their national COVID-19 response plans, only 17 per cent among them reported having full additional funding to cover these activities. 

“This all highlights the need for more money for mental health,” said WHO, noting that as the pandemic continues, even greater demand will be placed on national and international mental health programmes that have suffered from years of chronic underfunding.  

Prior to the pandemic, countries were spending less than 2 per cent of their national health budgets on mental health, and struggling to meet their populations’ needs, the UN agency added, calling for greater resources for the sector, including from international partners as mental health receives less than 1 per cent of international aid earmarked for health. 

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Health & Wellness

Clarity still needed on effectiveness of COVID-19 vaccine passports

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Being vaccinated against COVID-19 may not prevent transmission and vaccination passports may not be an “effective strategy” for restarting travel, the World Health Organization (WHO) cautioned on Tuesday.

“At this stage, we would not like to see vaccination passports as a requirement for entry or exit because we are not sure at this stage that the vaccine prevents transmissions,” said WHO spokesperson Dr Margaret Harris, just ahead of World Health Day on 7 April 2021.

Supply and demand

Dr. Harris added that vaccine passports may not be an effective strategy as “not everyone has access to vaccines and there are groups in society who are excluded…We are still waiting on adequate supplies to provide the vaccines to all the countries that need them.”

Highlighting how COVID-19 has impacted some people more than others, Dr. Harris said that the virus “has really exposed the stark inequities in access to and coverage of health services…Groups who already faced discrimination, poverty, social exclusion, difficult living and working conditions were the hardest hit by the pandemic”.

World Health Day plea

For this year’s World Health Day, the UN agency has urged countries to build a fairer, healthier world post-COVID-19. Dr. Harris called for action to “put in place policies and allocate resources so the most vulnerable groups can see their condition improve faster”.

This means “improving living conditions for all”, tackling “poverty and health inequities”, building sustainable societies and strong economies, and promoting “a more equitable sharing of resources, ensuring food security and nutrition” and turning “the tide on climate change”.  There is so much work to do”, she said.

Latest WHO data from Tuesday 6 March at the time of posting, indicates that there have been 131,309,792 confirmed cases of COVID-19, including 2,854,276 deaths globally, reported to WHO.

By the end of 5 April, a total of 604,032,357 vaccine doses have been administered.

Regionally, infections and deaths remain highest in the Americas, with 56,880,123 million confirmed cases, followed by Europe (46,085,310 million), South-East Asia (15,438,907), Eastern Mediterranean (7,785,717), Africa (3,126,037) and Western Pacific (1,992,953).

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How a Digital Algorithm is Helping Doctors Treat COVID-19 Patients

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Moscow’s backup hospitals and inpatient clinics for treatment of the coronavirus infection have started using a new solution as part of the unified digital healthcare platform. The News2 app, which is integrated into the Unified Medical Information and Analysis System (EMIAS), helps physicians assess the severity of a patient’s COVID-19 symptoms and risks of deterioration, and suggests adjustments to treatment tactics where necessary.

The system is operated on tablets with specialized software. These allow medics to read the QR codes on a patient’s hospital identification bracelet or on an identification sheet in an inpatient clinic and enter data on their condition: heart rate, blood oxygen saturation level, blood pressure, body temperature, and respiration rate. The system then calculates the result and assigns the patient to a risk group, highlighting the relevant category with a specific color.

The patient’s risk score is entered in their electronic medical record. Physicians can then review both the patient’s current integrated risk score on the international NEWS2 scale and any changes to it at any time, together with the baseline data used to generate the information. Use of this clinical scale significantly improves patient safety, ensuring that examinations are conducted at predetermined time intervals and that specific indicators are measured, resulting in timely and optimal adjustments to patient therapy.

The benefits of the system for physicians are obvious: when the risk score increases from 3 to 5, for instance, the clinician can simply decide whether more treatment is necessary or, conversely, satisfy himself that the treatment is effective if the score subsequently falls.

The NEWS2 scale is used around the world to assess the severity of a patient’s condition by interpreting results based on a sum of scores. These are used to generate a final score for assigning the patient to a specific risk group.

Digital solutions in Moscow’s healthcare sector are being implemented jointly by the city’s Department of Health and Department of Information Technology.

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COVID-19 origins report inconclusive: We must ‘leave no stone unturned’

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research coronavirus

The report from a team of international scientists assembled by the World Health Organization (WHO) to examine how COVID-19 first spread to humans was published on Tuesday, and was described by the UN health agency’s chief as a welcome start, but far from conclusive.

“This report is a very important beginning, but it is not the end”, said WHO Director-General, Tedros Adhanom Ghebreyesus. “We have not yet found the source of the virus, and we must continue to follow the science and leave no stone unturned as we do.”

He welcomed the findings of the 34-member team, which in January, visited the Chinese city of Wuhan where the first cases of the then new coronavirus came to light at the end of 2019.

But the WHO chief was clear that overall, it raises “further questions that will need to be addressed by further studies, as the team itself notes in the report.”

He noted that although much data had been provided, to fully understand the earliest cases, they would need access from Chinese authorities “to data including biological samples from at least September” 2019.

“In my discussions with the team, they expressed the difficulties they encountered in accessing raw data. I expect future collaborative studies to include more timely and comprehensive data sharing.”

Animal markets’ role, ‘still unclear’

Tedros welcomed the recommendations for further studies to understand the earliest human cases and clusters, and to trace animals sold at markets in and around Wuhan, but “the role of animal markets is still unclear.”

The team confirmed there had been widespread contamination in the large market of Huanan but could not determine the source of this contamination.

“Again, I welcome the recommendations for further research, including a full analysis of the trade in animals and products in markets across Wuhan, particularly those linked to early human cases”, he said.

He agreed that farmers, suppliers and their contacts should be interviewed, and that more study was needed to identify what role “farmed wild animals may have played in introducing the virus to markets in Wuhan and beyond.”

Lab leak theory not ruled out

The team also visited several laboratories in Wuhan and considered the possibility that the virus had entered the human population as a result of a laboratory incident, noted Tedros.

“However, I do not believe that this assessment was extensive enough. Further data and studies will be needed to reach more robust conclusions”, he said.

“Although the team has concluded that a laboratory leak is the least likely hypothesis, this requires further investigation, potentially with additional missions involving specialist experts, which I am ready to deploy.”

As far as WHO is concerned “all hypotheses remain on the table”, he told the Member State briefing on the report in Geneva.

“Finding the origin of a virus takes time and we owe it to the world to find the source so we can collectively take steps to reduce the risk of this happening again. No single research trip can provide all the answers.”

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