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与新冠病毒共存。

Living with covid-19.

作者信息

Ploumpidis D

机构信息

Emeritus professor of Psychiatry, President of the Hellenic Psychiatric Association.

出版信息

Psychiatriki. 2020 Jul-Sep;31(3):197-200. doi: 10.22365/jpsych.2020.313.197.

Abstract

From the beginning of 2020, the alarming news from Italy and the first known cases arrived in Greece, along with travelers from the Holy Land. Spain, France and all other countries followed. From the first week of March, restrictive measures began in Greece and then confinement in order to limit the spread of the pandemic and not drown the National Health System by serious cases. The policy of restrictive measures to stop the pandemic was the internationally accepted response1 and the generalized adherence proved effective, despite the shock and the various reactions from the unprecedented, generalized state of restriction, different scale from epidemics of other times.2-4 In other countries, the loose restrictive measures have cost thousands of deaths. The general restrictive measures, however, have serious consequences for people's mental equilibrium, economy and employment, and for this reason they can only be of limited duration.5 The gradual return to normal life rhythms began gradually from May. But the test of the holiday time and the gradual opening of the tourist season, that is, the open communication of moving populations with limited, random checks for the virus and only local restrictions of the gathering of citizens. We are experiencing now the gradual and severe increase in cases, with an uncertain spreading, with asymptomatic and younger in age likely playing a central role in the spread of the virus, while the fear of a potential large increase in serious cases remains. At the time of this writing, the only means of coping is to maintain and locally strengthen the protective measures, while we gradually realize that these measures came to stay for many more months.6,7 A major problem is that the initial small number of cases favored the underestimation of risk by part of the population, and the serious consequences on people's jobs and lives, along with the deregulation of employment and social security relations legislated in recent months, have provided substantial material to conspiracy theories. We carefully monitor the research on the epidemiological behavior of covid-19 and the clinical data, the discussion on the drugs that make the symptoms milder, the effect of the virus on the CNS and the expected vaccine or vaccines. Our role from the beginning concerned the enormous psychological burden of a global health crisis, with serious consequences on people's working and social lives and equally avoiding the deregulation of the management of our patients and of the units that provide it. At the time of confinement, the telephone contact, familiar to all generations, offered valuable information and support, the lines 10306 and 1110, as well as many local or voluntary help-lines. Telepsychiatry was used more widely - being also an initiative of the Hellenic Psychiatric Association - and seems to have entered impetuously in our work, as well as in education. Its central or complementary role and its safe use are issues that are widely discussed at the moment.8 Protection measures against the virus seriously affect the normal functioning of health and mental health services. The solution should be sought in the urgent operational upgrade, the very necessary reinforcement of the staff and its effective protection from the virus and stress from exposure to danger, which has emerged as important factors for the normal operation of the mental health units.9 The use of telepsychiatry has solved a number of operational problems, but in many cases, it remains complementary, as it cannot replace physical presence in more specific care operations. The need not only to normalize, but to improve the follow up of our patients, the need to strengthen the units that provide basic, community mental health services, is shown by the increase in cases of involuntary hospitalization in the psychiatric hospitals of Athens and Thessaloniki during the last two months. A health crisis that affects almost the entire planet and the working and social life of most is a major social and political problem that concerns all of us,10 while mental health professionals are called to offer their scientific tools for people to face a multifaceted threat and in particular to claim and ensure the continuation of the treatment of our patients and the normal operation of our units.

摘要

从2020年初开始,来自意大利的惊人消息以及首批已知病例随着来自圣地的旅行者抵达希腊。西班牙、法国和其他所有国家也相继出现疫情。从3月的第一周开始,希腊开始实施限制措施,随后实行封锁,以限制疫情传播,避免国家卫生系统因重症病例而不堪重负。采取限制措施以遏制疫情的政策是国际公认的应对方式 ,尽管这种前所未有的全面限制状态带来了冲击和各种反应,且规模与以往疫情不同,但普遍的遵守证明是有效的。2-4 在其他国家,宽松的限制措施已导致数千人死亡。然而,全面的限制措施对人们的心理平衡、经济和就业产生了严重影响,因此只能在有限时间内实施。5 从5月开始逐渐恢复正常生活节奏。但假期时间的考验以及旅游季节的逐渐开放,即流动人群的开放交流,对病毒进行有限的随机检查,且仅对公民集会实施局部限制。我们现在正经历病例的逐渐且严重增加,传播情况不明,无症状感染者和年轻人可能在病毒传播中起核心作用,同时对重症病例可能大幅增加的担忧依然存在。在撰写本文时,唯一的应对方法是维持并在当地加强防护措施,同时我们逐渐意识到这些措施将持续更多个月。6,7 一个主要问题是最初病例数量较少使部分民众低估了风险,而对人们工作和生活的严重影响,以及近几个月就业和社会保障关系的放松管制,为阴谋论提供了大量素材。我们密切关注关于新冠病毒流行病学行为的研究和临床数据、关于使症状减轻的药物的讨论、病毒对中枢神经系统的影响以及预期的一种或多种疫苗。从一开始我们的角色就涉及全球健康危机带来的巨大心理负担,这对人们的工作和社会生活产生了严重影响,同时也要避免对患者及其治疗单位管理的放松。在封锁期间,各代人都熟悉的电话联系提供了宝贵信息和支持,如10306和1110热线,以及许多当地或志愿帮助热线。远程精神病学得到了更广泛的应用——这也是希腊精神病学协会的一项举措——并且似乎已迅速融入我们的工作以及教育领域。其核心或辅助作用以及安全使用是目前广泛讨论的问题。8 针对病毒的防护措施严重影响了卫生和心理健康服务的正常运作。应寻求通过紧急提升业务能力、非常必要地加强工作人员力量以及有效保护他们免受病毒感染和接触危险带来的压力来解决问题,这些已成为心理健康单位正常运作的重要因素。9 远程精神病学的使用解决了一些业务问题,但在许多情况下,它仍然是辅助性的,因为在更具体的护理操作中它无法替代亲自到场。雅典和塞萨洛尼基的精神病院在过去两个月里非自愿住院病例增加,这表明不仅需要使对患者的随访正常化,而且需要改善随访,还需要加强提供基本社区心理健康服务的单位。一场几乎影响整个地球以及大多数人工作和社会生活的健康危机是一个关乎我们所有人的重大社会和政治问题,10 而心理健康专业人员被要求提供科学工具,以便人们面对多方面的威胁,特别是要求并确保我们患者的治疗得以持续以及我们单位的正常运作。

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