Sheek-Hussein Mohamud, Abu-Zidan Fikri M, Stip Emmanuel
Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
Int J Emerg Med. 2021 Mar 24;14(1):19. doi: 10.1186/s12245-021-00342-z.
The COVID-19 pandemic has exposed a suboptimal response to this threatening global disaster, including the response to the psychological impact. Both the economic hardship and the continuous media coverage of alarming news have exacerbated this effect which also includes increased domestic violence.
To address this important aspect of disaster management and provide recommendations on how to mitigate these effects.
This is a narrative review written by three experts in community medicine, disaster medicine and psychiatry reflecting the interdisciplinary approach in managing disasters. Selected important papers, personal published papers, PUBMED articles and media news related to the disaster management of the psychological effects of COVID-19 pandemic were collected over the last year, critically appraised and used in writing this manuscript.
The COVID-19 pandemic causes major emotional distress. Lack of effective treatments and availability of the current vaccines for this virus increases the fear of being infected and infecting others. Negative emotions are common and are related to adjustment but may progress in the long term to anxiety, depression, and post-traumatic stress syndrome. The COVID-19 pandemic has a major impact on mental health. The most common distress reactions include anxiety, insomnia, perception of insecurity, anger, fear of illness, and risky behaviors. Patients having mental disorders are vulnerable during the pandemic because of (1) somatic vulnerability, (2) cognitive and behavioral vulnerability, (3) psychosocial vulnerability, and (4) disruption to psychiatric care. Psychiatric wards, which are commonly separate from main hospitals, should be included in the disaster management plans. Acute care physicians carry the psychological and ethical impact of difficult triage decisions when ending the support of some patients to save others. A combination of fear and guilt may overcome normal human tolerance levels in vulnerable health workers. The moral injuries can be carried for a long time.
Addressing the psychological effects is an essential component of disaster management of infectious pandemics. This should be implemented through the whole spectrum of disaster management including preparedness, mitigation, response, and recovery.
新冠疫情暴露出对这一全球性威胁灾难的应对存在不足，包括对心理影响的应对。经济困境以及媒体对令人担忧新闻的持续报道加剧了这种影响，其中还包括家庭暴力的增加。
解决灾害管理的这一重要方面，并就如何减轻这些影响提供建议。
这是一篇叙述性综述，由社区医学、灾害医学和精神病学领域的三位专家撰写，反映了灾害管理中的跨学科方法。在过去一年中收集了与新冠疫情心理影响的灾害管理相关的重要论文、个人发表的论文、PubMed文章和媒体新闻，进行严格评估并用于撰写本文。
新冠疫情引发了严重的情绪困扰。缺乏针对该病毒的有效治疗方法和现有疫苗，增加了人们对感染和传染他人的恐惧。负面情绪很常见，与适应有关，但从长远来看可能会发展为焦虑、抑郁和创伤后应激综合征。新冠疫情对心理健康有重大影响。最常见的困扰反应包括焦虑、失眠、不安全感、愤怒、对疾病的恐惧和危险行为。患有精神障碍的患者在疫情期间很脆弱，原因如下：（1）身体脆弱性；（2）认知和行为脆弱性；（3）心理社会脆弱性；（4）精神科护理中断。通常与主医院分开的精神科病房应纳入灾害管理计划。在结束对一些患者的支持以拯救其他患者时，急诊医生承担着艰难分诊决策带来的心理和伦理影响。恐惧和内疚的结合可能会突破弱势医护人员的正常人类耐受水平。道德伤害可能会持续很长时间。
应对心理影响是传染病大流行灾害管理的重要组成部分。这应通过灾害管理的全过程来实施，包括预防、减轻、应对和恢复。
