Victory in the Time of c ovi n Defying a Pandemic at an Indian Megachurch

The global COvID-19 pandemic of 2020-2021 required significant ritual adjustment in churches worldwide, particularly the larger ones. It has also provoked theological reflection on the origins on the virus, as well as on what God's Word had to say in response. This article investigates the adjustments and reflections at one Indian megachurch, Bangalore's Full Gospel Assembly of God (FGAG), with special reference to its utilization of a victory-oriented and defiant gospel of divine care, protection, and health. The question that animates this investigation is: Can a gospel of victory and health survive a global pandemic? The answer, somewhat counterintuitively (but in another sense - for those familiar with prosperity theology - not at all) is that it not only survives, but thrives. The article attempts to account for this thriving with reference to two distinctive characteristics of the soft version of the prosperity gospel that are manifest in FGAG's victory gospel, both of which are inculcated through ritual repetition and performance: 1) Its paradoxically simultaneous insistence that the faithful are, by God, already victorious, and that miraculous reversals await those who aren't, and 2) its boldly defiant response to evidence that all is not well..

Effect of the COVID-19 Pandemic on ED Adult Psychiatric Visits

Objectives: Our goal was to determine whether the proportion of ED visits for specific psychiatric conditions, namely anxiety disorders, depression, self-harm/suicidal thoughts, bipolar disorder, and psychotic disorders, changed after the arrival of COVID-19. Background(s): In March 2020, the COVID-19 pandemic reached the New York tri-state area, which, at the time, was one of the regions in the United States (US) that the virus most severely affected. ED visits dramatically declined, likely due to social isolation mandates and fear of exposure to the virus. Quarantining at home, fear of becoming sick, and job disruptions caused the level of stress in the population to increase. In a previous US study, the proportion of ED visits for some psychiatric conditions increased. Method(s): Design: Retrospective cohort. Setting(s): EDs of 28 hospitals within 150 miles of New York City. Hospitals were teaching and non-teaching in rural, suburban and urban areas. Total annual ED volumes were 12,000 to 122,000. Population: Consecutive ED patients = 21 years old from March 1 to November 30 in 2019 and 2020. Data analysis: We tallied the number of patients in 2019 and 2020 with anxiety disorders, depression, selfharm/ suicidal thoughts, bipolar disorder, and psychotic disorders, identified using International Classification of Disease codes (version 10). We calculated the proportion of these visits to total ED visits in 2019 and 2020. We report the changes in these proportions from 2019 to 2020, along with 95% CIs. Result(s): Total ED visits decreased 27%, from 844,017 in 2019 to 618,195 in 2020. In 2019 and 2020 combined, the number of patients were: 13,151 with anxiety disorders, 6884 with depression, 8886 with suicidal ideation/self-harm, 3252 with bipolar disorder, and 7129 with psychotic disorders. The changes [with 95% CIs] in the proportion of visits from 2019 to 2020 were: anxiety disorders -1% [-4,+3%], depression -5% [-10,-1%], self-harm/suicidal thoughts +23% [+18,+29%], bipolar disorder +14% [+6, +22%], and psychotic disorders +23% [+18,+29%]. Conclusion(s): The proportion of adult ED visits for selfharm/ suicidal thoughts, bipolar disorder, and psychotic disorders increased following the arrival of COVID-19, whereas the proportions for anxiety and depression changed minimally. These results are somewhat different from the findings in the previously reported study. Our study highlights the need for continued surveillance of the impact of COVID-19 on mental health.

Effect of the COVID-19 Pandemic on Emergency Department Adult Psychiatric Visits

Study Objective: In March 2020, the COVID-19 pandemic reached the New York tri-state area, which, at the time, was one of the regions in the United States (US) that the virus most severely affected. ED visits dramatically declined, likely due to social isolation mandates and fear of exposure to the virus. Quarantining at home, fear of becoming sick, and job disruptions caused the level of stress in the population to increase. In a previous US study, the proportion of ED visits for some psychiatric conditions increased. Our goal was to determine whether the proportion of ED visits for specific psychiatric conditions, namely anxiety disorders, depression, self-harm/suicidal thoughts, bipolar disorder, and psychotic disorders, changed after the arrival of COVID-19. Methods: Design: Retrospective cohort. Setting: EDs of 28 hospitals within 150 miles of New York City. Hospitals were teaching and non-teaching in rural, suburban and urban areas. Total annual ED volumes were 12,000 to 122,000. Population: Consecutive ED patients ≥ 21 years old from March 1 to November 30 in 2019 and 2020. Data analysis: We tallied the number of patients in 2019 and 2020 with anxiety disorders, depression, self-harm/suicidal thoughts, bipolar disorder, and psychotic disorders, identified using International Classification of Disease codes (version 10). We calculated the proportion of these visits to total ED visits in 2019 and 2020. We report the changes in these proportions from 2019 to 2020, along with 95% CIs. Results: Total ED visits decreased 27%, from 844,017 in 2019 to 618,195 in 2020. In 2019 and 2020 combined, the number of patients were: 13,151 with anxiety disorders, 6884 with depression, 8886 with suicidal ideation/self-harm, 3252 with bipolar disorder, and 7129 with psychotic disorders. The changes [with 95% CIs] in the proportion of visits from 2019 to 2020 were: anxiety disorders -1% [-4, +3%], depression -5% [-10, -1%], self-harm/suicidal thoughts +23% [+18, +29%], bipolar disorder +14% [+6, +22%], and psychotic disorders +23% [+18, +29%]. Conclusion: The proportion of adult ED visits for self-harm/suicidal thoughts, bipolar disorder, and psychotic disorders increased following the arrival of COVID-19, whereas the proportions for anxiety and depression changed minimally. These results are somewhat different from the findings in the previously reported study. Our study highlights the need for continued surveillance of the impact of COVID-19 on mental health.

Development and implementation of the Mobility Clinic COVID-19 pandemic patient outreach program

Background: At the beginning of the COVID-19 pandemic, there was uncertainty if individuals with spinal cord injury (SCI) were at greater risk for adverse health events. Certainly, there was great concern over direct effects (e.g. physical illness, hospitalization) but also fear of indirect effects (e.g. mental health, isolation, caregiver disruption) due to COVID-19 and the public health measures to contain it. Since individuals with SCI often have limited or tenuous access to healthcare and resources, they are at greater risk than the general population of destabilization. Objective: To proactively identify risks that may be exacerbated by the pandemic and mitigate them where possible, a primary care outreach program was developed. Methods: A screening algorithm was developed by our interdisciplinary Mobility Clinic team, and focuses on 5 domains: health destabilization, mental health, access to services and supports, social isolation, and caregiver stress. The algorithm was administered by phone to a total of 107 individuals, who were identified as past and current Mobility Clinic patients. Any risks identified received further investigation by the team. We used the opportunity to educate patients about the risks of COVID-19 and protective measures. Follow-up with patients continued every 6-8 weeks throughout the duration of the pandemic. An evaluation of this outreach program involved a description of the patient population contacted, the identification of common risks for patients, and patient satisfaction with the program. Results: The contacted patient population consisted of 76 males and 31 females. 74 patients were identified as having a spinal cord injury. Some of the most common questionnaire responses by patients with SCI included feelings of stress and/or anxiety and a reduction in Personal Support Worker services leading to increased caregiver stress. A patient satisfaction survey demonstrated that 83% of patients (n=12) were very satisfied with the phone call and the care received. Conclusion: The outreach program helps us to proactively identify risks for individuals with SCI and address any healthcare needs they have. Risk assessment and care at the primary care level can mitigate adverse events and hospitalizations, which is especially important during a pandemic situation when healthcare and hospital resources are limited.