ABSTRACT
BACKGROUND COVID-19 was a global shock, causing challenges to many countries’ healthcare services. This paper provides a summary of Malta’s healthcare system journey during the COVID-19 pandemic with its initial preparedness for COVID-19 pandemic and the impact of COVID-19 on the service during the first 12 months of the pandemic. METHODS A literature search was conducted using Google and reviewing Maltese online newspapers. A comprehensive summary of internal operations conducted at Mater Dei Hospital, the country’s only acute general hospital, was provided by the Chief Operating Officer. RESULTS Several infrastructural changes including the increase in bed capacity and ITU areas were instituted in preparation for the pandemic. The health system showed resilience during the first wave. However, the situation was more precarious during the second wave. The end of December 2020 saw the start of the Covid-19 vaccination rollout, with over 30 health system hubs offering this service across the islands. Simultaneously health professional’s burnout is on the rise as resources and workforce are overstretched. CONCLUSION The collaborative effort between the guidance provided by the Public Health Authorities and the hospital’s multi-disciplinary team have been pinnacle during the pandemic. However, the future of the healthcare system is heavily dependent on the population’s behaviour, timely measures, the vaccination rollout and the type of immunity acquired through vaccination or infection.
ABSTRACT
INTRODUCTION: Data are emerging showing the adverse consequences on mental health of the general public due to the COVID-19 pandemic. Little is known about the needs of veterans with pre-existing mental health difficulties during the COVID-19 pandemic. METHODS: Data were collected through a cross-sectional online survey from a randomly selected sample (n=1092) of military veterans who have sought help for mental health difficulties from a veteran-specific UK-based charity. The response rate was 25.2% (n=275). Participants were asked to complete a range of standardised mental health outcomes (post-traumatic stress disorder (PTSD): Post-traumatic Stress Disorder Checklist, common mental health difficulties (CMDs): 12-Item General Health Questionnaire, difficulties with anger: 5-Item Dimensions of Anger Reactions-Revised and alcohol misuse: Alcohol Use Disorders Identification Test) and endorse a list of potential stressors related to changes to daily life resulting from COVID-19. Regression analyses were fitted to explore predictors of mental health severity. RESULTS: It was observed that symptoms of common mental disorder and PTSD (69.3% and 65.0%, respectively) were the most commonly reported to have been exacerbated by the pandemic. Lack of social support and reporting increasing numbers of stressors related to COVID-19 were consistently associated with increasing severity of a range of mental health difficulties. CONCLUSIONS: Our findings suggest veterans who had pre-existing mental health difficulties prior to the outbreak of COVID-19 may be at increased risk of experiencing CMDs as a result of the pandemic. Intervening to improve levels of social support and offering practical guidance to better manage any additional stressors relating to the pandemic may provide strategies to help reduce the burden of mental health symptoms.