Likely Exacerbation of Psychological Disorders from Covid-19 Response.

Anxiety and fear felt by people around the world regarding the coronavirus pandemic is real and can be overwhelming, resulting in strong emotional reactions in adults and children. With depressive and anxiety disorders already highly prevalent in the general population (300 million worldwide), depression and/or anxiety specifically because of the pandemic response is likely. Moreover, the current state of panic in the face of uncertainty is apt to produce significant amounts of stress. While this situation has the potential to cause psychological disorders in previously unaffected populations, perhaps more impactful is the exacerbation of symptoms of many existing disorders including anxiety, depression, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD) and hoarding disorder.

Stigma on first responders during COVID-19

During the pandemic, first responders were at an increased risk of being stigmatized because of their direct exposure to COVID-19;stigmatization is an undesirable stereotype that can contribute to a myriad of adverse effects, including, but not limited to, anxiety, depression, devaluing, rejection, stress, health problems, exposure to risks, and limiting protective factors. The objectives of this research were to understand stigma on first responders during the COVID-19 pandemic as well as the consequences of stigma on first responder's mental health. A qualitative phenomenological study used semistructured interviews to understand the experiences of first responders during the pandemic. This study included a convenience sampling of 31 first responders (e.g., physicians, nurses, paramedics, police officers, firefighters, etc.) located worldwide. First responders reported feelings of isolation, lack of support and understanding by family or friends, decreased or forced removal in immediate social interaction (e.g., within family and friend circles), sentiments of being infected or dirty, increased feelings of sadness and anxiety, and reluctance to ask for help or get treatment (e.g., self-approval of being isolated). By answering these research questions, this information highlighted additional challenges that may be faced by first responders aside from being a frontline worker during a pandemic, which is equally stressful. By understanding the role of stigma, public health practitioners during pandemics or emergency situations can seek to diminish it. (PsycInfo Database Record (c) 2020 APA, all rights reserved)

A Bottom-Up Approach Addressing Patient Care and Differential Diagnosis Amidst the Covid-19 Response.

Patient care often refers to the broad spectrum of care, prevention, and treatment that a provider delivers, while the point of a differential diagnosis is to make a distinction between 2 or more conditions that share similar signs or symptoms. A broad differential should be considered for every single patient who is currently ill (eg, all patients with respiratory illnesses); without it, there will likely be an increase of misdiagnosis, unnecessary patient suffering, and an influx of patients to the emergency department. The COVID-19 response has forced many of these basic medical values aside, like providing differential diagnosis or practicing bedside manner through social interaction, while physicians struggle to continue care for patients. As a result, newly formed hospital and clinical policies may have dangerously traded everyday diagnosis and treatment of patients for the pandemic and quarantine recommendations. This type of assumptive medicine is based on a singular differential that can be detrimental to patients, who are more likely affected with more common illnesses, like bronchitis or pneumonia-or perhaps, even more threatening illnesses, like a pulmonary embolism, COPD exacerbation, congestive heart failure and even lung cancer. Although these new policies and reactions to COVID-19 are proactive, these actions could be at the cost of providing quality patient care for people who have not contracted COVID-19.