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.

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.