|Year : 2021 | Volume
| Issue : 3 | Page : 125-126
Challenges to the Medical World during Pandemic: Looking for Innovations
Rakesh Kumar Chadda1, Rachid Bennegadi2
1 Secretary General, World Association of Social Psychiatry, Professor & Head, Department of Psychiatry, and Chief, National Drug Depedence Treatment Centre, All India Institute of Medical Sciences, New Delhi - 110 029, India
2 President, World Association of Social Psychiatry, Medical Referent of the Sigmund Freud University, Paris, France
|Date of Submission||14-Nov-2021|
|Date of Decision||15-Nov-2021|
|Date of Acceptance||15-Nov-2021|
|Date of Web Publication||23-Dec-2021|
Prof. Rakesh Kumar Chadda
Department of Psychiatry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Chadda RK, Bennegadi R. Challenges to the Medical World during Pandemic: Looking for Innovations. World Soc Psychiatry 2021;3:125-6
The last 2 years (2020 and 2021) have changed the way the world works, and threw a major challenge to the health services in the background of the COVID-19 pandemic. The health services needed to be geared up to deal with the upsurge of an illness for which no one had experience of dealing with. Highly infectious nature with an extremely large number of fatalities reported worldwide brought a kind of widespread panic reaction. Even the countries with the best health infrastructure found themselves incapable to deal with the upsurge of the infection and control the pandemic. The health services needed to be diverted from the general healthcare to the pandemic-related care. The pandemic had devastating effects on the world economy due to the countrywide lockdowns that needed to be declared to control the spread of the infection. The pandemic along with its socioeconomic consequences brought into focus need for many innovations to deal with its impact. The impact on mental health was observed all over the world. This editorial especially focuses on the innovations used in the mental health sector with a special emphasis on social psychiatry.
The development of the vaccine by the end of 2020 brought some solace but vaccinating a huge population across the world remains a big challenge even in the high-income countries, leave aside a large Global South. Despite the availability of vaccine and following a proactive approach vaccine hesitancy has remained a big challenge even in many resource-rich countries.
Due to the industrial and business shutdowns and the associated unemployment, a large section of labor force was left without any income leading to social unrest. This was in addition to a massive community fear of the infection in both those who had been infected and in the general population. There were reports of mass anxiety and phobia, suicides, and massive migration of the labor force. Mental health consequences of the pandemic included an initial fear and worry of getting an infection along with psychosocial consequences of measures needed to be taken to control the spread of the infection. Need for social distancing, constant fear of exposure, closing of educational institutions, transport, industrial establishments, businesses, and sources of entertainment all had adverse psychosocial and mental health consequences, affecting growing children, adolescents, the workforce, entrepreneurs, and others. Those with chronic and serious physical illnesses could not access the health services due to nonavailability of transport as well as diversion of general health services to the pandemic related services leading to increased morbidity and mortality attributed to non-Covid causes. Persons with Covid infection developed many secondary mental health problems during treatment including delirium, depression, and anxiety reactions, some of which continued even after recovery from the infection. Quarantine and social isolation of both patients and their contacts also had its own psychosocial consequences. Those infected and their contacts also faced stigma and discrimination especially during the initial phase of the pandemic. Many people had to go through grief due to loss of near and dear ones. Many children also got orphaned.
The healthcare workers were at increased risk of getting the infection, and were working under great stress of dealing with a completely unknown disease with uncertainties of treatment response, frequently changing treatment protocols, exposures to death, and the heavy personal protective exposure kit.
Dealing with the pandemic required initiatives from the international agencies such as the World Health Organization, local governments, collaboration and coordination at national as well as international levels, sharing information and experiences on how to control the spread and reduce the associated morbidity and mortality. Strategies included raising awareness in the general population about social distancing and respiratory hygiene, the two strategies found to be the most effective preventive approaches. Educational materials sensitizing the general population were developed and widely disseminated on mass media. This was especially needed to deal with the widespread myths and misconceptions associated with the pandemic. Facilities for social isolation, quarantine and treatment needed to be created with modifications in the existing health infrastructure. Various innovative approaches were used. Hotels, community facilities, and even educational institutions were used as quarantine facilities.
Advances in the information technology in the last 10–15 years came as a great boon. The last one decade has brought mobile phone penetration to a large section of the population including in the low-and middle-income countries. Easier availability of wireless internet has brought the people across the world closer. In this background, telemedicine offered a great opportunity to provide health services using the virtual media, which could be used for consultation, psychosocial interventions, and health education. Teleconsultation, though having a limitation of not having a physical contact and a facility of physical examination, had the advantage of saving on travel expenses and the time. It could especially be applied for follow-up assessments after the initial clinical evaluation. Tele helplines were also created for providing Covid-related information and counseling. The healthcare workers also needed updating of their knowledge and skills in providing Covid-related care, which could be provided in form of regular webinars. Psychosocial support sessions also needed to be organized in virtual modes for the healthcare workers.
The World Association of Social Psychiatry (WASP) took special initiatives during the Covid-19 pandemic by coming out with a Position Statement on April 15, 2020. WASP also organized a Webinar “Mental Health, Well Being, and Social Psychiatry: Challenges Imposed by The Covid-19 Pandemic” on September 18, 2021, highlighting the psychosocial issues related to the pandemic. The Webinar was attended by about 200 delegates. WASP's official Journal, the World Social Psychiatry, came out with an exclusive May-August 2020 issue devoted to the pandemic with a theme of Covid-19 Pandemic and Mental Health. December 2020 issue of the WASP Newsletter was devoted to the theme “Covid-19 and after: Challenges and Opportunities.” Educational material related to the pandemic was posted on the WASP website and has been regularly updated. WASP Secretary-General has edited a multiauthor e-Monograph on “COVID-19 Pandemic and Mental Health: Experiences of Organizing Services at a Tertiary Care Healthcare Institution.”
The pandemic also brought new challenges for the scientific meetings since it was not possible to organize the conferences and other similar programs in a physical mode. As discussed, WASP organized its first webinar on September 18, 2020. WASP also presented two symposiums in collaboration with the American Psychiatric Association in its annual meet in May 2021. We proposed to organize Asia Pacific Hybrid Meeting of the WASP in September 2021. The proposal was moved by the Delhi team in March 2021, when the pandemic was on downslide and was approved by the WASP Executive Council. But as we started working on it, 2nd wave of the pandemic started in India, sabotaging all our plans. In early June, as the Covid situation started normalizing, we resumed our work for the Congress. There were lots of apprehensions and we proposed to have 3 parallel sessions. But as days progressed, we got an overwhelming response and a large number of proposals, which needed expansion of the scientific program to 9 parallel sessions. Finally, the Congress turned out to be more like a World Congress with 714 delegates representing 30 countries representing Americas, Africa, Europe, Asia, Australia, and New Zealand. We also attempted to keep the timing of the Congress at 1.30–9.30 PM Indian Standard Time so that delegates from different parts of the world could join depending on their convenient time zone. The theme of the Congress was suitably chosen as “Innovations in Social Psychiatry Across the World.”
We are presenting the special issue of the World Social Psychiatry commemorating the WASP Asia Pacific Hybrid Congress 2021. This issue includes full papers on selected set of presentations made during the Congress and abstracts of all the papers presented in the Congress. This Congress has set an example of organizing an international scientific meeting in difficult times and is also an example of innovation during the pandemic.
| References|| |
Chadda RK, Bennegadi R, Di Nicola V, Molodynski A, Basu D, Kallivayalil RA, et al.
World association of social psychiatry position statement on the coronavirus disease 2019 pandemic. World Soc Psychiatry 2020;2:5.
Basu D. The Plague
by Albert Camus, the COVID-19 pandemic, and the role of social psychiatry – Lessons shared, lessons learned. World Soc Psychiatry 2020;2:51-6. [Full text]