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Medical experts signal increase in mental health problems amid Covid-19



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Public health experts have flagged a manifold increase in mental health cases amid the coronavirus pandemic, with many attributing the rising stress and anxiety levels to isolation, loss of loved ones, economic uncertainty and the fear of contracting the disease.

According to a survey by the World Health Organisation (WHO), the pandemic disrupted critical mental health services in 93 per cent of the countries worldwide. World Mental Health Day is observed on October 10 every year with the objective of raising awareness about mental health, global mental health education, awareness and advocacy against social stigma.

During the pandemic people have been experiencing anxiety, fear, frustration, sadness and loneliness to the point that these feelings have become constant and overwhelming or promoting the urge to attempt suicide. Existing mental health conditions, including severe anxiety and major depression, have also worsened.

Dr Jyoti Kapoor, Senior Psychiatrist at Gurugram’s Paras hospital, said, “In the last three months, the cases of mental health illness have increased nearly two-fold, with 25 per cent new cases of obsession and 50 per cent more cases of anxiety in the psychiatry OPD. Psychosomatic manifestations are also on the rise.”

“The prolonged self-isolation and social-distancing measures have caused deterioration in the condition of old or pre-existing patients. Even depressive symptoms have recurred in patients who were otherwise stable,” Kapoor added.

People are now taking the help of experts to tackle the situation as awareness about mental health has increased due to celebrities’ endorsement of mental health concerns coupled with unfortunate events such as the death of Bollywood actor Sushant Singh Rajput.

“There is an increase of 80 per cent in patients. Most of the patients are between 19 and 40 years, and the predominant concerns they have include job loss, anxiety due to Covid-19 cases nearby, separation from near and dear ones and the inability to meet them or friends due to lockdown,” said Dr Shweta Sharma, Consultant Clinical Psychologist, Columbia Asia hospital.

Nearly half of these patients do not have any history of mental illness. Despite the lifting of lockdowns, the number of cases has remained largely the same, Sharma added.

Dr Manu Tiwari, Consultant Psychiatrist at Noida’s Fortis hospital, said, “With anxiety and insomnia in the beginning, now we are also seeing mood disturbances. The cases of substance abuse withdrawal and domestic violence have also increased substantially. One can identify and manage the triggers better as well as develop emotional-coping mechanisms.”

A Delhi-based doctor said self-harm is one of the extreme manifestations of mental illness and emphasised the need to destigmatise mental health issues. “Right now approaching a mental health doctor or consultant is considered to be a major stigma.”

Dr Shuchin Bajaj, Founder-Director of Ujala Cygnus Group of hospitals, said there is a need to ensure that mental health counselling is available to each and every member of the community. “Telemedicine is playing a big role in providing high quality, low-cost mental healthcare to all citizens of the community and we need to promote it in a big way.”

According to a report by WHO it is estimated that nearly 36 per cent of Indians are depressed or suffering from some kind of mental disorder, said Kartik Naidu, Transpersonal Therapist and Trainer at Green Aura Holistic.

“The problem with our society is that there is a stigma attached to mental health problems. People are dismissive and judgmental towards the victim which discourages him/her to seek therapy and professional help. It is considered to be a sign of weakness which is why many people would rather suffer than speak about it or get help,” Naidu added.

“Not only this, companies should start providing facilities for treating any kind of mental illness. A recent WHO study suggests that the financial returns are more than four times the investment made in treating mental health issues. We as a society should treat it as any physical illness,” said Naidu.


Call for Covid-19 studies to focus on mucosal immunity



Researchers have stressed that more Covid-19 studies should be devoted to how immunity to coronavirus emerges in the mucous membranes of the nose and mouth.

Anyone who has undergone a nasal swab or saliva test for Covid-19 knows that the virus is most easily detected in the nose and mouth, the study, published in the journal Frontiers in Immunology, reported.

Noting that the mucosal immune system is the immune system’s largest component, the researchers expressed concern that it hasn’t been a focus of much of the research on Covid-19 to date.

“We think it is a serious omission to ignore the mucosal immune response to SARS-CoV-2, given its initial sites of infection,” said study author Michael W Russell from the University at Buffalo in the US.

“Clearly the response of the systemic immunoglobulin G antibody (the most abundant circulating antibody) is important — we do not deny that — but on its own it is insufficient,” Russell added.

Russell noted that naturally, the initial focus of research on the disease was on cases of severe disease when the virus descends into the lower respiratory tract, especially the lungs, where the cellular immune responses exacerbate the inflammation rather than fight the infection.

But since the upper respiratory tract, including the nose, tonsils and adenoids are the initial point of infection for the SARS-CoV-2 virus, the immune responses that are triggered there are of special interest.

“Given that many infected people remain asymptomatic, and that a large number of those who develop symptoms suffer only mild to moderate disease, this suggests that something, somewhere, does a fairly good job of controlling the virus,” said Russell.

“Could it be that this is due to early mucosal immune responses that succeed in containing and eliminating the infection before it becomes serious? We will not know unless these questions are addressed,” he asked.

The paper recommends that studies are needed to determine the nature of mucosal secretory immunoglobulin A (SIgA) antibody responses over the course of infection, including asymptomatic or pre-symptomatic infection, and mild and moderate cases of Covid-19 disease.

In addition, the authors point out that the mucosal immune responses may vary depending on different age groups and populations.


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