SARS-CoV-2 Risk Management in Clinical Psychiatry: A Few Considerations on How to Deal With an Unrivaled Threat

Abstract

The pandemic spread of the corona virus SARS-CoV-2 has even-handedly shattered national and international health systems and economies almost in an instant. As numbers of infections and COVID-19-related deaths rise from day to day, fears and uncertainties on how to deal with this unknown threat are extremely present both for individuals and societies as a whole. In this manuscript, we aim to exemplarily describe the bullet points concerning (a) the internal risk management, (b) the organizational and structural changes, and (c) the communicational strategies applied in a Psychiatric University Hospital in the Southern part of Germany. The authors are well aware about the fact that almost none of these considerations may be considered as evidence-based at the moment. However, the authors trust that these reflections and experiences may be useful as an orientation for similar risk constellations in other afflicted countries due to the temporal delay of the pandemic course.

Psychological Impacts Related to Stress and Fear during the COVID-19 Pandemic: Cardiovascular Diseases, Diabetes and Psychological Disorders as Risk Factors

“…This shows that this population should receive special attention from public health agencies with the implementation of policies aimed at mental health monitoring during the pandemic and post-pandemic periods. The self-efficacy of human beings seems to strongly rely on the stability of the notion that based on our yesterday's experience we trust that we can strongly rely on our today's condition and predict the environmental changes of tomorrow [26]. For that, it is necessary to identify the most vulnerable, promote risk management and implement public health measures aimed at-risk groups.…”

Tele-Psychiatry Assessment of Post-traumatic Stress Symptoms in 100 Patients With Bipolar Disorder During the COVID-19 Pandemic Social-Distancing Measures in Italy

“…As the general population, subjects affected by pre-existing mental disorders faced several stressors during the period of national lockdown in Italy, such as isolation, loneliness, sudden bereavement without being able to bury their loved ones, and fear of ultimately and suddenly losing their own lives (11). Despite the fact that some authors did not find any detrimental effect of the COVID-19 outbreak on the social inclusion and well-being in subjects with mental health problems (12), pandemic concerns might have represented a significant stressor, particularly for subjects with severe mental illness, which were vulnerable to the risk of anxiety and mood relapse (13). Further, social distancing limited access to treatment and support centers, including mental health services, day programs, and congregate care settings, as well as limiting contact with families and loved ones, enduring increasingly prohibitive visitor policies (13)(14)(15)(16).…”

“…Despite the fact that some authors did not find any detrimental effect of the COVID-19 outbreak on the social inclusion and well-being in subjects with mental health problems ( 12 ), pandemic concerns might have represented a significant stressor, particularly for subjects with severe mental illness, which were vulnerable to the risk of anxiety and mood relapse ( 13 ). Further, social distancing limited access to treatment and support centers, including mental health services, day programs, and congregate care settings, as well as limiting contact with families and loved ones, enduring increasingly prohibitive visitor policies ( 13 – 16 ). On one hand, some individuals with severe mental disorders might have been less impacted by the public health restrictions, because they lived already “socially distanced,” with minimal interpersonal contacts outside of their immediate living environment and necessities, whether as a result of their symptoms, societal marginalization, or personal choice; on the other hand, in most of these patients the lockdown measures further reduced and collapsed the weak existing social networks ( 17 ).…”

Staying Connected: Reaching Out to Psychiatric Patients During the Covid-19 Lockdown Using an Online Blog

“…On March 20, 2020, a partial lockdown was announced in Bavaria, Germany, due to the corona pandemic, leading to a rapid shutdown of the outpatient unit of the Psychiatric District Hospital Regensburg (13). Within 10 days, the online blog "Bleib Zuhause" (German for "Stay at home") (www.medbo.de/bleibzuhause) was launched with its first article being published on March 30 2020.…”

“…Corona risk management in the Psychiatric District Hospital Regensburg, Germany, also included the reduction of such group activities for inpatients and the complete cancellation of group therapies for outpatients (13). As patients reported facing problems staying at home and feeling deserted by their health care professionals, therapists from the outpatient clinic joined forces with patient representatives and the hospital's Public Relations department to launch a patient-centered online Blog as an add-on to phone-calls and video-meetings.…”