Lawrence S .Bacow, president of Harvard University, published an open letter to teachers, students and the whole world, especially emphasizing that COVID-19 is testing the kindness and care of human nature in a difficult situation. I hope everyone can show their best character, help diagnose patients, support the orphaned and care for the disadvantaged groups in society.
Liao Junzhi, president of Academia Sinica, also posted on Facebook at the beginning of the epidemic. He believes that those who expose or conceal the diagnosis have blind spots, and hope to show the brilliance and sincerity of human nature, patiently communicate, coordinate and explain dissent or opponents, and give the greatest care, support and tolerance to the diagnosis.
According to the big data statistics of the Central Ministry of Medical Insurance, the top 20 diseases in outpatient visits in June-June this year were acute upper respiratory tract infections such as colds, which decreased by 3.83 million compared with the same period of last year, with a decrease of about 3 1.7%, while relative anxiety and insomnia surged rapidly. According to experts' analysis, this year's epidemic has made people feel anxious, and anxiety can be divided into two waves. The first wave is the initial stage of the epidemic. People are afraid of being infected by the COVID-19 epidemic or can't afford masks and alcohol, so they worry too much and have anxiety. The second wave is worried that the epidemic will seriously affect economic development, lead to layoffs or pay cuts, and also cause public anxiety. It can be seen that before the epidemic is lifted, people's anxiety and tension will inevitably linger.
In addition, home isolation or isolation will also have a serious psychological impact. Other poor and other vulnerable groups, diagnosed patients, young children, the elderly and front-line medical staff have more serious psychological influence than normal people. The Lancet, a well-known medical magazine, recently published an article calling for the urgent need to provide timely mental health care during the epidemic. The following is to discuss with readers how to attach importance to humanistic care, how to give consideration to human rights and epidemic prevention, and how to protect privacy when the epidemic situation in COVID-19 has not slowed down.
(A) the psychological impact of isolators
Quarantine is called "quarantine" in English. This word originated from17th century Italy's "quarantine", which means 40. At that time, the plague spread in Italy, and ships entering Venice had to be quarantined for 40 days before they could be released, hence the name.
According to a review article by Brookset, a scholar at King's College London, etc. Picking a thorn magazine collected 24 articles to investigate the isolated population under SARS, H 1N 1, Ebola, MERS and other epidemics.
It is found in the report that most people will have negative psychological effects, and the most common one is post-traumatic stress syndrome, with symptoms including depression or instability, depression, anxiety, irritability and insomnia.
In addition, it may cause loneliness, fear of going home to infect family members, fear of being discussed, rejected and stigmatized by neighbors or relatives. In some long-term follow-up isolators, even after three years, there are still post-traumatic stress, depressive symptoms and alcoholism.
From the perspective of * * *, medical care and public health, isolation can prevent the spread of the epidemic, protect people's health and avoid the exhaustion of medical resources after the outbreak. However, it is undeniable that under the premise of actively fighting the epidemic, the situation and physical and mental influence of the isolators are also the focus of public attention. If the treatment process is improper or too rough, it will cause trauma to isolated individuals and groups. There are six ways to solve the problem and relieve the isolation pressure:
1. First, try to shorten the isolation time.
Provide correct information
3. Daily necessities will be replenished immediately.
4. Reduce boredom and increase goodwill communication.
5. Provide enough mobile phones, charging cables, sockets and other contact tools.
6. Establish a 24-hour online service hotline.
In short, it is their greatest "self-healing ability" and "spiritual pillar" to let the isolated people feel people's care, social support and protection, and let them feel love from all directions.
(B) the psychological impact on children
According to Li Sixian, a professor at Normal University, the online survey found that 47% of people were able to keep calm about the epidemic, and 22% to 27% were quite nervous and worried about the epidemic. In particular, children's psychological state is different from that of adults. Children's emotional reaction is not anxiety, but disgust and anger, because they want to play, but they can't.
According to the "SARS Prevention Manual" compiled by China Mental Health Association in 2003, it is also applicable to COVID-19, and the following points should be noted:
◎ Keep calm, adults should make children feel safe.
Empathy, don't avoid talking about the current situation, but when the epidemic expands, they should be restricted from watching TV reports.
◎ Let them feel that they can also stay healthy.
◎ Maintain a normal routine and provide children with correct information.
◎ For children who are isolated at home, students in the class can be encouraged to call and ask for care in turn, or write cards to care, instead of smiling and avoiding.
◎ If the situation worsens, seek the assistance of professionals or psychiatrists.
(c) Pay attention to high-risk and vulnerable groups.
According to statistics, the higher the age, the higher the mortality rate. The mortality rate over 70 years old exceeds 8%, while the mortality rate of healthy people is only 0.9%. In addition, there are some chronic diseases such as cardiovascular diseases, diabetes, hypertension, chronic respiratory diseases, cancer, etc., and the mortality rate is relatively high, with an average of 5.6%- 10.5%. Before these patients are infected, we should pay more attention to and care about them than in the past, be stricter about epidemic prevention measures, and try not to let them go out and go to crowded places. Regular check-ups and routine medication can't be interrupted. (as shown in figure 1 and figure 2)
In addition, generally speaking, poor people, unemployed people, migrant workers or disabled people and other vulnerable groups have low income, few job opportunities, uncertain diet, low nutritional intake and poor health, and are often more likely to be infected with the virus and neglected to take care of them. We should pay special attention to these vulnerable groups, show empathy, ignore illegal immigrants for the time being, and ensure that they do not panic and dare not report the epidemic. At present, the immigration department of China is actively promoting the "self-invited project", adhering to the principle of legal principle, humanistic care and providing help. * * * This good policy has really helped new immigrants and migrant workers.
Bill Gates, the founder of Microsoft, also stressed that vaccine research and development is public wealth, and should be used in the nation that needs to be beaten most, not in the country with resources or rich people, so as to show the universal value of human supreme care.
Nursing care of medical staff
The first-line medical staff dealing with the epidemic situation will show fatigue and irritability because of the increased workload and being in high-risk areas. What they expect most is the support and encouragement of colleagues in charge of the hospital, and they also hope that they will not be unnecessarily criticized or disturbed in their work. They also hope that all medical and epidemic prevention materials and equipment are scarce, and of course they urgently need the safety of the workplace to be fully guaranteed. The Lancet pointed out that these front-line workers will show their love and enthusiasm when facing the cruel epidemic, and actively devote themselves to saving people in the workplace with their own specialties. On the contrary, they hope that psychiatrists or social workers should spend more time and energy to deal with patients' anxiety, fear and other emotional problems.
In addition, the World Psychiatric Association also put forward some suggestions for medical and health care personnel:
In order to realize that mental health is as important as physical health, we need to relieve stress and have a proper rest. Colleagues should support each other and keep in touch with relatives and friends.
The above three items actually apply to the general public.
(five) epidemic prevention and anti-epidemic, privacy and human rights protection must still be taken into account.
During the epidemic in COVID-19, besides isolation, other epidemic prevention measures including 3T mode: detection, tracking and treatment are also very important. The so-called tracking is mainly to track the previous contacts of infected patients for isolation and quarantine, so as to cut off the infection route of patients, reduce the chance of infection, and reduce the R0 value (basic infection number) to below 1. The traditional way of epidemic prevention tracking is "epidemic investigation", that is, it often takes a long time for epidemic prevention personnel to find or find patients' previous contacts through questionnaires and interviews, and the epidemic situation is unclear or concealed.
Now a mobile phone can find people's past footprint activities through the tracking technology of mobile phone positioning. At present, the epidemic prevention in Taiwan Province Province mainly adopts the base station mode of mobile phone signal, and the "Entry Quarantine System" has also built an "electronic fence system" to facilitate epidemic prevention personnel to stay at home for 14 days.
However, science and technology should be based on human nature, and should be regulated in detail by individual capital Law to protect personal privacy. At present, there are "Special Regulations on Prevention, Treatment and Revitalization of Severe Special Infectious Pneumonia" to flexibly regulate personal privacy and human rights, but we also have to worry that epidemic prevention measures should conform to the principle of proportionality and should not excessively infringe people's privacy in individual capital. Otherwise, although the epidemic prevention is very successful, privacy protection will be violated, which is not what everyone likes.
(vi) Ethical considerations in vaccine development and vaccination.
Countries all over the world have invested a lot of manpower, financial resources and resources to accelerate the research and development of vaccines. So far, 27 vaccines have entered clinical trials and 6 vaccines have entered phase III clinical trials. The whole world has accelerated research and development with moderate deregulation. Of course, we expect a sufficient number of vaccines to be available at reasonable prices, so as to ensure that they are applied to the most needy groups. In addition to the above, we deeply expect the following moral considerations:
◎ The effectiveness and safety of vaccines should be taken into the top priority and the strictest consideration.
◎ Has the induced effective antibody and T cell immunity been fully confirmed? Is it suitable for all ages? In addition, the duration of the vaccine's continuous effectiveness should also be paid attention to.
◎ Be very careful whether there are strong or even fatal side effects, such as antibody dependence enhancement (ADE) or vaccine-related respiratory diseases (VAERD).
◎ Vaccines are the public wealth of the world, and there should be fair vaccination opportunities (such as vaccine distribution and vaccination sequence), and the price should be civilian.
label
COVID-19 has been burning for a long time since the end of last year. It is undeniable that human beings will inevitably have psychological reactions of panic and anxiety in the face of any major epidemic. Therefore, how to calm people's hearts and provide psychological counseling and related treatment in time is particularly important.
Generally speaking, the stress and worries caused during the epidemic include: fear of getting sick, fear of infecting others, changing sleep and eating habits, and fear of worsening one's original chronic diseases, instead of forming the bad habit of smoking or drinking to relieve boredom and increasing the dosage of sleep or sedative drugs. Everyone's psychological condition is different, but to sum up, the following points are * * * homosexuality, which is worth following:
(1) Get rid of utilitarianism, replace suspicion, selfishness and egoism with trust, care and altruism, and realize the importance of "* * keeping * * honor".
(2) Use self-isolation or reduce going out to participate in public activities. At the same time, self-study, self-reflection, more understanding, tolerance and respect.
(3) Give play to empathy, cooperation, communication, coordination and care.
(4) Self-decompression techniques should be actively used, such as mindfulness decompression, breathing pranayama, exercise or reading.
Cooperate with * * * to publicize and practice peace of mind and epidemic prevention (peace)
Patient: Cultivate patience and compassion.
Enhancement: strengthen safety awareness and understand the correct epidemic information.
A ccept: accept the ups and downs of emotions and try to calm yourself down.
Change: improve bad habits and establish a new life of epidemic prevention.
E ngage: Return to normal life and devote yourself to various healthy lifestyles.
At present, in Taiwan Province Province, the epidemic situation of COVID-19 has gradually slowed down, but it is still in an unpredictable state of chaos. As long as we always keep a sense of crisis and vigilance, attach importance to humanity, care and solidarity, we believe that the fight against the epidemic will be successful.