Health experts shared the findings and consensus of the medical community in key areas of COVID-19 medicine and the impact of the pandemic on physical and mental health.
The Royal Society of Medicine brought together international thought leaders from around the world in a COVID-19 online conference on Monday, July 27. Health experts from a handful of countries shared the findings and consensus of the medical community in key areas of COVID-19 medicine, and the impact of the pandemic on physical and mental health.
The conference discussed in detail the complications of COVID-19 in several broad areas – respiratory complications, cardiovascular complications, thrombosis (blood clotting disorders), neurological complications (brain and nervous system), mental illness, fair access to vaccines and future public health policies.
Comments on comorbid COVID-1
Experts pointed to a frequent complication in many seriously ill COVID-19 patients with hypoxemia – an insufficient supply of oxygen to the lungs and body. Treatments such as high current oxygen therapy and continuous positive pressure therapy (CPAP), both of which are minimally invasive treatments, have been shown to improve the condition. 30-50 percent of cases where hypoxia occurs do not require invasive methods or intubation for treatment, they added.
On the panel on COVID-19 complications in cardiovascular patients, experts discussed some specific comorbidities in patients with existing heart diseases and how the health system reacted to them. COVID-19 and cardiovascular diseases are not directly related. There is a lot of data from research in several countries that show a strong connection between comorbidities. Experts say fewer deaths and intakes have been reported in the last few months of the pandemic than in previous days.
In the past six months, researchers have also highlighted neurological symptoms that affect the brain and nervous system and are becoming increasingly common in COVID-19 patients. Early diagnosis and differential diagnosis will make the crucial difference in treating these symptoms, experts said.
Experts agreed that many comorbidities would benefit from early diagnosis. Taking blood clotting disorders or thrombosis as an example, one of the panelists emphasized that the symptoms of the disorder can be better controlled if doctors and researchers know in advance who is at higher risk, through early intervention and drugs such as anticoagulants or heparin. Regardless of comorbidity, COVID-19 patients would have a much better medical perspective if their status and risks were known at an early stage.
India’s findings from the COVID-19 pandemic
The mortality rate in India is relatively low and the number of infections higher than in most other countries, possibly due to the country’s younger age profile, said Professor K Srinath Reddy of the Public Health Foundation of India. Comorbid conditions are abundant in the population – urban diabetes, obesity, and high blood pressure are among the most common. There are many cases of stroke among those admitted to COVID-19, and myocardial infarction has been observed frequently, said Prof. Reddy.
The growth of telemedicine during the pandemic could be a positive change that would benefit the Indian health system even if the pandemic is no longer in play, he added.
Regarding the long-term changes in the health system, Prof. Reddy emphasized that in all past epidemics, people with comorbid conditions, older populations and serious health conditions are often the most severely affected. The teaching for the health system is to deal aggressively with the most common comorbid conditions even in non-epidemic phases – diabetes, high blood pressure and obesity are some examples in India.
Unequal access to vaccines
At a meeting on global access to vaccines, an official from the Ugandan Ministry of Health said the country is working on many vaccine research projects – with London and the Institute of Tropical Medicine – because “they are not sure when a vaccine will reach them”. Experts from other countries also said that access to vaccines will be a global challenge.
Wealthier countries will of course “spread their bets widely” and increase their chances of getting more vaccines and earlier, experts said. It is likely that middle and low-income countries will later benefit from a vaccine. As long as more vaccine distribution programs come into play with the number of ongoing trials, middle and low income countries will also have faster and fairer access to a working vaccine, experts added.
COVID-19 mental health fee
The global COVID-19 pandemic has affected both physical and mental health across a wide range of age groups, said the mental health expert. Vulnerable groups, such as those who have had major and minor mental health problems, are further aggravated by the effects of the COVID-19 pandemic. Anxiety is one of the most common diseases that experts see and that affects all ages, from children to older adults.
Some new groups in which experts see mental health problems during the COVID-19 pandemic include intensive care patients and front-line health workers who are at risk of post-traumatic stress disorder (PTSD), depression, and anxiety. It is important to include solutions such as public health messaging as an important addition to the public health system, the expert added, stressing that mental health is a highly treatable disease.
There are many evidence-based therapies for psychosocial treatments that have been proven to work. We need to be able to take risks and accept what seems unconventional – be it in the form of billboards to promote mental health awareness or in a game that uses a methodology rooted in psychology – to meet needs of people who see mental health problems as a result of COVID-19, the expert suggested.
Health food stalls – for COVID-19 and beyond
Regular communication and information sharing between peers during the pandemic have made a remarkable difference in the medical and research community, experts said. For example, daily symptom discussion meetings, the latest medical research on symptom treatment, and the involvement of international expertise and advisors are helpful to maintain high quality health care around it given the rapidly evolving nature of the pandemic and medical research.
Another consensus was that adapting the public health system to patient needs was important. While we’re ready to treat patients, patients don’t necessarily present themselves to get the care they need at the right time, said a medical expert. Considerations for patient care based on patient needs and behavior are important for the health system to function well.
Similar to the international nature of the pandemic, which had no borders for transmission, the global exchange of information, ideas and experiences is crucial. It has significantly improved the quality of care and is approaching combating the pandemic, an expert added, and should be stepped up.
The panel stressed that the most basic prevention tools – hand washing, masks and physical distancing – saved thousands, if not millions, of human lives and cannot be emphasized enough.
The organizers of the Royal Society of Medicine hope to be able to put together another edition of a COVID-19 conference in the near future.