The New York Times (3/23, Goldberg) reports that many healthcare workers are facing questions about coronavirus that they don’t know how to answer. The article says that “physicians across every field who are trained to care for very specific medical problems are confronting a surge of patient questions and scrambling to keep up with rapid changes in case numbers and advisories from governments and health agencies.” While “specialists in heart medicine, lung care and obstetrics have training that is highly pertinent to treating the effects of the coronavirus…specialists in other fields are hearing queries they may not be used to answering.” The article says that “psychiatrists, especially on campuses, are facing a barrage of questions on an array of topics, like potential virus exposure and the sudden upending of work and academic schedules.” Dr. Gauri Khurana, a psychiatrist who works mainly with college students, said that he has been flooded with questions from young people who are concerned about the risk of being infected and whether they will be able to graduate, “I don’t think a lot of them have primary care doctors and at this point everyone is terrified, wondering what’s going to happen. I have patients that want to drop out of school, move to Canada. They’re grateful for any advice, especially coming from a doctor because there’s so much misinformation.”

Related Links:

— “These Doctors Have Specialties. Fighting Coronavirus Wasn’t One of Them., “Emma Goldberg, The New York Times, March 23, 2020

MD Magazine (3/23, Rosenfeld) reports, “Frontline healthcare workers, women, and nurses exposed to coronavirus disease 2019 (COVID-19) are at a greater risk of developing unfavorable mental health outcomes,” research indicates. Investigators in China “used data from >1200 healthcare workers to assess the magnitude of mental health outcomes and associated factors among those treating patients who were exposed to the virus in” that country. Researchers “found that among the Chinese workers exposed to COVID-19, women, nurses, those in Wuhan, and frontline healthcare workers had a greater risk of worsening mental health outcomes than average,” which suggests that “such individuals may need psychological support or interventions.” The findings were published online March 23 in JAMA Network Open.

Psychiatric News (3/23) quotes the author of an accompanying commentary, who wrote, “These findings, consistent with those observed in the 2003 severe acute respiratory system (SARS) epidemic, may help to guide strategies for responding to mental health sequelae of this and future epidemics.” He added the study “provides a reminder of the toll that will likely linger” after the COVID-19 pandemic is over, that is, “the consequences of chronic stress, including major depression and anxiety disorders.”

Related Links:

— “COVID-19 Affects Mental Health of Nurses, Frontline Workers More Than Others, “Samara Rosenfeld, MD Magazine, March 23, 2020

Healio (3/20, Gramigna) reported, “Access to identity documents that reflected transgender individuals’ identified gender helped to improve their mental health and reduced suicidal thoughts,” investigators concluded after obtaining and analyzing data derived from “27,715 participants in the 2015 U.S. Transgender Survey.” The study revealed that while just “11% of transgender individuals had their preferred name and gender markers on all IDs…this group saw a marked reduction in serious psychological distress and suicide ideation.” The findings of the “cross-sectional observational study” were published online March 16 in The Lancet Public Health.

Related Links:

— “Gender-concordant IDs improve mental health, reduce suicidal thoughts among transgender individuals, “Joe Gramigna, Healio, March 20, 2020

CQ Roll Call (3/19, Raman) reports the coronavirus pandemic is requiring healthcare professionals to change how they offer behavioral treatments in light of social distancing practices and stay-at-home orders. The article outlines what government agencies and behavioral health organizations are doing to try to address the problem.

For example, Psychiatric News (3/19) reports, “In light of the coronavirus (COVID-19) outbreak, some patients receiving treatment for opioid use disorder (OUD) may take a 28-day supply of their medications home to avoid daily trips to their clinic, the Substance Abuse and Mental Health Services Administration (SAMHSA)” announced “in a guidance [pdf] issued on” March 16.

Related Links:

— “Mental health care adapts to telehealth because of COVID-19, “Sandhya Raman, CQ Roll Call, March 19, 2020

Medscape (3/19, Brooks, Subscription Publication) reports, “Media reports of celebrity suicides are associated with a ‘clear and compelling’ increase in suicide rates in the general population,” investigators concluded after identifying and then analyzing data from “31 relevant studies.” The conclusions of the “systematic review and meta-analysis show reports of celebrity suicide were linked to an increase in suicide of up to 18% over the following one to two months.” Additionally, “reporting the method of suicide was associated with an increase of 18% to 44% in the risk of suicide by the same method.” The findings were published online March 18 in BMJ. The authors of an accompanying editorial wrote that “these findings will help give media outlets a ‘clearer sense of the potential effect of their reporting.’” HealthDay (3/19, Norton) also covers the story.

Related Links:

— Medscape (requires login and subscription)

Medscape (3/19, Brooks, Subscription Publication) reports, “Opioid overdose deaths in the United States involving prescription opioids and heroin decreased from 2017 to 2018, while deaths involving synthetic opioids (excluding methadone) increased,” CDC data indicate. Specifically, “from 2017, to 2018, US overdose death rates involving all opioids, prescription opioids, and heroin fell 2%, 13.5%, and 4.1%, respectively, while deaths involving synthetic opioids (other than methadone) jumped by 10%.”

Healio (3/19, Miller) reports the study authors “linked the decrease in prescription opioid-involved deaths to an increase in efforts to reduce high-dose opioid prescribing.” Investigators also “associated the increase in synthetic opioid-involved deaths to an uptick in illicitly manufactured fentanyl or fentanyl analogs in the illegal drug supply.” The findings were published online in the CDC’s Morbidity and Mortality Weekly Report.

Related Links:

— Medscape (requires login and subscription)

Healio (3/18, Dobkowski) reports, “Women veterans with PTSD had a significantly elevated risk for ischemic heart disease after adjusting for factors such as age, psychiatric disorders, ischemic heart disease risk factors, and alcohol and illicit drug dependence,” researchers concluded after analyzing “data from 835,197 women veterans (mean age, 50 years) who visited a VA medical center between 2000 and 2017.” The findings were slated for presentation at the American College of Cardiology Scientific Session.

Related Links:

— “Ischemic heart disease risk elevated in women veterans with PTSD, “Darlene Dobkowski, Healio, March 18, 2020

CNN (3/17, Hunt) reports, “A review of existing research…found that a single dose of the main psychoactive ingredient (THC) in cannabis – equal to one joint – in otherwise healthy people, can temporarily induce psychiatric symptoms, including those associated with schizophrenia.” But, the review “found no evidence that cannabidiol (CBD), a non-psychoactive compound in weed that’s used in some medicinal cannabis and other products, does induce psychiatric symptoms.” The findings were published in Lancet Psychiatry.

MedPage Today (3/17, Hlavinka) reports that the review included “nine studies involving 196 healthy young adults.”

Related Links:

— “Single joint linked with temporary psychiatric symptoms, review finds,  “Katie Hunt, CNN, March 17, 2020

The AP (3/17, Alonso-Zaldivar) reports CMS announced Medicare “will immediately expand coverage for telemedicine nationwide to help seniors with health problems stay home to avoid the coronavirus.” With the policy change, Medicare beneficiaries will be able to consult physicians, “while heeding public health advice to stay home during the outbreak.”

STAT (3/17, Facher) reports President Trump said “Medicare patients can now visit any doctor by phone or videoconference at no additional cost, including with commonly used services like FaceTime and Skype. A historic breakthrough – this has not been done before.” Federal health officials also said that they would stop enforcing many HIPAA provisions in order to facilitate the expanded use of telemedicine for seniors.

Among other sources providing coverage are: The Hill (3/17, Johnson), Modern Healthcare (3/17, Brady, Subscription Publication), and Healthcare IT News (3/17, Miliard).

Related Links:

— “To keep seniors safe at home, Medicare expands telemedicine, “Ricardo Alonso-Zaldivar, AP, March 17, 2020

The Washington Post (3/17, Achenbach) reports that many people are feeling grief amid the coronavirus pandemic. Dr. Joshua Morganstein, the chair of APA’s Committee on Psychiatric Dimensions of Disasters, said, “Right now people are feeling grief over the loss of routines, certainty, and a perception of themselves as being generally healthy and protected.” Dr. Morganstein and other “experts say there are steps people can take…to ease some of that anxiety and give a person a better sense of being in control of this chaotic situation. Some of the advice comes from research on natural disasters, mass shootings, terrorist attacks and other traumas.” For example, Dr. Morganstein said, “Things like getting good sleep, eating regularly, staying hydrated, exercising. When we take care of our body, with good sleep in particular, but certainly food and water, our ability to think clearly, our ability to solve problems, our ability to manage our emotions, are all optimized.”

Related Links:

— “The Washington Post, Requires login and subscription