As hundreds of thousands of people continue to die each day from this disease, the COVID-19 pandemic continues to impact almost every aspect of daily life for the global population.
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Introduction
The emergence of the coronavirus disease 2019 (COVID-19), which is caused by infection from the previously unknown severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has devastated economies and caused unprecedented challenges to healthcare and food systems around the world. Globally, billions of people have been ordered to stay at home as a result of lockdowns, while almost three million people have died (as of the end of March 2021).
The Global Health Security (GHS) Index
At the end of the Ebola outbreak that occurred in 2014, the GHS Index was developed to determine the ability of a total of 195 countries to cope with a future infectious disease outbreak. In order to make this prediction, the GHS Index considers the biological risks of each country, which includes an analysis of the nation’s current geopolitics, health system and capacity to control infectious disease outbreaks.
To evaluate a given country’s GHS Index, they are rated on prevention, detection and reporting, rapid response, health system, compliance with international norms and risk environment.
Since the outbreak of COVID-19, public health officials have investigated whether the GHS Index could be used to assess the performance of countries during the current pandemic. In a research study looking to do just this, the GHS Index was found to have a positive correlation with COVID-19 associated morbidity and mortality rates in 178 different countries.
Despite this observation, these researchers actually found that this positive association had a limited value in determining a country’s ability to deal with a global pandemic.
The effect of COVID-19 on other health problems
The COVID-19 pandemic has overwhelmed healthcare systems around the world, having a knock-on effect on the diagnosis and treatment of other diseases.
Social distancing and lockdowns have reduced diagnosis rates of infectious diseases such as seasonal influenza, as would be expected with reduced social contact.
However, individuals have avoided seeking help for other health problems due to lockdowns and avoidance of medical settings, leading to reduced diagnosis and treatment despite the problem still being there. Meanwhile, even in diagnosed cases, treatment for diseases and conditions such as cancer had to be postponed in many cases due to the immediate threat of COVID-19 consuming health systems and their resources.
Scientific research around the world has also focused on COVID-19, potentially delaying research and breakthroughs on other diseases.
Furthermore, other infectious diseases such as malaria, HIV and tuberculosis were put on the sidelines, despite still being very real problems, particularly in more vulnerable populations. An assessment by the Bill & Melinda Gates foundations in September 2020 assessed data on vaccine coverage from the first portion of the pandemic and came to a conclusion that vaccine coverage in health systems had been pushed back around 25 years in 25 weeks.
Before the pandemic, around half of the world's population did not have access to essential healthcare, and this number has been increased by the pandemic. Healthcare systems across the globe need to become more accessible and need to be prepared for future pandemic-like events in a way that will reduce the impact on the management of other diseases.
Global mental health impact
The most common characteristics associated with the novel infectious COVID-19 include respiratory symptoms including cough, fever, respiratory problems, and, in certain cases, atypical pneumonia. Outside of the respiratory system, SARS-CoV-2 also appears to affect the cardiovascular, gastrointestinal, and urinary systems.
Psychological effects of COVID-19
In addition to these symptoms, various neurological manifestations have been observed following infection by SARS-CoV-2. Some examples of these manifestations include hyposmia, dysgeusia, encephalitis, meningitis, and acute cerebrovascular disease. It has been suggested that these neurological effects are due to direct infection of the brain, a virus-induced hyperinflammatory response, hypercoagulation, and post-infectious immune-mediated processes. As a result, these neurological effects can lead to a wide range of psychological issues ranging from depression, anxiety, fatigue, and post-traumatic stress disorder (PTSD).
Healthcare workers
In addition to having a direct impact on COVID-19 patients, the mental health of both health care providers and non-infected members of the general population has also been dramatically changed during the pandemic.
Health care providers, for example, are at a high risk of infection to the virus, as well as COVID-19 related traumatic events. Furthermore, healthcare workers who must quarantine have been shown to be at a greater risk of avoidance behaviors and more severe symptoms of PTSD as compared to the general public.
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General population
Many will agree that the physical and social distancing measures that have been introduced throughout many parts of the world have significantly affected how the general population connects to and interacts with others. This loss of connection has been further impaired by the inability to meet with others at central areas of social interaction and support such as restaurants, libraries, sports facilities and both cultural and community centers.
The closures of both schools and businesses have also increased the sense of isolation as unemployment numbers have risen and affected individuals experience significant financial distress. Taken together, these dramatic social changes have increased the mental health burden and subsequently worsened mental health outcomes. Furthermore, fear-related behaviors such as extreme avoidance of social contact have also risen, further exacerbating the risk of poor mental health issues.
Lessons learned
Overall, it is generally believed that no country was fully prepared to handle a pandemic, particularly one at the magnitude of the COVID-19 pandemic. SARS-CoV-2 has a unique ability to spread from asymptomatic people prior to the onset of symptoms which, combined with its long incubation time, makes it difficult for countries to prevent the spread of this disease.
Additional barriers to control the spread of COVID-19 include community resistance to outbreak mitigation efforts including travel restrictions, use of face masks in public, and social distancing, hospital transmission rates and a general lack of crucial funding and resources.
One of the most significant lessons that can be learned from the COVID-19 pandemic is the importance of political will in its role in protecting people from epidemics. The COVID-19 outbreak also awakened much of the global population to the broken and overextended health systems in many parts of the world.
In order to ensure that the world is better prepared for the next new infectious agent, public health systems must remain committed to developing adequate surveillance programs, prompt diagnostic techniques, and robust research initiatives that can detect and understand the basic biology and treatment, if necessary, of new organisms.
References
- Bill & Melinda Gates Foundation. COVID-19 A Global Perspective. Available from: https://www.gatesfoundation.org/goalkeepers/report/2020-report/#GlobalPerspective
- Hou, L., Mehta, S. D., Christian, E., et al. (2020). Impact of the COVID-19 pandemic on global health research training and education. Journal of Global Health 2. doi:10.7189.jogh.10.020366.
- Impact of COVID-19 on people’s livelihoods, their health and our food systems [Online]. Available from: https://www.who.int/news/item/13-10-2020-impact-of-covid-19-on-people%27s-livelihoods-their-health-and-our-food-systems.
- Ji, Y., Shao, J., Tao, B., et al,. (2021). Are we ready to deal with a global COVID-19 pandemic? Rethinking countries’ capacity based on the Global Health Security Index. International Journal of Infectious Diseases. doi:10.1016/j.ijid.2021.03.089.
- Lange, K. W. (2021). Coronavirus disease 2019 (COVID-19) and global mental health. Global Health Journal. doi:10.1016/j.glohj.2021.02.004.
Further Reading
One in four healthy young Marines report long-term physical, cognitive, or psychiatric effects after mild COVID-19