The WHO’s COVID-19 strategy update and its relationship to mental health 

As of June 21st, 2020, the World Health Organization (WHO) has recorded 8,708,008 confirmed cases of COVID-19 and 461,715 related deaths. The figures, although steady at the moment, underlie how the pandemic can still present formidable problems in this transitional period to low-level or no transmission, if not controlled. Should different members of society now seek to mitigate any further possible adverse effects of the infectious disease, especially within the context of mental health, it may do well to understand the strategic recommendations proposed by the WHO in its latest publication entitled COVID-19 Strategy Update. The following overview seeks to summarize the main points presented in the document as it relates to mental health care, with a brief emphasis on frontline health workers, private companies, and vulnerable communities. 

The global strategy approach of WHO against COVID-19

Before delving into the specifics of the COVID-19 mitigation measures, it is recommended to highlight the three defining characteristics that have shaped the development of the WHO’s current strategy:

• Speed and scale: the disease has spread across the world at a rapid, explosive pace. As a result of such speed, even the strongest health systems have been inundated by the myriad of unprecedented challenges. 
• Severity: approximately one-fifth of cases present as severe or critical, with a crude clinical case mortality rate of more than 3%. For those who are of older age or with certain underlying conditions, the rate increases. 
• Societal and economic disruption: in attempts to control disease transmission, stringent measures and lockdowns across health and social care systems have led to notable socio-economic repercussions.  

Per these three facets, the overall guiding principle is that the speed by which cases are discovered, tested and isolated will be the ultimate determinant of COVID-19 disease control. Rapid identification of clusters, immediate responses by health authorities and efficient collaborative efforts among various society members can prevent additional serious outbreaks and negative consequences.

How does this translate into mental health care terms?

In order to address the possibility of other outbreaks, unified efforts across all stakeholders will include that close contacts of every confirmed or probable case be quarantined and monitored for 14 days. Quarantine can be a period that foments stress and anxiety, and disrupts the lives of both quarantined individuals and their relatives. By recommendation of the WHO, every endeavor that could provide support to those about to experience quarantine should be undertaken, including basic necessities, income support, health care and psychosocial support.Similarly, as an overabundance of information and misinformation has pervaded both online and offline, the WHO underscores taking advantage of the WHO Information Network for Epidemics (EPI-WIN)18. The network comprises partnerships with different sectors and their respective members, and affords trustworthy, timely advice and information from qualified sources. As misinformation may result in perilous behaviors, such as self-medication with deleterious substances, promoting such aforementioned platforms could strengthen public health responses and prevent unnecessary harm. Likewise, more integration of risk communication and community engagement data tools (surveys, questionnaires, rapid assessment methods) would help provide a more accurate depiction of perception among communities of interest and guide prospective response measures. 

Which members of society remain at higher risk of experiencing mental health issues?

• Frontline healthcare workers: both health systems and health workers have faced an unprecedented wave of stress and fatigue due to the large, sudden number of COVID-19 cases. Moreover, these healthcare professionals have placed themselves at continuous risk to care for patients; some have even sacrificed their lives. 
• Migrants and refugees: these individuals, alongside those in displaced populations or of high-density and informal settlements already lack access to many of the health and social services afforded to other members of the general community. A COVID-19 outbreak has and will represent further disruptions of whatever limited services are available. 
• Students:  the closure of schools has witnessed an increase in risk of neglect, abuse or exploitation in some students. Similarly, school closings may have interrupted basic services like school meals. 
• Women: with women representing 70% of the health workforce, this particular group has been disproportionately affected and will have more to lose from additional COVID-19 outbreaks. Additionally, the need to protect women from an elevated risk of domestic abuse has become of higher priority, and should be accompanied with refuge or safe space accommodations where necessary. 

How can other members of society mitigate repercussions of COVID-19 currently?

• Health authorities: with the aim to reduce exposure and lower transmission, public health and health system measures must be coupled with context-appropriate, population-leveling distancing and proportionate movement restriction measures. 
• Private businesses: given the expertise and innovation to scale and maintain responses, businesses are encouraged to maintain a continuous flow of essential services, e.g. food chain, public utilities, health and social services, and medical supply manufacturing. 
• Private citizen: it is important to share responsibility in adopting and adhering to measures that prevent the transmission of COVID-19. Citizens can also provide support to others in quarantine by serving as community volunteers or making phone calls or sending messages to reach out. 

The approach that unites in a common cause                                                            

The COVID-19 crisis has impacted every aspect of global society to leave a wake of unfavorable socio-economic consequences and mental health issues. Certain groups of the global population, like frontline health workers and migrants, will continue to be at high risk while the pandemic remains. In order to move ahead against COVID-19 in a forthcoming time of a low-level-to-no transmission, each societal member must come together, and propose and adopt measures conducive to accomplish such aim.  As suggested by the WHO, women can play a great part in leading community mobilization efforts; private citizens can adhere to recommended guidelines on physical distancing and preventive measures. Private business too, can serve as propellers in the advancement of this common cause. Indeed, it is the collective action by all public and private entities that will determine the final outcome of this fight against COVID-19.       

Other articles that might interest you:

• Stress and anxiety due to isolation
• A child’s mental health during and after the COVID-19 pandemic: A Series of Helpful Approaches
• Virtual reality exposure therapy for anxiety: A meta-analysis of randomized controlled trials