Spain’s virus surge hits mental health of front-line workers

Spain’s virus surge hits mental health of front-line workers
A health care worker attends to a patient at the Covid-19 Intensive Care Unit (ICU) of the Hospital Del Mar in Barcelona on January 20, 2021. (AFP)
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Updated 24 January 2021

Spain’s virus surge hits mental health of front-line workers

Spain’s virus surge hits mental health of front-line workers
  • Spanish health care workers are far from the only ones to have suffered psychologically from the pandemic
  • To prevent infections, patients are rarely allowed family visits, adding to their dependency on nurses

BARCELONA, Spain: The unrelenting increase in COVID-19 infections in Spain following the holiday season is again straining hospitals, threatening the mental health of doctors and nurses who have been at the forefront of the pandemic for nearly a year.
In Barcelona’s Hospital del Mar, the critical care capacity has more than doubled and is nearly full, with 80 percent of ICU beds occupied by coronavirus patients.
“There are young people of 20-something-years-old and older people of 80-years-old, all the age groups,” said Dr. Joan Ramon Masclans, who heads the ICU. “This is very difficult, and it is one patient after another.”
Even though authorities allowed gatherings of up to 10 people for Christmas and New Year celebrations, Masclans chose not to join his family and spent the holidays at home with his partner.
“We did it to preserve our health and the health of others. And when you see that this isn’t being done (by others) it causes significant anger, added to the fatigue,” he said.
A study released this month by Hospital del Mar looking at the impact of the spring’s COVID-19 surge on more than 9,000 health workers across Spain found that at least 2 percent suffered major depression. That is six times higher than the rate in the general population before the pandemic, said Dr. Jordi Alonso, one of the chief researchers.
In addition, the study found that nearly half of participants had a high risk of anxiety, post-traumatic stress disorder, panic attacks or substance- and alcohol-abuse problems.
Spanish health care workers are far from the only ones to have suffered psychologically from the pandemic. In China, the levels of mental disorders among doctors and nurses were even higher, with 50 percent reporting depression, 45 percent reporting anxiety and 34 percent reporting insomnia, according to the World Health Organization.
In the UK, a survey released last week by the Royal College of Physicians found that 64% of doctors reported feeling tired or exhausted. One in four sought out mental health support.
“It is pretty awful at the moment in the world of medicine,” Dr. Andrew Goddard, president of the Royal College of Physicians, said in a statement accompanying the study. “Hospital admissions are at the highest-ever level, staff are exhausted, and although there is light at the end of the tunnel, that light seems a long way away.”
Dr. Aleix Carmona, a third-year anesthesiology resident in Spain’s northeastern region of Catalonia, didn’t have much ICU experience before the pandemic hit. But as surgeries were canceled, Carmona was summoned to the ICU at the Moisès Broggi hospital outside Barcelona to fight a virus the world knew very little about.
“In the beginning, we had a lot of adrenaline. We were very frightened but we had a lot of energy,” Carmona recalled. He plowed through the first weeks of the pandemic without having much time to process the unprecedented battle that was unfolding.
It wasn’t until after the second month that he began feeling the toll of seeing first-hand how people were slowly dying as they ran out of breath. He pondered what to tell patients before intubating them. His initial reaction had always been to reassure them, tell them it would be alright. But in some cases he knew that wasn’t true.
“I started having difficulty sleeping and a feeling of anxiety before each shift,” Carmona said, adding that he would return home after 12 hours feeling like he had been beaten up.
For a while he could only sleep with the help of medication. Some colleagues started taking anti-depressants and anti-anxiety drugs. What really helped Carmona, though, was a support group at his hospital, where his co-workers unloaded the experiences they had bottled up inside.
But not everyone joined the group. For many, asking for help would make them seem unfit for the job.
“In our profession, we can handle a lot,” said David Oliver, a spokesman for the Catalonia chapter of the SATSE union of nurses. “We don’t want to take time off because we know we will add to the workload of our colleagues.”
The most affected group of health care workers, according to the study, were nurse’s aides and nurses, who are overwhelmingly women and often immigrants. They spent more time with dying COVID-19 patients, faced poor working conditions and salaries and feared infecting family members.
Desirée Ruiz is the nurse supervisor at Hospital del Mar’s critical care unit. Some nurses on her team have asked to take time off work, unable to cope with the constant stress and all the deaths.
To prevent infections, patients are rarely allowed family visits, adding to their dependency on nurses. Delivering a patient’s last wishes or words to relatives on the phone is especially challenging, Ruiz said.
“This is very hard for ... people who are holding the hand of these patients, even though they know they will end up dying,” she said.
Ruiz, who organizes the nurses’ shifts and makes sure the ICU is always staffed adequately, is finding it harder and harder to do so.
Unlike in the summer, when the number of cases fell and health workers were encouraged to take holidays, doctors and nurses have been working incessantly since the fall, when virus cases picked up again.
The latest resurgence has nearly doubled the number of daily cases seen in November, and Spain now has the third-highest COVID-19 infection rate in Europe and the fourth-highest death toll, with more than 55,400 confirmed fatalities.
But unlike many European countries, including neighboring Portugal, the Spanish health minister has for now ruled out the possibility of a new lockdown, relying instead on less drastic restrictions that aren’t as damaging to the economy but take longer to decrease the rate of infections.
Alonso fears the latest surge of virus patients could be as detrimental to the mental health of medical staff as the shock of the pandemic’s first months.
“If we want to be cared for adequately, we also need to take care of the health care workers, who have suffered and are still suffering,” he said.


On Doha deal anniversary, Taliban pushing US for total troop withdrawal

On Doha deal anniversary, Taliban pushing US for total troop withdrawal
Updated 28 February 2021

On Doha deal anniversary, Taliban pushing US for total troop withdrawal

On Doha deal anniversary, Taliban pushing US for total troop withdrawal
  • Any move to replace historic accord is ‘doomed to fail,’ militant group warns
  • Demands follow rumors Biden administration looking to ‘review’ deal

KABUL: The Taliban on Sunday demanded that the US complete its troop withdrawal process from Afghanistan by May 1, in line with a historic agreement signed between the two sides in Doha last year

The militant group warned that any move to replace the deal was “doomed to fail.”

“The Islamic Emirate (the name of the Taliban’s former government) is committed on its part to all contents of the agreement and views its implementation as the sole effective tool for resolving the Afghan issue and establishing peace, that shall be realized under the shade of an Islamic system,” it said in a statement.

The demands were issued on the anniversary of the controversial deal that followed almost a year and half of secret talks between the Taliban and US delegates. The insurgent group has said that its fighters had not attacked foreign troops and major Afghan cities since signing the agreement.

“The Islamic Emirate also calls on the other party to the agreement to honor its own commitments towards security and stability in Afghanistan by implementing all parts of the agreement,” the group said.

The Taliban further termed the Doha deal as a “historic accord,” and one that had “created a practical framework for bringing peace and security to Afghanistan.”

It added: “If any other pathway is pursued as a replacement, then it is already doomed to fail.”

The Taliban’s statement follows repeated comments by officials in US President Joe Biden’s administration that Washington will review the deal signed under former President Donald Trump’s watch.

In addition, NATO delivered a recent announcement saying that it would withdraw foreign troops from Afghanistan “when the time was right,” suggesting that the Taliban had not abided by the accord.

Besides US and NATO officials, the Afghan government has also insisted that the Taliban have not severed their relationship with Al-Qaeda, nor reduced violence — two critical components of the Doha deal — allegations that the Taliban have vehemently denied.

While the militant group pushed for the total departure of all foreign troops and overseas contractors by May 1, 2021, the Doha deal also served as a catalyst for the Taliban and President Ashraf Ghani’s government to begin intra-Afghan peace talks in Qatar by March 10 last year.

The talks finally began six months later, amid an intensification of violence that both Kabul and the Taliban have blamed on one another.

The crucial negotiations have faced several setbacks — the latest being a plan by Washington to review the deal.

Rahmatuallah Andar, a spokesman for the office of Ghani’s national security advisor, said that the Doha talks had failed to meet expectations.

“Afghans have not gained the expectations they had from Doha deal for peace and security. This agreement so far only has ensured the Taliban’s cease-fire with the US,” he told Arab News.

He added that the Taliban’s relationship with Afghans was “still confined to killing, terror and horror.”

Andar said: “So far, there is no hope for Afghans in this deal. Even the intra-Afghan talks have been stopped because of the Taliban. If seen from the perspective of Afghanistan, the time has been wasted in the hope of peace, while heavy material and heavy casualties have been inflicted on Afghans.”

Taliban representatives were unavailable for comment when contacted by Arab News on Sunday.

However, despite the government blaming the Taliban for a surge in violence and failing to pursue negotiations, Feraidoon Khawzoon, a spokesman for the government-appointed High Council of Peace, said that officials are “still hopeful for the peace process.”

He said: “A year on since the Doha deal, we are still hopeful that the opportunity created for peace is not wasted, and that the war ends in Afghanistan and talks are pursued earnestly, so that a political compromise acceptable to all is created.”

On the other hand, Afghan, US and NATO officials have warned that any resumption of serious intra-Afghan talks will require foreign troops to remain in the country until the Taliban end their violent attacks.

The UN said last week that 3,035 Afghan civilians had been killed in 2020 due to a surge in violence since the signing of the Doha deal a year ago — a 15 percent spike from the previous year.

“Since the Doha deal, more than 350,000 Afghans have been internally displaced by the violence,” Abdul Basit Ansari, an advisor for Afghanistan’s Ministry of Refugees and Repatriation, told Arab News.

Meanwhile, with the fate of the Doha deal in limbo, some fear an imminent escalation of violence in Afghanistan.

“The US may want to extend the presence of the troops, and the Taliban may oppose it altogether. This will mean fighting and a serious drop in the trust both sides have built in recent years, with so much difficulty,” Taj Mohammad, an Afghan analyst and former journalist, told Arab News.

Tameem Bahiss, an analyst and expert on Afghanistan and Pakistan, agreed, adding that while the US and Taliban have blamed each other for breaching the Doha deal, neither side has come forward to nullify the agreement.

“The Biden administration is ‘reviewing’ the Doha agreement. In the meantime, experts are calling for an extension to the May 1 deadline,” he said.

“It seems very unlikely that the Taliban will agree to an extension. If Biden unilaterally decides to stay past the deadline, this could propel the Taliban to walk away from the negotiation table and pursue power through violent means.”

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Filipinos to roll up sleeves as government receives first batch of jabs

Filipinos to roll up sleeves as government receives first batch of jabs
Updated 28 February 2021

Filipinos to roll up sleeves as government receives first batch of jabs

Filipinos to roll up sleeves as government receives first batch of jabs
  • President Duterte urges public to get vaccinated during nationwide campaign

MANILA: President Rodrigo Duterte has urged Filipinos to get vaccinated during a nationwide campaign after the country received its first batch of coronavirus disease (COVID-19) vaccines on Sunday.

The president, along with his Cabinet members, welcomed the delivery of the 600,000 doses of the Chinese Sinovac vaccine, delivered by a Chinese military aircraft, at the Philippine Air Force’s (PAF) Villamor Airbase in Pasay City.

Philippine officials said that with the arrival of the vaccines, the government would formally roll out its inoculation program on Monday to vaccinate two-thirds of the population, or 50 to 70 million Filipinos, by the end of the year.

During a televised ceremony, Duterte urged Filipinos to “set aside their fears” as he vouched for the vaccines’ safety and efficacy.

“These vaccines are backed by science and (were) deliberated on by our Filipino experts. I encourage you to get vaccinated at the soonest possible time, and be our partner in preventing the further spread of this disease,” he said.

The president’s reaffirmation follows reports that many Filipinos, including health workers, lacked confidence in the Chinese vaccine based on data from its late-stage trials, which showed that Sinovac had a lower efficacy than other jabs.

According to the Philippines Food and Drug Administration (FDA), the vaccine is recommended only to healthy individuals aged 18 to 59 years old, but not senior citizens and medical front-liners.

The FDA said local clinical trial data showed that the vaccine had an efficacy rate of 65.3 to 91.2 percent when used on clinically healthy individuals aged 18 to 59, but only 50.4 percent on health workers.

The Department of Health (DOH) and the National Immunization Technical Advisory Group have nevertheless recommended the Sinovac vaccine for health workers.

Duterte called on those being inoculated to continue practising health and safety protocols as the country awaits the final approvals for more vaccines.

“Remember to wear masks, wash hands and observe social distancing. Your cooperation here is key and will undoubtedly save numerous lives along the way,” Duterte said, adding: “With the entire nation’s support, I am confident that we will claim victory over this pandemic.”

The president described the arrival of the Sinovac jabs as another step forward in the nation’s fight against COVID-19, as he thanked China and its people for “the gesture” of friendship and solidarity.

“I said it before, and I will say it again: COVID-19 vaccines should be treated as a global public good and made available to all, rich and poor alike. No nation — no people — should be left to suffer the ravages of this pandemic for whatever reason," he said, adding that the government had welcomed the delivery of the vaccines with “high hopes of finally ending the COVID-19 pandemic in the country.

“The delivery of this first batch, I hope, will serve as a guarantee to everyone that we are taking a big step in our efforts to overcome this health crisis ... we cannot afford to waste time or resources in the distribution of these vaccines because we are dealing with precious lives,” Duterte said.

He expressed his gratitude to Chinese Ambassador Huang Xilian and said he intended to “make a short visit to China just to shake hands with President Xi Jinping and personally thank him for the donation.”

Meanwhile, another batch of vaccines comprising 525,600 doses of AstraZeneca from the COVAX facility led by the World Health Organization was also due to arrive on Monday.

According to the DOH, as of Sunday, the Philippines had reported more than 576,000 infections, including 12,318 deaths, the second-highest totals in Southeast Asia after Indonesia.


UN Human Rights Office says 18 dead in Myanmar crackdown

A wounded protester is carried during a protest against the military coup in Mandalay, Myanmar, Sunday, Feb. 28, 2021. (AP)
A wounded protester is carried during a protest against the military coup in Mandalay, Myanmar, Sunday, Feb. 28, 2021. (AP)
Updated 28 February 2021

UN Human Rights Office says 18 dead in Myanmar crackdown

A wounded protester is carried during a protest against the military coup in Mandalay, Myanmar, Sunday, Feb. 28, 2021. (AP)
  • Security forces in Myanmar made mass arrests and used lethal force
  • A violent crackdown also occurred in Dawei, a much smaller city in southeastern Myanmar

YANGON: The UN Human Rights Office says it has received “credible information” that a crackdown Sunday on anti-coup protesters in Myanmar has left at least 18 people dead and over 30 wounded.
“Deaths reportedly occurred as a result of live ammunition fired into crowds in Yangon, Dawei, Mandalay, Myeik, Bago and Pokokku,” it said in a statement, referring to several cities in Myanmar. “Tear gas was also reportedly used in various locations as well as flash-bang and stun grenades.”
“We strongly condemn the escalating violence against protests in Myanmar and call on the military to immediately halt the use of force against peaceful protesters,” its spokesperson Ravina Shamdasani was quoted saying.
It would be the highest single-day death toll among protesters who are demanding that the elected government of Aung San Suu Kyi be restored to power after being ousted by a Feb. 1 coup.
Security forces in Myanmar made mass arrests and used lethal force on Sunday as they intensified their efforts to break up protests a month after the military staged a coup. At least four people were reportedly killed.
There were reports of gunfire as police in Yangon, the country’s biggest city, fired tear gas and water cannons while trying to clear the streets of demonstrators demanding that the elected government of Aung San Suu Kyi be restored to power. Photos of shell casings from live ammunition used in assault rifles were posted on social media.
Reports on social media identified by name one young man believed to have been killed in Yangon. His body was shown in photos and videos lying on a sidewalk until other protesters were able to carry him away.
A violent crackdown also occurred in Dawei, a much smaller city in southeastern Myanmar, where local media reported that at least three people were killed during a protest march. The fatalities could not immediately be independently confirmed, though photos posted on social media showed a wounded man in the care of medical personnel, and later laid out in a bed under a blanket with flowers placed on top.
Confirming reports of protesters’ deaths has been difficult amid the chaos and general lack of news from official sources.
Prior to Sunday, there had been eight confirmed reports of killings linked to the army’s takeover, according to the independent Assistance Association of Political Prisoners.
The Feb. 1 coup reversed years of slow progress toward democracy after five decades of military rule. Suu Kyi’s National League for Democracy party would have been installed for a second five-year term in office, but the army blocked Parliament from convening and detained her and President Win Myint, as well as other top members of Suu Kyi’s government.
Sunday’s violence erupted in the early morning when medical students were marching in Yangon’s streets near the Hledan Center intersection, which has become the gathering point for protesters who then fan out to other parts of the city.
Videos and photos showed protesters running away as police charged at them, and residents setting up makeshift roadblocks to slow their advance. Some protesters managed to throw tear gas cannisters back at police. Nearby, residents were pleading with police to release those they picked up from the street and shoved into police trucks to be taken away. Dozens or more were believed to have been detained.
Demonstrators regrouped later Sunday and security forces continued to chase them in several neighborhoods.
There was no immediate word on Yangon casualties. Sounds of gunfire could be heard in the streets and there were what appeared to be smoke grenades thrown into the crowds.
“The Myanmar security forces’ clear escalation in use of lethal force in multiple towns and cities across the country in response to mostly peaceful anti-coup protesters is outrageous and unacceptable, and must be immediately halted,” said Phil Robertson, deputy Asia director for New York-based Human Rights Watch. “Live ammunition should not be used to control or disperse protests and lethal force can only be used to protect life or prevent serious injury.”
“The world is watching the actions of the Myanmar military junta, and will hold them accountable,” he said.
On Saturday, security forces began employing rougher tactics, taking preemptive actions to break up protests and making scores, if not hundreds, of arrests. Greater numbers of soldiers have also joined police. Many of those detained were taken to Insein Prison in Yangon’s northern outskirts, historically notorious for holding political prisoners.
According to the Assistance Association of Political Prisoners, as of Saturday, 854 people had been arrested, charged or sentenced at one point in relation to the coup, and 771 were being detained or sought for arrest. The group said that while it had documented 75 new arrests, it understood that hundreds of other people were also picked up Saturday in Yangon and elsewhere.
MRTV, a Myanmar state-run television channel, broadcast an announcement Saturday night from the Foreign Ministry that the country’s ambassador to the United Nations had been fired because he had abused his power and misbehaved by failing to follow the instructions of the government and “betraying” it.
Ambassador Kyaw Moe Tun had declared in an emotional speech Friday at the UN General Assembly in New York that he represented Suu Kyi’s “civilian government elected by the people” and supported the struggle against military rule.
He urged all countries to issue public statements strongly condemning the coup, and to refuse to recognize the military regime. He also called for stronger international measures to stop violence by security forces against peaceful demonstrators.


UK’s Sunak says vaccine passport idea might help the economy

UK’s Sunak says vaccine passport idea might help the economy
Updated 28 February 2021

UK’s Sunak says vaccine passport idea might help the economy

UK’s Sunak says vaccine passport idea might help the economy

LONDON: British finance minister Rishi Sunak said the idea of giving people vaccine passports or certificates to allow them to enter venues or events might be a way to help the country and its economy recover from the coronavirus pandemic.
“Obviously it is a complicated but potentially very relevant question for helping us reopen those parts of our country like mass events,” Sunak told BBC television on Sunday.
Prime Minister Boris Johnson said last week that the government would hold a review to consider the scientific, moral, philosophical and ethical questions about using vaccine certificates for people who have received a coronavirus shot, which could help entertainment and hospitality venues reopen.


Myanmar police crack down on protests for second day; two dead, several hurt

Myanmar police crack down on protests for second day; two dead, several hurt
Updated 28 February 2021

Myanmar police crack down on protests for second day; two dead, several hurt

Myanmar police crack down on protests for second day; two dead, several hurt
  • Two dead as police crack down
  • UN envoy says he will fight on

Myanmar police shot and killed two protesters on Sunday and wounded several as they cracked down in a bid to end weeks of demonstrations against a Feb. 1 military coup, a doctor and a politician said.
Police opened fire in the town of Dawei, killing one and wounding several, politician Kyaw Min Htike told Reuters from the southern town. The Dawei Watch media outlet also said at least one person was killed and more than a dozen wounded.
Police also fired in the main city of Yangon and one man brought to a hospital with a bullet wound in the chest had died, said a doctor at the hospital who asked not to be identified. The Mizzima media outlet also reported that death.
Police and the spokesman for the ruling military council did not respond to phone calls seeking comment.
Myanmar has been in chaos for a month since the army seized power and detained elected government leader Aung San Suu Kyi and much of her party leadership, alleging fraud in a November election her party won in a landslide.
The coup, which stalled Myanmar’s progress toward democracy after nearly 50 years of military rule, has brought hundreds of thousands of protesters onto the streets and drawn condemnation from Western countries, with some imposing limited sanctions.
In Yangon, several people, some bleeding heavily, were helped away from protests, images posted earlier by media showed.
It was not clear how they were hurt, but media reported live fire. The Myanmar Now media group said people had been “gunned down” but did not elaborate.
Police also threw stun grenades, used tear gas and fired into the air, witnesses said.
Junta leader General Min Aung Hlaing has said authorities have been using minimal force to deal with the protests.
Nevertheless, at least five protesters have died in the turmoil. The army said a policeman has been killed.
The crackdown appears to indicate a determination by the military to impose its authority in the face of widespread defiance, not just on the streets but more broadly in areas such as the civil service, municipal administration, the education and health sectors and media.

’RUNNING’
Police were out early on Sunday, taking positions at main protest sites in Yangon as protesters, many clad in protective gear, began to congregate, witnesses said.
They moved swiftly to break up crowds.
“Police got out of their cars and started throwing stun grenades without warning,” said Hayman May Hninsi, who was with a group of fellow teachers in Yangon. They fled to nearby buildings. “Some teachers got hurt running.”
Doctors and students in white lab coats fled as police threw stun grenades outside a medical school elsewhere in the city, posted video showed.
Police in the second city, Mandalay, fired guns into the air, trapping protesting medical staff in a city hospital, a doctor there said by telephone.
Saturday brought disturbances in towns and cities nationwide as police began their bid to crush the protests with tear gas, stun grenades and by shooting into the air.
State-run MRTV television said more than 470 people had been arrested on Saturday. It said police had given warnings before using stun grenades to disperse people.

’INSTIL FEAR’
Youth activist Esther Ze Naw said people were battling to overcome the fear they had lived with for a long time.
“This fear will only grow if we keep living with it and the people who are creating the fear know that. It’s obvious they’re trying to instil fear in us by making us run and hide,” she said. “We can’t accept that.”
The police action came after state television announced that Myanmar’s UN envoy had been fired for betraying the country after he urged the United Nations to use “any means necessary” to reverse the coup.
MRTV said he had been fired in accordance with civil service rules because he had “betrayed the country” and “abused the power and responsibilities of an ambassador.”
The ambassador, Kyaw Moe Tun, was defiant. “I decided to fight back as long as I can,” he told Reuters in New York.
UN Special Rapporteur Tom Andrews said he was overwhelmed by the ambassador’s “act of courage,” adding on Twitter, “It’s time for the world to answer that courageous call with action.”
Myanmar’s generals have traditionally shrugged off diplomatic pressure. They have promised to hold a new election but not set a date.
Suu Kyi’s party and supporters said the result of the November vote must be respected.
Suu Kyi, 75, spent nearly 15 years under house arrest during military rule. She faces charges of illegally importing six walkie-talkie radios and of violating a natural disaster law by breaching coronavirus protocols.
The next hearing in her case is set for Monday.