News Scan for Jan 13, 2021

Pandemic ICU staff mental health
;
COVID mitigations and death rates
;
DNA of Lyme bacteria in longhorned ticks

Depression, anxiety, PTSD reported in ICU staff during pandemic

Almost half (45.4%) of intensive care unit (ICU) physicians, nurses, and other healthcare workers in England reported a mental disorder during the pandemic, including suicidal thoughts, according to survey results published in Occupational Medicine yesterday.

Across June and July 2020, 709 ICU healthcare workers from nine ICUs voluntarily completed the 5-minute online survey. The researchers integrated components from the Generalized Anxiety Disorder scale, the Patient Health Questionnaire (for depression), the post-traumatic stress disorder (PTSD) checklist for civilians, the AUDIT-C score to evaluate drinking habits, and the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS).

Respondents' mental health problems included depression (43.3%), anxiety (36.7%), probable PTSD (39.5%), and alcohol abuse (7.2%). Of special concern, 13% of respondents said that, in the past 2 weeks, they thought they might be better off dead or thought about self-harm.

The researchers noted that nurses reported greater mental health burdens than physicians: 19% reported suicidal or self-harm thoughts, compared with 8% of doctors and 10% of other clinical staff. Overall, 59.0% of all respondents appeared to have good well-being as described by their responses to the WEMWBS items.

"Evidence-based mechanisms should be in place so all healthcare workers, including ICU staff, can promptly access treatment for mental health issues," says lead author Neil Greenberg, MD, in a King's College London press release. "If we protect the mental health of healthcare workers during the COVID-19 pandemic, staff will be better able to sustainably deliver high quality care to the large numbers of patients seriously unwell with COVID-19."
Jan 12 Occup Med study
Jan 12 King's College
press release

 

Earlier COVID-19 mitigations in Europe tied to less mortality

European countries who put COVID-19 mitigations into place sooner prevented more deaths, according to a Mortality & Morbidity Weekly Report (MMWR) study published yesterday.

The researchers looked at data from Jan 1 to Jun 30, 2020, when COVID death rates for all the countries had dropped to relatively low levels. Of the 37 countries included in the study, the most common mitigations, measured using the Oxford Stringency Index (OSI), were public event cancellations (94.6%), school closures (89.2%), gathering restrictions (83.8%), workplace closures (83.8%), and border closures (73.0%).The investigators did not include mask usage.

Pivotal to the study's findings was the mortality threshold date, which was when 0.02 COVID-19 deaths occurred per 100,000 people. This date ranged from Mar 2 (Italy) to Apr 18 (Ukraine), depending on the country, and for 26 countries (70.3%), OSI was lower than 80 units at that time.

Linear regression indicated that if OSI had been 80 for every country, 74,139 fewer deaths would have been expected. In the United Kingdom, which had the lowest score when it reached the mortality threshold (16.7), an estimated 22,776 (31% of its COVID mortalities) may have been prevented.

Each OSI increase a country had by the time it hit the mortality threshold was associated with 0.55 fewer deaths per 100,000 people on Jun 30. Similarly, OSI that increased by a full standard deviation (22.9 units) was associated with 12.5 fewer cumulative deaths per 100,000 people by the same end date.

"Countries that implemented stringent policies earlier might have saved several thousand lives relative to those countries that implemented similar policies, but later," the researchers write. "These findings suggest that earlier implementation, even by just a few weeks, might be important to preventing widespread transmission and large numbers of deaths."
Jan 12 MMWR study

 

Evidence of Lyme bacteria detected in Pennsylvania longhorned ticks

Biologists from Pennsylvania and the Centers for Disease Control and Prevention (CDC) have detected the DNA of Borrelia burgdorferi, the bacterium that causes Lyme disease, in invasive longhorned ticks in the state, according to a report yesterday in Emerging Infectious Diseases.

The Asian longhorned tick (Haemaphysalis longicornis) has spread to 17 states since 2017, when it was first found on a sheep in New Jersey, according to CDC data.

Experts have sounded the alarm on the arachnid because it reproduces without mating: A single female Asian longhorned tick can reproduce offspring—1,000 to 2,000 eggs at a time. Though the ticks prefer to feed on animals, they can harbor several diseases that threaten humans, including severe fever and thrombocytopenia syndrome virus, which causes hemorrhagic fever.

In the new report, 263 longhorned ticks were collected from southeast Pennsylvania in 2019 and tested by polymerase chain reaction for pathogens. One adult female tick was positive for Borrelia burgdorferi sensu stricto DNA, yielding a 0.4% infection rate, the authors said.

Pennsylvania has the most reported Lyme disease cases in the United States, and the spirochete has been identified in nearly 50% of adult blacklegged Ixodes scapularis ticks, the primary vector, in the state.

"Despite limited documentation of H. longicornis ticks biting humans in the United States, findings presented here support continued use of personal protective measures," the authors concluded. "H. longicornis ticks are a vector of human pathogens in its native range; further investigation is needed to determine its potential public health significance in the United States."
Jan 12 Emerg Infect Dis study

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