Living with covid-19

From the beginning of 2020, the alarming news from Italy and the first known cases arrived in Greece, along with travelers from the Holy Land. Spain, France and all other countries followed. From the first week of March, restrictive measures began in Greece and then confinement in order to limit the spread of the pandemic and not drown the National Health System by serious cases. The policy of restrictive measures to stop the pandemic was the internationally accepted response1 and the generalized adherence proved effective, despite the shock and the various reactions from the unprecedented, generalized state of restriction, different scale from epidemics of other times.2-4 In other countries, the loose restrictive measures have cost thousands of deaths. The general restrictive measures, however, have serious consequences for people's mental equilibrium, economy and employment, and for this reason they can only be of limited duration.5 The gradual return to normal life rhythms began gradually from May. But the test of the holiday time and the gradual opening of the tourist season, that is, the open communication of moving populations with limited, random checks for the virus and only local restrictions of the gathering of citizens. We are experiencing now the gradual and severe increase in cases, with an uncertain spreading, with asymptomatic and younger in age likely playing a central role in the spread of the virus, while the fear of a potential large increase in serious cases remains. At the time of this writing, the only means of coping is to maintain and locally strengthen the protective measures, while we gradually realize that these measures came to stay for many more months.6,7 A major problem is that the initial small number of cases favored the underestimation of risk by part of the population, and the serious consequences on people's jobs and lives, along with the deregulation of employment and social security relations legislated in recent months, have provided substantial material to conspiracy theories. We carefully monitor the research on the epidemiological behavior of covid-19 and the clinical data, the discussion on the drugs that make the symptoms milder, the effect of the virus on the CNS and the expected vaccine or vaccines. Our role from the beginning concerned the enormous psychological burden of a global health crisis, with serious consequences on people's working and social lives and equally avoiding the deregulation of the management of our patients and of the units that provide it. At the time of confinement, the telephone contact, familiar to all generations, offered valuable information and support, the lines 10306 and 1110, as well as many local or voluntary help-lines. Telepsychiatry was used more widely - being also an initiative of the Hellenic Psychiatric Association - and seems to have entered impetuously in our work, as well as in education. Its central or complementary role and its safe use are issues that are widely discussed at the moment.8 Protection measures against the virus seriously affect the normal functioning of health and mental health services. The solution should be sought in the urgent operational upgrade, the very necessary reinforcement of the staff and its effective protection from the virus and stress from exposure to danger, which has emerged as important factors for the normal operation of the mental health units.9 The use of telepsychiatry has solved a number of operational problems, but in many cases, it remains complementary, as it cannot replace physical presence in more specific care operations. The need not only to normalize, but to improve the follow up of our patients, the need to strengthen the units that provide basic, community mental health services, is shown by the increase in cases of involuntary hospitalization in the psychiatric hospitals of Athens and Thessaloniki during the last two months. A health crisis that affects almost the entire planet and the working and social life of most is a major social and political problem that concerns all of us,10 while mental health professionals are called to offer their scientific tools for people to face a multifaceted threat and in particular to claim and ensure the continuation of the treatment of our patients and the normal operation of our units.