Psychological first aid and crisis intervention for healthcare workers in COVID-19 pandemic

RESUMEN: La pandemia del COVID-19 ha afectado física y psicológicamente a la sociedad global, especialmente a los trabajadores relacionados con el campo de la salud. Estos se vieron obligados a ofrecer una solución a un contagio del que aún no se conocían los detalles. Tampoco contaban con los elementos de protección necesarios, de tal manera, se exponían al riesgo de contagio tanto ellos como sus familiares. Esto se tradujo en altos niveles de ansiedad, preocupación, miedo, entre otros síntomas. Como resultado, en México se implementó un servicio telefónico de atención psicológica ante la emergencia sanitaria. Dicho servicio ofrece: psicoeducación, primera ayuda psicológica, intervención en crisis o incluso una posible intervención psicoterapéutica futura. Tiene la intención tanto de resolver la emergencia demandada por dichos trabajadores de la salud, como escucharlos, apoyarlos y orientarlos. En el presente trabajo se describe dicho servicio, las técnicas utilizadas, se exponen dos casos representativos atendidos en este contexto y se plantea la necesidad y utilidad de servicios psicológicos duraderos para los empleados prestadores de servicio. ABSTRACT: The COVID-19 pandemic has had a physical and psychological impact on global society, especially on healthcare workers, who found themselves obliged to offer a solution to a contagion whose details were not yet known. They also lacked the necessary protective equipment, thus exposing themselves and their families to the risk of infection. This resulted in high levels of anxiety, preoccupation, fear, and other symptoms. Consequently, a mental health helpline was implemented in Mexico to deal with the unforeseen sanitary crisis. This service offers: psychoeducation, first psychological help, crisis intervention or even possible future psychotherapeutic intervention. It is intended both to resolve the emergency demanded by said health workers, as well as listening, supporting and guiding them. This paper describes this service, explores the techniques used, presents two representative cases dealt with in this context and raises the need for and usefulness of long-term psychological services for service provider employees

Subcutaneous anti-COVID-19 hyperimmune immunoglobulin for prevention of disease in asymptomatic individuals with SARS-CoV-2 infection: a double-blind, placebo-controlled, randomised clinical trialResearch in context

Summary: Background: Anti-COVID-19 hyperimmune immunoglobulin (hIG) can provide standardized and controlled antibody content. Data from controlled clinical trials using hIG for the prevention or treatment of COVID-19 outpatients have not been reported. We assessed the safety and efficacy of subcutaneous anti-COVID-19 hyperimmune immunoglobulin 20% (C19-IG20%) compared to placebo in preventing development of symptomatic COVID-19 in asymptomatic individuals with SARS-CoV-2 infection. Methods: We did a multicentre, randomized, double-blind, placebo-controlled trial, in asymptomatic unvaccinated adults (≥18 years of age) with confirmed SARS-CoV-2 infection within 5 days between April 28 and December 27, 2021. Participants were randomly assigned (1:1:1) to receive a blinded subcutaneous infusion of 10 mL with 1 g or 2 g of C19-IG20%, or an equivalent volume of saline as placebo. The primary endpoint was the proportion of participants who remained asymptomatic through day 14 after infusion. Secondary endpoints included the proportion of individuals who required oxygen supplementation, any medically attended visit, hospitalisation, or ICU, and viral load reduction and viral clearance in nasopharyngeal swabs. Safety was assessed as the proportion of patients with adverse events. The trial was terminated early due to a lack of potential benefit in the target population in a planned interim analysis conducted in December 2021. ClinicalTrials.gov registry: NCT04847141. Findings: 461 individuals (mean age 39.6 years [SD 12.8]) were randomized and received the intervention within a mean of 3.1 (SD 1.27) days from a positive SARS-CoV-2 test. In the prespecified modified intention-to-treat analysis that included only participants who received a subcutaneous infusion, the primary outcome occurred in 59.9% (91/152) of participants receiving 1 g C19-IG20%, 64.7% (99/153) receiving 2 g, and 63.5% (99/156) receiving placebo (difference in proportions 1 g C19-IG20% vs. placebo, −3.6%; 95% CI -14.6% to 7.3%, p = 0.53; 2 g C19-IG20% vs placebo, 1.1%; −9.6% to 11.9%, p = 0.85). None of the secondary clinical efficacy endpoints or virological endpoints were significantly different between study groups. Adverse event rate was similar between groups, and no severe or life-threatening adverse events related to investigational product infusion were reported. Interpretation: Our findings suggested that administration of subcutaneous human hyperimmune immunoglobulin C19-IG20% to asymptomatic individuals with SARS-CoV-2 infection was safe but did not prevent development of symptomatic COVID-19. Funding: Grifols