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Concerns high for mental health crisis caused by COVID-19 pandemic

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Stressed from home-schooling your kids? Lonely from lockdown? Worried about a sick loved one isolated in a nursing home? Worried you might lose your job?

The ongoing COVID-19 pandemic is affecting everyone’s mental health in ways small and large, and experts are concerned that for many, today’s anxiety will become a tidal wave of mental health problems in the years ahead.

The pandemic is adding to what already was an underrecognized mental health crisis in the United States, according to Dr. Don Mordecai, national mental health and wellness lead at Kaiser Permanente in Oakland, Calif.

Rates of anxiety and depression have steadily risen for years, as have deaths of despair related to suicide and drug overdose, he said during a HD Live! interview.

“All those things have been going up for decades, really, and now you bring the pandemic in,” Mordecai said. “It’s not like we were in good shape in terms of our mental health and now it’s getting worse. It’s more like we were not in good shape, and then you bring in another big stressor.”

Clinical psychologist Jelena Kecmanovic also is concerned about the toll of the anxiety-provoking changes to everyday life that people are enduring.

“Anxiety is exhausting and terrifying,” said Kecmanovic, director of the Arlington/DC Behavior Therapy Institute in Arlington, Va. “If it is happening long enough, you’re going to get depressed about it. You’re going to get hopeless and maybe even suicidal.”

She expects some long-lasting emotional scars.

“This is going to go on long enough and it’s going to be traumatic enough for enough people that it’s not realistic to expect we’ll spring back to normal,” Kecmanovic said.

America’s pandemic-related mental health crisis hasn’t rolled out as you might think, she said. There wasn’t much of an initial uptick in people seeking help even as the lockdown altered everyday life in profound ways.

“After these couple of first months, when reopening started, that’s when we started really seeing people’s mental health worsen quite a bit,” she said.

What changed?

“What’s dawning on us is the realization that we’re in this for the long haul,” Kecmanovic said. “The uncertainty is really hitting people, that this is going to be a year or a year and a half living with this ever-changing normal. The new normal is changing every day, every week.”

Surveys have shown that people are concerned about the pandemic’s effect on their mental health, and symptoms of anxiety and depression are on the rise, Mordecai said.

But “that’s different from a full-blown mental health disorder,” he noted. “I think it remains to be seen how it translates long term.”

The folks most at risk for long-term problems are those most directly impacted by COVID-19, Mordecai and Kecmanovic said. These include front-line health care workers, people who have been infected, and people who have lost loved ones.

“There’s going to be a &hellip tremendous amount of grief that’s not being processed,” Kecmanovic said, adding that it’s impossible to paper over it. “It’s going to catch up with you eventually.”

All this sounds dire, but both experts predict most people will bounce back.

“I am hoping that essential human resilience will prevail — people might not be able to snap their fingers and be back to normal, but they will generally be fine,” Kecmanovic said.

Mordecai said past experience offers reason for hope.

“When we look at studies of past natural disasters and pandemics, most people do OK, which I think gives me some reason for optimism,” he said. “But there will be some people who have long-term effects. It’s people who’ve been profoundly affected by the pandemic.”

People worried about their own mental state should double down on efforts to stay healthy and happy, Mordecai said.

“The greatest risk is that when people get socially isolated, they drop their routines around maintaining their mental health and their physical health — that’s really a set up,” he said.

A daily workout can do much to lower your stress. People should also consider meditation or yoga as a means of reducing stress, as well as limiting their news intake, Mordecai added.

Don’t dwell on the news, he advised.

“It’s important to stay up to date, but that doesn’t require hours and hours a day,” Mordecai said. “If the TV’s on in the background, maybe turn it off, because it’s a constant message that’s anxiety-provoking.”

It’s also important to acknowledge how you’re feeling, and that your feelings are valid, Kecmanovic said. “These are crazy times. These are unprecedented times. No wonder I’m feeling anxious, and it’s OK,” she said.

Some potential bright spots could come out of the pandemic, too. Some people might emerge with a sense of pride in enduring the crisis, she said.

“It can be realizing &hellip I’m stronger than I thought I would be,” Kecmanovic said. “I never thought of myself as a strong and hearty person, but what I’ve lived through for the last year and a half, it’s amazing I was able to go through this.”

The experts also hope that what people have endured will help them empathize with those who struggle with their mental health.

“One of the silver linings here may be that so many of us have had to deal with symptoms of anxiety and concerns about isolation,” Mordecai said. “Those are things that people with mental health conditions have known for a long time. If the rest of us essentially get a taste of it, does that allow us all to talk more openly about it? I hope so.”

More information

The U.S. Centers for Disease Control and Prevention has more about coping with stress during COVID-19.

Copyright 2020 HealthDay. All rights reserved.



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Study: Racquet sports make arthritic knees worse for overweight people

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Stay off the court: For overweight people with arthritic knees, racket sports like tennis and racquetball may accelerate degeneration of the joints, a new study finds.

Exercise can benefit overweight people, but the wrong type might damage knees and lead to the need for knee replacement surgery, the researchers said.

“Fast-paced and high shear load physical activities, such as racket sports, are more harmful for overall knee joint health,” said lead researcher Dr. Silvia Schiro, from the University of California, San Francisco.

Racket sports include frequent and high-intensity lateral movements that can worsen knee osteoarthritis, as opposed to activities that mostly involve forward movements — such as running, an elliptical machine, swimming and bicycling — or forward and diagonal movements, such as ball sports, Schiro said.

“Overweight or obese people may benefit from working out with an elliptical trainer in order to lose weight and engage a healthy lifestyle,” Schiro said.

For the study, Schiro’s team used MRI scans to assess the rate of degeneration of the knee joint in 415 overweight or obese patients who were part of the U.S. Osteoarthritis Initiative.

Participants kept records of different types of physical activity, including ball sports, bicycling, jogging/running, elliptical trainer, racket sports and swimming. The participants were evaluated using the Whole-Organ Magnetic Resonance Imaging Score — “WORMS” — a measure of knee degeneration.

Patients who regularly took part in racket sports saw their WORMS increase significantly, compared with patients who used the elliptical machine, the researchers found.

Surprisingly, the same happened in those participating in racket sports when compared with those who jogged or ran. Those doing racket sports had a significantly greater degeneration in the medial tibial cartilage compartment, which is the area where arthritis often first appears.

Those using the elliptical machine showed the smallest changes in degeneration over the four years of the study.

The faster degeneration of the knee joints in people who participated in racket sports is likely due to the high-speed lateral movements inherent in such sports, Schiro said.

Overweight people who continue to play racket sports might slow degeneration in their knees by switching to sports with less fast-paced and high shear loads like badminton or doubles tennis, the researchers suggested.

Schiro emphasized that the degenerative process is complex and individualized. Some people may be able to safely play these sports, she said. But as a group, overweight and obese people who play racket sports are at higher risk for disease progression.

Knee osteoarthritis, which gradually wears down the cartilage that cushions the ends of the bones, is a major cause of pain and disability, affecting about 14 million Americans, the researchers noted.

Dr. Karen Schneider is an orthopedic surgeon at Lenox Hill Hospital in New York City. She said, “Moderate daily exercise and weight loss for those who are overweight are important in the treatment of knee and hip osteoarthritis.”

Besides improvement in bone density, cardiovascular health and mental well-being, exercise helps decrease joint stiffness associated with osteoarthritis, and improves flexibility and strength, she added.

It may seem counterintuitive that running did not increase the risk of progressive osteoarthritis, but that has been shown in other studies looking at the association of moderate running and osteoarthritis, Schneider said.

“Lower-impact exercises — such as biking, elliptical trainer and swimming — are easier on the joints and often may be preferable to patients with obesity and osteoarthritis,” she said. “For those patients who enjoy tennis, I would encourage them to play doubles on a softer surface and cross-train with other low-impact forms of exercise.”

The findings are scheduled for presentation at the upcoming virtual annual meeting of the Radiological Society of North America. Such research is considered preliminary until published in a peer-reviewed journal.

More information

For more on knee osteoarthritis, head to the American Academy of Orthopaedic Surgeons.

Copyright 2020 HealthDay. All rights reserved.



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Chinese COVID-19 vaccine said to show promise in early clinical trials

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Nov. 17 (UPI) — A vaccine against COVID-19 developed in China safely produces antibodies against the virus in 92% of the people who receive it, according to a study published Tuesday by The Lancet Infectious Diseases.

Still, antibody levels among participants receiving the shot, called CoronaVac, were lower than those seen in patients who have recovered following infection, the researchers said.

The trial was not designed to assess the effectiveness of the vaccine, however, and those studies are ongoing, they said.

“Our findings show that CoronaVac is capable of inducing a quick antibody response within four weeks of immunization by giving two doses of the vaccine at a 14-day interval,” study co-author Fengcai Zhu said in a statement.

“We believe that this makes the vaccine suitable for emergency use during the pandemic,” said Zhu, a researcher with the Jiangsu Provincial Center for Disease Control and Prevention in Nanjing, China.

The findings are the latest to fuel hopes that a viable vaccine against COVID-19 will become available in the short-term.

In recent days, both Pfizer and Moderna have released positive, preliminary results with their respective vaccines. More than 120 potential vaccines are being evaluated, and 48 are in clinical trials.

CoronaVac is a chemically inactivated whole virus vaccine based on a strain of the coronavirus that causes COVID-19, originally was isolated from a patient in China.

In this phase 1/2, two-part clinical trial — the first stage of the evaluation process — researchers administered CoronaVac to more than 700 healthy volunteers ages 18 to 59 in China between April 16 and May 5.

No participant had a history of COVID-19 infection, had not traveled to areas with high incidence of the disease and did not have signs of fever at the time the vaccine was administered, the researchers said.

In both parts of the trial, participants were split into two groups to receive one of two vaccination schedules — either two injections 14 days apart or two injections 28 days apart.

Within each of the two groups, participants were randomly assigned to receive either a low dose of the vaccine — 3 micrograms — or a high dose — 6 mcg.

Antibody responses — proteins produced by the immune system to fight off viruses — could be induced within 28 days of the first immunization by giving two doses of the vaccine at the lower dose 14 days apart, the data showed.

In the phase 1 portion of the study, the vaccine produced an immune response in 46% of participants, a figure that more than doubled to just over 92% during the second phase.

The vaccine used in the second phase of the study was produced using a different manufacturing process that may have enabled it to produce a stronger immune response, researchers said.

Participants in all dosing schedules and levels reported similar side effects, with pain at the injection site the most common.

Most of the reported side effects were mild and participants recovered within 48 hours.

CoronaVac can be stored in a standard refrigerator at 36 to 46 degrees Fahrenheit, which is “typical for many existing vaccines including flu,” and can remain in storage for up to three years, according to study co-author Dr. Gang Zeng, of China-based Sinovac Biotech, which makes the vaccine.



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Buying gun during pandemic may increase suicide risk, study says

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Those who buy guns as the pandemic rages are more likely to be suicidal than those who already own firearms, a new study finds.

In fact, among people who bought guns during the pandemic, about 70% reported having suicidal thoughts, while just 37% of other gun owners had such thoughts, researchers found.

“People who were motivated to purchase firearms during COVID-19 might have been driven by anxiety that leaves them vulnerable to suicidal ideation,” said researcher Michael Anestis, executive director of the New Jersey Gun Violence Research Center and an associate professor at the Rutgers School of Public Health in Piscataway, N.J.

“While this does not guarantee an increase in suicide rates, it represents an unusually large surge in risk made more troubling by the fact that firearms purchased during COVID-19 may remain in homes beyond the pandemic,” he said in a university news release.

During the first four months of the pandemic, more than 2.5 million Americans bought guns for first time. In March alone, when the pandemic began with a vengeance in the United States, roughly 2 million guns were purchased, Anestis said.

For the study, the researchers surveyed 3,500 Americans. A third of them owned guns.

The researchers found that of those who bought a gun during the pandemic, 70% had suicidal thoughts throughout their lives, 56% had suicidal thoughts during the past year, and 25% had suicidal thoughts during the past month.

Among people who did not buy guns during the pandemic only 56%, 24% and 12%, respectively, had suicidal thoughts during those time periods.

“Firearm owners are usually no more likely than non-firearm owners to experience suicidal thoughts,” Anestis noted. “It is possible that a higher-risk group is driving the current firearm purchasing surge, introducing long-term suicide risk into the homes of individuals who otherwise may not have acquired firearms during a time of extended social isolation, economic uncertainty and general upheaval.”

People who bought a gun during the pandemic also were also less likely to store guns in a secure way, including storing the weapons unloaded or using locking devices.

“The increase in firearm purchases is concerning, given that suicide is three times more likely in homes with firearms, and there is a hundred-fold increase in an individual’s suicide risk immediately following the purchase of a handgun,” Anestis said. “And unsafe firearm storage increases that risk.”

The report was published this week in the American Journal of Preventive Medicine.

More information

For more on guns and suicide, see Harvard University.

Copyright 2020 HealthDay. All rights reserved.



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