José Cañete has been a specialist in Psychiatry since 1985 and received a doctorate in Medicine in 1993 with the doctoral thesis: “Origins of chronic anxiety”. As a clinical psychiatrist, he has developed his activity in various Catalan public health centers, treating people with problems of anxiety, depression, bipolar disorders, and other pathologies. Since 1999, he has held the position of director of the Mental Health area of the Consorci Sanitari del Maresme (Mataró Hospital) and collaborating professor at the Blanquerna Faculty of Psychology at the Ramón Llull University of Barcelona. Since 2019, he has been a consultant and president of the Fundació Salut Plus for the psychosocial care of people with chronic diseases.
In recent months and as a result of the arrival of Covid-19, there has been a lot of talk about pandemic fatigue, what it is, etc., but … How can a person know if they have it? What are its signs or symptoms?
From my point of view, the pandemic has acted as a source of chronic stress that began in March 2020 and is still present in all areas of society. This stress has its origin in the continuous threat to health posed by the virus (income, pneumonia, ICUs, death, etc.) but also in the impact of the confinement measures and the resulting social and economic problems.
Thus, there would be a direct effect of the virus on the affected people and on their relatives and relatives, but a general indirect effect due to the sustained stress. Certain groups (for example the elderly or people with chronic diseases) have experienced stress and suffering more intensely. Pandemic fatigue refers to psychological discomfort (tiredness, lack of motivation, worry, etc.) derived from the pandemic that has been observed in various studies and surveys in the general population. These are basically mild symptoms such as anxiety, irritability, occasional sleeplessness, hopelessness, mood swings, and some apathy. Fortunately, vaccination has brought about a very positive change in people’s expectations and limitations, and we can say that pandemic fatigue is also beginning to decrease and disappear.
An investigation carried out in Ireland during the summer showed that half of the people who had contracted Covid-19, presented symptoms of severe physical fatigue up to 10 weeks after receiving medical discharge. However, this fatigue can also occur in other people who have not passed Covid-19, why? What can cause it in these people?
It has been seen that more than 10% of patients who have required hospitalization for Covid-19 infection continue to experience symptoms -mainly fatigue, dyspnea, headache- long after discharge and after having eliminated the virus. This condition is called “persistent Covid” and, although the mechanism of its production is unknown, it is linked to the infection and the immunological mechanisms involved and, therefore, does not appear in uninfected people. In contrast, as we have said, “pandemic fatigue” does affect uninfected people.
Some professionals indicate that it is not the fatigue of an individual, but a fatigue of society, what do you think?
Fatigue is tiredness and includes the negative social aspects associated with the pandemic (limitation, isolation, fear, etc.) as well as the effect of an excess of information on the covid and the progress of the pandemic.
Young people are said to be the most affected by pandemic fatigue, why do you think this is the case?
The weighting of the negative effects of the pandemic in the different ages and groups is a subject still under study. Young people are talked about because they are considered to be in a stage of maturation and growth and are more sensitive to the negative effects of stress or trauma. For example, the interruption of classes or confinement and the limitation of social contacts has had negative effects on this population.
For people, who already before the pandemic, suffered from a mental illness, how has this fatigue affected them? What consequences has it had on them?
In addition to young people, people with previous illnesses, both for medical and mental health reasons, have been more affected. Along with a greater vulnerability to complications in case of infection, this population has often been deprived of the medical follow-up, treatments or tests required for their disease due to the collapse of the health system.
In the hospital context, we have initially witnessed a reduction in visits to psychiatric emergencies and hospitalizations during the pandemic due to confinement. Currently, the figures for the demand for care in psychiatry and mental health are increasing and I believe that it is not only due to fatigue, but also because care was stopped (or it was done in a precarious way) to these patients during 2020.
There is no doubt that we are vulnerable to pandemic fatigue due to psychological causes, but it can also be dealt with, what activities or practices would you recommend for it?
As we have said, pandemic fatigue is a form of prolonged stress and to combat it, healthy practices are recommended, starting with reducing exposure to negative news that does not contribute anything and increases fear in the population. It is essential to seek hygienic measures, follow reasonable hours that ensure sufficient hours of sleep at night, eat a healthy diet, moderate exercise and achieve a friendly environment.
It is important to have and practice hobbies that allow you to “disconnect” from worries, foster relationships and allow spaces for relaxation and stress reduction through relaxation, yoga, meditation, mindfulness or other techniques.
In this sense, when would it be recommended that a person with this condition visit an emotional health professional?
In certain cases the symptoms of stress can be more intense and appear insomnia, tension, anxiety, phobias, obsessions or even symptoms of depression (sadness, low self-esteem, pessimistic ideas, loss of appetite …). If the symptoms clearly interfere with day-to-day life, they indicate that it is necessary to seek the help of a specialist.
The new coronavirus has caused an increase in the use of technologies, how has telemedicine impacted the care of psychiatric patients?
It is considered something positive that has resulted from the pandemic. As in other resources, it is important to establish the bases and indications of telemedicine. The confinement and the absence of services available in the vicinity has caused many people and professionals to have used telemedicine intensively, in my case especially in the teleconsultation modality.
I consider it very useful in psychiatry and psychology, since it allows access to specialists quickly, avoiding the barriers that face-to-face visits entail. In my case, I have been able to connect and visit people with mental health problems from different regions of Spain who did not have the option of going to their reference professionals, and I believe that we have helped many by reviewing the treatment guidelines, giving continuity to the prescriptions o solving anxiety and depression problems related to pandemic fatigue
Do you think telemedicine is here to stay?
Yes, of course, but there is still a way to expand access to telemedicine to older people or people who do not have the knowledge or the means to connect to the internet or mobile.
José Cañete’s Online Agenda at WeDoctor
Hello! I am Dr. José Cañete, clinical psychiatrist and director of the Mental Health Area of the Consorci Sanitari del Maresme and Mataró Hospital. I specialize in caring for patients with problems of anxiety, depression, bipolar disorders, addictions and other pathologies. Do you want a consultation? I’m in We Doctor! I will be happy to assist you through a video consultation or in writing.