La psicología de emergencias ante la COVID-19: enfoque desde la prevención, detección y gestión operativa del riesgo

Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.

Bioterrorism policy discussions and response planning efforts have tended to discount the capacity of the public to participate in the response to an act of bioterrorism, or they have assumed that local populations would impede an effective response. Fears of mass panic and social disorder underlie this bias. Although it is not known how the population will react to an unprecedented act of bioterrorism, experience with natural and technological disasters and disease outbreaks indicates a pattern of generally effective and adaptive collective action. Failure to involve the public as a key partner in the medical and public-health response could hamper effective management of an epidemic and increase the likelihood of social disruption. Ultimately, actions taken by nonprofessional individuals and groups could have the greatest influence on the outcome of a bioterrorism event. Five guidelines for integrating the public into bioterrorism response planning are proposed: (1) treat the public as a capable ally in the response to an epidemic, (2) enlist civic organizations in practical public health activities, (3) anticipate the need for home-based patient care and infection control, (4) invest in public outreach and communication strategies, and (5) ensure that planning reflects the values and priorities of affected populations.

The aim of this paper is to describe the structure, production and function of secretory immunoglobulin A (sIgA) as well as changes of its concentration caused by exercise of various intensity and duration. Immunoglobulin A is the main class of antibodies present in the body secreted fluids such as saliva, tears or mucus from the intestines. It is generally recognized that IgA, due to its dominance in the immune system of mucous membranes, is the first line of defence against harmful environmental factors. The secretion and composition of saliva depends on the activity of the sympathetic and parasympathetic nervous systems. Physical activity, stimulating the autonomous nervous system, may reduce the amount of saliva and/or inhibit its secretion. The relationship between physical activity and the suppression of the immune system is not fully understood, but it is known that moderate intensity exercise can improve immune defences, while extreme effort can reduce them by creating an increased risk of upper respiratory tract inflammation (URTI). In athletes, the lowest risk of upper tract infection was connected with the case of moderate intensity exercise. It is now believed that the relationship between exercise volume and the risk of URTI has the shape of the letter “J”. This means that both too little and too much physical activity may increase the risk of upper respiratory tract infection. Training optimization and correct balance between exercise and rest periods may reduce the risk of adverse changes in the immune system and decrease the frequency of URTI.