COVID-19 pandemic: what's next for public health?

Global projections of excess mortality from the Institute for Health Metrics and Evaluation, released two years after SARS-CoV-2 was designated a public health emergency, show that 182 million people died as a result of the epidemic by December 31, 2021—three times greater than government data suggests. According to World Bank estimates, the pandemic has pushed 100 million people into extreme poverty. Is a mental health crisis being concealed as the actual weight of COVID-19 is being revealed? Long-standing gaps and global underinvestment in mental health care and prevention have been exposed by the epidemic, which has disproportionately affected young people and women. According to the World Health Organization's Mental Health Atlas, global median spending on mental health is still approximately 2% of government health spending. In 2020, however, cases of anxiety disorders climbed by 256%, while instances of major depressive disorders increased by 276% globally. To satisfy this rapidly rising demand and meet people's needs, immediate action is required to expand mental health services. Adverse mental health outcomes and psychiatric morbidity have been documented in patients with COVID-19, and concerns persist regarding the long-term health effects of the drug. Long COVID, or post-COVID-19, and its possibly serious psychological consequences are yet poorly understood. According to the latest Office for National Statistics figures, approximately 1 in 7 million people in the UK had self-reported long COVID as of March 5, 2022, according to the latest Office for National Statistics figures. In this issue of The Lancet Public Health, Ingibjörg Magnsdóttir and colleagues report that acute COVID-19 disease severity (indicated by the number of days bedridden) is associated with a long-term impact on mental health. Individuals bedridden for 7 days or longer were 50–60% more likely to experience depression and anxiety symptoms. COVID-19 has been linked to negative mental health outcomes and psychiatric morbidity in patients, raising concerns about the drug's long-term health impacts. The post-COVID-19 syndrome, sometimes known as extended COVID, and its possibly serious psychological consequences are still unknown. According to the latest estimates from the Office for National Statistics, about 17 million people in the UK have self-reported long COVID as of March 5, 2022. In this issue of The Lancet Public Health, Ingibjörg Magnsdóttir and colleagues find that the severity of acute COVID-19 disease (as measured by the number of days spent bedridden) is linked to long-term mental health consequences. Individuals who were confined to their beds for seven days or more were 50–60% more likely to experience depression and anxiety symptoms. Non-pharmaceutical therapies, physical separation, and lockdown measures were effective in preventing COVID-19 transmission, but they caused significant disruption to people's everyday lives. According to UNICEF, school closures and confinement have an impact on children and adolescents' well-being, with higher levels of stress, anxiety, and depressive symptoms. The loss of schooling and the implications for mental health—directly, because a lack of education could result in a persistent human capital deficit, and indirectly, because of shattered social networks among children and young people—should be a source of concern.