The situation about responses to the COVID-19 outbreak is evolving. Up-to-date data can be found in the guidelines prepared by federal public health sources and the daily updates from the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO).
The Coronavirus Outbreak (COVID-19) In The EU
Individuals who use drugs face the same risks as those of the general population and hence must know about the appropriate advice to lower their risk of infection. They may be subjected to additional risks, though, that need developing assessment and mitigation strategies.
These link to the behaviours associated with drug use. The settings where drug use takes place, or where care is provided. Risks increased by the high level of psychological and physical comorbidity found among many people take drugs. The fact that drug problems are usually more prevalent in marginalising communities, and the stigmatisation that people who take drugs regularly experience.
The current public health emergency raises serious additional concerns for the wellbeing of people. Who use drugs, assuring service continuity for people who have drug problems. The protection of those providing support and care for this population.
The aim of this briefing is to highlight emerging risks associate with COVID-19 pandemic. For people who use drugs and those offering services for them from a European perspective. Were require to support review, planning, and adaption of frontline and specialist drug interventions. For responding to the COVID-19 outbreak, national and local level service reviews and upgrades will have to take place within the context of respective rules and guidelines, as well as the information offer by ECDC and WHO.
Risks For People Who Use Drugs (PWUD) During The COVID-19 Outbreak
While PWUD is subject to the same risks of infection by COVID-19 as the general population, also face additional risks that require consideration and mitigation. By way of instance, Europe ageing cohort of opioid users is particularly vulnerable due to their high level of lifestyle factors and preexisting health issues.
Recreational drug use takes place within settings in which people gather together, and drugs or drug equipment may be shared. Generally, the marginalisation and stigmatisation linked with some kinds of drug use and may not only develop risk but also create barriers to supporting risk reduction measures.
Underlying chronic health conditions are associated with some types of drug use and increase the probability of developing severe illnesses.
Due to the high prevalence of the chronic medical disease among PWUD, many will be at risk for severe respiratory problems if they get infected with the new Coronavirus. Examples of this are:
- The ubiquity of chronic obstructive pulmonary diseases (COPD) and asthma are high among consumers in drug treatment, and smoking of crack cocaine or heroin may be an aggravating factor (Palmer et al., 2012).
- There’s also a high prevalence of cardiovascular diseases among patients injecting drugs and people using cocaine.
- Methamphetamine constricts the blood vessels, which may give rise to pulmonary damage, and there is evidence that opioid abuse can interfere with the immune system (Sacerdote, 2006).
- The prevalence of viral hepatitis infections, HIV, and liver cancers — contributing to weakened immune systems — is high in people who inject drugs.
- Tobacco smoking and nicotine addiction is quite common among some groups of PWUD and might increase their risks of experiencing more negative outcomes.
The risk of medication overdose may be raised among PWUD who tested positive with COVID-19.
The major life-threatening effects of an opioid, such as heroin, are to slow down and stop a person from breathing. Since COVID-19 (like any acute infection of the lung) may lead to breathing difficulties, there can be an increase in the risk of overdose among opioid users. The antidote naloxone stops the impact and reverses the breathing problems. Brought on by opioids and can be used as a prevention measure in both community and clinical settings. As an overdose prevention method. Naloxone is not confirmed to impact the breathing problem caused by COVID19.
Sharing Drug-Using Gear May Increase The Chance Of Disease
- While sharing injecting substance increases the chance of disease with blood-borne viruses, including HIV and viral hepatitis B and C, the sharing of vaping, inhalation, smoking or injecting equipment contaminated with COVID-19 might increase the chance of disease and play a part in the spread of this virus. The virus spreads from person-to-person, between individuals that are related to each other, and through respiratory droplets generated when infected individual sneezes or coughs. The virus can survive on several surfaces for long periods.
- Whereas harm reduction messages generally focus on risks link with injecting. The COVID-19 outbreak may pose additional risks which not recognise, by way of example the sharing of cannabis drug paraphernalia or vaping, smokes, joints or inhalation device.
Crowded Places Increase The Risk Of Exposure To COVID-19.
The characteristics of a few of the settings frequented by those using drugs may place them at a higher risk of vulnerability to COVID-19:
- Recreational drug use frequently occurs in groups or in crowded environments, thereby increasing the risk of vulnerability to COVID-19. This can, to some extent, be controlled by social distancing and set safety guidelines or other steps to reduce the use or access to high-risk operations.
- Low-threshold services, drug treatment centres, and social support services for folks who use drugs might have areas were social distancing is difficult, like waiting rooms or community centres. Like other settings, introducing proper distancing and hygiene practices are essential.
- PWUD undergoing homelessness often don’t have any alternative but to spend some time in public spaces and low access to resources for personal hygiene. Self-isolation is challenging for homeless people and access to healthcare is quite restricted. Addressing the requirements of PWUD who are homeless or in unstable housing will be necessary for responses in this field.
The control of COVID-19 transmission risks is likely to be especially challenging in prisons. Prevalence of infectious disease and drug use is high in prisons. Closed environments, where over-crowding, inadequate infrastructure and the delayed diagnosis has recorded.
Risks of disruption in access to clean drug-using equipment, drug services, and vital medications
- Continuity of care for PWUD using medication services might be challenging in the face of staff shortages, service disruption and closing, self-isolation and limitations placed on the free movement. Within this circumstance, continuity and contingency planning are crucial. Drug services, particularly small and locally finance NGO-run services operating together. With the formal structures of public health systems may be especially vulnerable and lack access to the further resources require to ensure continuity of care.
- There’s a risk of decreased access to opioid substitution treatment and other essential medications in addition to clean drug use equipment, particularly if community pharmacies are expected to reduce their opening hours and services and stop supervising methadone. Access to medicines is very likely to be challenging for those self-isolating, under lockdown or in quarantine.
- Restrictions on movement in certain localities because of COVID-19 may also cause the disruption of drug markets and a reduced supply of illegal drugs. This might lead to an increased demand for medication services and could have a range of effects, especially for dependent drug users.
Online Therapy Service To Give Free Sessions Around UK
An online therapy service is providing several free sessions aimed at exposed older people, and others who are struggling or self-isolating after therapists across the UK volunteered their help.
The Help Hub was primarily intended to serve a small area in West Oxfordshire but will expand nationwide when it starts this week following an influx of support.
“Thanks to the kindness of therapists directly across the nation willing to work at no cost, the idea snowballed in the area of less than a fortnight to the extent that we are now able to cover the whole of the UK,” explained Ruth Chaloner, the creator of the service, who’s requesting therapists to email her at if they would like to get involved.
Chaloner is now setting up another scheme to assist the members of her community. She hopes this is just another idea that could extend nationally.
“We know several very vulnerable people around who isolated, struggling and difficult to reach,” she said. “We have set up a Facebook page — TheHelpHubWestOxford — where volunteers map out their place and organise teams to take responsibility for every single street. Those teams will be sure that every house in every street receives a leaflet from us, offering our help. Then we go back a few days later and knock on the door of anyone who hasn’t contacted us.
“I’d like to see people in different areas replicate our FB page in their community,” she said. “Getting involved and supporting our neighbours will bring individuals together in a manner in a way that our fractured communities have not been for several years.”
There has been a surge of stress since the coronavirus crisis. The Company Chemists Association and the National Pharmacy Association and have issued an open letter to customers asking them not to stockpile drugs amid fears the most vulnerable will be left without.
Other pharmacy leaders said so many folks are self-isolating that the unfunded home-delivery services given for free by chemists around the country will be overwhelmed.
“We understand that people need to feel prepared, given the uncertainty that Coronavirus is currently generating. Although, it is essential that everyone plays their part in reducing the spread of the virus and helping us to keep the supply of medications for all,” stated Malcolm Harrison, the chief executive, Company Chemists Association, which leads large community pharmacy workers.
The chief executive of the Association of Independent Multiple Pharmacies, Leyla Hannbeck stated: “we would like to ask the public to be recognition of the circumstance, not stockpiling on drugs and also to be aware that medicines delivery to houses isn’t a funded service and in this present pace without support from the government it won’t be sustainable.”
Hannbeck said pharmacies reported an enormous increase in phone calls stressed people, essentially over the age of 70 or pregnant women.
“They ask about why some doctors’ surgeries closed and what to do next,” she said. “They concern about their medications when self-isolating and requesting their medications to sent to their homes immediately. This, as you can imagine, has set an unbelievable level of stress on pharmacy teams who are understaffed and under-funded.”
Reena Barai, a member of the board of the National Pharmacy Association, and a pharmacist in South London said: “We have seen a tsunami effect, with stress levels of our clients through the roof. We think that it’s just going to get worse. Week 2 of self-isolation will be when people have this dawning feeling of what life will be like for the next few weeks. That is when the peak of anxiety is truly going to strike.”
In Egypt, online therapy social enterprise Shezlong has provided 150,000 free sessions to help people cope with depression or anxiety. People suffering from”pseudo coronavirus” where people believe they’ve COVID-19 although they do not.
Hard Feelings, a Canadian social program that intends to make therapy more accessible by providing low-cost counselling sessions. Closed its Toronto shop, and its counsellors will speak to customers online.
Meanwhile, in the U.S., online therapy program Talkspace, a company with over one million users. Providing a free month of therapy to 1,000 healthcare workers fighting the coronavirus outbreak.
“With negative headlines coming from news outlets about COVID-19, people are becoming more stressed and panicked, and a growing number of individuals will need emotional support,” founder of Shezlong, Ahmed Abu ElHaz informed the Thomson Reuters Foundation.
About 1,500 therapy online meetings have been performed since the three-month initiative launched in Egypt, which currently has over 3490 coronavirus confirmed cases and 264 deaths, base on data from the worldometers.info coronavirus resource centre.
Conducted through video conference, the sessions provide coping techniques for dealing with bad news. In a country where 3 per cent of the population — or 8.2 million – suffer from mood and anxiety disorders. Based on 2018 Egyptian health ministry data.
Therapists use cognitive behavioural therapy, which guides patients on how to control stress and anxiety and provides relaxation techniques. Like positive and self-talk deep breathing.
Professor of Psychology at Cairo University Gamal Freusar state 70 percent of Egyptians categorised as”pseudo coronavirus.” Since they assume they have the virus and believe they have the symptoms, although they really do not. Probably close to two-thirds of Egyptian society is having high levels of tension and stress, and which may cause many physical problems for them.