After the World Health Organization declared COVID-19 disease a pandemic, the number of confirmed cases has progressively increased to more than 1,600,000, including 95,000 deaths, which has led to the implementation of quarantine and isolation strategies worldwide. However, approaches highly focused on COVID-19 infection control may tend to ignore the psychosocial consequences of the outbreak. As da Silva et al. recently stated, the stress experienced by patients, healthcare personnel and communities could increase the possibility of anxiety, depressive, and stress-related disorders, which could add an underestimated additional risk during the epidemic. However, we think that some Latin American countries might face particular challenges. As the COVID-19 epidemic advances, our fragile health systems already face a high internal (regional) migration, an increase in measles cases, intense transmission of dengue and recent outbreaks of zika and chikungunya. Unlike temperate zones, the co-circulation of these viruses in tropical countries could affect diagnostic capacity and worsen the epidemiological situation. In areas with adverse geographical and sanitary conditions, the risks are further increased. For example, some remote areas of Colombia have fewer than 0.5 hospital beds per 1,000 inhabitants, much less than the national average of neighboring countries. These areas are inhabited by approximately nine million victims of a 50-plus year armed conflict. The Colombian National Mental Health Survey revealed that people who resided near armed conflict events had a higher prevalence of mental problems and disorders. Notably, self-declared Amerindians also had higher rates of poverty, displacement due to violence, and mental disorders associated with acculturation. During the pandemic, numerous successful interventions involving technological tools have been reported around the globe. However, the wide urban/rural gap and an internet access rate around 50% in many countries could be a barrier to web-based mental health services. Therefore, locally adapted responses to the COVID-19 pandemic must consider their impact on the mental health of vulnerable communities, emphasizing the strengthening of primary care and the role of social leaders. Critical situations like this pandemic will make the longstanding social inequities of our continent more evident. Amartya Sen aptly said that the fundamental requirement for enjoying better community mental health implies establishing high degrees of justice, equality, and social capital. Jairo M. Gonzalez-Diaz,0000-0000-0000-0000 Lina Lozano-Lesmes,0000-0000-0000-0000 Adalberto Campo-Arias0000-0000-0000-0000 Centro Rosarista de Salud Mental (CERSAME), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia. Clı́nica Nuestra Señora de la Paz, Bogotá, Colombia. Facultad de Ciencias de la Salud, Universidad del Tolima, Ibague, Colombia. Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Magdalena, Santa Marta, Colombia.

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评论“心理健康：为什么它在大流行中仍然很重要”

在世界卫生组织宣布 COVID-19 疾病为大流行病后，确诊病例数逐渐增加到 1,600,000 多人，其中 95,000 人死亡，这导致在全球范围内实施隔离和隔离策略。然而，高度关注 COVID-19 感染控制的方法可能倾向于忽视疫情的社会心理后果。正如达席尔瓦等人。最近表示，患者、医护人员和社区所经历的压力可能会增加焦虑、抑郁和压力相关疾病的可能性，这可能会在流行期间增加被低估的额外风险。然而，我们认为一些拉美国家可能面临特殊挑战。随着 COVID-19 流行病的发展，我们脆弱的卫生系统已经面临大量内部（区域）迁移、麻疹病例增加、登革热的强烈传播以及最近爆发的寨卡病毒和基孔肯雅热。与温带地区不同的是，这些病毒在热带国家的共同传播可能会影响诊断能力并使流行病形势恶化。在地理和卫生条件较差的地区，风险进一步增加。例如，哥伦比亚一些偏远地区每1000名居民的病床不足0.5张，远低于邻国的全国平均水平。这些地区居住着大约 900 万在 50 多年的武装冲突中的受害者。哥伦比亚全国心理健康调查显示，居住在武装冲突事件附近的人的心理问题和障碍发生率较高。值得注意的是，自称美洲印第安人的贫困率、因暴力而流离失所以及与文化适应相关的精神障碍的发生率也较高。在大流行期间，全球报告了许多涉及技术工具的成功干预措施。然而，在许多国家，城乡之间的巨大差距和大约 50% 的互联网接入率可能成为基于网络的心理健康服务的障碍。因此，针对 COVID-19 大流行的适应当地情况的应对措施必须考虑它们对弱势社区心理健康的影响，强调加强初级保健和社会领袖的作用。像这种流行病这样的危急情况将使我们大陆长期存在的社会不平等现象更加明显。Amartya Sen 恰当地说，享受更好的社区心理健康的基本要求意味着建立高度的正义、平等和社会资本。Jairo M. Gonzalez-Diaz,0000-0000-0000-0000 Lina Lozano-Lesmes,0000-0000-0000-0000 Adalberto Campo-Arias0000-0000-0000-0000 Centro Rosarista de Saludcia Centro Rosarista de Saludcia de la Salud，罗萨里奥大学，哥伦比亚波哥大。Clı́nica Nuestra Señora de la Paz，哥伦比亚波哥大。Facultad de Ciencias de la Salud，托利马大学，伊巴格，哥伦比亚。Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Magdalena, Santa Marta, Columbia。0000-0000-0000-0000 Adalberto Campo-Arias0000-0000-0000-0000 Centro Rosarista de Salud Mental (CERSAME)，Escuela de Medicina y Ciencias de la Salud，Universidad del Rosario，哥伦比亚波哥大。Clı́nica Nuestra Señora de la Paz，哥伦比亚波哥大。Facultad de Ciencias de la Salud，托利马大学，伊巴格，哥伦比亚。Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Magdalena, Santa Marta, Columbia。0000-0000-0000-0000 Adalberto Campo-Arias0000-0000-0000-0000 Centro Rosarista de Salud Mental (CERSAME)，Escuela de Medicina y Ciencias de la Salud，Universidad del Rosario，哥伦比亚波哥大。Clı́nica Nuestra Señora de la Paz，哥伦比亚波哥大。Facultad de Ciencias de la Salud，托利马大学，伊巴格，哥伦比亚。Programa de Medicina, Facultad de Ciencias de la Salud, Universidad del Magdalena, Santa Marta, Columbia。