Doctor in clinical psychology and psychopathology, now attached to the medical oncology service at the Pitié-Salpêtrière hospital group, Doctor Marilyne Baranes who lives in Val-de-Marne, is also a specialist in Posttraumatic stress disorder (PTSD) or Post traumatic stress disorder, psycho-traumatic disorder and burnout. She launched a cry of alert by saying that we must immediately prevent the multi-trauma that the health situation due to Covid-19 will inevitably cause.
What analysis do you make of the current situation?
DR MARILYNE BARANES. There is an urgent need to prevent and establish pre-traumatic screening. It is necessary to take charge of what is not seen.
After the attacks that France, Europe and the world have suffered, thermal warming, climatic disturbances, from the unleashing of winds to deadly pesticides, our psyche would today need a break. But without warning, the Covid-19 was unleashed on our planet, leaving us as one and only resource, the containment and the uninterrupted mourning of our dead in the intensive care units, the Ehpad and against all odds, with a young or even very young audience.
Our psyche has its limits. And as our President pointed out, this observation is that of a state of war. We certainly have a warrior spirit to fight to the end, but we are not, however, an army trained to fight the enemy. A fortiori when it is invisible.
What do you think will be after Covid-19?
I think from experience that there are going to be very many cases of traumatic experiences at full level. Taking into account several data, we could reach 1,529,052 people affected, the result of the impact on the families of the deceased, on survivors hospitalized and returned home, on survivors of resuscitation, on caregivers exposed. Not to mention the impact of audio visual in the context of confinement, which is an additional variable in terms of stressor, and the deadly atmosphere experienced and felt by confined people, large or small.
And even if a toll free number is set up to call the caregivers, it doesn't sound like it should sound. So, instead of waiting for rebound effects in the months to come or for dramatic action, we must anticipate today.
Trauma, listed as a disease in the bible of international psychiatry, is not treated in France. This is not measured in a blood test. Those who have money will go to the shrink, those who do not have it, even if there are free Medico-Psychological Centers (CMP), but without PTSD specialist.
How could post-Covid trauma be declared?
In a traumatic mechanism, one is not aware that one is not well. This can range from the same day to 3 or 4 months after the shock. In addition, the trauma is individual and not situational; each member of a family can react differently. People could be nervous, insomniac, sad, afraid of going back to work…
What do you recommend?
I recommend a large-scale test questionnaire, to be done as quickly as possible, without waiting for rebound effects or even dramatic acts.
So, I propose a psycho-traumatic vaccine. One could imagine, within a cell of a scientific committee which deals with the care of Covid, to have a rapid test questionnaire which will be given to patients, families, carers, but also to all the world. It could be anonymous, but people would leave a phone number.
The record of his responses could show us that some are people at risk. It is up to us professionals not to wait for someone to knock on our door. Traumatic fixation can be prevented, sometimes in a few interviews.
What would this questionnaire be?
We already have tools that tell us whether people are in a very vulnerable mental situation or not. I am thinking in particular of those showing the intensity of stress and therefore the traumatic propensity. Like the questionnaire created by Canadians, called PHQ-9, on the health of the patient who answers if he feels tired, has trouble concentrating, sleeping, eating, moving, etc. And GAD-7, on generalized anxiety disorders in which the person indicates if he is nervous, worried, has trouble relaxing, having fun, is always afraid, etc.
But we can also create a mini-questionnaire of ten questions directly related to the traumatic impact and, a particular for children. The latter could possibly be traumatized because they will have understood and translated into their childhood world, in their own way, the experience at home, the parents who are talking, who are anxious, the TV loop on the news, the mask …
Prevention is choosing to treat alongside the emergency, which is currently a priority. It will cost France dearly if we don't do it!