Electroconvulsive Therapy During the Coronavirus Pandemic

Covid-۱۹ has been officially declared a pandemic by the World health organization. The world is undergoing a major transformation and what will be the new normal is yet to be determined. Therefore, the anesthesiologist has the dual responsibility of providing care to victims of pandemic and patients with severe mental illness requiring electroconvulsive therapy (ECT)The covid -۱۹ pandemic is likely to affect the mental health of healthcare professionals (HCP), survivors, and persons kept in isolation or quarantine. Data from the SARS outbreak showed that ۴۰-۶۰% of survivors suffered from depression and post-traumatic stress disorder (۱). Jianbo Lai et al (۲) surveyed mental health outcomes in HCP taking care of covid patients and found that a significant portion of HCP was feeling symptoms of insomnia, anxiety, distress, and depression. ECT should be considered as an emergent or semi-urgent procedure for patients suffering from suicidal tendencies, mania, catatonia, and severe depression so that treatment is not denied or delayed.Doing ECT with limited resources due to pandemic is a challenging task. ECT requires general anesthesia which places anesthesiologists at close contact with patient airway secretion. Patients coming for ECT are kept in close contact with each other before and after the procedure posing a significant risk of disease transmission. They are mainly elderly with several comorbidities which increase the risk of severe covid disease. Furthermore, they have poor body hygiene, live in crowded places, and not able to follow the recommendation of social distancing and hygiene. Another logistic challenge is the availability of adequate staff, HCF, PPE, N۹۵ mask, goggles, gowns, hand sanitizers, and disinfectants during a pandemic of such severity.