As the pandemic grows, healthcare workers are experiencing a new level of stress and fear. Since our first piece about healthcare workers and mental health, the toll that COVID-19 cases have taken on them has become more difficult than any could have imagined.

First, let us again say thank you to all of you, from EMTs who answer the first calls to the doctors and nurses who tend to the sickest. Your selflessness and heroism is inspiring.

We’ve set up a counseling hotline for healthcare workers and first responders at 1-800-327-7451 (TTY 711). Your call will be answered by our licensed mental health clinicians. Our team is trained and ready to listen and help during this difficult time.

There are so many things that are out of our control. We are dependent on others to address many aspects of the big picture, but there are things outlined below that we can do for ourselves and those close to us. No single recommendation is enough by itself, but when taken together, they may help.

Talk about it

Acknowledge your anxiety, fear and grief, and talk about it.

Many of our colleagues and friends say that leaning on fellow healthcare workers is very difficult. Everyone’s heart beats a little bit faster when they greet a COVID-19-positive patient, so how can we ask them to support one another? Yet this is what we do as a medical community daily. Peer support is key.

• If a compassion fatigue group isn’t available at your workplace, work with your employer to put one together.
• If a group option isn’t available, talk to your co-workers about what you are seeing and how it is affecting you. You’ll be surprised at how many share your feelings but have been afraid to say anything. Hospital workers have talked about how a quick meeting at the beginning of their shift, during a break or at other times—to talk, pray, or have a moment of silence—has helped them tremendously.¹
• Many hospital systems have been deploying their psychiatric workforce as volunteers to help colleagues who need it.² Ask your employer if this is available.
• If you don’t want to talk about it at work, find a former co-worker or friend from school or training to talk to, or contact Magellan Healthcare at the phone number above.
• Finally, if you are at a point where your feelings impact your ability to perform or feel comfortable in your role, talk to your supervisor or your organization’s human resources group about your employee assistance programs. Monitor your physical and mental symptoms. You may reach a position that you need to be treated by a behavioral health professional. If that happens, contact one as soon as possible.

Make your voice heard

Some healthcare workers are feeling betrayed by their employers and others.² Whether it’s lack of PPE, feeling unappreciated or being expected to work excessive hours, these feelings can make an already untenable situation worse. While there is much you cannot control, don’t let that stop you from advocating for yourself and others.

• Ask for more PPE or the protocols for how it is allocated. Understanding why things are happening can help people accept them and enable you and your colleagues to offer suggestions from the front lines.
• If you are frustrated about things that you see, think about how you would make them better. Make a list and discuss them with coworkers to come up with solutions. Once things slow down, you’ll have strong suggestions for improving your work environment.

Maintain focus

• Remember why you became a healthcare worker. Maybe you watched a family member battle an illness, or you felt a calling to help people. Think about that during these times.
• Remind yourself that what you are doing is noble. The cognitive impact of recognizing the value you offer will help you serve your patients in a positive way.
• Consistent with your training and dedication, keep your focus on the patient in front of you, on protecting yourself to the best of your abilities and extending those protections to the home setting when you are off work.
• When you are off work, turn your focus to what is happening in the moment.

Take care of yourself

• We acknowledge that recommending meditation or focusing on breathing in the midst of chaos and fear may not seem helpful for some. Think about how you breathe when you are stressed. Some of us hold our breath without realizing it; others breathe very shallowly. We don’t realize it until we get around to taking a real breath.
• As you work around people with COVID-19, you might be afraid to breathe deeply. If you can, try to go to a place where you feel comfortable doing so, and take a few deep, slow breaths. Something as simple as this can release stress and clear your mind.
• Exercising may feel like a lofty goal as well. Try to find 10 minutes for a brisk walk, or a quick set of jumping jacks, sit-ups and push-ups.
• If you don’t have time or energy to cook, find easy-to-eat fresh foods like bananas, oranges and carrots.
• To help you relax and get to sleep, try apps like Headspace, Calm and Balance. AMA members can access these for free.
• Finally, if you are on medications for a pre-existing behavioral health condition, don’t stop taking them, and contact your provider if your symptoms are getting worse.

For more information and tips, visit www.MagellanHealthcare.com/COVID-19.

With stock market volatility and worrying headlines about how long the pandemic will last, it’s hard not to feel uneasy and question what the future holds. Consider these tips and resources to help you work through financial decisions and challenges that you may face in the weeks ahead.

Create a budget

Make a list of your regular monthly expenses, like rent, loan payments, utilities, food, etc. Compare that with your household’s take-home pay. If you are bringing home more money than your expenses, consider putting a bit of the extra to the side as a financial cushion. If your budget is more than you bring home each month, look for places you can cut to make ends meet. For help, visit www.consumer.gov.

Control your spending

Being isolated and bored at home can give you a lot of time to shop online. With so much uncertainty, it’s important to resist the urge to buy impulse items. Prioritize your most important financial obligations such as food, shelter and transportation first, and items like household décor and extra clothing last. If necessary, consider pausing automatic bill payments so you can control the payment timing until you are on better financial footing.

Contact your lenders (mortgage, car, rent, utilities, student loans, etc.)

If you are unable to work due to COVID-19 – you’ve fallen ill, your place of employment has temporarily closed, you have to stay home and take care of children or loved ones who are ill, etc. – you may not be able to pay your bills. Many lenders have set up exceptions, special accommodations and relief funds to support the public during this health crisis. Take advantage of them.

Reach out to your credit card company

Even if your credit card issuer has not formally released a statement of support, if you are at risk of missing a payment, it is worthwhile to contact the company to discuss your options. The Federal Deposit Insurance Corporation (FDIC) advises on its website that during a disaster, “Your creditors will likely work with you on a solution, but it’s important to contact them as soon as possible and explain your situation.” Late payments can hurt your credit score, and pile on extra charges and fees, so getting ahead of the issue will save you down the road.

Be aware of financial scams

If you receive a phone call, text message or email asking for your financial information in exchange for COVID-19 testing or medication, do not provide it. Unfortunately, fraudulent companies are taking advantage of people worried about COVID-19 and trying to steal their money and/or sensitive information by offering unproven cures. In particular, note that the World Health Organization is warning about people posing as their representatives to get sensitive information and solicit donations through emails, phone calls, text messages and even fax messages. You can find links to sources of fraud reports at MagellanHealthcare.com/COVID-19/fraud.

Discuss finances with your partner or someone you trust

Concerns over money is at or near the top of the list of things that stress most of us out. It’s important to communicate with your partner and family about finances on a regular basis to understand your situation and agree on financial priorities. If necessary, consult with a financial professional.

Access community resources

• State and local human service agencies can connect you with public assistance programs such as food stamps or emergency financial funds, Medicaid, housing and the like. Learn more at hhs.gov/programs/social-services/index.html.
• The United Way has information on food banks, clothing closets, shelters, rent and utility assistance, support for older Americans and persons with disabilities, etc. Visit www.unitedway.org.
• Aunt Bertha is a social care network where you can search for services like medical care, food, job training, transportation and more, right in your area. Visit www.auntbertha.com.
• The U.S. Government offers benefit information for individuals younger than age 55. Visit www.benefits.gov.

To learn more about what Magellan Healthcare is doing to support clients during the  COVID-19 pandemic, visit  MagellanHealthcare.com/COVID-19.

To learn more about Magellan Health’s corporate response to the COVID-19 pandemic and to view Magellan’s available resources click here: https://www.magellanhealth.com/news/covid-19/

While our everyday lives are becoming faster and more digital is your medical life doing the same? Do you miss filling your prescription because you forgot to call it in? Do you receive texts from pharmacists checking in on your current health conditions? Do you have a health coach a text away to help with your health goals?

Did you know that the average opt-in rate for receiving text messages is less than 2%? With MRx Connect we have seen more than 33% opt in. In addition, 98% of those who have opted in read the text message.

MRx Connect is an engaging digital communication service that helps prevent gaps in care and enhance awareness by sending proactive texts, emails, and chats. By receiving real-time information, people can make better healthcare decisions. MRx Connect messaging can be done in many ways and has shown many great results:

1. Refill Reminders: Receive a text when your prescription is getting low so that you know when to call in a new fill.
2. Flu Shot Reminder: Know when the best time is to receive your flu shot before it is too late in the season.
3. Re-enrollment Reminders: Be aware of when your enrollment is coming up, so you don’t have any gaps in care.
4. Health Coaching: Communicate with a professional health coach, pharmacist, or tech on your current health in real-time and on your own time.

Results:

• 35% engagement rate and improved refill rates for refill reminder for chronic conditions
• 23% of members received flu shots after receiving text message

Digital communication in healthcare allows you to be more aware and adherent to your care. You are never alone in your health journey and by being a click away from receiving answers or direction you are leading an even healthier, more vibrant life.

As more people are working from home to limit the spread of the novel coronavirus (COVID-19), what was once a perk may now seem like a punishment. It can be hard just to find and set up a workspace and connect with work, let alone deal with the isolation.

If you are used to going into work, you may miss opportunities for regular social interaction and connection with co-workers. Regardless of which life stage you’re in, working from home may cause feelings of isolation, frustration or stress that can impact your mental health.¹ Here are some tips to help you manage your new work-life balance:

Set yourself up for success

Find the most quiet place you can to set up your home work area. Make sure you have good lighting, a comfortable chair and plenty of outlets to plug in your computer, monitor, phone charger, etc. Put everything you need nearby so that you don’t need to constantly hop up to find a report, get supplies, etc. Maintain as much of an office-like demeanor as you can. If you are using video for meetings, remember, you’re on camera too.

Establish your routine

When you’re away from the workplace, it’s important to set specific hours—and stick to them. It’s easy to work more hours than normal, but that may cut into your family time and affect your sleep schedule. You may also feel pressure to prove that you are spending your time productively, and this can result in increased anxiety and stress. Set your boundaries and develop a routine: wake up at the same time every day, take a shower, get dressed, etc. Keep as much of your non-work life as it was before the pandemic: eat well, exercise and get fresh air—just remember to maintain a 6-foot distance from others.

Practice self-care

Self-care is any proactive activity that we do to take care of our mental, emotional and physical health. Good self-care is the key to improved mood, reduced anxiety and a good relationship with yourself and others. While so many normal activities are disrupted, take some time to practice gratitude, eat healthy, get enough sleep and maintain or start an exercise program. You will feel better for it.²

Increase communication

You might find it easier to be productive without your most chatty coworkers constantly buzzing in your ear. But social interactions—even with coworkers—can alleviate feelings of isolation and loneliness. Try to maintain normalcy by setting up regular check-ins with your team or manager that allow you to provide progress updates, sort through problems or brainstorm ideas.

Cherish children

If you have children at home due to school closings, helping them make sense of what is happening in the world will help you process the situation too. Kids of all ages are as vulnerable as adults to feelings of anxiety, stress and sadness. Do the best you can to manage childcare, plan for different age groups and ask for help from those near to you, while staying mindful about social distancing. Be flexible to accommodate your children’s needs and those of your employer. This is a unique moment in history. Move through it as gracefully as you can and create good memories for your family.

Take breaks

In the office, there’s usually time for coffee breaks, lunch walks and chats with colleagues that give some breathing room from work. Just because you are working from home doesn’t mean you aren’t entitled to the same breaks. Hitting the pause button throughout the workday can be good for productivity. Get up and stretch, take deep breaths and look up from the computer at regular intervals. Remember to eat, and check with your supervisor for permission to take a break for a quick walk.

For more information and tips, visit MagellanHealthcare.com/COVID-19.

To learn more about Magellan Health’s corporate response to the COVID-19 pandemic and to view Magellan’s available resources click here: https://www.magellanhealth.com/news/covid-19/

¹Smith, P. (2020, March 10). How To Deal If Working From Home Is Hurting Your Mental Health. Retrieved from https://www.huffpost.com/entry/working-from-home-mental-health_n_5afd88e2e4b0a59b4e014602?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAALPysx5taWAnltmdXV9uEcuIXzXyRxgs3xGUH0ztFrzmyZfyFKQUQo1BetFTXXoiY1lnEVcXeQbFXLffHW2baI7Yr9eG5nDkYyB5iecH6hx8iRFumbBwpzRVhn1H7uRr-3ZngjIoto2Ctd1o-7Sl4sEDdIr-GAyVlgsNUEul-5MM

²Michael, R. (2018, July 8). What Self-Care Is – and What It Isn’t. Retrieved from https://psychcentral.com/blog/what-self-care-is-and-what-it-isnt-2/

Making smoother transitions from work to home and vice versa can help you enjoy all aspects of your life more. While bringing work issues home seems to be the most common problem, some simple strategies can help ease the transition in either direction.

Use goodbye rituals
Whether it’s saying goodbye to your family members and pets, or playing a quick game with your kids, it helps to use a consistent pattern for your farewells. A dependable kiss and a phrase of affection can steer everyone toward having a good day.

Glance at your planner
To prepare for the day’s activities, take a quick look at whatever type of planner you use. This can trigger some creative ideas and strategies for the day. Each evening, check what is on the schedule or needed for the next day.

Try to cut down on the daily rush
When driving, ease up on the gas pedal. Try to leave a few minutes earlier so that you’re not weaving in traffic or tailgating slower drivers. If you are working from home, try preparing the night before your work day. If you’re going to be on your computer, tidy your home office, and pre-program your coffee maker or tea kettle.

From work to home
Leave work issues at work. If you’ve had a bad day, whether it be in your home office or at work itself, the last thing you want to do is bring those issues and feelings home with you. For everyone’s benefit, mentally remove yourself from work before coming home or logging off for the day.

Start fresh at home
Familiar end of work day rituals can help clear your head and refresh you. Do something simple like changing clothes or washing your face. Or, stand out on the back porch for a moment to breathe. Put on your favorite soothing music or do your favorite exercise. Sweep out the garage. Experiment and find out what works best for you.

Enjoy a little down time
Don’t rush right into preparing a meal if you can help it. Grab at least a few moments of relaxation with your partner, children and/ or pets first.

Make a clean break
At home for the evening, avoid work-related email and messaging if possible. If you can’t fully avoid it, limit it to just a set time, away from the family space.

For additional information, visit MagellanHealth/MYMH

This document is for your information only. It is not meant to give medical advice. It should not be used to replace a visit with a provider. Magellan Health does not endorse other resources that may be mentioned here.

Coronavirus (COVID-19) concerns are growing, and school closures are happening in most states. While grown-ups are anxiously figuring out how to handle the impacts of these decisions, kids are observing everything and may feel just as scared and confused as adults.

Talking with children about COVID-19

Children look to parents, guardians, caregivers and other trusted adults to help them make sense of what is happening in the world. COVID-19 is the topic of conversations everywhere on social media, web news outlets and TV. Everyone is being exposed to the fear and uncertainty of this global pandemic.

Children might find it difficult to understand what they are seeing or hearing about COVID-19, so they can be particularly vulnerable to feelings of anxiety, stress and sadness. As an adult, it’s important to make yourself available to listen to children’s thoughts and communicate in an age-appropriate way that addresses children’s questions without stoking anxiety. Children react, in part, on what they see from the adults around them. When parents and caregivers deal with a stressful situation calmly and confidently, they can provide the best support for their children.

The Substance Abuse and Mental Health Services Administration provides Tips for Caregivers, Parents and Teachers During Infectious Disease Outbreaks that includes information on possible reactions and tips for talking with children and youth of different age groups.

Tips for staying at home with children during the outbreak

• Focus on the uniqueness of the moment. This situation has never happened before. How can you make the best of it? Yes, it is stressful on many levels, but for your children, it is a time they will never forget and there is an opportunity in forced togetherness to reinforce your family bonds.
• Plan for different age groups. Younger children will love being home. Young teenagers may not be as thrilled by not being able to hang out with their friends on a daily basis. High schoolers can handle themselves and may be able to help with the younger kids if you have to work.
• Bend with the wind. Meaning: be flexible with the schedule. Let children play, do a fun project together (make cookies or do a craft), eat breakfast for lunch and make room for downtime to read and hang out. Your kids may have quite a bit of time at home, so try to maintain your patience and perspective.

To learn more about what Magellan Healthcare is doing to support clients during the  COVID-19 pandemic, visit  MagellanHealthcare.com/COVID-19.

To learn more about Magellan Health’s corporate response to the COVID-19 pandemic and to view Magellan’s available resources click here: https://www.magellanhealth.com/news/covid-19/

Adapted from: Stockwell, A. (2020, March 13). What to do with your kids when schools are canceled. Retrieved from https://www.vox.com/the-highlight/2020/3/13/21178234/coronavirus-covid-19-school-closures-kids-home

Humans are social beings, and the social distancing that is necessary to flatten the coronavirus curve is hard on everyone. The forced change in social behavior and the resulting isolation can affect people’s mental health in many ways. Whether you are home alone, with a sick family member or with kids out of school, isolation can increase stress and anxiety.

Depending on your situation, isolation can impact you in different ways. From loneliness to feeling cramped, dealing with these feelings on top of worrying about the COVID-19 outbreak can be overwhelming.

General tips
• Keep in touch with your social support groups virtually through social media, FaceTime, Skype, online games and other digital platforms.
• If the weather is nice, go outside and get some fresh air. Maintain a 6-foot distance from others.
• Stay busy. Read, play games or work on a project.
• Decrease the time you spend watching or listening to upsetting media coverage.
• Draw on skills that you have used during difficult times in the past to manage your emotions. That may include deep breathing, meditation, positive self-talk, etc.
• Maintain a healthy lifestyle. Stay hydrated, eat nutritious meals, exercise and get enough sleep.
• Avoid using tobacco, alcohol or other drugs to cope with your emotions.
• Access information that can help you cope with stress, worry and confusion during the pandemic. Visit Magellan Healthcare’s COVID-19 response website for information and links to self-assessments, videos and other resources.
• Get the facts about your risk and how to take precautions. Use trusted national and international resources including the World Health Organization, Centers for Disease Control & Prevention and State Departments of Health.

For people living with children
• Remember that during times of stress, it is common for children to seek more attachment and be more demanding on parents.
• Be honest when discussing COVID-19, but do so in an age-appropriate way. If your children have concerns, help them ease their anxiety.
• Make sure you model good behavior. Children will observe adults for cues on how to manage their own emotions during difficult times.
• Help children find positive ways to express their fears about the situation. Every child has their own way to express emotions. Sometimes engaging in a creative activity such as drawing can help this process.
• Maintain a safe and supportive environment and practice familiar routines in daily life as much as possible, especially if children are confined to home.
• Provide children with engaging activities

For caretakers of older adults
• Provide practical and emotional support by sharing simple facts about what is going on.
• Give clear information about how to reduce risk of infection in words older people with/without cognitive impairment can understand. Repeat the information whenever necessary.
• Engage their family and other support networks in providing information and helping them practice prevention measures (handwashing, proper sneezing and coughing techniques, etc.).
• Be aware that older adults in isolation and/or those with cognitive decline/dementia may become more anxious, angry, stressed, agitated or withdrawn during this time.
• Encourage older adults with experience and special skills to help others by providing virtual peer support, reading to children over the phone, and the like.

To learn more about what Magellan Healthcare is doing to support clients during the  COVID-19 pandemic, visit  MagellanHealthcare.com/COVID-19.

To learn more about Magellan Health’s corporate response to the COVID-19 pandemic and to view Magellan’s available resources click here: https://www.magellanhealth.com/news/covid-19/

Adapted from Miller, H. (2020, March 10). WHO gives advice on handling mental health toll from the coronavirus. Retrieved from https://www.cnbc.com/2020/03/10/who-gives-advice-on-handling-mental-health-toll-caused-by-coronavirus.html. March 13, 2020.

In January 2020, the United States (US) Food and Drug Administration’s (FDA) Center for Drug Evaluation and Research (CDER) published Advancing Health through Innovation: New Drug Therapy Approvals 2019. This report provides a summary of a number of approvals and highlights the “game-changers” approved in 2019, solidifying the upward trend in approval volume initially seen in 2017. Compared to 2017 and 2018, in which CDER approved 46 and 59 new drugs, respectively, 48 novel agents were approved in 2019. This number does not include new and expanded uses of already approved drugs, new formulations, new dosage forms, vaccines, blood products, cellular or gene therapy, or the 10 biosimilar approvals. This far exceeds the average of 38 novel approvals per year in the past 10 years. Figure 1 outlines approvals over the past 10 years.

In 2019, the FDA continued its strategic initiatives, with additional approvals of biosimilars and generics (both first-time agents and those off-patent with limited competition), as well as a focus on the expedited approval process, particularly for rare diseases and agents supported by positive patient-reported outcomes. Notably, the FDA hosted a public meeting in April 2019 to receive input on how to tackle barriers associated with the development of treatments for rare diseases, and held another meeting to celebrate “Rare Disease Day” in February 2020. Moreover, this trend is likely to continue, with the FDA releasing several guidances on gene therapy. The new pathway for insulin approval under biologic license applications planned for March 2020 and the launch of internet-based repositories or apps to improve access to information for both providers and patients (e.g., CURE ID in 2019, antiretrovirals in 2020) also highlight strategic initiatives of the FDA.

Last year, all 48 novel drug approvals met their Prescription Drug User Fee Act (PDUFA) goal dates, cementing this as a priority for the Agency. In 2019, 42% were considered first-in-class, and 44% were approved for rare diseases (Orphan Drugs). Priority Review was granted to 58% of novel drugs, 19% received Accelerated Approval (more than doubling the rate of 7% last year), 27% were designated as Breakthrough Therapy, and 35% garnered Fast Track designation. Overall, 60% of all drug approvals in 2019 used expedited development and review methods. In addition, 90% were approved in the first review cycle, and 69% were approved in the US prior to receiving approval in other countries. A breakdown of the types of drugs approved in 2019 is illustrated in Figure 2, with approvals once again dominated by drugs in the expansive oncology spectrum.

Some of the notable 2019 approvals included new advances for the treatment of cystic fibrosis (CF), with the first triple combination therapy and expanded indications of existing CF therapy available to younger patients, and the first new medications in several years for sickle cell disease. Additionally, several approvals targeted rare conditions, such as erythropoietic protoporphyria, neuromyelitis optica spectrum disorder, tenosynovial giant cell tumor, Duchenne muscular dystrophy, and systemic sclerosis-associated interstitial lung disease. Beyond treatments for rare disease and cancer, the FDA also approved agents for more common disorders, including multiple sclerosis, novel treatments for depression, migraine and cluster headaches, epilepsy, several autoimmune conditions, age expansions for diabetes therapy, and a drug-sparing regimen and new prophylaxis option for human immunodeficiency virus-1 (HIV-1). Although down slightly from 2018, the large number of approvals from 2019 represent a continued trend by the FDA to expedite and increase the quantity of annual approvals.