Knipe D, Evans H, Marchant A et al. Mapping population mental health concerns related to COVID-19 and the consequences of physical distancing: a Google trends analysis [version 1; peer review: 2 approved with reservations]. Wellcome Open Res 2020, 5:82 (https://doi.org/10.12688/wellcomeopenres.15870.1)
Background: The 2020 Coronavirus pandemic is a major international public health challenge. Governments have taken public health protection measures to reduce the spread of the virus through non-pharmalogical measures. The impact of the pandemic and the public health response on individual and population mental health is unknown. Methods: We used Google Trends data (1 Jan 2020 – 1 Apr 2020) to investigate the impact of the pandemic and government measures to curb it on people’s concerns, as indexed by changes in search frequency for topics indicating mental distress, social and economic stressors and mental health treatment-seeking. We explored the changes of key topics in Google trends in Italy, Spain, USA, UK, and Worldwide in relation to sentinel events during the pandemic. Results: Globally there appears to be significant concerns over the financial and work-related consequences of the pandemic, with some evidence that levels of fear are rising. Conversely searching for topics related to depression and suicide fell after the pandemic was announced, with some evidence that searches for the latter have risen recently. Concerns over education and access to medication appear to be particular social stressors. Whilst searches for face-to-face treatments have declined, those for self-care have risen. Conclusions: Monitoring Google trends shows promise as a means of tracking changing public concerns. In weeks to come it may enable policy makers to assess the impact of their interventions including those aiming to limit negative consequences, such as government funded financial safety nets.
“Covid-19 has taught us that health is the basis of wealth, that global health is no longer defined by Western nations and must also be guided by Africa and Asia, and that international solidarity is an essential response and a superior approach to isolationism. We may emerge from this with a healthier respect for the environment and our common humanity. All citizens, governments, businesses, and organisations must heed these lessons. Covid-19 is the virus that is turning the world upside down. It will destroy the world as we know it; in the process we may learn to hold it together.”
“While modelling predictions1 suggest that uncontrolled or even partially mitigated COVID-19 epidemics in high-income countries could lead to substantial excess mortality, the virus’ impact on people living in low-income settings or affected by humanitarian crises could potentially be even more severe. Three mechanisms could determine this: (i) higher transmissibility due to larger household sizes2, intense social mixing3 between the young and elderly4, overcrowding in urban slums and displaced people’s camps, inadequate water and sanitation, and specific cultural and faith practices such as mass prayer gatherings, large weddings and funerals during which super-spreading events might propagate transmission disproportionately5; (ii) higher infection-to-case ratios and progression to severe disease due to the virus’ interaction with highly prevalent co-morbidities, including non-communicable diseases (NCDs; prevalence of hypertension and diabetes is often higher in low- than high-income settings, with a far lower treatment coverage6), undernutrition, tuberculosis7 and HIV; and (iii) higher case-fatality due to a dire lack of intensive care capacity, especially outside large cities. Moreover, extreme pressure on curative health services could result in indirect impacts resulting from disrupted care for health problems other than COVID-19.8 While these risk factors could be counterbalanced by younger age distributions and hot temperatures, on balance we believe that, given current evidence and plausible reasoning, drastic action is required immediately to protect the world’s most fragile populations from this unfolding threat.”
“Millions of refugees and migrants reside in countries devastated by protracted conflicts with weakened health systems, and in countries where they are forced to live in substandard conditions in camps and compounds, and high-density slum settings.1 Although many such settings have yet to feel the full impact of coronavirus disease 2019 (COVID-19), the pandemic is now having an unprecedented impact on mobility, in terms of border and migration management, as well as on the health, social, and economic situation of migrant populations globally. An urgent coordinated effort is now needed to align these populations with national and global COVID-19 responses.”
“….an outbreak in a facility threatens the outside community as well. An outbreak in a detention facility endangers all who come in contact with migrants, from immigration enforcement staff to workers at detention facilities, asylum officers, lawyers, and judges. All those people come in contact with the detainees and go home to their families at night.”
Over 168 million people across 50 countries are estimated to need humanitarian assistance in 2020 . Response to epidemics in complex humanitarian crises—such as the recent cholera epidemic in Yemen and the Ebola epidemic in the Democratic Republic of Congo—is a global health challenge of increasing scale . The thousands of Yemeni and Congolese who have died in these years-long epidemics demonstrate the difficulty of combatting even well-known pathogens in humanitarian settings. The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may represent a still greater threat to those in complex humanitarian crises, which lack the infrastructure, support, and health systems to mount a comprehensive response. Poor governance, public distrust, and political violence may further undermine interventions in these settings.
What do we know about the landscape of migration health research? Who is doing the research? What are they researching on? Which migrant categories are included? What are the health related themes? How can we better understand the research and evidence gap in migration and health? What collaborations are taking place, and can we map who funds this research?
These are some of the questions that a group of scholars, policy makers and International Organization for Migration (IOM) staff investigated at a workshop on bibliometrics analysis of migration health research held in November 2019 at IOM’s Global Administrative Centre in Manila, Philippines.
The workshop was the first of this kind, harnessing research collaboration not only within IOM but also with the government agencies, clinicians and research institutions, mainly from South and Southeast Asia.
“Bibliometric analysis is a useful research method as it lets you look at the patterns of research activities such as publications. In any global health field, it is extremely helpful to know where the work is being done, who is doing it, where the collaborations are happening, and what topics are being explored,” said Dr. Margaret Sampson, an international expert on bibliometric analysis who facilitated the workshop.
Jointly organized by IOM, together with the Migration Health and Development Research Initiative (MHADRI) and the Migration & Health South Asia Network, the workshop served as a platform to develop research capacity, with particular focus on researchers in the Global South, in undertaking bibliometric analysis to identify the gaps in research output on migration health.
BackgroundIn 2018, IOM and MHADRI undertook the first-ever bibliometric analysis of global migration health research in peer-reviewed literature focusing on international migrants. The study revealed major gaps in research productivity especially in the Global South as most literature is from high-income migrant destination countries, despite the significant migration flows within the countries in Asia, Latin America, Africa, Middle East, and Eastern Europe. For example, according to the study, only 6.2 per cent of the total published research output on the health of migrants focused on migrant workers, despite 60 per cent of international migrants represented within this category. Supporting the networking, capacity development of researchers, especially those from developing nations, to undertake migration health-related research was highlighted. The importance of undertaking more in-depth mapping of migration health research output for both international and internal migrants in low to middle income countries were also highlighted in the research by IOM and MHADRI.
The Manila Consensus Group forged at the workshop aimed at further refining and testing the search strategies for bibliometrics research and provide analytical rigour to apply these methods for migration health research.
The group committed to developing methodological guidelines in undertaking bibliometric analysis as well as to work on providing a standardized approach to undertaking bibliometric analysis relevant to research on international and internal migration dynamics.
The group committed to publishing these outputs in open source platforms supported by IOM so as to make this publicly available so that researchers, policy makers and UN agencies can utilize to undertake tailored analytics.
“It boils down to how you frame your question, the right key words, and the right way to search – maybe we are making it too wide or too tight – maybe we are not getting the right information. So, the tools and strategies presented were really helpful,” said one of the workshop participants, Dr. Roomi Aziz, Technical Lead Health Data and Communication, Pathways to Impact in Pakistan
The Manila Consensus group will delve into questions focusing on the research productivity relating to migration and health in Philippines, internal migration and health related research in South Asia as well as the research productivity relating to health assessments of migrants and refugees at pre- and post-migration phases and health outcomes in areas ranging from Infectious disease, communicable disease and occupational health.
“The workshop provided an excellent opportunity to build research capacity among Global South scholars, to enable them to go back and take deep dives to understand the research productivity in the field of migration health in their local areas and use that as evidence to move the field forward,” said Associate Professor Charles Hui, Chairperson of MHADRI network and Chief of Infectious Diseases at Children’s Hospital Eastern Ontario, Ottawa.
In addition to harnessing the synergies created through this initiative, IOM seeks to work with member states, partner organizations and research networks to replicate such mapping and collaboration in other regions.
Manila – IOM, the Migration & Health South Asia network and the Migration Health and Development Research Initiative (MHADRI) – a global network of researchers aimed to advance evidence-informed global migration health policies and practices, jointly organized a workshop on undertaking bibliometric analysis of migration health research. Participants ranged from government, academia, clinical practice and research institutions, mainly from South and Southeast Asia.
“Bibliometric analysis is a useful research method as it lets you look at the patterns of research activities such a publication. In any global health field, it is extremely helpful to know where the work is being done, who is doing it, where the collaborations are happening, and what topics are being explored,” said Dr. Margaret Sampson, an international expert on bibliometric analysis who facilitated the workshop. Bibliometrics is an important first step in undertaking systematic review as it reveals patterns in publications in terms of authorship, geographical distribution, international research collaboration, and important themes discussed in the realm of migration and health.
The workshop also served as a venue among migration health actors and scholars to explore research questions on the research productivity relating to migration and health at the global, regional, sub-regional, and national levels as well as the research productivity relating to migration and health, focusing on specific themes such as migrant type, health outcomes (e.g., infectious diseases, non-communicable diseases, nutrition, mental health), among others.
Queen Mary University and the British Council, UK provided funding support to leading migration health scholars from Pakistan, India and Bangladesh as part of the Migration & Health South Asia network.
Expounding on the value of bibliometric research methods to map landscape of migration health research productivity, Associate Professor Charles Hui, Chairperson of MHADRI network and Chief of Infectious Diseases at Children’s Hospital Eastern Ontario, Ottawa, said that, “the workshop provided an excellent opportunity to build research capacity among Global South scholars, to enable them to go back and take deep dives to understand the research productivity in the field of migration health in their local areas and use that as evidence to move the field forward.”
The workshop was the first ever of this kind and IOM working with partner organizations and research networks seeks to facilitate these in other regions. In 2018, IOM and MHADRI network undertook a bibliometric analysis of global migration health research in peer-reviewed literature. The data showed major gaps in the research productivity especially in the ‘global south’. To read the full paper: Bibliometric analysis of global migration health research in peer-reviewed literature (2000–2016)
“The World Migration Report 2020 presents key data and information on migration as well as analysis of complex and emerging migration issues. Some of the topics covered in the report include human mobility and environmental change, migrants’ contributions in an era of disinformation, children and unsafe migration, migration and health, among others.”
The Director General of the IOM addresses the goals of the report (and indeed of the IOM as an agency) in his foreword:
“As the United Nations’ migration agency, IOM has an obligation to demystify the complexity and diversity of human mobility. The report also acknowledges IOM’s continuing emphasis on fundamental rights and its mission to support those migrants who are most in need. This is particularly relevant in the areas in which IOM works to provide humanitarian assistance to people who have been displaced, including by weather events, conflict and persecution, or to those who have become stranded during crises.”
“Likewise, IOM remains committed to supporting Member States as they draw upon various forms of data, research and analysis during policy formulation and review processes. Indeed, this is reflected in IOM’s Constitution where the need for migration research is highlighted as an integral part of the Organization’s functions. The World Migration Report is a central component of this important function.
In this era of heightened interest and activity towards migration and migrants, we hope this 2020 edition of the World Migration Report becomes a key reference point for you. We hope it helps you to navigate this high-profile and dynamic topic during periods of uncertainty, and that it prompts reflection during quieter moments. But most importantly, we hope that you learn something new from the report that can inform your own work, be it in studies, research and analysis, policymaking, communication, or migration practice.”
Ideas for India for more evidence-based policy (Published March 2019)
“Seasonal migrants in India engage in temporary informal work in work environments that actively flout labour laws on wages, work hours, and living conditions. The most significant impact of this is on the health outcomes of workers and their children. In this note, Varma and Ravindranath describe the roadblocks in conducting in-depth enquiries into migrants’ health status and healthcare-seeking behaviour, and designing and implementing health programmes conducive to their needs.“