Electroconvulsive Therapy During COVID-19-Times: Our Patients Cannot Wait

The rapidly evolving COVID-19 pandemic is a major challenge for health services and drastic measures have been taken to contain this global crisis. Anticipating a shortage of health-care providers, in particular anesthesiologists, hospitals around the world did not hesitate to close down their electroconvulsive therapy (ECT)-units. In Flanders, a region in Belgium with 6,596,000 inhabitants, 70% of the ECT-units stopped treatments from the start of the pandemic. The remaining have put treatments for older patients residing in nursing homes on hold. Reasons cited are unavailability of anesthesiologists rescheduled to work in intensive care units, shortage of muscle relaxants needed for mechanical ventilation of COVID-patients, and fear of virus transmission through bag-mask-ventilation during the ECT-procedure. Another reason for closing down the ECT-service is that ECT is considered an elective intervention, and that, moreover, "psychiatry can wait." It is not unusual for patients with a psychiatric disorder to experience poor access to health care compared with people without a psychiatric disorder.