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HEALTH

WHO warns ‘high’ risk of monkeypox in Europe as it declares health emergency

The World Health Organisation on Saturday declared the monkeypox outbreak, which has affected nearly 16,000 people in 72 countries, to be a global health emergency -- the highest alarm it can sound.

Published: 23 July 2022 17:44 CEST
Director-General of the World Health Organisation (WHO) Tedros Adhanom Ghebreyesus
Director-General of the World Health Organisation (WHO) Tedros Adhanom Ghebreyesus said he assessed the risk of monkeypox in the European region as high. Ludovic MARIN / POOL / AFP

“I have decided that the global monkeypox outbreak represents a public health emergency of international concern,” WHO chief Tedros Adhanom Ghebreyesus said at a press conference.

He said a committee of experts who met on Thursday was unable to reach a consensus, so it fell on him to decide whether to trigger the highest alert possible.

“WHO’s assessment is that the risk of monkeypox is moderate globally and in all regions, except in the European region where we assess the risk as high,” he added.

Monkeypox has affected over 15,800 people in 72 countries, according to a tally by the US Centers for Disease Control and Prevention (CDC) published on
July 20.

A surge in monkeypox infections has been reported since early May outside the West and Central African countries where the disease has long been endemic.

On June 23, the WHO convened an emergency committee (EC) of experts to decide if monkeypox constitutes a so-called Public Health Emergency of International Concern (PHEIC) — the UN health agency’s highest alert level.

But a majority advised Tedros that the situation, at that point, had not met the threshold.

The second meeting was called on Thursday with case numbers rising further, where Tedros said he was worried.

“I need your advice in assessing the immediate and mid-term public health implications,” Tedros told the meeting, which lasted more than six hours.

A US health expert sounded a grim warning late on Friday.

“Since the last #monkeypox EC just weeks ago, we’ve seen an exponential rise in cases. It’s inevitable that cases will dramatically rise in the coming weeks & months. That’s why @DrTedros must sound the global alarm,” Lawrence Gostin, the director of the WHO Collaborating Center on National and Global Health Law, said on Twitter.

“A failure to act will have grave consequences for global health.”

And, on Saturday, he called for “a global action plan with ample funding”, saying there was “no time to lose”.

Warning against discrimination
A viral infection resembling smallpox and first detected in humans in 1970, monkeypox is less dangerous and contagious than smallpox, which was eradicated in 1980.

Ninety-five percent of cases have been transmitted through sexual activity, according to a study of 528 people in 16 countries published in the New England Journal of Medicine — the largest research to date.

Overall, 98 percent of infected people were gay or bisexual men, and around a third were known to have visited sex-on-site venues, such as sex parties or saunas within the previous month.

“This transmission pattern represents both an opportunity to implement targeted public health interventions, and a challenge because in some countries, the communities affected face life-threatening discrimination,”
Tedros said earlier, citing concern that stigma and scapegoating could make the outbreak harder to track.

The European Union’s drug watchdog on Friday recommended for approval the use of Imvanex, a smallpox vaccine, to treat monkeypox.

Imvanex, developed by Danish drugmaker Bavarian Nordic, has been approved in the EU since 2013 for the prevention of smallpox.

It was also considered a potential vaccine for monkeypox because of the similarity between the monkeypox virus and the smallpox virus. 

The first symptoms of monkeypox are fever, headaches, muscle pain and back pain during the course of five days.

Rashes subsequently appear on the face, the palms of hands and soles of feet, followed by lesions, spots and finally scabs.

READ ALSO: WHO says European festivals should go ahead despite monkeypox risk

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HEALTH

How to find available therapists in Germany

It’s no secret that mental health care can be particularly tricky to access in Germany. Here are some helpful tips for anyone who is struggling to book an appointment for therapy.

Published: 23 April 2024 12:55 CEST
How to find available therapists in Germany

The process to find psychotherapy in Germany’s urban centres is arduous – licensed therapists often have impossibly long wait times, and private practices don’t accept public health insurance.

A major reason that public insurance funded mental health care is hard to find in Germany comes down to regulations. Specifically the ‘coverage plan’ (Bedarfsplanung) that basically limits the number of licences available for publicly insured therapists in a region.

Germany’s maddening bureaucracy probably won’t be fixed any time soon. So residents in need of therapy will need to find a way through the system as it is.

So here are a few helpful tips for finding therapists, as well as how publicly insured patients can have private practice therapy costs reimbursed.

Look for therapists enrolled at academies

You’ll probably have a better chance getting an appointment with therapists who are currently in training, because not everyone knows that this option exists.

You can search for “Akademie für Psychotherapie”, to find one in your location. The Berliner Akademie für Psychotherapie, is one in the capital city, for example.

If you arrange an appointment this way, you can expect to be connected with a grad student therapist in training who needs to complete their supervised practice hours. In this case, you would see your therapist as usual, and they will be going through your session with an experienced therapist afterward.

The main advantages to seeking a therapist in training is that it may be cheaper and you can probably more readily find an appointment. A potential disadvantage is that the therapist you’ll be seeing is less experienced. 

But according to a Stockholm University study, student therapists who receive regular feedback from supervisors may be just as effective as licensed therapists at treating patients.

How to get reimbursed for going to a private practice

As mentioned above, therapists covered by public health insurance are few and far between, especially in many urban centres, and therefore regularly come with long wait times. But for those willing to do battle with the bureaucracy, there is an option to have your costs reimbursed for seeing a private practice therapist.

Specifically, public insurance providers are obligated to provide full reimbursement of costs in the event of a “supply emergency”. 

Waiting times of more than three months are considered unreasonable. So generally, patients can claim a supply emergency if they have contacted several therapists, and none of them offered available appointments within that time frame.

But you’ll want to make sure that your process is properly documented so that you won’t be stuck with the out-of-pocket costs.

First, you’ll need to document your need for psychotherapy. To get this, make an appointment for a psychotherapeutic consultation with a practice in your area, and be sure to collect a written recommendation for treatment (a PTV 11 form). 

If you don’t know where to start with this, look to the Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung) for a database of therapists. You can also call 116 117 or use the 116 117 App.

After you’ve got your PTV 11 certificate, you’ll need to document your futile search for a licensed therapist. To do this, contact at least three to five therapists that have public health insurance approval. Keep a list of the names of therapists you contacted, as well as dates and times of contact and how long the waiting list for treatment is. 

Additionally, you should try to arrange treatment through the aforementioned Association of Statutory Health Insurance Physicians, and receive confirmation if it’s not possible. So you’ll need to call 116 117, or use the 116 117 App again. But this time go through the process to have them try to find you placement with a therapist. This should take a maximum of four weeks, but rarely happens.

Finally, if you have documented all of the above and have still not found a readily available therapist, then you can seek out a private practice. You’ll need to enroll as a self-paying patient initially, but then you can submit an application for an outpatient reimbursement (Kostenerstattungsverfahren) along with the previously collected certificates and proof of your search. Private practice therapists are usually familiar with this process, and may be able to help you with the application as well.

READ ALSO: What are the main reasons internationals in Germany turn to therapy?

Free phone consultations for students

Students in Berlin can also take advantage of a free 50-minute conversation with a therapist through StudierendenWERK.

For students elsewhere, it’s worth checking what kind of mental health support services your school offers. Many German universities offer mental health support to some extent, and if school counsellors can’t provide the care that you need, they may be able to offer helpful information about where such services are available in your area.

READ ALSO: Here’s how you can get mental health help in English in Germany

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