British negotiators arrived in Brussels on Sunday for what is potentially the final attempt to strike a deal with the European Union over future trade ties, even though “significant differences remain” on three essential points.

With less than four weeks remaining before the Jan. 1 cutoff day, the negotiators might have less than 48 hours to clinch a breakthrough because European Commission President Ursula von der Leyen and British Prime Minister Boris Johnson will assess late Monday if there is any point in continuing, reports AP.

While the U.K. left the EU on Jan. 31, it remains within the bloc’s tariff-free single market and customs union through Dec. 31. Reaching a trade deal by then would ensure there are no tariffs and trade quotas on goods exported or imported by the two sides, although there would still be technical costs, partly associated with customs checks and non-tariff barriers on services.

Britain’s main negotiator, David Frost, arrived on a high-speed Eurostar train Sunday and said that “we are going to see what happens,” amid an ever gloomier outlook that a breakthrough could be achieved on all outstanding points.

The meeting was authorized after a phone call between von der Leyen and Johnson on Saturday, where the two leaders noted that fundamental differences between the two sides remain over a “level playing field” — the standards the U.K. must meet to export into the bloc — how future disputes are resolved and fishing rights for EU trawlers in U.K. waters.

Still, they said a “further effort should be undertaken by our negotiating teams to assess whether they can be resolved.” Johnson and von der Leyen said they would talk again and underlined that “no agreement is feasible if these issues are not resolved.”

Speed is now of the essence since EU member states have to unanimously support any deal. EU chief negotiator Barnier has been invited to a pre-dawn briefing of EU ambassadors on Monday, as the bloc’s 27 nations want to fully grasp what the chances are of getting a deal before EU leaders arrive in Brussels for a two-day summit starting Thursday.

British Environment Secretary George Eustice warned that the talks were in a “very difficult position” after what he described as a series of “setbacks,” notably over “ludicrous” conditions on future fishing rights.

Both sides would suffer economically from a failure to secure a trade deal, but most economists think the British economy would take a greater hit, at least in the short-term, as it is relatively more reliant on trade with the EU than vice versa.

The talks would surely have collapsed by now were the interests and economic costs at stake not so massive. But because the EU is an economic power of 450 million people and Britain has major diplomatic and security interests beyond its own commercial might, the two sides want to explore every last chance to get a deal before they become acrimonious rivals.

The main problem at the heart of the negotiations is how to reconcile how Britain wrests itself free of EU rules and the bloc’s insistence that no country, however important, should get easy access to its lucrative market by undercutting its high environmental and social standards.

The politically charged issue of fisheries also continues to play an outsized role. The EU has demanded widespread access to U.K. fishing grounds that historically have been open to foreign trawlers. But in Britain, gaining control of the fishing grounds was a main issue for the Brexiteers who pushed for the country to leave the EU.

Also read:UK says Brexit trade talks with EU are in their ‘last week’

A top medical adviser to President Donald Trump’s administration saId Sunday he’s confident that the Food and Drug Administration will approve the coronavirus vaccine from pharmaceutical company Pfizer this week.

FDA officials will meet to review the Pfizer vaccine Thursday and it could be authorized almost immediately, reports AP.

“Based on the data I know I expect the FDA to make a positive decision, but of course, it’s their decision,” said Moncef Slaoui, the chief adviser to Operation Warp Speed told CBS “Face the Nation.”

But White House coronavirus task force coordinator Deborah Birx warned Americans not to let their guard down even so.

Birx, speaking on NBC’s “Meet the Press,” noted that more than 100 million Americans suffered preexisting heath conditions that put them at high risk if they contract the virus. The vast majority of those won’t have access to the vaccine for months still.

“I want to be very frank with the American people,” Birx said. “The vaccine’s critical, but it’s not going to save us from this current surge. Only we can save us from this current surge, and we know precisely what to do.”

THE VIRUS OUTBREAK:

— Vaccines are being shipped around UK. in super-cold containers ahead of a mass vaccination program that kicks off Tuesday and will be watched around the world

— Europe battles a surge in coronavirus deaths in nursing homes even as it gears up for a massive vaccination program that gives priority to the elderly

— Most of California to enter sweeping new virus lockdown

— China prepares large-scale rollout of coronavirus vaccines

— Ethiopia’s conflict stokes humanitarian and virus crisis

— Towns in the Austrian Alps postpone mass coronavirus testing after being hit by huge snowfall.

Here’s what else is happening:

WASHINGTON — A top Trump administration official is calling President-elect Joe Biden’s criticism of distribution plans for the upcoming COVID-19 vaccines “nonsense.”

Biden said Friday that “there’s no detailed plan that we’ve seen” for how to get vaccines out of a container, into syringes and into people’s arms.

Speaking to “Fox News Sunday,” Health and Human Services Secretary Alex Azar said, “With all respect, that’s just nonsense.”

Azar said the process is “micromanaged and controlled by the United States military,” and leverages state and local governments, retail pharmacies and national shipping chains.

The first vaccine could be approved by the Food and Drug Administration in the next week, with the Trump administration saying the first immunizations should follow within 24-36 hours of approval.

BERLIN — Several communities in the Austrian Alps have put mass coronavirus testing on hold and others were urged to do the same after a storm dumped huge amounts of snow, sending some avalanche warnings to their highest level.

Some parts of the province of Tyrol saw 70 centimeters (27.5 inches) of snow fall overnight Friday into Saturday, and another 110 centimeters (43 inches) were expected on Sunday, Austria’s APA news agency reported.

In East Tyrol, 500 households were left without electricity after trees brought down power lines and the avalanche warning was at its highest level of 5. Several areas in East Tyrol postponed virus testing.

Austria on Friday started a voluntary mass testing program that officials hope will prevent long, hard lockdowns in the future. The fast antigen tests started in Vienna and in the westernmost Vorarlberg and Tyrol provinces.

Over the first two days, some 300,000 people were tested out of Austria’s nearly 9 million. The government is hoping that several million will have been tested by mid December.

LONDON — The coronavirus vaccine developed by American drugmaker Pfizer and Germany’s BioNTech was being sent to hospitals across the U.K. in super-cold containers on Sunday, two days ahead of the kickoff of Britain’s biggest-ever immunization program, one being closely watched around the world.

Around 800,000 doses of the vaccine are expected to be in place for the start of the rollout on Tuesday, a day that British Health Secretary Matt Hancock has reportedly dubbed as “V-Day,” a nod to triumphs in World War II.

“Despite the huge complexities, hospitals will kickstart the first phase of the largest scale vaccination campaign in our country’s history from Tuesday,” said Professor Stephen Powis, NHS England’s national medical director.

Last week the U.K. became the first country to authorize the Pfizer-BioNtech vaccine for emergency use. In trials, the vaccine was shown to have around 95% efficacy. Vaccinations will be administered starting Tuesday at around 50 hospital hubs in England. Scotland, Wales and Northern Ireland will also begin their vaccination rollouts that day.

Governments and health agencies around the world will be monitoring the British vaccination program to note its successes and failures and adjust their own plans accordingly.

MOSCOW -- Coronavirus infections in Russia hit a new record on Sunday, as the country’s authorities registered 29,039 new confirmed cases, the highest daily spike in the pandemic.

Russia’s total of over 2.4 million reported infections remains the fourth largest caseload in the world. Russia has also reported 43,141 virus-related deaths.

Russia has been swept by a resurgence of the virus this fall, with daily confirmed infections and deaths significantly exceeding those reported in the spring. Nevertheless, Russian authorities have rejected the idea of another nationwide lockdown or any widespread closures of businesses.

On Wednesday, President Vladimir Putin ordered a “large-scale” vaccination against COVID-19 to begin in Russia with the domestically developed Sputnik V vaccine that is still undergoing advanced studies needed to ensure its safety and effectiveness. Doctors and teachers will be first in line.

Sputnik V has been offered to medical workers for several months even though the vaccine was still in the middle of advanced trials. Several top Russian officials said they had already gotten the required two jabs. The Russian military this week began vaccinating the crews of navy ships scheduled to depart on a mission.

Health Minister Mikhail Murashko said Wednesday that more than 100,000 people in Russia have already received the shots.

CAIRO — Egypt’s Coptic Orthodox Church is suspending Sunday services for one month in the capital, Cairo and the Mediterranean province of Alexandria because of a surge in coronavirus cases among the faithful and monks.

The measure, which takes effect Monday, also includes all other activities in the Coptic Orthodox churches.

Christians constitute around 10% of Egypt’s predominantly Muslim nation of more than 100 million people.

Egypt, the Arab world’s most populous country, has faced an increase in coronavirus cases, with authorities warning that a new wave of the pandemic lies ahead. Egypt on Saturday reported 431 confirmed cases, the highest daily tally in months. It also reported 18 deaths.

Overall, Egypt has reported more than 118,000 confirmed cases including 6,750 deaths but actual cases are thought to be much higher.

BEIJING — Eight people in the northern Chinese city of Manzhouli have coronavirus after everyone in the city was tested following the discovery of two locally acquired infections, the official Xinhua News Agency reported Sunday.

Authorities conducted nucleic acid tests on 203,378 people in the city on the border with Mongolia in two rounds starting Nov. 22 and Nov. 27.

The city had 24 locally acquired cases as of Sunday, Xinhua said. It said 1,239 people who had close contact with them were under medical observation.

SEOUL, South Korea __ South Korea says it’ll further toughen physical distancing rules as recent restrictions has failed to curb a viral resurgence that threatens the country’s health care system.

Health Minister Park Neung-hoo said Sunday recently elevated distancing rules haven’t showed much effect. Park says South Korea could face a shortage of intensive care unit beds if the current level continues for one to two weeks.

Under new restrictions effective Tuesday for three weeks, authorities will shut down karaoke rooms, fitness centers, indoor gyms and most of cram schools in the Seoul metropolitan area. Some high-risk facilities like nightclubs in the Seoul area have already been shut down.

Events must be under 50 people in the Seoul area and sports matches will be held without fans.

Park says South Korea has reported an average of 514 new virus cases each day in the past week, 375 of them in the Seoul area. South Korea reported 631 new cases Sunday, taking its total to 37,546 with 545 deaths.

SALEM, Ore. — The Oregon Medical Board has suspended the medical license of a doctor who said at a pro-Trump rally that he doesn’t wear a mask at his Dallas, Oregon, clinic.

KGW-TV reported Friday that Dr. Steven LaTulippe also said at the November rally that he also encourages others not to wear masks.

A state order requires health care workers to wear a mask in health care settings. The medical board voted this week to suspend LaTulippe’s license immediately due to concerns about patient safety.

ST. LOUIS — St. Louis children’s hospitals have started treating adult patients as area hospitals struggle to keep up with rising coronavirus cases.

Dr. Marya Strand, chief medical officer for SSM Health Cardinal Glennon Children’s Hospital, told the St. Louis Post-Dispatch that is treating adults who don’t have COVID-19 to take some of the pressure off other hospitals. St. Louis Children’s Hospital also has opened its doors to adults.

About 1,054 people were hospitalized in the St. Louis area Wednesday for COVID-19, including 221 patients in intensive care units. St. Louis-area hospitals are at about 82% capacity for in-patient beds and 81% capacity for ICU beds.

Staff at SSM Health and BJC Healthcare children’s hospitals have also started volunteering to work at other overwhelmed hospitals.

PHOENIX — Arizona health officials used a blunt tone Saturday as the state reported 6,799 coronavirus cases, the second-highest daily increase.

The Department of Health Services says on Twitter that people should wear masks “around anyone who isn’t a member of your household, even those you know and trust.”

Similarly, the department’s director, Dr. Cara Christ, says “we must act as though anyone we are around may be infected.”

The cases reported Saturday trailed only the record 10,322 cases reported Tuesday. Officials have said record high included data delayed by the Thanksgiving holiday weekend. There were four daily reports of more than 5,000 cases this week.

The hospitalizations for coronavirus rose to 2,931 on Friday, five times as many since early October. Republican Gov. Doug Ducey has not ordered a statewide mask mandate or curfews.

The state reported 40 deaths on Saturday. Arizona has 358,900 total cases and 6,935 confirmed deaths.

ROME — Italy had more than 21,000 daily coronavirus cases and added 662 deaths in the last 24 hours.

The 21,052 new cases raised Italy’s total to nearly 1.6 million. There’s been 59,514 confirmed deaths, the second-highest toll in Europe behind Britain’s toll.

This week, Italy’s Premier Giuseppe Conte signed a decree limiting travel between regions Dec. 21 to Jan. 6, national Epiphany Day holiday. Conte hopes that will prevent holiday vacations that could fuel contagion.

RALEIGH, N.C. — North Carolina reported a record increase in cases of the coronavirus and hospitalizations on Saturday.

The state reported 6,018 cases since Friday and 2,171 people with coronavirus in the hospitals. That’s up 14 from a day earlier.

“In less than a week, we went from exceeding 5,000 new cases reported in one day to exceeding 6,000,” said Dr. Mandy Cohen, the state’s health secretary. “This is very worrisome. This indicates we have even more viral spread across our state right now.”

North Carolina has a record number of people in intensive care, Cohen says. Another 49 people have died, bringing the confirmed total to 5,516, the health department says.

 

OKLAHOMA CITY — There were 4,370 newly reported coronavirus cases Saturday in Oklahoma.

The rolling averages of cases rose from 2,843 per day on Nov. 20 to 3,044 on Friday. The daily average of deaths increased from 15 daily to 22 during the same period, according to data by Johns Hopkins University.

The increase is due largely to community spread, according Dr. Dale Bratzler of the University Oklahoma medical center. He says, “it’s typically places like restaurants, bars, gyms, places of worship.”

Oklahoma has 213,245 total confirmed cases. There were 14 more deaths reported Saturday, bringing the total to 1,874 confirmed deaths.

Also read: US COVID-19 cases hit over 14.5 mln

Thousands of doctors, teachers and others in high-risk groups have signed up for COVID-19 vaccinations in Moscow starting Saturday, a precursor to a sweeping Russia-wide immunization effort.

The vaccinations come three days after President Vladimir Putin ordered the launch of a “large-scale” COVID-19 immunization campaign even though a Russian-designed vaccine has yet to complete the advanced studies needed to ensure its effectiveness and safety in line with established scientific protocols.

The Russian leader said Wednesday that more than 2 million doses of the Sputnik V jab will be available in the next few days, allowing authorities to offer jabs to medical workers and teachers across the country starting late next week.

Moscow, which currently accounts for about a quarter of the country's new daily infections, moved ahead of the curve, opening 70 vaccination facilities on Saturday. Doctors, teachers and municipal workers were invited to book a time to receive a jab, and Moscow Mayor Sergei Sobyanin said that about 5,000 signed up in a few hours after the system began operating on Friday.

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Russia boasted that Sputnik V was the world’s “first registered COVID-19 vaccine” after the government gave it regulatory approval in early August. The move drew criticism from international experts, who pointed out that the vaccine had only been tested on several dozen people at the time.

Putin has shrugged off doubts about it, saying in August that one of his daughters was among the early vaccine recipients.

Over the past months, Sputnik V has been offered to medical workers and teachers even as it was still in the middle of advanced trials. Several top officials said they also have received the jabs, and earlier this week the Russian military began vaccinating crews of navy ships scheduled to depart on a mission.

Health Minister Mikhail Murashko said Wednesday that more than 100,000 people in Russia already have received the shots.

The free vaccine is offered to people aged 18 to 60 who don’t suffer from chronic illnesses and aren’t pregnant or breastfeeding.

The two-shot Sputnik V was developed by the Moscow-based Gamaleya Institute. An advanced study among 40,000 volunteers was announced two weeks after the vaccine received government approval and that is still ongoing.

Last month, developers of the vaccine said interim analysis of trial data showed it was 91.4% effective. The conclusion was based on 39 infections among 18,794 study participants that received both doses of either the vaccine or a placebo, which is a much lower number of infections than Western drugmakers have looked at when assessing the effectiveness of their vaccines. Two other Russia-designed vaccines are also undergoing tests.

On Wednesday, Britain became the first country in the West to authorize the use of a vaccine against the coronavirus developed by U.S. drugmaker Pfizer and Germany’s BioNTech.

Russia has been swept with a resurgence of the outbreak this fall, with numbers of new infections exceeding the levels recorded early in the pandemic, but the authorities so far have refrained from a tight lockdown imposed in the spring.

On Saturday, Russia reported a new record high of daily infections at 28,782, including 7,993 in Moscow. The government task force has recorded a total of 42,684 virus-related deaths since the start of the outbreak.

Russia’s total of over 2.4 million confirmed cases is currently the fourth-largest caseload in the world behind the United States, India and Brazil.

Also read: Covid-19 vaccine raises hopes among scientists

The European Medicines Agency will convene a meeting on Dec. 29 to decide if there is enough data about the safety and efficacy of the COVID-19 vaccine developed by Pfizer and BioNTech for it to be approved, the regulator said Tuesday.

The agency also said Tuesday it could decide as early as Jan. 12 whether to approve a rival COVID-19 vaccine developed by Moderna Inc.

The German pharmaceutical company BioNTech and its U.S. partner Pfizer said earlier Tuesday that they had asked the regulator for speeded-up, conditional approval of their coronavirus vaccine, concluding the rolling review process they initiated with the agency on Oct. 6.

The move comes a day after rival Moderna said it was asking U.S. and European regulators to allow the use of its COVID-19 vaccine.

BioNTech said if the vaccine, currently named BNT162b2, is approved, its use in Europe could begin before the end of 2020.T he companies said last month that clinical trials with 44,000 participants showed the vaccine is 95% effective. The efficacy rate in particularly vulnerable older age groups was more than 94%, they said.

In a statement, the EU medicines regulator said it had already begun a “rolling review” of the Moderna vaccine based on laboratory data previously submitted by the company and would now assess data on how well that vaccine triggers an immune response and whether it is safe enough for broad use across Europe.

The agency said that “if the data are robust enough to conclude on quality, safety and effectiveness,” then it could approve the Moderna vaccine at a meeting scheduled for Jan. 12.

BioNTech and Pfizer have already submitted a request for emergency approval with the U.S. Food and Drug Administration and the U.K. regulator MHRA, as well as rolling submissions in other countries including in Australia, Canada and Japan.

“We have known since the beginning of this journey that patients are waiting, and we stand ready to ship COVID-19 vaccine doses as soon as potential authorizations will allow us,” Pfizer’s chief executive Albert Bourla said in a statement.

BioNTech said it stands ready to ship stockpiles of vaccines where they are needed when the Amsterdam-based agency or the FDA approve the vaccine.

“Depending on how the authorities decide we can start delivering within a few hours,” said BioNTech's chief operating officer, Sierk Poetting.

The European Union's top official said around 2 billion doses of potential COVID-19 vaccines have been secured for the bloc's 27 nations, with the first deliveries likely to start before the end of the year.

EU Commission President Ursula von der Leyen said EU nations have started working on their vaccination plans and on the logistics for delivering tens of millions of doses across the bloc, a major challenge for the EU.

“If everything goes well, the first European citizens might already be vaccinated before the end of December,” Von der Leyen said. “And it will be a huge step forward toward our normal life. In other words, I just wanted to say there is a light at the end of the tunnel.”

The Commission, the EU’s executive arm, has secured deals allowing to purchase doses with Moderna, AstraZeneca, Sanofi-GSK, Janssen Pharmaceutica NV, BioNTech-Pfizer and CureVac.

Von der Leyen however urged EU citizens to remain “disciplined till we have reached finally a vaccination that is appropriate to eradicate this virus.”

Germany’s science minister said Tuesday that the same safety standards are being applied in the approval process for coronavirus vaccines as for other drugs and that this would be key to gaining the widest possible public acceptance for COVID immunization.

Anja Karliczek cited the fact that Europan regulators plan to hold a public hearing on Dec. 11 about the approval request by BioNTech and Pfizer.

Speaking to reporters in Berlin, Karliczek stressed that the vaccine will be voluntary and that authorities will work hard to inform the public about possible side effects that a small percentage of recipients might experience after immunization, such as headaches, exhaustion and fever.

Marylyn Addo, a doctor at Hamburg’s UKE hospital who is involved in the trials for a rival vaccine, said the rapid development of a vaccine was the result of enormous efforts by scientists, early funding and experience from previous vaccines.

Also read: Covid-19 testing still vital even as vaccines roll out: WHO Chief

The panicked 22-year-old is led to Consultation Room No. 2, with its easy-mop floor and honeycombed meshing over the window. Behind her, the psychiatric emergency ward’s heavy double doors — openable only with a staff member’s key — thud shut.

With anxious taps of her white sneakers, she confides to an on-duty psychiatrist how the solitude of the coronavirus lockdown and the angst of not finding work in the pandemic-battered job market are contributing to her maelstrom of anxieties. She is unnerved that she is starting to obsess about knives, fearful that her mental health might be collapsing.

“The lockdown — let’s not pretend otherwise — worries me,” the young woman explains through her surgical mask, as the psychiatrist, Irene Facello, listens intently.

“I want to be reassured,” the woman says, “that I’m not going mad.”

Forcing millions of people to once again stay home — cutting them off from families and friends, shuttering businesses they invested in, university classes that fed their minds and nightspots where they socialized — has, for now, begun to turn back the renewed coronavirus surge in France that pushed it in November past the bleak milestone of 52,000 dead.

But the costs to mental health have been considerable. With numbers now falling for French COVID-19 patients in intensive care, psychiatrists are facing a follow-up wave of psychological distress. Health authorities’ surveying points to a surge of depression most acute among people without work, those in financial hardship and young adults.

The Rouvray Hospital Center in the Normandy town of Rouen is among places where psychiatrists are finding themselves on the front line of the pandemic’s mental-health fallout. They are fearful that a growing crisis of depression, anxiety and worse may be on the horizon as more livelihoods, futures and hopes are lost to the pandemic. Associated Press journalists spent 10 hours in the sprawling 535-bed facility, the day after French President Emmanuel Macron laid out a blueprint stretching into mid-January for the gradual lifting of lockdown restrictions.

At the psychiatric emergency unit, as Facello sends the 22-year-old home with a prescription for anti-anxiety drugs and an appointment to see her again in two weeks, the double doors swing open once more.

It is another young woman, aged 25, a linguistics student. She is steered to Consultation Room No. 1, where she sits silently in the gloom as night falls.

On the ward’s whiteboard, which lists patients’ names and details, an abbreviated initial diagnosis handwritten on a slip of paper uses acronyms to spell out how closely she may have brushed with the irreparable. For the past week, it says, she’d suffered “IDS” — suicidal ideas — and imagined “IMV,” or voluntarily ingesting medicines.

The ward’s chief psychiatrist, Sandrine Elias, gently teases out of the student how the lockdown has left her completely alone, with classes suspended.

It isn’t the sole cause of her malaise. Elias learns that the young woman had a difficult adolescence, with suicide attempts. Isolation during the epidemic has only amplified the student’s distress. In a quiet voice, she tells Elias that it “confronts us with ourselves.”

“I’m a stay-at-home type of person, but this absolute constraint is a real weight,” she says.

Elias promptly decides to hospitalize her. Supervised rest and medication, Elias determines, can help her through.

“You need a framework, to be taken into care. All alone, in your studio apartment, it’s not possible,” the psychiatrist says. “It’s very good that you came here.”

Not all of those seeking help have previous psychiatric histories. Mental health professionals say lockdowns and curfews have also destabilized people who, in less challenging times, might have surmounted difficulties by talking them through with family and friends rather than ending up in psychiatric treatment wards.

“Being alone between four walls is terrible,” Elias says. “The halting of life like this, it reverberates on people. It is not good.”

Nathan, a 22-year-old student, came through the emergency ward two days earlier. The log book shows he was admitted at 5:20 p.m. and was moved that evening to a longer-stay unit.

There, in Room 14, he told psychiatrist Olivier Guillin that he’d sought emergency help “because I felt that my morale was declining very rapidly, that I was at the point of tipping over, with suicidal thoughts.”

Similar thoughts had first laid him low in the summer, after France’s initial lockdown from March to May. They struck again when the country was confined for a second time from Oct. 30. His university shuttered. His political science classes went virtual. Rather than be alone in his student flat, he moved back with his parents in Rouen, severed from his support network and ruminating on his uncertain future.

“The first lockdown didn’t really have much of an effect on me,” he tells Guillin, but the second one “really sank me.”

“Being confined again, having to always stay in a limited perimeter, not being able to see my friends as often as usual, it disordered me,” he says.

The security of hospitalization and medication have quickly started to stabilize him. Resting on his bedside table was a Rubik’s Cube that he’d solved.

Guillin, who heads several units at the hospital and has 200 medical staff working under him, says they are seeing a sharp increase in young adults seeking help with anxieties, depression, addictions and other difficulties. He’s bracing for more.

“We’ll very likely see the crest of the wave in the months to come,” he says.

The pandemic has also had other mental health repercussions that are less evident but no less devastating.

Guillin still rues the death of a patient who killed herself during the first lockdown, 48 hours after what turned out to be their final appointment. She wore a mask to that meeting, to protect against the virus. It interfered with his reading of the depth of her distress, he says.

“She was a very expressive lady and there, with the mask, I incorrectly evaluated things,” he says. “Retrospectively, I tell myself that perhaps, without the mask, I would have been more alert and done more.”

Patients have also been hurt by the diversion of resources from mental health to battling COVID-19.

The electroconvulsive therapy that had been helping Laura, a student, emerge from her severe depression was thrown into disarray when anesthesiologists — who are needed to put her to sleep while electrical currents passed through her brain — were requisitioned to care for virus patients.

“My morale went downhill shortly after that, and the suicidal ideas came back,” she tells Guillin.

Laura says for her, the therapy is “as urgent as COVID-19.” She says prioritizing virus patients “is a bit stupid and mean.” Now, instead of being released from the hospital by mid-November as she’d hoped, Laura has had to stay.

In the emergency ward, for the third time in two hours, another young woman comes in through the double doors, dressed in black, looking hollow. With Room 1 already occupied by the 25-year-old, the 18-year-old high school student is shown into Room 2. After her initial interview by a nurse and a caregiver, she curls up on her chair.

The nurse, Sebastien Lormelet, and the caregiver, Anita Delarue, exchange notes in the staff room where the teenager’s name and admission time, 5:02 p.m., are written in black marker on the whiteboard.

“The lockdown has a lot to do with it, because she says that the first one was hard. With the second one, now, if she could slip away, she would,” Delarue says.

“She wouldn’t withstand a third one.”

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