Impact of the COVID-19 pandemic on healthcare workers

The COVID-19 pandemic has impacted healthcare workers physically and psychologically.[1] Healthcare workers are more vulnerable to COVID-19 infection than the general population due to frequent contact with infected individuals. Healthcare workers have been required to work under stressful conditions without proper protective equipment, and make difficult decisions involving ethical implications. Health and social systems across the globe are struggling to cope. The situation is especially challenging in humanitarian, fragile and low-income country contexts, where health and social systems are already weak. Services to provide sexual and reproductive health care risk being sidelined, which will lead to higher maternal mortality and morbidity.[2][3]

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Risk of infection

The World Health Organization reported that one in ten health workers is infected with coronavirus in some countries.[1] In March 2020, 9% of those affected with COVID-19 in Italy were health workers.[4] In May 2020, the International Council of Nurses reported that at least 90,000 healthcare workers have been infected and more than 260 nurses had died in the COVID-19 pandemic.[5] In March 2020, one in four doctors in the UK were off sick, in isolation or caring for a family member with COVID-19.[6]

The UK government announced that retired healthcare professionals would be brought out of retirement to help during the COVID-19 crisis. This led to concerns that they could be at a higher risk for severe COVID-19 illness.[7]

Shortage of PPEs

Shortcomings of personal protective equipment have been reported from several countries.[8][7] In China, inadequate staff training, shortage of PPEs, reduced understanding of PPE use and confused PPE guidance have resulted in infections and deaths among healthcare workers.[9]

In the United States, many hospitals have reported a shortage of PPE for hospital staff.[10] As COVID-19 cases increase, it is suggested that the United States will need far more surgical masks than they currently have.[10]

The shortage of PPE has put many healthcare workers at risks for getting infected with COVID-19. Healthcare workers have created unconventional solutions to make up for the lack of PPE by using the resources they do have in stock. They have used plastic bags as gowns and plastic water bottle cutouts for eye protection.[11]

The shortage of PPE is even worse for hospitals in low income communities. Items such as PPE have always been scare commodities in low income countries.[12] UICEF reported that the organization was only able to acquire one tenth of the 240 million masks requested by these communities.[12]

Deaths

Nurse and doctor deaths due to COVID-19 have been reported from several countries.[4][13] In May 2020, they added that at least 260 nurses have died due to COVID-19. In March 2020, at least 50 doctors were reported to have died in Italy due to COVID-19.[14] The number of deaths in Italy continued to go up. By April 2020, the estimated number of medical doctor deaths was about 119 and for nurses about 34.[15] Two of the deaths within those who were nurses were suicides due to unsustainable pressure at work.[15]

On 8 August 2020, the Indian Medical Association announced that 198 doctors have died in India due to COVID-19.[16]

Psychological impact

A study from Singapore showed that healthcare workers caring for patients with COVID-19 reported anxiety, depression and stress.[17] Increasing work demands on healthcare professionals conflict with their duties to family and friends, which causes psychological stress.[7] Healthcare professionals reported being anxious about having to self-isolate, quarantine or becoming ill.[18] For healthcare workers, being quarantined was positively associated with minimizing direct contact with patients and not reporting to work.[19]

Healthcare workers like nurses, doctors and other medical staff that worked on the front-lines in China experienced symptoms of anxiety, depression and difficulty sleeping.[20] More specifically, about 46.04% had anxiety, 44.37% had depression and 28.75% experienced insomnia.[20]

Healthcare workers are at risk for developing trauma or other stress-related disorders due to fears of falling ill and not knowing what will happen in the future.[21] Post-traumatic stress was common among health workers, with nurses demonstrating a higher likelihood of developing or having anxiety among others in the medical field.[22]

An Italian nurse committed suicide after being traumatized trying to save the lives of those with COVID-19.[23]

In Mexico, healthcare professional have also reported high levels of anxiety, because of the fear of being an asymptomatic patient, which could potentially lead to the unknowingly spread of the disease amongst their patients and their families.[24][25]

Violence against healthcare workers

Healthcare workers have been subjected to violent crimes, such as assault. Hospitals and governments have taken stricter measures to ensure the safety of their staff; however, many healthcare workers still face significant risk of physical injury.[26]

Because of COVID-19, healthcare personnel have experienced over 600 instances of negativity directed towards them in different forms. In Pakistan, doctors were attacked by family members of a deceased patient who succumbed to COVID-19. Residents of a community in Bangladesh forced a doctor who was COVID-19 positive and his family to leave his home and the area by throwing bricks at their home.[27]

Ethical decisions

The Conversation reports that healthcare workers will have to face 'moral injury' for making difficult decisions such as moving a patient off the ventilator or refusing an ICU bed due to limited resources.[7]

Impact on female staff
Main article: Gendered impact of the COVID-19 pandemic

Globally, women make up 70 percent of workers in the health and social sector. Women are playing a disproportionate role in responding to the disease, whether that be as front line healthcare workers, carers at home or community leaders and mobilisers. In some countries, COVID-19 infections among female health workers are twice that of their male counterparts.[28][29][30] Women are still paid much less than their male counterparts in almost all countries and hold fewer leadership positions in the health sector. Masks and other protective equipment designed and sized for men leave women at greater risk of exposure.[28][29][30][31] (Primary data on PPE fit, please?)

Recommendations

World Health Organization
See also: World Health Organization's response to the COVID-19 pandemic

The World Health Organization has given the following key recommendations to decrease the spread of COVID-19 among healthcare workers:[1]

  • Training healthcare workers to identify respiratory diseases
  • Providing increased access to personal protective equipment
  • Providing psychological support to health workers
  • Routinely conducting hospital surveillance
  • Recognizing that every healthcare system can have gaps

Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention has issued guidance on preventing transmission and reducing job stress in response to the COVID-19 pandemic for healthcare workers:

Infection prevention
  • Implement telehealth protocols where possible[32][33]
  • Screen ever one entering a healthcare facility for COVID-19 symptoms
  • Use appropriate face coverings dependent upon the procedure (i.e. N95s for aerosol-generating procedures)
  • Establish a plan to identify and track suspected and confirmed cases to promptly impose quarantine measures
  • Re-arrange waiting areas and install barriers to encourage physical distancing
  • Practice hand hygiene and frequent disinfection of surfaces

Managing job stress

A 2020 Cochrane review found that among healthcare workers there is low certainty evidence that resilience training may lead to greater levels of individual resilience for healthcare workers.[34] Due to limitations in the reviewed studies (44 RCTs), the authors advise caution in drawing definitive conclusions and recommend more studies with improved designs.[34]

Other recommendations:

  • Stay in communication with coworkers and supervisors about job stress[35]
  • Maintain a consistent sleep and meal schedule
  • Get exercise and make time for hobbies outside of work
  • Take breaks from watching, reading, and listening to the news
  • Practice mindfulness techniques, such as breathing exercises and meditation
  • Talk to a mental health professional if needed

UNFPA

UNFPA recommends that all women and girls must have access to a continuum of sexual and reproductive health services. In accordance to national guidelines and standards, some services for women and girls include antenatal, perinatal and postnatal care, and screening tests.[2][3]

Karolinska Institute

The Karolinska Institute recommends health workers to take care of oneself, avoid unhelpful strategies, stay in touch with loved ones, not blame oneself and reach out if physical or psychological help is required.[36]

Sources

 This article incorporates text from a free content work. Licensed under CC BY-SA 3.0 IGO License statement/permission on Wikimedia Commons. Text taken from Explainer: How COVID-19 impacts women and girls, UN Women. To learn how to add open license text to Wikipedia articles, please see this how-to page. For information on reusing text from Wikipedia, please see the terms of use.

References
  1. "How to protect health workers now: WHO Hay COVID-19 briefing". World Economic Forum. Retrieved 13 May 2020.
  2. Continuing essential Sexual, Reproductive, Maternal, Neonatal, Child and Adolescent Health services during COVID-19 pandemic (PDF). World Health Organization, UNFPA, UNICEF. 2020.
  3. Coronavirus Disease (COVID-19) Pandemic UNFPA Global Response Plan (PDF). UNFPA. 2020.
  4. Mitchell, Gemma (20 March 2020). "Nurses among confirmed deaths from Covid-19 around the world". Nursing Times. Retrieved 13 May 2020.
  5. "90,000 healthcare workers infected with COVID-19: ICN". www.aa.com.tr. Retrieved 13 May 2020.
  6. "Covid-19: One in four doctors off sick or in isolation". ITV News. Retrieved 13 May 2020.
  7. Taegtmeyer, Miriam; Wingfield, Tom. "Healthcare workers and coronavirus: behind the stiff upper lip we are highly vulnerable". The Conversation. Retrieved 13 May 2020.
  8. "Begging for Thermometers, Body Bags, and Gowns: U.S. Health Care Workers Are Dangerously Ill-Equipped to Fight COVID-19". Time. Retrieved 13 May 2020.
  9. Wang, J.; Zhou, M.; Liu, F. (1 May 2020). "Reasons for healthcare workers becoming infected with novel coronavirus disease 2019 (COVID-19) in China". Journal of Hospital Infection. 105 (1): 100–101. doi:10.1016/j.jhin.2020.03.002. ISSN 0195-6701. PMC 7134479. PMID 32147406. Retrieved 13 May 2020.
  10. Ranney, Megan L.; Griffeth, Valerie; Jha, Ashish K. (2020-04-30). "Critical Supply Shortages — The Need for Ventilators and Personal Protective Equipment during the Covid-19 Pandemic". New England Journal of Medicine. 382 (18): e41. doi:10.1056/NEJMp2006141. ISSN 0028-4793. PMID 32212516. S2CID 214643757.
  11. Livingston, Edward; Desai, Angel; Berkwits, Michael (2020-05-19). "Sourcing Personal Protective Equipment During the COVID-19 Pandemic". JAMA. 323 (19): 1912–1914. doi:10.1001/jama.2020.5317. ISSN 0098-7484. PMID 32221579. S2CID 214694823.
  12. McMahon, Devon E.; Peters, Gregory A.; Ivers, Louise C.; Freeman, Esther E. (2020-07-06). "Global resource shortages during COVID-19: Bad news for low-income countries". PLOS Neglected Tropical Diseases. 14 (7): e0008412. doi:10.1371/journal.pntd.0008412. ISSN 1935-2735. PMC 7337278. PMID 32628664.
  13. contributors, Lost on the Frontline (12 May 2020). "A striving school nurse, a devoted pharmacist: the US health workers who died from Covid-19". The Guardian. Retrieved 13 May 2020.
  14. "50 doctors have now died in Italy as health system struggles amid coronavirus epidemic". The Independent. 28 March 2020. Retrieved 13 May 2020.
  15. Lapolla, Pierfrancesco; Mingoli, Andrea; Lee, Regent (2020-05-15). "Deaths from COVID-19 in healthcare workers in Italy – what can we learn?". Infection Control & Hospital Epidemiology: 1–4. doi:10.1017/ice.2020.241. ISSN 0899-823X. PMC 7256220. PMID 32408922.
  16. "IMA says nearly 200 doctors in India have succumbed to COVID-19 so far; requests PM's attention". Economic Times. 8 August 2020. Retrieved 9 August 2020.
  17. Tan, Benjamin Y.Q.; Chew, Nicholas W.S.; Lee, Grace K.H.; Jing, Mingxue; Goh, Yihui; Yeo, Leonard L.L.; Zhang, Ka; Chin, Howe-Keat; Ahmad, Aftab; Khan, Faheem Ahmed; Shanmugam, Ganesh Napolean; Chan, Bernard P.L.; Sunny, Sibi; Chandra, Bharatendu; Ong, Jonathan J.Y.; Paliwal, Prakash R.; Wong, Lily Y.H.; Sagayanathan, Renarebecca; Chen, Jin Tao; Ying Ng, Alison Ying; Teoh, Hock Luen; Ho, Cyrus S.; Ho, Roger C.; Sharma, Vijay K. (6 April 2020). "Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Singapore". Annals of Internal Medicine. 173 (4): 317–320. doi:10.7326/M20-1083. ISSN 0003-4819. PMC 7143149. PMID 32251513.
  18. Brooks, Samantha K.; Webster, Rebecca K.; Smith, Louise E.; Woodland, Lisa; Wessely, Simon; Greenberg, Neil; Rubin, Gideon James (14 March 2020). "The psychological impact of quarantine and how to reduce it: rapid review of the evidence". The Lancet. 395 (10227): 912–920. doi:10.1016/S0140-6736(20)30460-8. ISSN 0140-6736. PMC 7158942. PMID 32112714. Retrieved 13 May 2020.
  19. Marjanovic, Zdravko; Greenglass, Esther R.; Coffey, Sue (1 August 2007). "The relevance of psychosocial variables and working conditions in predicting nurses' coping strategies during the SARS crisis: An online questionnaire survey". International Journal of Nursing Studies. 44 (6): 991–998. doi:10.1016/j.ijnurstu.2006.02.012. ISSN 0020-7489. PMC 7094220. PMID 16618485. Retrieved 13 May 2020.
  20. Que, Jianyu; Shi, Le; Deng, Jiahui; Liu, Jiajia; Zhang, Li; Wu, Suying; Gong, Yimiao; Huang, Weizhen; Yuan, Kai; Yan, Wei; Sun, Yankun (2020-06-14). "Psychological impact of the COVID-19 pandemic on healthcare workers: a cross-sectional study in China". General Psychiatry. 33 (3): e100259. doi:10.1136/gpsych-2020-100259. ISSN 2517-729X. PMC 7299004. PMID 32596640.
  21. Cabarkapa, Sonja; Nadjidai, Sarah E.; Murgier, Jerome; Ng, Chee H. (October 2020). "The psychological impact of COVID-19 and other viral epidemics on frontline healthcare workers and ways to address it: A rapid systematic review". Brain, Behavior, & Immunity - Health. 8: 100144. doi:10.1016/j.bbih.2020.100144. ISSN 2666-3546. PMC 7494453. PMID 32959031.
  22. Si, Ming-Yu; Su, Xiao-You; Jiang, Yu; Wang, Wen-Jun; Gu, Xiao-Fen; Ma, Li; Li, Jing; Zhang, Shao-Kai; Ren, Ze-Fang; Ren, Ran; Liu, Yuan-Li (2020-08-12). "Psychological impact of COVID-19 on medical care workers in China". Infectious Diseases of Poverty. 9 (1): 113. doi:10.1186/s40249-020-00724-0. ISSN 2049-9957. PMC 7422468. PMID 32787929.
  23. Squires, Nick (25 March 2020). "Italian nurse commits suicide as another 683 people die from coronavirus". The Telegraph. Retrieved 13 May 2020.
  24. Delgado-Gallegos, Juan Luis; Montemayor-Garza, Rene de Jesús; Padilla-Rivas, Gerardo R.; Franco-Villareal, Héctor; Islas, Jose Francisco (January 2020). "Prevalence of Stress in Healthcare Professionals during the COVID-19 Pandemic in Northeast Mexico: A Remote, Fast Survey Evaluation, Using an Adapted COVID-19 Stress Scales". International Journal of Environmental Research and Public Health. 17 (20): 7624. doi:10.3390/ijerph17207624. PMC 7593933. PMID 33086744.
  25. Padilla-Rivas, Gerardo R.; Delgado-Gallegos, Juan Luis; Montemayor-Garza, Rene de Jesús; Franco-Villareal, Héctor; De los Ángeles Coiser-León, María; Avilés-Rodriguez, Gener; Zuñiga-Violante, Erika; Romo-Cardenas, Gerardo Salvador; Islas, Jose Francisco (January 2021). "Dataset of the adapted COVID STRESS SCALES for Healthcare professionals of the Northeast region of Mexico". Data in Brief. 34: 106733. doi:10.1016/j.dib.2021.106733. PMC 7835532. PMID 33521178.
  26. "Health workers become unexpected targets during covid-19". The Economist. Retrieved 13 May 2020.
  27. Devi, Sharmila (2020-09-05). "COVID-19 exacerbates violence against health workers". The Lancet. 396 (10252): 658. doi:10.1016/S0140-6736(20)31858-4. ISSN 0140-6736. PMC 7470723. PMID 32891198.
  28. "UN Secretary-General's policy brief: The impact of COVID-19 on women | Digital library: Publications". UN Women. Retrieved 2020-06-12.
  29. "Gender equality matters in COVID-19 response". UN Women. Retrieved 2020-06-12.
  30. "COVID-19: Emerging gender data and why it matters | UN Women Data Hub". data.unwomen.org. Retrieved 2020-06-12.
  31. Rimmer, MP; Al Wattar, BH; UKARCOG Members (27 May 2020). "Provision of obstetrics and gynaecology services during the COVID‐19 pandemic: a survey of junior doctors in the UK National Health Service". BJOG: An International Journal of Obstetrics & Gynaecology. 127 (9): 1471–0528.16313. doi:10.1111/1471-0528.16313. ISSN 1470-0328. PMC 7283977. PMID 32460422.
  32. CDC (2020-02-11). "Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic". Centers for Disease Control and Prevention. Retrieved 2020-07-14.
  33. Chidiebere Okechukwu E, Tibaldi L, La Torre G (2020). "The impact of COVID-19 pandemic on mental health of Nurses". Clinica Terapeutica. 171 (5): e399–e400. doi:10.7417/CT.2020.2247. ISSN 0009-9074. PMID 32901781. S2CID 221569645.
  34. Kunzler, Angela M.; Helmreich, Isabella; Chmitorz, Andrea; König, Jochem; Binder, Harald; Wessa, Michèle; Lieb, Klaus (July 5, 2020). "Psychological interventions to foster resilience in healthcare professionals". The Cochrane Database of Systematic Reviews. 7: CD012527. doi:10.1002/14651858.CD012527.pub2. ISSN 1469-493X. PMID 32627860.
  35. CDC (2020-02-11). "Healthcare Personnel and First Responders: How to Cope with Stress and Build Resilience During the COVID-19 Pandemic". Centers for Disease Control and Prevention. Retrieved 2020-07-14.
  36. "Covid-19: Recommendations and resources for healthcare workers Karolinska Institutet". ki.se.
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