If you’re finding it hard to stay home right now, imagine how it would feel to be a doctor or nurse. Health care workers don’t have the luxury of holing up in their homes to shield themselves from the coronavirus. They have to expose themselves to the risk, and some are separating themselves from their families for weeks to avoid transmitting the virus to them.
They’re not only suffering the anxiety of caring for sick patients — while facing a dire lack of personal protective equipment and rapidly changing hospital protocols — but also forgoing the calming companionship of their partners and children. It’s a whole different level of lonely from what most of us are dealing with.
So, it should come as no surprise that the mental well-being of health care workers is in serious jeopardy. A new study, published this week in the Journal of the American Medical Association, quantifies that risk.
The survey-based study examines the mental health outcomes of 1,257 health care workers attending to Covid-19 patients in 34 hospitals in China. The results are not comforting. A large proportion of them report experiencing symptoms of depression (50 percent), anxiety (45 percent), insomnia (34 percent), and psychological distress (71.5 percent).
Women and nurses report especially severe symptoms — perhaps not surprising, given that they’re often called on to do extra emotional labor, like keeping up a steady stream of reassurances while suppressing their own feelings, which is known to take a toll. Front-line workers and those in Wuhan, the epicenter of the original outbreak, exhibit a greater psychological burden than Chinese health care workers farther from the epicenter.
The study notes that during the 2003 SARS outbreak, health care workers feared they would infect their family or friends and felt stigmatized because they were known to be in close contact with sick patients. They experienced significant long-term stress. Similar fears are probably contributing to health care workers’ distress now, in addition to the obvious concern that they are at higher-than-average risk of contracting Covid-19, the authors say.
“Protecting health care workers is an important component of public health measures for addressing the Covid-19 epidemic,” the study concludes. “Special interventions to promote mental wellbeing in health care workers exposed to Covid-19 need to be immediately implemented, with women, nurses, and frontline workers requiring particular attention.”
The study doesn’t specify which mental health interventions should be used to help health care workers, but the American Psychological Association (APA) notes that recommended methods for improving resilience during the SARS outbreak included a particular “stress appraisal and coping framework” as well as principles of “psychological first aid.”
The limitations of the study are worth noting. It can’t distinguish preexisting mental health symptoms from new symptoms, and it lacks longitudinal follow-up, since the survey was carried out during six days (January 29 to February 3). Plus, it focuses exclusively on health care workers in China.
Nevertheless, the mental health toll on health care workers in other countries is likely to be similarly dire.
Take Italy, for example. Doctors there have had to choose among patients for who gets put on a ventilator, a heartbreaking decision that may cause lasting psychological distress.
What’s more, because there aren’t enough infectious disease specialists to tend to all the Covid-19 patients, other doctors like ophthalmologists and dermatologists are being trained to care for them, for example by providing supplemental oxygen. (One Bergamo hospital trained 1,500 people in seven days.) Most have no experience watching a patient be intubated or die in front of them, and since that can be traumatic, some of them may end up with post-traumatic stress disorder or other mental health problems down the line. In the US, the situation is rapidly worsening, too.