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 Table of Contents  
LETTER TO EDITOR
Year : 2021  |  Volume : 37  |  Issue : 1  |  Page : 125-126

Healthcare workers' stress associated with the COVID-19 outbreak


1 Department of Psychiatry, Pt. BD. Sharma PGIMS, Rohtak, Haryana, India
2 Department of General Medicine Department, Pt. BD. Sharma PGIMS, Rohtak, Haryana, India

Date of Submission06-May-2020
Date of Decision01-Jul-2020
Date of Acceptance03-Jul-2020
Date of Web Publication31-Mar-2021

Correspondence Address:
Dr Ravi Parkash
Department of Psychiatry, Pt. BD. Sharma PGIMS, Room Number 8, Triveni Hostel, Rohtak, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijsp.ijsp_107_20

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How to cite this article:
Parkash R, Saini N. Healthcare workers' stress associated with the COVID-19 outbreak. Indian J Soc Psychiatry 2021;37:125-6

How to cite this URL:
Parkash R, Saini N. Healthcare workers' stress associated with the COVID-19 outbreak. Indian J Soc Psychiatry [serial online] 2021 [cited 2021 Jun 15];37:125-6. Available from: https://www.indjsp.org/text.asp?2021/37/1/125/312794



Sir,


  Introduction Top


The infection caused by novel coronavirus (COVID-19) was first detected in December 2019 at Wuhan in Hubei Province of China. In January 2020, the World Health Organization declared its outbreak an international public health emergency.[1] The main source of infection is the patients who are infected by the SARS-CoV-2, transmission being by droplets created from coughing or sneezing directly inhaled through the mouth or nose of a healthier individual or via contact with a contaminated surface, e.g., hands and handkerchief.[2]

While the outbreak has had many impacts, here, we focus, in particular, on the impact COVID-19 is having on healthcare workers' (HCW's) physical and mental well-being which in turn affects their willingness to continue to work. Therefore, it is crucial to anticipate the stresses associated with this work and ensure for supportive environment for HCWs.[3]


  Stress in Healthcare Workers during the Outbreak Top


Job-related stress

Job-related stress plays a significant role in forecasting impaired mental health. It includes physical burden of protective equipment (dehydration, heat, and exhaustion), physical isolation (restrictions on touching others, even after working hours), continuous awareness and vigilance of infection management procedures, and “role” (including negative emotions, and dealing with the high expectations of the public).[4]

Risk of disease transmission

Confronted with this precarious situation, front-line healthcare staff directly involved in the diagnosis, treatment, and care of COVID-19 patients are at high risk of being infected. Feeling insecure and vulnerable to infection are also the predictors of poor mental health. Studies have reported that perceived threat and/or lack of safety have also been shown to be the predictors of poor well-being in disaster responders and emergency personnel and more recently are noted as the important concerns in a qualitative study of staff deployed to Africa during the 2014/2015 Ebola outbreak.[5]

Multiple medical and personal demands

The difficulty of responding to COVID-19 can lead to conflicting personal and professional demands, including on-going daily workload requirements, need to maintain high expectations in face of a low-frequency situation in which official guidelines and policies change frequently, potential separation, and family issues. During duty in COVID facility and in quarantine period, healthcare workers being separated from friends and family, are forced to face stress on their own. A reduction in the levels of activity can lead to more time for “thinking” and a decreased capacity to use hobbies and interests as beneficial distractions.[6],[7]

Stigma

In the COVID-19 war, overworked Indian medical professionals are now constantly suffering on a whole new front: stigma. Completely under the grip of the global pandemic, the country records cases of physicians, nurses, and other healthcare professionals on the front line of the war, shunned by others for fear of infection.[8] This includes the threat of being evicted from their own apartments and general ostracism, even some of the house owner calling HCW dirty and asking them to vacate their house without any notice.


  Suggestions Top


Here are few considerations for protecting the mental health of HCWs who assist with the management of COVID 19 outbreak:

  1. Train HCWs with the skills, knowledge, and confidence to operate under challenging conditions – for example, infection control training
  2. Good mutual relation between colleagues is important, so they should be encouraged to attend courses or workshops aimed at developing team solidarity
  3. Ensuring adequate communication of the latest updates about the epidemic and how to best protect oneself
  4. Workplace wellness programs or service structures should be built to encourage psychological stability
  5. Online support or discussion groups may aid in providing support in crisis without fear of transmission, potentially reducing social isolation.


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res 2020;7:1-23.  Back to cited text no. 1
    
2.
World Health Organization. Mental health and psychosocial considerations during COVID-19 outbreak. World Health Organization; 2020. p. 1-6.  Back to cited text no. 2
    
3.
Brooks SK, Dunn R, Amlôt R, Rubin GJ, Greenberg N. A systematic, thematic review of social and occupational factors associated with psychological outcomes in healthcare employees during an infectious disease outbreak. J Occup Environ Med 2018;60:248-57.  Back to cited text no. 3
    
4.
Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020;3:e203976.  Back to cited text no. 4
    
5.
Chen CS, Wu HY, Yang P, Yen CF. Psychological distress of nurses in Taiwan who worked during the outbreak of SARS. Psychiatr Serv 2005;56:76-9.  Back to cited text no. 5
    
6.
Styra R, Hawryluck L, Robinson S, Kasapinovic S, Fones C, Gold WL. Impact on health care workers employed in high-risk areas during the Toronto SARS outbreak. J Psychosom Res 2008;64:177-83.  Back to cited text no. 6
    
7.
Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: Exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatry 2009;54:302-11.  Back to cited text no. 7
    
8.
Jiloha RC. COVID-19 and mental health. Epidemiol Int 2020;5:7-9.  Back to cited text no. 8
    




 

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