Impact of the COVID-19 pandemic on healthcare workers


The COVID-19 pandemic has impacted healthcare workers physically and psychologically. Healthcare workers are more vulnerable to COVID-19 infection than the general population because of being frequently in contact with affected individuals. Healthcare workers have been required to work under stressful conditions, without proper protective equipment and had to take difficult decisions involving ethical implications. In the US, black healthcare workers are disproportionately impacted by the pandemic due to staff shortage, poor working conditions and poor mental health care system. 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.

Risk of infection

The World Health Organization reported that one in ten health workers is infected with coronavirus in some countries. In March 2020, 9% of those affected with COVID-19 in Italy were health workers. 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. In March 2020, one in four doctors in the UK were off sick, in isolation or caring for a family member with COVID-19.
The UK government announced that retired healthcare professionals be brought out of retirment to help during the COVID-19 crisis. This led to concerns that they could be at a higher risk for severe COVID-19 illness.

Shortage of PPEs

Shortcomings of personal protective equipment have been reported from several countries. 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.

Deaths

Nurse and doctor deaths due to COVID-19 have been reported from several countries. 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.

Psychological impact

A study from Singapore showed that healthcare workers caring for patients with COVID-19 reported anxiety, depression and stress. Increasing work demands on healthcare professionals conflict with their duties to family and friends, which causes psychological stress. Healthcare professionals reported being anxious about having to self-isolate, quarantine or becoming ill. For healthcare workers, being quarantined was positively associated with minimising direct contact with patients and not reporting to work.
An Italian nurse committed suicide after being traumatized trying to save lives of those with COVID-19.

Violence against healthcare workers

Healthcare workers have been subjected to violent crimes. Hospitals and governments had to take stricter measures to ensure the safety of their staff.

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 the limtation in resources.

Impact on female staff

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, including as front line healthcare workers. In some countries, COVID-19 infections among female health workers are twice that of their male counterparts. 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.

Recommendations

World Health Organization

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

UNFPA recommends that all women and girls must have access to a continuum of sexual and reproductive health services, including antenatal, perinatal and postnatal care, and screening tests according to national guidelines and standards.

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.