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Impact of COVID-19 on Health Workers in General

Impact of COVID-19 on Health Workers in General

The COVID-19 pandemic has been a global health crisis that has affected millions of people and overwhelmed health systems in many countries. Health workers, who are at the frontline of the response, have faced unprecedented challenges and risks, such as increased workload, stress, burnout, infection, and death. This paper aims to provide an overview of the impact of COVID-19 on health workers in general, based on the available evidence from the first year of the pandemic.

According to the World Health Organization (WHO), as of September 2021, more than 115,000 health workers have died from COVID-19 globally, accounting for about 0.3% of all COVID-19 deaths reported to WHO . However, this is likely an underestimate, as many countries do not report the occupational status of COVID-19 cases and deaths, and there is a lack of standardized definitions and methods for data collection and analysis. A working paper by WHO estimated that the number of deaths among health workers could be as high as 160,000 to 360,000, depending on the assumptions and data sources used .

The impact of COVID-19 on health workers is not only measured by mortality, but also by morbidity, mental health, and well-being. A scoping review of qualitative studies published during the first year of the pandemic found that health workers experienced various challenges and needs at different levels of the socio-ecological model . At the individual level, health workers reported negative effects on their physical and mental health, such as fatigue, insomnia, anxiety, depression, post-traumatic stress disorder (PTSD), and suicidal ideation. They also faced changes in their daily routine, professional and personal identity, and career aspirations. At the interpersonal level, health workers had to cope with the impact of the pandemic on their personal and professional relationships, such as isolation from family and friends, stigma and discrimination, lack of social support, and conflicts with colleagues and managers. At the institutional level, health workers highlighted the importance of decision-making processes, organizational aspects, and availability of support from their employers. They expressed concerns about the lack of adequate training, equipment, resources, guidelines, protocols, incentives, recognition, and feedback. They also appreciated the opportunities for teamwork, collaboration, innovation, and learning. At the community level, health workers were influenced by the community morale, norms, and public knowledge about COVID-19. They felt frustrated by the public’s non-compliance with preventive measures, misinformation, and mistrust. They also felt grateful for the public’s appreciation, solidarity, and generosity. At the policy level, health workers were affected by the governmental support and response measures to COVID-19. They called for more political commitment, coordination, communication, transparency, accountability, and equity in addressing the pandemic.

The impact of COVID-19 on health workers is not homogeneous across different groups and contexts. The review identified a lack of studies that investigate other health workers than doctors and nurses (such as pharmacists or dentists), health workers in non-hospital settings (such as primary care or long-term care), and health workers in low- and lower middle-income countries . Moreover, there is evidence that some factors may increase the vulnerability or resilience of health workers to COVID-19-related stressors. For example,
gender , age , ethnicity , education , experience , specialty , role , location , exposure , infection status , coping strategies , social support , organizational culture , leadership style , and policy environment have been found to be associated with different outcomes among health workers during the pandemic.

In conclusion,
COVID-19 has had a significant impact on health workers in general,
but also with variations across different groups and contexts.
To better understand
and support
health workers during
and after
the pandemic,
more research is needed
that analyzes
the differences
and similarities
among
and within
countries,
institutions,
communities,
teams,
and individuals.
Similarly,
interventions
aimed at empowering
health workers
need to consider
their circumstances
and needs
at different levels
of the socio-ecological model.
Following a context-sensitive approach
to strengthening
the health workforce
could contribute to building
a sustainable
and resilient
health system
for future pandemics.

References

: The impact of COVID-19 on health and care workers: a closer look at deaths. Health Workforce Department – Working Paper 1. Geneva: World Health Organization; September 2021 (WHO/HWF/WorkingPaper/2021.1). Available from: https://apps.who.int/iris/bitstream/handle/10665/345300/WHO-HWF-WorkingPaper-2021.1-eng.pdf

: Chemali S, Mari-Sáez A, El Bcheraoui C, Weishaar H. Health care workers’ experiences during the COVID-19 pandemic: a scoping review. Hum Resour Health. 2022;20(1):27. Available from: https://human-resources-health.biomedcentral.com/articles/10.1186/s12960-022-00724-1

: Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A review. Asian J Psychiatr. 2020;51:102119. Available from: https://www.sciencedirect.com/science/article/pii/S1876201820302378

: 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(3):e203976-e203976. Available from: https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2763229

: Pappa S, Ntella V, Giannakas T, Giannakoulis VG, Papoutsi E, Katsaounou P. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun. 2020;88:901–7. Available from: https://www.sciencedirect.com/science/article/pii/S0889159120305345

: Chew NWS, Lee GKH, Tan BYQ, Jing M, Goh Y, Ngiam NJH, et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun. 2020;88:559–65. Available from: https://www.sciencedirect.com/science/article/pii/S0889159120304209

: Zhang WR, Wang K, Yin L, Zhao WF, Xue Q, Peng M, et al. Mental health and psychosocial problems of medical health workers during the COVID-19 epidemic in China. Psychother Psychosom. 2020;89(4):242–50. Available from: https://www.karger.com/Article/FullText/507639

: Rossi R, Socci V, Pacitti F, Di Lorenzo G, Di Marco A, Siracusano A, et al. Mental health outcomes among frontline and second-line health care workers during the coronavirus disease 2019 (COVID-19) pandemic in Italy. JAMA Netw Open. 2020;3(5):e2010185-e2010185. Available from: https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2765641

: Tan BYQ, Chew NWS, Lee GKH, Jing M, Goh Y, Yeo LLL, et al.
Psychological impact of the COVID-19 pandemic on health care workers in Singapore.
Ann Intern Med.
2020;173(4):317–20.
Available from:
https://www.acpjournals.org/doi/full/10.7326/M20-1083

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