Covid-19: a heavy toll on health-care workers

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The Covid-19 pandemic has challenged and, in many cases, exceeded the capacity of hospitals and intensive care units (ICUs) worldwide. Health-care workers have continued to provide care for patients despite exhaustion, personal risk of infection, fear of transmission to family members, illness or death of friends and colleagues, and the loss of many patients. Sadly, health-care workers have also faced many additional—often avoidable—sources of stress and anxiety, and long shifts combined with unprecedented population restrictions, including personal isolation, have affected individuals’ ability to cope.

As the pandemic unfolded, many health-care workers travelled to new places of work to provide patient care in overwhelmed facilities; those who volunteered in unfamiliar clinical areas were often launched into the pandemic ICU setting with insufficient skills and training. The burden of training and supervising these volunteers fell on already stressed clinicians. Hospital-based health professionals worked long hours wearing cumbersome and uncomfortable personal protective equipment (PPE), after initial shortages of PPE had been addressed. They strived to keep up with emerging knowledge, institutional and regional procedures, and changing PPE recommendations, while trying to distinguish accurate information from misinformation. Health-care workers had to adopt new technologies to fulfil patient care and educational responsibilities, including the provision of telemedicine.
Insufficient resources and the absence of specific treatments for Covid-19 added to the challenges of managing severely ill patients. Health-care workers had to care for colleagues who were ill, offer comfort to dying patients who were isolated from their loved ones, and inform and console patients’ family members remotely. Some health-care workers were burdened with emotionally and ethically fraught decisions about resource rationing and withholding resuscitation or ICU admission. They shared the pain of patients without Covid-19 who had their surgery or other essential treatments cancelled or postponed.

The fear of transmitting Covid-19 led many health professionals to isolate from their families for months. Working remotely and being shunned by community members further contributed to loneliness. Many health-care workers experienced lost earnings because of cancellations in outpatient visits and elective procedures. The training of health-care workers (eg, medical students, residents, and allied health learners) was also interrupted, leading to loss of tuition fees, missed learning opportunities.

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