Psychological Impact among Healthcare Workers during COVID-19 Pandemic

Dear Editor,

COVID-19, is a disease which has put entire world in a panic state. This disease is considered as public health emergency of International concern on 30th January 2020 by World Health Organization^[1],. It has a high transmission rate and affects people of all the age groups. Case fatality rate is high among people in the age group more than 70yrs and those with co-morbid conditions.^[2,3] The rate of infection among front line heath care workers is considerably high and they are more prone to develop psychological illness.^[4,5,6] Among health care workers psychological wellbeing is as important as physical health. Hence at this present situation we need to address the gap among health care workers and should provide timely psychological support as well as manage the consequences arising due to COVID-19 effectively.

Health care workers are at risk of contracting the disease as they provide direct care for the patients affected with COVID-19. Rapid spread, severity of illness, uncertainty about the treatment, shortage of resources like personal protective equipments which can aggravate the fear of acquiring the disease.^[4,5,7,8] The Psychosocial and economic factors like feeling of inadequate support, possibility of transmitting disease to the family, job loss, stigma, economic slowdown can lead to concern and worries.^[8] Places of recreation is important for better quality of life. But these non-essential services has been restricted to use as lock down was implemented to contain the spread of infection.^[4,5] All these factors can act as a major stressor among health care workers.

The common psychological consequences that are reported during COVID-19 pandemic are, anxiety[44.5%], insomnia[34%], distress[71.5%] and depression[50.4%] in a study conducted among health care workers in China.^[5] The stress deepens among health care workers once they are exposed or affected with COVID-19. Anxiety can be due to fear of acquiring infection, fear of infecting others, fear of not using the personal protective measures as it was not under routine practice, multiple conflicting information through social media.^[7,8] The duration of quarantine or isolation, avoidance by the community or family due to stigma associated with the disease, lack of routine activity, loss of social contact with friends /relatives and sense of isolation are the factors which can lead to distress. Stigmatizing attitudes from family, neighbors, relatives, place of residence and concern about physical safety can affect the psychological wellbeing of health care workers.^[8]

It's very important to take appropriate preventive measures to reduce long term psychological effects among health care workers due to COVID-19 pandemic. Self-care measures like, intake of adequate and healthy diet, good sleep and rest, keeping in contact with family members, practicing relaxation exercise like yoga, seeking social support from trusted person, engaging in physical activity and carrying out activities unrelated to work, listening to music or learning new tasks etc. will keep our stress level down. It is also necessary to avoid alcohol or use of drug to cope with stress.^[8,10] Leadership at hospital level should ensure good communication, which is clear, flexible and transparent as well as with accurate updates, which can build trust and confidence among health care workers.^[10] If, health care worker face persistent uncontrollable distress, they can be referred to nearest specialist mental health facility.

Most of the frontline healthcare workers are stressed to certain degree. Managing psychological wellbeing is the most important step to be considered at present situation. Self­Care measure has to be adopted to overcome this stressful situation. It is good to practice the art of de-stressing. The team leaders and administrator should also take prompt measures to keep their health care workers psychologically fit. Most importantly timely psychological support will make health care worker feel comfortable.