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Healthcare workers treating COVID-19 show more negative mental health effects

Anecdotal evidence suggests the psychological toll of being on the front lines may lead to an uptick in mental health disorders.

Jeff Lagasse, Associate Editor

Medical personnel treating coronavirus cases in China have higher rates of anxiety and other mental health symptoms than the general population, according to a questionnaire administered to medical personnel from 12 hospitals throughout China.

During the height of China's COVID-19 outbreak this year, more than 30,000 medical personnel from around China provided direct support to critically ill COVID-19 patients in Hubei province, the epicenter of the pandemic.

These healthcare providers were confronted by stressors not typical to their usual jobs. Anecdotal evidence has suggested that the psychological toll of being on the front line of this pandemic may lead to an uptick in mental health disorders among healthcare providers.

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In all, 560 medical personnel from 12 hospitals in eight provinces and cities across China completed an online questionnaire regarding their mental health status. The survey, carried out in January and February, collected demographic information, information about COVID-19 exposure and work, and used the well-established Symptom-Checklist-90 to quantify mental health symptoms.

Of the subjects, 75% were nurses and 25% were doctors, and 72% of those surveyed female.

The healthcare providers surveyed scored higher on scales of somatization (experiencing physical symptoms of psychiatric conditions), obsessive-compulsive symptoms, anxiety, phobic anxiety and psychoticism compared to a national average. They also scored lower on a scale of interpersonal sensitivity.

The authors identified several factors that predicted mental health status (p<0.05), including whether a clinician had worked in Hubei province, their level of concern that they had been infected, and their age. However, the findings are limited in that they did not directly compare doctors working with COVID patients to doctors not working with COVID patients.


The concern among data scientists and healthcare workers alike is that the trend found in China may be manifesting in other countries as well, including the United States, which leads the world in confirmed coronavirus cases at 1,532,212 as of Wednesday afternoon, according to Johns Hopkins University data.

The U.S. also leads the world in COVID-19-related deaths, at 92,128.

Dr. James Adams of Northwestern University's Feinberg School of Medicine and Dr. Ron Walls of Harvard Medical School wrote in a March paper that the combination of stress and possible exposure puts healthcare professionals, from physicians, to nurses, to specialists, at greater risk of contracting COVID-19 and potentially spreading it to others.

When it comes to transmission, the primary concern is surfaces that may be carrying the virus due to droplets or contact. Common-sense measures have so far been the most effective at limiting the risk this poses to healthcare workers, such as the use of personal protective equipment – gowns, gloves, N95 respirators with face shields or goggles, and air-purifying respirators.

But this poses its own set of problems. As has been the case with testing kits in the U.S., personal protective equipment for health personnel has been in short supply, in some cases leading to price spikes for such items.

Twitter: @JELagasse

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