San Francisco Chronicle - (Sunday)
Anxiety hits health care workers hard
The relentless coronavirus pandemic has caused high levels of anxiety and burnout in health care workers across the country, according to a new UCSF study that is among the first to look closely at mental health in the nation’s emergency rooms during this unprecedented year.
The study, done before the arrival of vaccines, offers a critical snapshot of medical personnel at the helm of a national emergency when little was known about the deadly disease that dominated their lives.
The study also serves as a guidepost for hospitals to help frontline workers reduce the effects of such stress now, its authors say. That includes doing a better job of stockpiling safety equipment and
preparing for the next, inevitable disaster — whether an earthquake, a mass shooting or another pandemic.
Of the 1,600 doctors, nurses, social workers and other emergency room employees surveyed between May and July, half reported at least one symptom of posttraumatic stress disorder — including emotional exhaustion, insomnia or nightmares — because of their pandemic work, according to the study published Friday in the Annals of Emergency Medicine. One in 5 of those employees was found to be at high risk of PTSD.
“This is a call to action for institutions to recognize, and start developing ways to mitigate against widespread posttraumatic stress disorder” in frontline health workers, said Dr. Robert Rodriguez, a professor of emergency medicine at UCSF and lead author of the study.
“If this aspect is not considered, you’re going to lose more and more providers, and you won’t have the workforce necessary to deal with the pandemic” and future emergencies, said Rodriguez, who served on the COVID19 task force appointed in November by then Presidentelect Joe Biden.
The study surveyed emergency department employees in 16 cities: San Francisco, Los Angeles, New York, New Orleans, Miami, Orlando, Pittsburgh, Detroit, Philadelphia, St. Louis, Minneapolis, Denver, Baltimore, Birmingham, Iowa City and Dallas. The research was sponsored by the Centers for Disease Control and Prevention and funded through a grant from the National Institutes of Health.
Throughout the spring and summer, health care workers feared becoming infected and bringing the virus home to their family, the study found. They worried that their coworkers would get sick, and they expressed strong concern that undiagnosed patients might be carrying the virus and spreading it around.
“We went from a place where people were already stretched thin, then layered on top of that a global pandemic,” said Dr. Jahan Fahimi, a UCSF emergency department doctor who works with COVID patients but wasn’t involved in the study.
Fahimi said that emergency workers are accustomed to dealing with stress, and that it’s what they’ve trained for. What was different about the pandemic in the earlier months was that doctors and nurses weren’t sure yet how the disease could be transmitted — through droplets, contact, aerosol or all three methods. This meant that while simply doing their jobs, they could be putting their lives at risk.
“You’d go into work with a whole lot of anxiety, though over time we figured it out,” he said.
Rodriguez said, “It had a profound effect on all of us. There’s not a frontline provider that I know who hasn’t been severely impacted by the COVID19 pandemic.”
He said he knows colleagues who spent much of the pandemic living in a hotel rather than risk infecting their family. Rodriguez himself would go home and duck into a bathroom by the front door to scrub before greeting his family.
Workers often found relief from taking an antibody test that told them whether they had previously been infected by the coronavirus and therefore might have some natural immunity, the study found.
Health care workers say some anxiety remains today, even after most of them have been vaccinated and much more is known about the coronavirus and how it spreads.
“The vaccine does not provide compete immunity,” said Tamara Hinckley, a night nurse in Sutter Santa Rosa Regional Hospital’s intensive care unit, who was not part of the study.
Hinckley, who takes off every other week from work to recover from the emotional effects of her job, told The Chronicle in December that she cried more during the pandemic than at any other time in her career.
“I still find myself crying,” she said Thursday. “Maybe not as frequently. But there just are not enough words in the human language to convey this past year.”