COVID-19 front-line healthcare workers at risk of mental health problems

A nurse in a protective suit feeds a novel coronavirus patient inside an isolated ward at Zhongnan Hospital of Wuhan University, during the Lantern Festival, which marks the end of the Chinese Lunar New Year celebrations, in Wuhan, Hubei province, China, on February 8, 2020. China Daily via REUTERS

Health workers battling coronavirus are at high risk of suffering depression, anxiety, and insomnia, a new study shows.

The survey conducted by Zhejiang University School of Medicine in Hangzhou, China revealed that front-line healthcare workers were 52 per cent more likely to have symptoms of depression.

It also showed that they are 57 per cent more likely to have symptoms of anxiety, 60 per cent more likely to experience distress and almost three times as likely to have insomnia than those who were not on the front-line.

The study examined the mental health of 1,257 healthcare workers who dealt with Covid-19 patients in 34 hospitals in China.

The study conducted from January 29, 2020, to February 3, 2020, was published in the Chinese journal JAMA Network Open.

Health care workers in hospitals equipped with fever clinics or wards for patients with Covid-19 were eligible.

“Facing this critical situation, health care workers on the front line who are directly involved in the diagnosis, treatment, and care of patients with Covid-19 are at risk of developing psychological distress and other mental health symptoms,” the study read in part.

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Jianbo Lai, a psychiatrist from Zhejiang University, was one of the experts who prepared the study.

Dr Lai and his colleagues set out to examine the mental health outcomes of healthcare professionals who treated patients with Covid-19 in China.

Participants were divided into three groups; those from Wuhan, those from other regions in Hubei province and those from regions outside Hubei.

Worked in Wuhan

A total of 813 participants (64.7 per cent) were between ages 26 and 40.  Again, 964 participants (76.7 per cent) were women.

Of all the health professionals involved, 764 (60.8 per cent) were nurses, and 493 (39.2 per cent) were doctors.

At least 760 (60.5 per cent) worked in hospitals in Wuhan, and 522 (41.5 per cent) were at the front-line in the coronavirus battle.

A considerable proportion of participants reported symptoms of depression (50.4 per cent), anxiety (44.6 per cent), insomnia (34.0 per cent), and distress (71.5 per cent).

“Nurses, women, front-line health care workers, and those working in Wuhan, China, reported more severe degrees of all measurements of mental health symptoms than other health care workers,” the study read.

It further showed  that front-line health care workers engaged in direct diagnosis, treatment, and care of patients with Covid-19 were associated with a higher risk of depression.

At least 18 per cent of front-line healthcare workers who experienced depression had a severe form of the condition, compared with 12.9 per cent of second-line workers.

Another 34.7 per cent of front-line workers who experienced anxiety had severe symptoms compared with 25 per cent of second-line workers.

“Similarly, 12.3 per cent had severe insomnia compared with 4.5 per cent of second-line workers, and 42.1 per cent of front-line specialists who had psychological distress experienced severe symptoms, compared with 29.9 per cent of second-line workers,” the study asserted.

Of health care workers in hospitals equipped with fever clinics or wards for patients with Covid-19 in Wuhan and other regions in China, participants reported experiencing psychological burden, especially nurses, women, those in Wuhan, and front-line health care workers directly engaged in the diagnosis, treatment, and care for patients with the disease.

Compared with those in Hubei province, outside Wuhan and those outside Hubei province, health care workers in Wuhan reported more severe symptoms of depression, anxiety, insomnia, and distress.

Multivariable logistic regression analysis showed that working outside Hubei province was associated with lower risk of experiencing distress.

The ever-increasing number of confirmed cases, overwhelming workload, depletion of personal protection equipment, widespread media coverage and feelings of being inadequately supported may all have contributed to the mental burden of these health care workers.