scholarly journals Drawing Parallels Among Past Public Health Crises and COVID-19

Author(s):  
George W. Contreras ◽  
Brigitte Burcescu ◽  
Tiffany Dang ◽  
Jeanette Freeman ◽  
Nathan Gilbreth ◽  
...  

Abstract In the early stages of the COVID-19 pandemic, there were shortages of personal protective equipment (PPE) and healthcare personnel across severely affected regions. Along with a lack of testing, these shortages delayed surveillance, and possible containment of the virus. The pandemic also took unprecedented tolls on the mental health of many healthcare workers who treated and witnessed the deaths of critically ill patients. To address these effects and prepare for a potential second wave, a literature review was performed on the response of healthcare systems during the Influenza pandemics of 1918, 1957, 2009, and the epidemics of Ebola, Severe Acute Respiratory Syndrome (SARS), and Middle East Respiratory Syndrome (MERS). We can use lessons identified to develop a competent and effective response to the current and future pandemics. The public must continue to engage in proper health mitigation strategies including utilization of face coverings, physical distancing, and hand washing. The impact the pandemic has had on the mental health of frontline healthcare workers cannot be disregarded as it is essential in ensuring effective patient care and mitigating psychological comorbidities. The lessons identified from past public health crises can help contain and limit morbidity and mortality with the ongoing COVID-19 pandemic.

Author(s):  
Okechukwu B. Anozie ◽  
Johnbosco I. Nwafor ◽  
Ephraim I. Nwokporo ◽  
Chidi U. Esike ◽  
Richard L. Ewah ◽  
...  

Background: Globally, mental health issues have become one of the predominant public health concerns as a result of the COVID-19 outbreak. The impact of COVID-19 pandemic on the mental health of frontline healthcare workers has not been fully described in Nigeria. Aim: To determine the mental health impact of COVID-19 pandemic and its associated factors among frontline healthcare workers in Ebonyi State, Nigeria. Materials and methods: This was an online cross-sectional study conducted among 315 frontline healthcare workers treating COVID-19 patients at Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria. The mental health outcome of the participants was assessed using the short form of the Mental Health Continuum (MHC-SF). Results: The prevalence of mental health outcome for different categories was 47% (n = 148) for flourishing, 28.3% (n = 89) for moderate and 24.7% (n = 78) for languishing mental health. The predictors of languishing mental health outcome were being married (OR = 3.12, 95%CI 1.67 - 4.09, p = 0.035), a physician (OR = 4.09, 95%CI 1.98 - 5.61, p = 0.002), a nurse (OR = 2.21, 95%CI 0.05 - 0.24, p < 0.001), limited access to personal protective equipment (OR = 3.25, 95%CI 1.62 - 6.22, p = 0.043) and self-isolation and quarantine due to SARS-CoV-2 infection (OR = 3.03, 95%CI 0.02 - 0.95, p < 0.001). Conclusion: Nigeria’s frontline healthcare workers, especially physicians and nurses, are experiencing COVID-19 related psychological distress. There is need to develop and implement interventions to reduce the impact of prolonged psychological distress on long-term mental wellbeing in healthcare workers treating COVID-19 patients.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jo Billings ◽  
Brian Chi Fung Ching ◽  
Vasiliki Gkofa ◽  
Talya Greene ◽  
Michael Bloomfield

Abstract Background Healthcare workers across the world have risen to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline workers and calls to provide psychosocial support for them. However, little attention has so far been paid to understanding the impact of working on a pandemic from healthcare workers’ own perspectives or what their views are about support. Methods We searched key healthcare databases (Medline, PsychINFO and PubMed) from inception to September 28, 2020. We also reviewed relevant grey literature, screened pre-print servers and hand searched reference lists of key texts for all published accounts of healthcare workers’ experiences of working on the frontline and views about support during COVID-19 and previous pandemics/epidemics. We conducted a meta-synthesis of all qualitative results to synthesise findings and develop an overarching set of themes and sub-themes which captured the experiences and views of frontline healthcare workers across the studies. Results This review identified 46 qualitative studies which explored healthcare workers’ experiences and views from pandemics or epidemics including and prior to COVID-19. Meta-synthesis derived eight key themes which largely transcended temporal and geographical boundaries. Participants across all the studies were deeply concerned about their own and/or others’ physical safety. This was greatest in the early phases of pandemics and exacerbated by inadequate Personal Protective Equipment (PPE), insufficient resources, and inconsistent information. Workers struggled with high workloads and long shifts and desired adequate rest and recovery. Many experienced stigma. Healthcare workers’ relationships with families, colleagues, organisations, media and the wider public were complicated and could be experienced concomitantly as sources of support but also sources of stress. Conclusions The experiences of healthcare workers during the COVID-19 pandemic are not unprecedented; the themes that arose from previous pandemics and epidemics were remarkably resonant with what we are hearing about the impact of COVID-19 globally today. We have an opportunity to learn from the lessons of previous crises, mitigate the negative mental health impact of COVID-19 and support the longer-term wellbeing of the healthcare workforce worldwide.


Author(s):  
Jo Billings ◽  
Brian Chi Fung Ching ◽  
Vasiliki Gkofa ◽  
Talya Greene ◽  
Michael Bloomfield

AbstractHealthcare workers across the world have risen to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline healthcare workers and growing calls to provide psychosocial support for them. However, little attention has so far been paid to understanding the impact of working on a pandemic from healthcare workers’ own perspectives or what their views are about support. This rapid review identified 40 qualitative studies which have explored healthcare workers’ experiences and views from previous pandemics, including and comparable to COVID-19. Meta-synthesis of this qualitative data using thematic analysis derived eight key themes which transcended pandemics, time, and geographical boundaries. This pandemic is not unprecedented; the themes that arose from previous pandemics were remarkably resonant with what we are hearing about the impact of COVID-19 globally today. We have an opportunity to learn from the lessons of these previous pandemics, mitigate the negative mental health impact of COVID-19 and support the longer-term wellbeing of the healthcare workforce worldwide.


2021 ◽  
Author(s):  
Jo Billings ◽  
Brian Chi Fung Ching ◽  
Vasiliki Gkofa ◽  
Talya Greene ◽  
Michael Bloomfield

Abstract Background: Healthcare workers across the world have risen to the demands of treating COVID-19 patients, potentially at significant cost to their own health and wellbeing. There has been increasing recognition of the potential mental health impact of COVID-19 on frontline workers and calls to provide psychosocial support for them. However, little attention has so far been paid to understanding the impact of working on a pandemic from healthcare workers’ own perspectives or what their views are about support. Methods: We searched key healthcare databases (Medline, PsychINFO and PubMed), reviewed relevant grey literature, screened pre-print servers and hand searched reference lists of key texts for all published accounts of healthcare workers’ experiences of working on the frontline and views about support during COVID-19 and previous pandemics/epidemics. Final searches took place on September 28, 2020. We conducted a meta-synthesis of all qualitative results to synthesise findings and develop an overarching set of themes and sub-themes which captured the experiences and views of frontline healthcare workers across the studies. Results: This review identified 46 qualitative studies which explored healthcare workers’ experiences and views from pandemics or epidemics including and prior to COVID-19. Meta-synthesis derived eight key themes which largely transcended temporal and geographical boundaries. Participants across all the studies were deeply concerned about their own and/or others’ physical safety. This was greatest in the early phases of pandemics and exacerbated by inadequate PPE, insufficient resources, and inconsistent information. Workers struggled with high workloads and long shifts and desired adequate rest and recovery. Many experienced stigma. Healthcare workers’ relationships with families, colleagues, organisations, media and the wider public were complicated and nuanced and could be experienced concomitantly as sources of support but also sources of stress. Conclusions: The experiences of healthcare workers during the COVID-19 pandemic are not unprecedented; the themes that arose from previous pandemics and epidemics were remarkably resonant with what we are hearing about the impact of COVID-19 globally today. We have an opportunity to learn from the lessons of these previous crises, mitigate the negative mental health impact of COVID-19 and support the longer-term wellbeing of the healthcare workforce worldwide.


2020 ◽  
Vol 3 ◽  
Author(s):  
Tanner Thornsberry ◽  
Jill Nault Connors ◽  
Julie Welch ◽  
Julie Hayden ◽  
Jennifer Hartwell ◽  
...  

Background:  The COVID-19 pandemic has placed a high psychological burden on frontline healthcare workers. Often quarantined away from their families and with little downtime to process their experiences, those on the frontlines of the pandemic are experiencing pronounced levels of distress and significantly elevated rates of burnout. Although many wellness and psychological resources are available to providers, there is low uptake and little is known about their effectiveness. In this study, we assess the impact of group-based peer support sessions on symptoms of acute distress, anxiety and depression, and provider burn out.    Methods:  An established peer support model is adapted for use with groups of frontline healthcare workers that will participate in 6 to 8 weekly group sessions using videoconferences. The study approach is a phased feasibility to research design. During the feasibility phase, we will initially test the intervention in 3 groups of 8 providers using a quasi-experimental, pre- post analysis of change. If preliminary results are positive, we will scale the intervention and progress to a more rigorous study design using a differences-in-differences approach to assess change over time between exposure and non-exposure groups. Outcomes will be measured at baseline, intervention completion, and 3- and 6- month follow ups. During the feasibility phase we will assess intervention fidelity and conduct qualitative analysis to assess the effects of the pandemic on work, family and social life.     Results:  This is a work in progress. At present we have recruited 28 emergency medicine physicians and residents with a target start date of August 1, 2020.    Potential Impact:  We anticipate the results of this study will provide evidence in support of a recent call for “the use of non-clinical mental health support, such as social or peer support” from the American College of Emergency Physicians in conjunction with 42 leading professional organizations in medicine. In addition, results may lead to advocacy for improved policies that mitigate against “fear of resultant loss of licensure, loss of income, or other career setbacks” for seeking mental health support. 


2021 ◽  
pp. 089198872199681
Author(s):  
Kerry Hanna ◽  
Clarissa Giebel ◽  
Hilary Tetlow ◽  
Kym Ward ◽  
Justine Shenton ◽  
...  

Background: To date, there appears to be no evidence on the longer-term impacts caused by COVID-19 and its related public health restrictions on some of the most vulnerable in our societies. The aim of this research was to explore the change in impact of COVID-19 public health measures on the mental wellbeing of people living with dementia (PLWD) and unpaid carers. Method: Semi-structured, follow-up telephone interviews were conducted with PLWD and unpaid carers between June and July 2020. Participants were asked about their experiences of accessing social support services during the pandemic, and the impact of restrictions on their daily lives. Results: 20 interviews were conducted and thematically analyzed, which produced 3 primary themes concerning emotional responses and impact to mental health and wellbeing during the course of the pandemic: 1) Impact on mental health during lockdown, 2) Changes to mental health following easing of public health, and 3) The long-term effect of public health measures. Conclusions: The findings from this research shed light on the longer-term psychological impacts of the UK Government’s public health measures on PLWD and their carers. The loss of social support services was key in impacting this cohort mentally and emotionally, displaying a need for better psychological support, for both carers and PLWD.


Author(s):  
Chris Bullen ◽  
Jessica McCormack ◽  
Amanda Calder ◽  
Varsha Parag ◽  
Kannan Subramaniam ◽  
...  

Abstract Background: The global COVID-19 pandemic has disrupted healthcare worldwide. In low- and middle-income countries (LMICs), where people may have limited access to affordable quality care, the COVID-19 pandemic has the potential to have a particularly adverse impact on the health and healthcare of individuals with noncommunicable diseases (NCDs). A World Health Organization survey found that disruption of delivery of healthcare for NCDs was more significant in LMICs than in high-income countries. However, the study did not elicit insights into the day-to-day impacts of COVID-19 on healthcare by front-line healthcare workers (FLHCWs). Aim: To gain insights directly from FLHCWs working in countries with a high NCD burden, and thereby identify opportunities to improve the provision of healthcare during the current pandemic and in future healthcare emergencies. Methods: We recruited selected frontline healthcare workers (general practitioners, pharmacists, and other medical specialists) from nine countries to complete an online survey (n = 1347). Survey questions focused on the impact of COVID-19 pandemic on clinical practice and NCDs; barriers to clinical care during the pandemic; and innovative responses to the many challenges presented by the pandemic. Findings: The majority of FLHCWs responding to our survey reported that their care of patients had been impacted both adversely and positively by the public health measures imposed. Most FLHCs (95%) reported a deterioration in the mental health of their patients. Conclusions: Continuity of care for NCDs as part of pandemic preparedness is needed so that chronic conditions are not exacerbated by public health measures and the direct impacts of the pandemic.


2020 ◽  
Author(s):  
Fatih Çölkesen ◽  
Oguzhan Kilincel ◽  
Mehmet Sozen ◽  
Eray Yıldız ◽  
Sengul Beyaz ◽  
...  

BACKGROUND The adverse effects of COVID-19 pandemic on the mental health of high-risk group patients for morbidity and mortality and its impact on public health in the long term have not been clearly determined. OBJECTIVE To determine the level of COVID-19 related transmission fear and anxiety in healthcare workers and patients with primary immunodeficiency disorder (PID), severe asthma, and the ones with other comorbidities. METHODS The healthcare workers and patients with PID, severe asthma (all patients receiving biological agent treatment), malignancy, cardiovascular disease, hypertension (90% of patients receiving ACEI or ARB therapy), diabetes mellitus (42 % of patients receiving DPP-4 inhibitor therapy) were included in the study. A total of 560 participants, 80 individuals in each group, were provided. The hospital anxiety and depression scale ( HADS ) and Fear of illness and virus evaluation (FIVE ) scales were applied to the groups with face to face interview methods. RESULTS The mean age was 49.30 years and 306 (55 %) were female. The FIVE Scale and HADS-A scale scores of health care workers were significantly higher than other groups' scores (p = 0.001 and 0.006). The second-highest scores belonged to patients with PID. There was no significant difference between the groups for the HADS-D score (p=0.07). The lowest score in all scales was observed in patients with hypertension. CONCLUSIONS This study demonstrated that in the pandemic process, patients with primary immunodeficiency, asthma patients, and other comorbid patients, especially healthcare workers, should be referred to the centers for the detection and treatment of mental health conditions.


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