Keywords

Mental health; Medical staff; COVID-19 pandemic

Introduction

In December 2019, COVID-19 was identified in Wuhan, China. In 2020, the World Health Organization (WHO) announced the global outbreak of the novel coronavirus. This has greatly affected public health around the world, currently resulting in 108 million confirmed cases and 2.3 million deaths [1]. The COVID-19 pandemic has tremendously impacted medical staff because of the highly infectious and potentially fatal nature of virus [2-4]. For medical staff that must treat uncertain or confirmed cases, a sense of unease, depression, or anxiety may develop [4]. The anxiety of medical staff facing COVID-19 can arise from: not knowing whether supervisors understand the pressure burdening frontline staff, whether enough personal protective equipment (PPE) will be provided, worries about infecting family members, concerns over whether one’s professional knowledge is enough, concerns of inadequate physical and mental support, concerns of work-life balance, etc. Lack of understanding of the individual/individual’s family’s needs and concerns can result in a decrease of medical staffs’ confidence when facing patients [5]. Thus, hospital administrators should first understand the anxiety and expectations of medical staff to formulate related accommodations and support, thereby reducing the pressure and anxiety [5].

Taiwan’s previous experience in the 2003 SARS pandemic has prepared the health care system on how to best approach the COVID-19 pandemic, which shares several points of similarities. In particular, a focus on the physical and mental health of medical staff has prevented the health care system from becoming overwhelmed and a much more effective handling of the COVID-19 pandemic. Through initiatives such as “assembling a mental health task force,” “increasing transparency in information and communication,” “providing educational training,” “establishing physical and mental health assessment mechanisms,” “providing mental health services,” etc., Taiwan’s hospitals specifically provided medical staff mental support and assistance. As a result, hospitals were able to effectively overcome the pandemic and minimize its impact [5-7].

Assembling a Mental Health Task Force

A mental health task force was created, consisting of representatives from various departments (i.e. medical, nursing, infectious disease management, psychology, social worker, psychiatry, human resources, etc.). The task force should assist the hospital in taking practical, feasible actions to provide an environment caring for medical staff through physical and mental health support. Arranging an executive hospital administrator to act as the medical staff’s mental health services leader will further promote its effectiveness [5,6].

Increasing Transparency in Information and Communication

Hospitals should keep pandemic-related information to all employees as clear as possible, especially frontline medical staff. Public transparency and announcements about confirmed cases can reduce the impact of pandemic rumors and misinformatio [5-7].

Providing Educational Training

Taiwan’s SARS experience has shown the importance of enhanced educational training, which includes scenario-specific simulation training (i.e. outbreak simulations) and COVID-19 knowledge and handling skills. In particular, an adequate supply of PPE must be provided to give medical staff peace of mind. This acknowledges concerns of medical staff and addressing them can help reduce their stress and psychological burdens. It is also a priority to recruit voluntary and experienced staff to join the team and advance their infection protection knowledge and skills. Additional volunteers should be recruited later [5,6].

Establishing Physical and Mental Health Assessment Mechanisms

The assessment of physical and mental health for medical staff during a pandemic is immensely important. An online self- reporting system can be created with dedicated personnel monitoring, tracing, caring, and referring an individual for psychological support when necessary. To reduce the level of stress among medical staff, active medical consultations and COVID-19 screening should be arranged [6].

Providing Mental Health Services

Peer and supervisor support can increase an individual’s coping skills, as well as reducing their emotional burden. In addition, increased understanding of medical staff and their family’s needs and expectations are necessary to address their concerns (i.e. fear of affecting friends and families, etc.). Hospital policies should arrange a place of residence and access to food during the pandemic, thereby reducing the worries of transmission. In addition, proactive care should be provided to quarantine medical staff [5,6].

Conclusion

The COVID-19 pandemic has severely impacted medical staff in various aspects. As medical staff enter frontline battles against the virus and simultaneously take care of patients, they are placing themselves at high-risk of contracting the virus. This sacrifice means that their mental health requires governmental and hospital respect and support, now and in the future, to prevent a healthcare system burnout. We trust that the medical community can come together as one, face the pandemic head- on, and overcome the pandemic crisis.

References

1. World Health Organization. Weekly epidemiological update-16
2. February 2021.22 February 2021.
3. Li Q, Guan X, Wu P, Wang X, Zhou L, et al. (2020) Early transmission dynamics in Wuhan, China, of novel coronavirusâ?? infected pneumonia. N Engl J Med 382:1199-1207
4. Rothe C, Schunk M, Sothmann P, Bretzel G, Froeschl G, et al. (2020) Transmission of 2019-nCoV infection from an asymptomatic contact in Germany. N Engl J Med 382(10):970â?? 971.
5. Lai J, Ma S, Wang Y, Cai Z, Hu J, et al. (2020) Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. J American Med Asso Netw Open 3(3): e203976.
6. Ming-Chu F, Hsiang-Chun W, Hui-Tzu L, Lei L, Chia-Ling C, et al. (2020) Exploring the stress, psychological distress, and stress- strategies of Taiwan nursing staff facing the global outbreak of COVID-19. Hu Li Za Zhi 67(3): 64-74.
7. Ju-Chuan S, Lih-Jong S, Hsiu-Chin C (2021) Maintaining mental health among medical staff: Taiwanâ??s Experience. J Formos Med Assoc 120(3): 923-925.
8. Maunder R (2004) The experience of the 2003 SARS outbreak as a traumatic stress among frontline healthcare workers in Toronto: Lessons learned. Philos Trans R Soc Lond B Biol Sci 359(1447): 1117â??1125.