Hat off for serving humanity!
The pandemic Covid-19 is a global problem, touching every corner of the world. It has forced health care institutions to consider universal guidelines to allocate scarce resources, including personal protective equipment, ICU access, and ventilators. Covid-19 already killed more than 3.7 lac people globally making it cataclysmic events that left indelible imprints on the global psyche.
Like the volunteers who flooded into different professional sectors, the health care providers working on the front lines of the ongoing pandemic will be remembered forever. These courageous fighters are risking their lives, threatened not only by exposure to the virus but also by deleterious effects on their mental health. Unfortunately, we are already seeing reports of clinicians dying amid the pandemic. Before the virus struck, the clinical workforce was already experiencing a crisis of burnout. We are now facing a surge of physical and emotional harm that amounts to a parallel pandemic.
Just as the countries of the world rallied to care for different disasters, we must take responsibility for the well-being of clinicians, the first responders to deadly infection, now and in the long run. We are calling for several immediate actions to lay the groundwork for a clear and accountable global strategy to safeguard the health and well-being of those workforces.
After 2003, SARS outbreak in different parts of the world with high levels of emotional distress among hospital workers; stemming from social isolation, the pain of losing colleagues to the disease and social stigma associated with exposure to SARS virus. Among other factors, self-stigmatization was also a problem for nurses in nuclear and other disasters, who described the emotional turmoil of being, forced to choose between protecting themselves and their loved ones and doing their duty as caregivers during a crisis.
With overwhelming numbers of critically ill patients and shortages of essential supplies, providing the optimal standard of care becomes beyond reach. People who feel that they are called as healers in the altruistic Hippocratic tradition must stand by powerlessly as their patients sicken and dies a tragic that may cause serious moral injury. Such injury may be most acute and long lasting in the brave health professionals serving on the front lines.
Many international organizations have already created a chief wellness officer position at the highest executive level. As a first immediate action at institutional level, officials should be given a powerful voice in command centers or decision-making bodies. As a second immediate action, organizations can empower and encourage clinicians to speak freely about the stressors they face and to advocate for that their own health as well as of their patients. This effort might include the use of unique hotline systems to allow clinicians to voice their concerns without fear of reprisal. For such systems to be meaningful authorities engaged in national and international health sectors must be prepared to respond transparently to feedback.
The clinicians are an exhaustible global resource and it is already stretched to the breaking point in many locations. The Covid-19 crisis comes as a blow to a population already at heightened risk for psychological distress and mental health problems. Even before the pandemic, alarmingly high numbers of health professionals were suffering from burnout according to some epidemiological survey and research of western world. Such a burnout is associated with higher rates of psychological disorders and depression that will be aggravated by the pandemic. We need a single standard solution across globe that acknowledges the scale of the crisis, and we cannot afford to wait.
The Coronavirus Aid, Relief, and Economic Security Act and follow-on legislation appropriated financial fund to support hospitals, health systems, and providers in bearing the economical costs of the pandemic. Although they represent an important start, these funds are unlikely to cover the projected losses of these institutions; let alone meet the enormous need to care for workforce.
We face the paradox of ongoing activity of the virus, even as institutions begin to furlough employees in response to economic ramifications of the pandemic for international health care delivery system. The number of clinicians experiencing long-term harms from pandemic is likely to be much greater than many other disasters and therefore the inclusion of specific funding for their well-being is very urgent.
Another quintessential need is a national epidemiologic tracking program to measure clinician well-being during and after the crisis. Ideally, such a program would be led by the CDC; Atlanta would use random sampling and standardized instruments to assess acute and long-term effects of Covid-19 service on clinicians. The crisis has revealed with painful clarity and fraying threads of the global clinicians while repairing the fabric will take all of us. Clinician well-being is an intricate issue with multiple responsible parties, including employers, professional associations, quality-improvement organizations and government. This includes effective planning and assurance of availability of the precautionary items for all health workers.
We have a brief window of opportunity to get ahead of two pandemics, the spread of the virus today and the harm to clinician well-being tomorrow. If we fail, we will have to pay higher price for years to come.
Dr Iftikhar Ahmed, Head, Department of Microbiology, Enam Medical College, Savar, Dhaka