Page 10 - GHES-2-4

Global Health Economics and
Sustainability
COVID-19 and the burden on healthcare workers

many healthcare workers (HCWs). By May 2023, there b. To highlight responses implemented by health services
had been over 766 million cases globally, with almost 7 to mitigate the psychological symptoms, burden, and
million deaths (WHO, 2023). The threat of COVID-19 impact on frontline HCWs
posed a great challenge to hospital systems, leading to c. To highlight previously initiated programs to support
staff shortages, a scarcity of medical supplies, and an the well-being of frontline HCWs throughout the
increased risk of workplace-acquired infections (Master COVID-19 pandemic, thereby providing inspiration
et al., 2020). In September 2020, the WHO announced that for individuals’ health services to design, institute, and
despite HCWs accounting for only 3% of the population, validate specific programs to reduce similar burdens
they had accounted for 14% of COVID-19 cases in many from a potential disease X, major health threat, or
countries, with this figure being as high as 35% (WHO, psychologically distressing event; and
2020). COVID-19 was a worldwide health crisis, yet it was d. To provide the initial makings of a toolkit through an
not the first pandemic that the modern world has faced nor infographic and generalized assessment tool for health
will it be the last. The Spanish flu, severe acute respiratory services to kick-start future well-being initiatives.
syndrome, Middle East respiratory syndrome, Ebola, and
swine flu have all emerged over the last century (Gupta 2. Methods
& Sahoo, 2020). The WHO identifies “Disease X” as a 2.1. Study design
priority for global investment, research, and development;
it denotes a currently unknown pathogen with the This narrative review following a systematic approach
potential to cause a serious international epidemic (WHO, was designed based on informal discussions with
2022). Disease X is a placeholder concept that encourages senior emergency department physicians, nurses, and
scientists, HCWs, non-profit organizations, and the administration staff at three Victorian teaching hospitals,
pharmaceutical industry to act proactively and not merely with a research question, study aims, and subsequent search
be wedded to responses to previous pandemics. Just as they strategy developed to attempt to gain a greater understanding
have occurred in the past, pandemics will occur again; of the broad impact of COVID-19 on frontline HCWs and,
thus, preparation is crucial. Previous pandemics highlight more specifically, in the emergency department. Given the
that, apart from physical morbidity and mortality, these vast inter-hospital and inter-unit variability worldwide, this
events cause a significant mental health burden among design was adopted to limit the search strategy to emergency
frontline HCWs, including anxiety, depression, burnout, departments where senior clinicians felt that this vast
insomnia, and post-traumatic stress disorder (PTSD; heterogeneity would be somewhat reduced.
Gupta & Sahoo, 2020). Frontline HCWs are those in direct 2.2. Search strategy
patient-facing roles, who are essential for providing care
for COVID-19-positive patients in wards, the emergency Published studies were found by searching the MEDLINE
department, the operating theater, and intensive care units (OVID interface), Cumulative Index to Nursing and
(ICUs). Despite this knowledge and previous experience, Allied Health Literature, and Cochrane Central Register of
the mental health of frontline HCWs often remains a Controlled Trials (Cochrane Library) databases. Additional
secondary consideration behind the public’s needs. The literature was identified through reference tracking.
psychological, emotional, and physical demands placed A bibliographic and gray literature search of the official
on overstretched frontline HCWs may cause long- WHO website was also conducted. The search strategy is
lasting and substantial negative impacts on their well- highlighted in Table 1. The databases were searched for the
being (Roberts et al., 2020), stretching far beyond the following terms and included articles up to April 2024:

COVID-19 pandemic. Gaining an understanding of these 2.3. Types of studies
impacts, especially in the early stages of a pandemic, using
COVID-19 as a case study, will provide greater insights Primary empirical research studies were included, while
into the impact on the health-care network and allow for editorials, protocols for planned studies, abstracts, and
improvements to bolster responses to future health threats dissertations were excluded from the study.
or major psychologically distressing events.
2.4. Inclusion criteria
1.1. Review objectives All relevant articles published or translated into English,

The primary aims of this study were as follows: with the full text available, were included in the review.
a. To review and describe the available literature on the While the search strategy limited the search to emergency
psychological symptoms, burden, and impact of the departments, publications that also included findings on
early stages of the COVID-19 pandemic on frontline frontline HCWs in ICUs, or COVID wards were included
HCWs in the study.

Volume 2 Issue 4 (2024) 2 https://doi.org/10.36922/ghes.2530