Commentary: COVID is traumatizing our doctors and nurses

Bloomberg
Published: 1/20/2021 6:00:07 AM

Hand it to human beings. We have repeatedly defied predictions that we will buckle under the extreme pressure of adverse events. Time and again, whether it was during the eight-month blitz in World War II, or after 9/11, people have proved remarkably resilient in the face of adversity.

Will it be the same with this pandemic? On aggregate, probably yes. Most people have experienced, or know someone who has experienced, mental stress as a result of pandemic-related circumstances. (Irritation, anxiety, helplessness, tiredness, sadness, burnout, trouble sleeping or difficulty concentrating – any of these sound familiar?) But once vaccinated and our lives are unlocked, most people will probably return to their individual baseline levels of happiness, even if there are new post-pandemic adjustments to be made.

And yet while different people experience the threat of the virus and repeated lockdowns differently, the mental health impact of the crisis for many cannot be ignored. The pandemic affects so many drivers of well-being – from social isolation to financial loss, housing insecurity, remote working and rising unemployment – while removing normal coping mechanisms.

Most recently, the spotlight has been on the huge pressure facing hospital staff. A study of 709 doctors, nurses and other clinical staff across six hospitals in England found that nearly half reported symptoms consistent with post-traumatic stress disorder in June and July. What they are experiencing is analogous to combatants in a war zone, researchers found. They face not only the relentless demands of their jobs – heightened because of a shortage of beds and nurses - but also the constant loss of life of those in their care. One in five ICU nurses reported thoughts of self-harm. Those are much higher rates than found among even U.K. military personnel who have been deployed.

Ami Jones, a doctor and an intensive care consultant with the Aneurin Bevan University Health Board, says she’s particularly worried about the nurses in their mid-20s who have a full career ahead of them. “If we damage them to the point that they don’t want to do ICU care anymore, who have we got in future to look after us?” she asked on Bloomberg Radio last week. “This could have a very long sting in the tail.”

What these medical workers face is extreme, and the mental health impact of the pandemic is widespread. The Prince’s Trust annual survey of young people’s happiness found that more than half said they always or often felt anxious; it is 64% for those not in work, education or training.

In some ways, the pandemic may be worse than warfare for many from a mental health perspective. When U.K. Prime Minister Boris Johnson referred to COVID as an “invisible killer,” he inadvertently put his finger on an element of this crisis that makes it so hard on mental health. If this is war, we are deprived of one of its great salves – the comfort of the human touch and camaraderie. If it’s a blitz, we can’t see the enemy and can’t huddle together. On the contrary, the pandemic has made us weaponize self-isolation.

It’s hard to overstate the potential costs to companies and the broader economy. Even before the outbreak, governments were just getting to grips with the costs of neglecting (or stigmatizing) mental health. Related services are chronically underfunded (often 2% or less of national health budgets) in most countries. For companies and public health systems, the failure to provide support has translated into lost productivity, the phenomenon of “presenteeism,” and increased health-care costs. In Britain, some 74% of people with a mental health problem were out of work for more than a year and workplace mental ill-health cost employers around 26 billion pounds ($35 billion) per year.

The World Health Organization found that mental health services have been disrupted in 93% of countries worldwide since the virus arrived. Household income to pay for healthcare will likely drop as the economic impact of the pandemic bites and insurance protection may decline. As with other aspects of this crisis, the most vulnerable parts of the population will be hardest hit.

How to deal with the long tail of the pandemic? We know from studies of past recessions that poor mental health can be both a contributor and an effect. Economist and happiness guru Richard Layard argues in a recent podcast hosted by Bloomberg Economics head Stephanie Flanders that societies cannot just focus on a return to growth and assume the mental health impacts of the pandemic will melt away.

It will largely fall to families, schools, community services and charities to provide the first line of support. But the scale of the coronavirus’s impact will also require an increased role for the state and employers too. For companies, it may mean more strategies to manage burnout, foster connections and support workers divided into Zoom or Microsoft Teams squares, something Microsoft Corp. Chief Executive Officer Satya Nadella has spoken about a lot.

For governments, the key is finding interventions that are evidence-based and improve the focus on preventive care. The pandemic recession will demand more active labor market programs to help people retain jobs, or retrain them, and better legal protections. That certainly fits with Boris Johnson’s emphasis on “levelling up” and his manifesto commitment to improving support for mental health. Some in his party will want to focus on growth policies, but Layard’s research suggesting people worry about health and well-being, relationships and community ahead of income points to a more nuanced approach to post-pandemic policy.

I began by saying we humans are good at adapting to change, finding meaning in the new normal and developing solutions – or else we wouldn’t be here. But our survival also comes through anticipating threats and preparing to meet them. Well, here’s one in plain sight.




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