By Jennifer Wider, MD and Mahek Shah, MD, MBA
As the Delta Variant wreaks havoc on parts of the United States, governing bodies are trying to increase vaccination and decide whether to mask up yet again. American society is dividing its attention between a new mutation and ongoing mental health pandemic, but our doctors, nurses and fellow healthcare professionals are largely being left out of the discussion.
The Covid-19 pandemic and subsequent economic recession took a significant toll on the mental health of Americans across the country. According to statistics from the Kaiser Family Foundation, roughly 40 percent of adults in the US reported depression or symptoms of anxiety during the pandemic. Sleeping difficulties, eating issues and an increase in alcohol and substance use were at an all-time high.
The plight of American health care workers is largely ignored, as the country battles the Delta variant, low vaccination rates and compliance in certain states including Mississippi, Arkansas, Alabama and Louisiana and a growing mental health epidemic. Healthcare providers have been relentlessly fighting the pandemic within healthcare settings and combating misinformation online and in person. As a result, our healthcare workers are largely burnt out from a steady sixteen months with little to no time off.
“There was no adequate preparation for the heaviness of the pandemic,” says Natasha Abadilla, MD a first year pediatric neurology resident at Stanford University School of Medicine. “Attendings, residents and students are burnt out because of a thick layer of emotional and mental trauma.”
Dr. Abadilla is not alone. According to data from a study conducted by Medscape, a significant number of doctors reported burnout before the pandemic, but for more than one in five, severe burnout started with the pandemic. The factors listed include: lack of adequate personal protective equipment, grief from losing patients, watching families suffer, difficult working conditions and long hours.
Healthcare providers were feeling overworked, underappreciated and burned out before the pandemic, in many cases the pandemic pushed them over the edge. According to Jonathan Fisher, MD FACC, clinical cardiologist and Chair and Co-founder of the upcoming Global Summit on Ending Physician Burnout, “Burnout affected 2 out of 3 internal medicine physicians during the pandemic with women and ethnic minorities and those impacted by COVID more likely to be burned out.”
In one study from the British Medical Journal, more than 1 in 5 doctors considered quitting the profession or had quit during the pandemic. Physicians who reported that Covid-19 affected their burnout were more likely to consider quitting their job. If proper care is not taken to support our healthcare workers, there may be a significant shortage of them in the future.
Not surprisingly, these patterns are seen outside of the United States, as well. In India, a country hit particularly hard by the Delta variant, medical students are largely underprepared and have been experiencing acute anxiety. Rachel Logue, a rising high school senior in Fairfield CT served as a global health research assistant at Nuvance Health/University of Vermont Global Health Program and reports that students in India were struggling and their mental health needs weren’t being properly addressed. “Knowing that countries like India have been hit especially hard by Covid-19, I wanted to contribute through global health research projects to find ways to better support the emotional well-being of deeply affected populations like the students in India.” The project is on-going but represents the universal struggle of healthcare students and workers all across the world.
Amanda Kingston, MD, MSMA, an assistant professor at the University of Missouri in the department of psychiatry has researched the topic of healthcare worker suicide during the pandemic. She has presented at a variety of conferences and published numerous times on the topic of physician suicide. In a letter published in the Journal of the Missouri State Journal of Medicine, she writes: “All of us are working long hours, picking up extra shifts, and putting our own self-care last during this pandemic which will have dire consequences if gone unchecked. We know from previous research that physicians are a vulnerable group for depression and suicide and hesitant to seek care in the best of circumstances.” Her advice is a warning to the lay population to recognize and take care of the doctors and nurses putting their lives on the line every day, “This is a marathon, not a sprint; we must continue to take care of our physicians so that they can continue to care for those who need them most.”
Dr. Jonathan Fisher decided not to sit by idly and watch the pandemic wreak havoc on a field he has dedicated his life to. He organized the first ever Ending Physician Burnout Global Summit to address the growing mental health needs of healthcare workers across the world. The Summit will feature fireside chats with Arianna Huffington, (CEO of Thrive Global) BJ Miller, MD (>13 million TED Conferences video views) , Omar Dawood, M.D., M.P.H., M.B.A. (Chief Medical Officer of Calm and Thom Mayer, MD (CMO of NFL Players Association) and other thought leaders. including sessions with Q & A with Robert Pearl, M.D. (former President and CEO of Kaiser Permanente) and Hansa Bhargava MD (Chief Medical Officer of Medscape).
Fisher is hoping to empower his fellow healthcare providers and potentially save lives. “If even a single doctor somewhere in the world who is suffering from loneliness, isolation, hopelessness, anxiety, depression, burnout, or suicidal thoughts finds hope in this event and what it stands for, I will consider it a success.”
Frellick, M. COVID-19 Drives Physician Burnout for Some Specialties, Clinician Insights, Medscape. January, 2021.
Khan, N. Cross-sectional survey on physician burnout during the COVID-19 pandemic in Vancouver, Canada: the role of gender, ethnicity and sexual orientation. BMJ Vol 11, Issue 5, 2021.
Kingston, A. Break the Silence: Physician Suicide in the Time of COVID-19 Mo Med. 2020 Sep-Oct; 117(5): 426–429.