COVID-19 Pandemic; Anxiety and Depression among Frontline Healthcare Workers: Rising from the Ashes

*Salman Sharif and Faridah Amin*

#### **Abstract**

This chapter gives an insight into the psychological journey of the essential healthcare workers (HCWs) during the COVID-19 pandemic. The catastrophe which started off with uncertainty, provoked fear-related behaviors among the frontline doctors, nurses and paramedical staff. With meager resources and lack of a disaster plan, fire-fighting was a reflex response of healthcare institutions. Though the whole world seemed to be unprepared for the calamity, developing countries with fragile healthcare systems were more vulnerable to collapse. The negative aura was complicated by mistrust among the general population, regarding healthcare workers, institutions and government. Furthermore, with economic downfall; balancing work and protecting the family was a challenge for HCWs, especially during the pandemic peak. The psychological distress translated to rising incidence of depression and anxiety among them. As institutions gained insight into psychosocial issues of HCWs; support and therapies were offered to them. Positive messages labelling HCWs as "Heroes of the Pandemic" were circulated and structured programs developed to address their needs. With the advent of COVID-19 vaccine, a ray of hope emerged, although there are still apprehensions about its efficacy and side-effects. The whole world now eagerly awaits the calamity to perish while normality can rise from ashes.

**Keywords:** Health care worker, Covid 19 Pandemic, Anxiety, Depression, Phycological distress

#### **1. Introduction**

"2020" has been a revolutionary year especially in terms of exploring new healthcare horizons. The voyage of the pandemic which started off with crises, disbelief, qualms and fears; with the advent of the vaccine, seems to be ending with revival, hope, insights and new acumens.

In its true sense, within a couple of months the world transformed into a global village attacked by a common enemy "The SARS COVID-19 virus" with healthcare workers (HCW) stepping into the battlefield, leading from front; few losing their lives while the others still struggling to get through the catastrophe. Although the unsung heroes are working nonstop under tremendous pressure, surely the effects

of this struggle may take a long time to fade. Especially the psychological pressure, stress and burnout may leave long lasting effects such as post-traumatic stress disorder, anxiety and depression which may continue to shape their lives in the long term.

This chapter gives an insight into the psychological journey of the essential healthcare workers; doctors, nurses and paramedical staff who are selflessly working at the frontlines, caring for their patients while striving to protect themselves, their families and loved ones from the outbreak. The chapter discusses the psychological distress caused, its associated factors and the coping strategies developed. As the pandemic is still not over, with the long term efficacy of vaccine unknown and as the third wave is approaching, recommendations can be made for preventive measures to limit the damage.

#### **2. The beginning - Fear of unknown**

The infection was first reported as a case series of patients with pneumonia in Wuhan, China in December 2019. Tracing back exposure, all the cases were found to have visited a seafood market in Wuhan. The virus identified as a new strain of Corona virus, was later named as COVID-19 [1]. More than 200 countries and around 500,000 population worldwide were affected within a short span on 3–4 months, while death attributable to COVID-19 globally was reaching more than 20,000 by the end of March 2020 [2]. Though the whole world seemed to be unprepared for the calamity, developing countries with fragile healthcare systems were more vulnerable to collapse [3]. With a mortality rate as high as 12% reported in industrialized countries, the general speculations were devastating [4, 5].

#### **2.1 Fear of disease and shortage of Personal Protective equipment**

Soon, the xenophobia spread to communities, institutions, regional and international governance while all the hopes to address, control and prevent widespread damage from the infection were laid on scientists, public health and medical professionals. High expectations from healthcare workers (HCWs) who were themselves vulnerable and exposed, further complicated the situation especially in an overwhelming situation with resource constraints. Healthcare workers including front line physicians, nurses and paramedical staff combating at forefront were especially susceptible to get infected, taking the disease back home and infecting their family members. As the association of higher mortality with older age became evident, the senior health professionals and their families were even more concerned for the health of their loved ones [6, 7].

Due to unpreparedness, availability of personal protective equipment (PPE) was limited even for the healthcare professionals, let alone for the general population. Dearth of knowledge about nature of disease and its spread, further created mental pressure and psychological distress [3]. Institutions which were already overburdened and functioning beyond their limits, were unable to provide adequate support to the petrified HCWs.

#### **2.2 Psychological distress and associated factors**

The beginning of the pandemic was therefore taxing for the mental wellbeing especially of healthcare professionals. Various studies among frontline physicians, nurses, para medical and administrative staff, revealed a high prevalence of stress, anxiety and depression [8] as depicted in **Table 1**. Although most of the studies did not compare the prevalence of mental distress during COVID than the


*COVID-19 Pandemic; Anxiety and Depression among Frontline Healthcare Workers… DOI: http://dx.doi.org/10.5772/intechopen.98274*



#### *COVID-19 Pandemic; Anxiety and Depression among Frontline Healthcare Workers… DOI: http://dx.doi.org/10.5772/intechopen.98274*


