**3. Prevalence**

Many studies in different countries quoted tremendous stress among health care workers, resulting in burnout. In the Coping with COVID study, a US national survey was administered by multiple healthcare organizations covering 20,947 respondents in 42 organizations and reported that daily stress was scored as high or very high by 30% of healthcare workers [14]. Anxiety or depression was described by 38% of workers in the health care sector [14]. A stress summary score (SSS) was 9.52 (SD 2.82, possible range 4–16), with burnout (present, high, or very high) in 49% of the healthcare workers [14]. Women workers described more challenging work environments than men. Work overload, fear of exposure to infection, and self-reported anxiety/depression are some of the factors related to burnout [15]. Other studies suggest that the mean prevalence of burnout among physicians in the United States is between 40% and 50% [15]. The burnout rate in US physicians is about 1.5 to 2.5 times higher than it is for US workers in other professions [16, 17].

Studies in low- and middle-income countries among primary health-care professionals suggest that burnout is substantial, mainly because of the workforce and resource shortages in these countries. Estimates ranged from 2.5% for severe burnout among family physicians in China to 87.9% for burnout among midwives in Uganda [18].

**Factors associated with HCWs burnout:** Burnout among HCWs is multifactorial. Individual and workplace-related factors act independently and synergistically for HCW's burnout.


patient's relatives, lack of adequate Government policies to protect the HCWs, and limited interprofessional collaboration also influence burnout [2]. Moreover, discrimination in society against HCWs during the initial month of Covid-19 pandemics was an additional stressor.
