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COVID-19 Acceleration Induced Moderate to Severe Anxiety in Emergency Physicians

July 28, 2020

During the acceleration phase of the COVID-19 pandemic, emergency medicine physicians in 7 US cities experienced moderate to severe levels of anxiety at work and at home, regardless of the intensity of the local surge. Researchers published the findings online in the journal Academic Emergency Medicine.

“Although several investigators have examined the effects of the COVID‐19 pandemic on health care worker mental health in other countries, we were unable to find any similar studies of US physicians,” the study team wrote.

Investigators surveyed emergency medicine physicians at 7 academic emergency departments via email between February 23, 2020, and April 10, 2020. Among the 426 respondents, the median reported effect of the pandemic on work and home stress levels was 5 on a scale of 1 (not at all) to 7 (extremely). Female physicians reported a median 6, while male physicians reported a median 5. Both women and men reported levels of emotional exhaustion or burnout increased from a median 3 before the pandemic to a median 4 during the survey.

“Their primary work concerns relate to COVID‐19 exposure compromising their personal health, availability of adequate personal protective equipment (PPE), limited rapid diagnostic testing, and risks of community spread of discharged COVID‐19 patients,” researchers reported. “Occupational exposure has changed the vast majority of physicians' behavior at home, where they are worried about exposing family members and roommates, the possibility of needing to self‐quarantine, and the effects of excess social isolation.”

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The most commonly cited ways to mitigate anxiety included improving access to PPE, increasing the availability of rapid COVID-19 testing, providing clearer communication about COVID-19 protocol changes, and ensuring access to personal leave to care for family and self. 

The study spanned emergency departments in California, Louisiana, and New Jersey, with the majority of sites in California. At the time of the survey, researchers pointed out, California had not yet experienced the surges of patients seen in other areas of the country—yet median anxiety levels at California sites were similar to those in New Orleans, Louisiana, and Camden, New Jersey, which were experiencing surges.

“This suggests that the impact of COVID-19 on anxiety levels is pervasive and that measures to mitigate stress should be enacted universally,” said study lead author Robert M. Rodriguez, MD, a professor of emergency medicine at the University of California, San Francisco. “Some of our findings may be intuitive, but this research provides a critical early template for the design and implementation of interventions that will address the mental health needs of emergency physicians in the COVID-19 pandemic era.”

—Jolynn Tumolo

References

Rodriguez RM, Medak AJ, Baumann BM, et al. Academic emergency medicine physicians' anxiety levels, stressors, and potential stress mitigation measures during the acceleration phase of the COVID-19 pandemic. Academic Emergency Medicine. 2020 June 22;[Epub ahead of print].

Fernandez E. Front-line physicians stressed and anxious at work and home [press release]. San Francisco, California: University of California, San Francisco; July 21, 2020.

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