The Brutal Reality For Those On The Front Line
The news of the current pandemic has been plastered all over the world for the past year, shocking figures of death tolls, new variants and lockdowns that have put all our lives to a halt. As the world begins to regain some sense of normalcy, the hidden consequences of the pandemic are just beginning to show. For healthcare workers on the front line the consequences of the pandemic are far from over, and emerging research shows that the psychological impacts on those fighting the pandemic may be just beginning.
In February of this year, a paper was published in the European Journal of Psychotraumatology by Talya Greene of the University of Halifa and Jo Billings of University College London showing that during the first wave of the pandemic, 22% of all UK medical staff met the diagnostic criteria for post traumatic stress disorder (PTSD), and 47% for both anxiety and depression. In addition to this RCP reported that as many as a quarter of their doctors sought mental health support during the pandemic, further showing the impact of the pandemic on those on the front line. These trends are not only apparent in the UK, but have been reported by medical professionals all across the world.
For many of those on the front line, their traumatic experiences are vastly different from the heroic stories that are displayed on the media on a daily basis. This also hints at an issue, which was prevalent even before the pandemic, of mental illness plaguing those in the profession that is solely based on looking after others. A statement from the ICN also highlighted the seriousness of the situation, by explaining that “This unique mass trauma is having an immediate and profound effect, but it is also highly likely to have a significant long -term impact as it contributes to a wave of post-traumatic stress disorder (PTSD), depression and anxiety, the scale of which we cannot yet determine.
Due to the stress of the pandemic, the Washington Post reported that as many as 3/10 American doctors are considering leaving their profession for good. Many say that they not only have had to suffer from the emotional trauma of working, but have also had to deal with the feeling of being betrayed and let down by the healthcare system they have dedicated so much to. This included long shifts, no breaks, and non-medical grade equipment, which put many at unnecessary risk. Even before the pandemic, the US was facing a shortage of doctors and nurses, and an additional loss to the workforce could result in extreme consequences for US health care. According to studies, as many as 1 million nurses could retire by 2030, and by then, the country could be 130,000 doctors short. This has left many hospitals desperate for workers to deal with their increased number of patients. Due to this, many of those in their penultimate or last year of education have started their placements early to fill the demand, and multiple medical courses have become shorter to cut the shortage quicker. This has caused issues as the public now worry that they are not receiving the same standard of care they would have before the pandemic, and are more anxious to trust them and their ‘professional’ opinions. It is unclear whether this is a permanent or temporary solution, but with many courses cutting their length, this is likely to attract more people to a career in medicine — yet the quality of their education is unclear.
However, this was not the only concern for doctors during the pandemic. WHO estimates that 115,000 healthcare workers died from the virus whilst working on the front line — many also suspect this number to be higher, as they believe that numerous deaths were ruled off as other causes. These numbers have sparked multiple debates around the world from both the public and healthcare workers themselves. Many medical workers felt let down by the systems they work for, and believe that they weren’t as protected as they should have been during the early stages of the pandemic. This has also led to many retiring from their roles as they no longer want to work for those who they felt sacrificed by. This is very prevalent in both the UK and US where the number of deaths amongst workers was substantially higher than in countries in Asia (minimal staff contracted the virus). Issues have also been caused in the media due to the lack of statistics on the deaths of those in the healthcare system, further suggesting that both the US and UK governments have been ‘hiding’ the brutal reality from the public.
The effects of understaffing are already being experienced across the globe. Dominique Muldoon, a nurse from Massetucheus, told the Guardian that under-staffing considerably worsened over the pandemic, with more furloughs and staffing cuts, whilst nurses worked past their shifts with no breaks to try to keep up with the demand for patient care. She claimed that this is the new normal and it is damaging not only the quality of care the patients are receiving, but also the wellbeing of those who are trying to keep the system afloat. One other major consequence also affecting the sector is the increased waiting times and delaying of many patient’s treatments internationally. The cuts made have resulted in many people having to wait months for vital appointments, this could cause them further difficulties, which would then put more pressure on the already crumbling healthcare systems. In the NHS for example, it was reported that 4 million less people were offered their elective treatments during the year of the pandemic compared to 2019, and that the waiting list has now reached its highest level to date. It has also been reported that 1/12 people on the NHS waiting list have been waiting for over a year. This is a similar case for the US as according to PLOS ONE, the average waiting time for elective surgeries increased from 85.1 days (pre-pandemic level) to 93.8 days (during 2020), with no signs of reverting. This is not only due to understaffing but the public’s continued fear of visiting hospitals. The New York Times reported that many patients with symptoms of other illnesses were too afraid to visit medical practices in 2020 in fear of catching COVID, and that doctors are now desperately trying to convince patients to receive the care they need. This has also led to a surge of patients now trying to book appointments and increasing the overall waiting times drastically. In the UK, many minor appointments have been shifted to over the phone in 5-10 minute time slots to safely accommodate as many patients as possible. However, this has caused great controversy as a number of patients believe that they are not receiving the medical attention they deserve as there are limits to a virtual diagnosis.
These effects of the pandemic illustrate the mental and physical strain placed on the healthcare workers before and after COVID-19, and how it’s affecting the quality of the care being provided to those who need it most. Many researchers predict that the impacts of the past two years will take multiple years to revert, and that the cost of doing so could be dire for healthcare systems around the world. These front liners were not trained for the battle they were shoved into, but we hope their level of support is improved.
