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The Advisory Board can offer rapid deployment support to offer multi-faceted COVID-19 wellbeing and post-crisis trauma recovery programs including digital apps, hotlines, weekly webinars, and website resource portals. We also provide clinical leadership consultation for behavioral health screening tools, communication strategies, strategy and financial planning, as well as access to emerging best practices and case studies across the globe

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"Those of you who are working with patients need extra support. You are heroes of this pandemic"

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Welcome!

This site of resources for coping and emotional health has been developed for the benefit of our whole community - UCSF staff, faculty, students, patients, providers, Bay Area families, and the public at large. Please share it with others. This is a very challenging time and we all must step up to maintain our well-being and help one another. We are here to support you.

This is an evolving, living website that will be updated to respond to the emerging demands of the COVID-19 pandemic. We have tried to address special situations and mental health needs caused or worsened by the crisis. On this site, our faculty offer their best advice and resources on how to maintain good mental health while practicing physical distancing, particularly during this period of "shelter in place." We are all flooded with information and advice, so we have curated the information for you and your loved ones. There are many links to online wellness resources, prioritizing those that are free. If you have suggestions for additional content, please let us know us at ame.center@ucsf.edu.

Medical information about COVID-19 can be found at coronavirus.ucsf.edu.

Protecting your own wellness will also help those around you. Together we can become a more stress resilient community during this difficult period. Stay well and safe.

With warm regards,
UCSF Department of Psychiatry

A note to frontline providers

Those of you who are working with patients need extra support. You are heroes of this pandemic. You are likely to be facing both personal and professional challenges, and it is essential that you continue self-care and take breaks. Please consider immediately using one of the high-quality digital health apps, now free to providers, that can support your mental health or one of the referral resources for counseling.

Further resources for UCSF Health employees, providers, and patients, such as peer counseling, phone support, and spiritual counseling, can be found at coronavirus.ucsf.edu/emotional-health-wellbeing-resources. You can also take part in our weekly webinar series.

Site contents

1. Useful mental health apps

2. Emotional well-being and coping during COVID-19

3. Seeking help: Resources for clinical anxiety and mental health issues

4. Maintaining wellness for older adults and caregivers

5. Practical resources for low-income and other groups

This COVID-19 coping guide was created by the UCSF Department of Psychiatry COVID-19 Community and Coping Communications Working Group with the tremendous collaborative effort of many additional experts. The guide is managed by department communications director Nicholas Roznovsky, and Elissa Epel, PhD, with the UCSF AME Center (including Elena Fromer and Samantha Schilf). Please email any comments or suggestions to ame.center@ucsf.edu.

Special acknowledgements to those who contributed content and resources, including Nicole Bush, PhD (children); Whitney Ence, PhD (autism); Elissa Epel, PhD (emotional well-being and coping); Sharon Epel, LMFT (family); Jennifer Felder, PhD (pregnancy); Elena Fromer (family, resources); Lauren Haack, PhD (ADHD); Elissa Hamlat, PhD (resources); Steve Hinshaw, PhD (children); Mardi Horowitz, MD (grief); Bryan King, MD, MBA (family); Alicia Lieberman, PhD (children); Jennifer Ly (ADHD); Shira Maguen, PhD (moral injury); Christina Mangurian, MD (resources); William Martinez, MD (social needs and mental health); B.J. Miller, MD (grief); Aric Prather, PhD (sleep); Mike Rabow, MD (grief); Danielle Roubinov, PhD (children); Jason Satterfield, PhD (resources); Samantha Schilf (family, resources); Andrea Seritan, MD (geriatrics); Esme Shaller (children); Marina Tolou-Shams, PhD (resources); and Lowell Tong, MD (resources).

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Resources to Support Your Mental Health During the COVID-19 Outbreak

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Welcome! This site of resources for coping and emotional health has been developed for the benefit of our whole community - UCSF staff, faculty, students, patients, providers, Bay Area families, and the public at large. Please share it with others. This is a very challenging time and we all must step up to maintain our well-being and help one another.

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Self-care strategies for psychologists during COVID-19 crisis

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Prioritize

Make a plan of action by listing your work and personal priorities and deciding what can be delegated or postponed, says Laura Boxley, PhD, of The Ohio State University. Be sure to add self-care to your schedule, she adds. "In stressful times, self-care can seem frivolous or selfish," she says. "But committing to self-care will preserve your ability to rise to the challenge of this time."

Pivot, if necessary

For researchers, university shut-downs don't have to mean that work grinds to a halt. "Lots of labs are nimble," says Jeff Zacks, PhD, of Washington University in St. Louis. "If we can't collect data face to face, we can work on other things that are often pushed to the back burner, such as data analysis and writing."

Stick to a routine

"I still pack my lunch every day and put on work clothes even if I'm not going into the office," says Gebhardt. "Still doing those routines gives a sense of normalcy to the otherwise abnormal situation we're in."

Create a separate workspace

"Working from home can blur the boundaries between work and your personal life so that you feel you're working all the time," says Nathaly Shoua-Desmarais, PsyD, of Florida International University. "I could be on the computer 24/7 now." Create a separate workspace if possible, even if that means setting up a desk in a corner of your living room with your back to the larger space, she suggests. Keep your sleeping area as personal space, she adds.

Exercise

If you can get outside, take a walk or run. But there's plenty you can do inside. "People are posting workouts on social media and hosting exercise classes on Zoom or FaceTime," says Gebhardt. Ask your gym or yoga studio if they're offering virtual sessions or look for workouts on YouTube. Even dancing to your favorite music in your living room can help.

Stay connected

While psychologists often worry about excessive screen time, technology like Zoom, Skype and Google Hangouts is now helping people stay connected despite physical isolation. "It's such a breath of fresh air to be able to see people and laugh with them," says Gebhardt, who recently enjoyed a "family Zoom date" with relatives around the world. "I've been blown away by how social distancing can make a community come together."

Limit news consumption

Checking the news or social media constantly or having the news on in the background only causes unnecessary distress, says Shoua-Desmarais. Decide how much time you're going to devote to checking reliable sources and stick to that limit, even if you have to ask a friend to serve as an accountability partner and check up on whether you followed through with your commitment. For Shoua-Desmarais, that means spending 5 minutes scanning the news in the morning and another 5 minutes before doing pre-bedtime relaxation exercises.

Practice mindfulness and other relaxation techniques

"Mindfulness activities can be helpful for dealing with anxiety," says Richelle Concepcion, PsyD, MPH, of Tripler Medical Center in Hawaii. "Meditation, yoga, even mindful breathing are ways to slow things down." And there are plenty of free resources, including autogenic training

on YouTube, the apps Breathe2Relax and Tactical Breather, or the Mindfulness Coach and other resources available on the VA's App Store. Headspace and the Ten Percent Happier app are offering free access to health-care providers during the pandemic.

Learn something new

Now is a good time to burnish your professional skills, says Bethany A. Teachman, PhD, of the University of Virginia. "This is a good opportunity to build your skill set virtually," she says, citing as one example an online statistics course. Use this time to earn some continuing education credit, suggests Concepcion. If you've had to go virtual, for instance, check out APA's Telepsychology Best Practices 101 webinar series, available for free. Or just engage in self-enrichment. Another free resource is Coursera's " The Science of Well-being," a course touted as "Yale's most popular class ever," created by psychologist Laurie Santos, PhD, of Yale. These online resources are a good way to distract yourself from the news and keep your self engaged in learning, says Concepcion.

Cut yourself some slack

"It's important to be kind to others - and to ourselves," says Teachman. Keep in mind that in abnormal times like these, you're not going to be as productive as you were before and that's OK, she says.

Check in with colleagues

Keep an eye on colleagues who may be struggling, and let them know you're struggling, too, as a way of normalizing their reactions. And find meaning in helping others. "There's not enough yoga in the world to deal with the magnitude of what we're coping with right now," says Boxley. "We have to think flexibly about self-care: It's not just about taking care of ourselves but about taking care of others."

For more information, check out APA's self-care resources and its Self-Care Resource Center. Listen to a podcast on self-care for psychologists. Or watch a webinar on stress and coping from APA's Div. 35 (Society for the Psychology of Women).

If you're an early-career practitioner, watch a short video about how two of your colleagues practice self-care and read these Practice Update articles on taking care of yourself and practicing self-care.

If you're a graduate student, try these tips for positive mental health and strategies for better work/life balance. Or watch APA's webinar for students on coping in the era of coronavirus.

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Self-care for psychologists during the COVID-19 outbreak

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Make a plan of action by listing your work and personal priorities and deciding what can be delegated or postponed, says Laura Boxley, PhD, of The Ohio State University. Be sure to add self-care to your schedule, she adds. "In stressful times, self-care can seem frivolous or selfish," she says.

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Wellness programs and self care strategies for healthcare workers to manage stress during the COVID-19 crisis

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Managing Healthcare Workers' Stress Associated with the COVID-19 Virus Outbreak

Available en Español

The wellbeing and emotional resilience of health care workers are key components of maintaining essential health care services during the COVID-19 virus (coronavirus) outbreak. Therefore, it will be crucial to anticipate the stresses associated with this work and put in place supports for health care workers. Monitoring and assessment of mental health and wellbeing of health care personnel will be important, along with efforts to ensure their successful reintegration with work colleagues, should they themselves become infected.

Both institutional supports and self-care strategies are important.

Fighting Stress through Preparedness

Health care workers are accustomed to participating in frequent formal and informal trainings. Additional organizational efforts during the COVID-19 outbreak should be ongoing and can provide a measure of stress reduction. Health care workers need training in:

specific details about transmission of the COVID-19 virus

when and how to screen patients and, potentially, family members

the use of personal protective equipment

when to invoke quarantine and isolation

ethical decision-making about triage and surge capacity issues

In order to increase their sense of self-efficacy, workers may also want to take part in training and planning exercises that include:

practicing response roles

implementing all levels of quarantine

enforcing movement restrictions

managing limited resources

handling mass fatalities

understanding surge-related triage decision trees

conducting mental health screening

coping with high stress demands

preparing for the needs of their families if workers are required to be more engaged at work or quarantined

Staff in health care facilities may also want to meet with leaders to discuss the importance of stress management and psychosocial support for the workforce. Discussions could include the possibility of frontline stress control teams, appropriate work/rest schedules, and support for the needs of providers' family members.

Stress in Health Care Workers during the Outbreak

There are specific sources of stress for health care workers treating patients with the COVID-19 virus. These stressors include:

Need to employ strict biosecurity measures

Health care workers who are called upon to assist or treat those with COVID-19 may experience stress related to:

physical strain of protective equipment (dehydration, heat, exhaustion)

physical isolation (restrictions on touching others, even after working hours)

constant awareness and vigilance regarding infection control procedures

pressures regarding procedures that must be followed (lack of spontaneity)

Risk of disease transmission

Infection control is a significant concern that can be exacerbated by:

common flu and cold symptoms being mistaken for COVID-19

the extended symptom-free incubation period of COVID-19

a relatively higher mortality rate compared to influenza

the tension between public health priorities and the wishes of patients and their families regarding quarantine

Multiple medical and personal demands

The complexity of responding to COVID-19 may result in conflicting personal and professional demands, including:

continued daily workload demands competing with COVID-19 preparation and treatment measures

a need to maintain high standards in the face of a low-frequency event within which official recommendations and policies change regularly

possible separation from and concern about family members

fears about infection and subsequent implications for self, patients, and family

inner conflict about competing needs and demands

Stigma

Health care workers can be affected by both internal and external stigma related to the COVID-19 virus and its impact, such as:

others' fear of contact with those treating patients with COVID-19

health care workers' self-stigma about voicing their needs and fears

Dealing with Stress during the Outbreak

A strong service-orientation, a lack of time, difficulties in acknowledging or recognizing their own needs, stigma, and fear of being removed from their duties during a crisis may prevent staff from requesting support if they are experiencing stress reactions. Given this, employers should be proactive in encouraging supportive care in an atmosphere free of stigma, coercion, and fear of negative consequences.

Self-care for health care workers can be complex and challenging, given that people in these roles may prioritize the needs of others over their own needs. Therefore, a self-care strategy should be multi-faceted and phased properly to support the sense of control and contribution of health care providers without making them feel unrealistically responsible for the lives of patients. For instance, during work shifts, providers should engage in these behaviors:

self-monitoring and pacing

regular check-ins with colleagues, family, and friends

working in partnerships or in teams

brief relaxation/stress management breaks

regular peer consultation and supervision

time-outs for basic bodily care and refreshment

regularly seeking out accurate information and mentoring to assist in making decisions

keeping anxieties conscribed to actual threats

doing their best to maintain helpful self-talk and avoid overgeneralizing fears

focusing their efforts on what is within their power

acceptance of situations they cannot change

fostering a spirit of fortitude, patience, tolerance, and hope

At the same time, they should avoid:

working too long by themselves without checking in with colleagues

working "round the clock" with few breaks

feeling that they are not doing enough

excessive intake of sweets and caffeine

engaging in self-talk and attitudinal obstacles to self-care, such as:

"It would be selfish to take time to rest."

"Others are working around the clock, so should I."

"The needs of survivors are more important than the needs of helpers."

"I can contribute the most by working all the time."

"Only I can do. . .."

Dealing with Stress in the Aftermath of the Outbreak

After a period of caring for those with COVID-19-especially quarantined patients-a readjustment period is to be expected. Health care workers will need to commit to making personal reintegration a priority. This includes:

seeking out and sharing social support, which may need to occur virtually

checking in with other colleagues to discuss work experiences

increasing supervision, consultation, and collegial support

scheduling time off work for gradual reintegration into personal life

preparing for worldview changes that may not be mirrored by others in one's life

avoiding negative coping strategies such as:

use of alcohol, illicit drugs, or excessive amounts of prescription drugs, which all interfere with sleep cycles and prolong recovery

suddenly making big life changes

negatively assessing their work contributions

keeping too busy

viewing helping others as more important than self-care

not wanting to talk about work experiences with others

If stress persists for longer than two to three weeks and interferes with functioning, health care workers should consider participating in formal mental health treatment.

Printable Handout

References

1. Brymer, M., Jacobs, A., Layne, C., Pynoos, R., Ruzek, J., Steinberg, A., ... & Watson, P. (2006). Psychological first aid: Field operations guide. National Child Traumatic Stress Network and National Center for PTSD. Retrieved from www.nctsn.org and www.ptsd.va.gov

2. Gonzales, G. (2003). Deep survival. Who lives, who dies, and why. True stories of miraculous endurance and sudden death. W.W. Norton & Company. New York.

3. Hobfoll, S. E., Watson, P. J., Bell, C. C., Bryant, R. A., Brymer, M. J., Friedman, M. J., et al. (2007). Five essential elements of immediate and mid-term mass trauma intervention: Empirical evidence. Psychiatry, 70(4), 283-315.

4. Reissman, D. B., Watson, P. J., Klomp, R. W., Tanielian, T. L., & Prior, S. D. (2006). Pandemic influenza preparedness: adaptive responses to an evolving challenge. Journal of Homeland Security and Emergency Management, 3(2).

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managing stress associated with the covid-19 virus

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Available en Español The wellbeing and emotional resilience of health care workers are key components of maintaining essential health care services during the COVID-19 virus (coronavirus) outbreak. Therefore, it will be crucial to anticipate the stresses associated with this work and put in place supports for health care workers.

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Frontline healthcare workers are also impacted by stigma around seeking help

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Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions

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Mental illness-related stigma, including that which exists in the healthcare system and among healthcare providers, creates serious barriers to access and quality care. It is also a major concern for healthcare practitioners themselves, both as a workplace…

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"During an infectious disease outbreak like COVID-19, it is not uncommon for people to experience feelings of fear, depression or anxiety. Colleagues and providers are urged to practice self-care and get support"

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During an infectious disease outbreak like COVID-19, it is not uncommon for people to experience feelings of fear, depression or anxiety. Colleagues and providers are urged to practice self-care and use the support resources below:
Emotional Support Helpline for employees: 984-215-5699, available 7 a.m. - 7 p.m. Resources Available After Hours:
Hope4Healers is available 24/7 for people to reach out for support; they will be contacted quickly by a licensed mental health professional for follow-up.
The Hope4Healers Helpline 919-226-2002 is a new initiative in partnership with the North Carolina Psychological Foundation. It provides mental health and resilience supports for health care professionals, emergency medical specialist, first responders, other staff who work in health care settings and their families throughout the state who are experiencing stress from being on the front lines of the state's COVID-19 response.
UNC Resources
UNC COVID-19 Helplines
Pastoral Care
National Helplines
Webinars and Video Based Mental Health/Self Care Resources
Parenting, Family, and Home Safety Resources
Beacon Program
Articles and Tip Sheets

Please reach out if you need help. We will get through this difficult time by taking care of each other.

More in-depth details for each of the resources listed above, as well as additional helpful information can be found via the links below.

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Mental Health/Emotional Support Resources for Co-workers and Providers Coping with COVID-19

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During an infectious disease outbreak like COVID-19, it is not uncommon for people to experience feelings of fear, depression or anxiety. Colleagues and providers are urged to practice self-care and use the support resources below: Emotional Support Helpline for employees: 984-215-5699, available 7 a.m. - 7 p.m.

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The Hidden COVID-19 Crisis: Healthcare workers

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The Hidden COVID-19 Crisis: Healthcare workers

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Healthcare workers are placed at higher risks to exposure as well as social isolation.

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n the midst of this global pandemic, people are talking about the urgent and critical need for personal protective equipment. They are sharing concerns about the impending lack of respirators and the need for testing. And they are encouraging people to #flattenthecurve through social distancing. But no one is talking about a potential mental health crisis facing health care workers on the frontlines of this pandemic.

To an outside observer, health care workers look strong and resilient in the face of the unknown. They inspire us as they go to work every day, at great personal risk, to keep others safe.

But, as a psychiatrist, I spend much of my life observing and listening - I know that their calm surface appearance is the only armor they have left. Underneath it, many health care workers are barely keeping it together. They are anxious and they are afraid. They aren't sleeping and they find themselves crying more than usual. The overall feeling in my friends, family, and co-workers is one of an impending doom and an existing gloom that is both physically and psychologically palpable.

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We also know it is only the beginning. As such, it is my duty to sound the alarm and try to protect their mental health - before it is too late.

In truth, personal protective equipment is critical to protecting health care professionals' physical and mental well-being. Without this protection, they worry that they will get sick and infect others. Given that 20 of the 44 cases in Philadelphia are health care workers, this is a reasonable fear to have. The risk of infection, especially if it is asymptomatic, instills fear of spreading the virus to their patients and families.

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To lower this risk, many health care workers have decided to socially isolate themselves. Some have chosen to have their at-risk family members spend time with relatives away from them and others have isolated themselves, even within their own homes. This significant disruption in social support - in the name of helping and protecting others - could go on for months. It is also quite lonely.

These fears are further magnified when being quarantined because of a positive Covid-19 test. We know from studies during the SARS epidemic that quarantine has a serious effect on the mental health of health care workers. It predicted symptoms of acute stress disorder, depression, and alcohol abuse. Even three years later, quarantine was associated with post-traumatic stress symptoms, which were, again, more severe in health care workers. As a result, many experienced avoidance behaviors and sought to minimize contact with patients. Some didn't report back to work at all.

Health care workers are also concerned they might die from Covid-19. This could seem like an irrational fear, but frontline health care workers have died in China and Italy and in the United States - and this will only increase. Knowing this, some health care workers have begun drafting living wills.

Some health care workers are using words like betrayal and coercion and moral injury to describe this experience. They feel betrayed by their employers, the health care system, and the government, all of which were woefully unprepared for a pandemic and then chose to ignore their warnings. Some are concerned they will be called upon to do work they have not done in years due to staffing needs. Even still, others are grieving the traumas they will see and the decisions they will be forced to make. Some have said even they will simply not come to work and would rather quit medicine all together.

These choices are not easy to make - between protecting oneself and one's family and doing one's job - on top of the life-or-death decisions they may be forced to make due to limited resources. It is no wonder they are not sleeping, are anxious, or afraid. It is no wonder that the preliminary research on coronavirus in China showcases high rates of mental health issues, including depression, anxiety, insomnia, and distress, which are much higher in nurses, women, and those on the front line.

To support health care workers, experts need to intervene to help protect their mental health, not just their physical health. This was done in China and we should follow their lead. Some universities, like UNC Chapel Hill and the University of California, San Francisco, have been leaders in this effort, deploying their psychiatric workforce as volunteers. These approaches are comprehensive and multifaceted. They consider the need for preventive measures (stress reduction, mindfulness, and educational materials), in-the-moment measures (hotlines, crisis support), and treatment (telepsychiatry for therapy, and medication if needed). They also acknowledge that mental health treatment is not just something that happens urgently or in crisis, but rather is something that needs to continue and be available long into the future.

These changes cannot happen overnight. Our mental health system is deeply flawed and understaffed and is in no way prepared to manage the onslaught of mental health issues in health care providers and the citizenry in general after such a mass tragedy. We must think about ways to prevent mental health from deteriorating while also coming up with innovative ways to target at risk groups, particularly health care workers. My friends and family, and the people who are saving lives, cannot afford for us to wait. They could die from the virus, or even from suicide. Mental health cannot be an afterthought in coping with a pandemic.

It took far too long for us to start talking about how to protect health care workers physically. Let's talk about mental health now - and do better this time.
Jessica Gold, M.D., is an assistant professor of psychiatry at Washington University in St. Louis.

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The hidden Covid-19 crisis: health care workers' mental health - STAT

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n the midst of this global pandemic, people are talking about the urgent and critical need for personal protective equipment. They are sharing concerns about the impending lack of respirators and the need for testing. And they are encouraging people to #flattenthecurve through social distancing.

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"Every clinician is also a patient"

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Health care workers in Wuhan and other regions of China reported experiencing psychological burden related to the novel coronavirus pandemic, according to results of a survey study published in JAMA Network Open. Those in Wuhan, women, nurses and frontline health care workers directly engaged in the diagnosis, treatment and care of patients with COVID-19 were especially affected.

"The ever-increasing number of confirmed and suspected cases, overwhelming workload, depletion of personal protection equipment, widespread media coverage, lack of specific drugs and feelings of being inadequately supported may all contribute to the mental burden of these health care workers," Jian b o Lai, MSc, of the department of psychiatry at Zhejiang University School of Medicine First Affiliated Hospital, and colleagues wrote. "Previous studies have reported adverse psychological reactions to the 2003 SARS outbreak among health care workers. Studies showed that those health care workers feared contagion and infection of their family, friends and colleagues, felt uncertainty and stigmatization, reported reluctance to work or contemplating resignation, and reported experiencing high levels of stress, anxiety and depression symptoms, which could have long-term psychological implications."

The researchers noted that the treatment and care of patients with COVID-19 have led to similar concerns about the psychological adjustment, mental health and recovery of health care workers. Local and national mental health institutions have deployed telephone-, internet- and application-based counseling or interventions in response to the outbreak. Specifically, the State Council of China announced in February that it was setting up nationwide psychological assistance hotlines during the epidemic. Despite these responses, evidence-based evaluations and mental health interventions targeting frontline health care workers are relatively scarce, according to the investigators.

To address this gap, Lai and colleagues aimed to assess the magnitude of mental health outcomes and associated factors among health care workers treating individuals exposed to the virus in China. They conducted a cross-sectional, survey-based, region-stratified study using mental health measurements and demographic data of 1,257 health care workers in 34 hospitals in China from Jan. 29 to Feb. 3. The researchers included only those who worked in hospitals equipped with fever clinics or wards for patients with COVID-19. Main outcomes and measures included the degree of symptoms of anxiety, insomnia, distress and depression, which they assessed by the Chinese versions of the 7-item Generalized Anxiety Disorder scale, the 7-item Insomnia Severity Index, the 22-item Impact of Event Scale-Revised and the 9-item Patient Health Questionnaire, respectively. They performed multivariable logistic regression analysis to identify factors associated with mental health outcomes.

The researchers reported a participation rate of 68.7%. Further, 64.7% of respondents were aged 26 years to 40 years and 76.7% were women. A total of 764 (60.8%) were nurses, 493 (39.2%) were physicians, 760 (60.5%) worked in hospitals in Wuhan and 522 (41.5%) were frontline health care workers.

A significant proportion of respondents reported the following symptoms:

Compared with other health care workers, frontline health care workers, those working in Wuhan, nurses and women reported more severe degrees of all measurements of mental health symptoms. Respondents from outside Hubei province had lower risk for symptoms of distress than those in Wuhan (OR = 0.62; 95% CI, 0.43-0.88). Frontline health care workers who engaged in direct diagnosis, treatment and care of patients with COVID-19 had a higher risk for symptoms of depression (OR = 1.52; 95% CI, 1.11-2.09), anxiety (OR = 1.57; 95% CI, 1.22-2.02), insomnia (OR = 2.97; 95% CI, 1.92-4.6) and distress (OR = 1.6; 95% CI, 1.25-2.04).

"Protecting health care workers is an important component of public health measures for addressing the COVID-19 [pandemic]," the researchers wrote. "Special interventions to promote mental well-being in health care workers exposed to COVID-19 need to be immediately implemented, with women, nurses and frontline workers requiring particular attention."

In a related editorial, Roy H. Perlis, MD, MSc, of the Center for Quantitative Health and department of psychiatry at Massachusetts General Hospital, highlighted the inevitable but mitigable risks associated with health care professions.

"Across the world, physicians, nurses and other frontline health care workers do heroic and lifesaving work in stressful settings on a daily basis," Perlis wrote. "However, the toll that providing such care takes must also be recognized: sooner or later, every clinician is also a patient. Even outside epidemics, wars and other public health crises, health care workers face mounting stresses, exacerbated by structural changes in medicine but ultimately reflecting the nature of the work itself. Such stresses far exceed the popular but imprecise concept of burnout." - by Joe Gramigna

Disclosures: The study authors report no relevant financial disclosures. Perlis reports biotech investments in Burrage Capital, Outermost Therapeutics, Psy Therapeutics and RID Ventures, as well as personal fees from Genomind and Takeda Pharmaceutical Co.

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'Every clinician is also a patient': Study shows psychological impact of COVID-19 pandemic on health care workers

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Health care workers in Wuhan and other regions of China reported experiencing psychological burden related to the novel coronavirus pandemic, according to results of a survey study published in JAMA Network Open.