COVID-19: The Impact on Healthcare Workers and Patients

By Elizabeth Ziemba, JD, MPH, Regional Representative for Temos Accreditation and President of Medical Tourism Training, Inc.

Part 1 of 3-part series exploring the relationship between and among healthcare workers, society, patients, and the impact of COVID-19 on the delivery of healthcare services

Healthcare workers are the foundation of an excellent patient experience. They deliver the clinical care as well as the compassion, comfort, and confidence that patients and their families need when confronting any medical procedure. Healthcare professionals impact service delivery from low acuity treatments like routine dental examinations or cosmetic procedures to complex surgery. Then COVID-19 came along and changed the role of healthcare professionals, possibly forever, and, by association, changed the patient experience.

The Impact on Healthcare Professionals

Infection and Death

It is hard to understate the impact that COVID-19 had and is having on healthcare workers around the world. The pandemic has taken its toll on the health and personal lives of hundreds of thousands of doctors, nurses, and all essential personal engaged in healthcare.

In May 2020, the International Council of Nurses (ICN) stated that it “believes at least 90,000 healthcare workers had been infected and more than 260 nurses had died in the novel coronavirus pandemic.”[1] These estimates may be substantially underreporting the impact on all healthcare workers as governments fail to keep statistics on the numbers of infections and deaths of healthcare professionals related to COVID-19. The ICN has called for tracking this data and reporting it to a central authority such as the World Health Organization (WHO) is essential to verifying the impact on all healthcare workers.

The number of COVID-19 related deaths among healthcare workers is reported to be climbing. In June 2020, it was reported that “Nearly 600 frontline healthcare workers have died of Covid-19, according to Lost on the Frontline, a project launched by the Guardian and Kaiser Health News (KHN) that aims to count, verify and memorialize every healthcare worker who dies during the pandemic.”[2] It is a devastating personal look at the lives lost.

Adequate and accurate data about the numbers of COVID-19 infections and deaths is needed to prepare for the future impacts of this pandemic, demonstrate the value of the lives of healthcare workers, and create a supply chain that delivers what is required.

Lack of access to PPE

It is impossible to say how many lives were lost or infections spread to healthcare workers because of lack of Personal Protective Equipment (PPE) – an acronym that has suddenly become part of our everyday vocabulary. PPE includes gloves, medical masks, respirators, goggles, face shields, gowns, and aprons designed for use in medical settings.

Stated accurately and simply by Dr. Tedros Adhanom Ghebreyesus, General Director of the WHO, “Without secure supply chains, the risk to healthcare workers around the world is real. Industry and governments must act quickly to boost supply, ease export restrictions, and put measures in place to stop speculation and hoarding. We can’t stop COVID-19 without protecting health workers first.” [3]

Failure to prepare, breakdown of supply chains, hoarding, and other global system malfunctions resulted in acute shortages of PPEs. Images of doctors and nurses wearing garbage bags or reusing available supplies provided evidence of the risks taken by healthcare professionals, exposing themselves and their families, other staff members, and patients.

Hospitals, clinics, and other healthcare providers have serious lessons to learn to protect the supply chain of PPEs for the on-going treatment of COVID-19 patients as the disease shows no sign of retreating but rather appears and reappears, seemingly at random.

Some of those lessons that require immediate implementation include:[4]

  • Monitoring PPE use and distribution and centralizing visibility of orders placed.
  • Improving just-in-time supply system and sharing responsibility.
  • Improving domestic manufacturing surge capacity at the time of an event.
  • Sharing information and communicating regularly.

Supply chain experts are needed to build or rebuild systems that work.

Exhaustion and other health impacts

The physical, emotional, and mental impact that COVID-19[5] is taking on healthcare workers around the globe is just beginning to be measured. Understanding the impact is the first step in providing resources, services, and relief from the extreme stress and pressure that healthcare workers are experiencing.

Research is just beginning to emerge that explores this topic.

A June 2020 survey of more than 2,500 dental professionals conducted by Anne Nugent Guignon opens a window into the impact of delivering healthcare services in the time of COVID-19. Her survey included the following question: Since using the new PPE in the clinical setting I am now experiencing the following conditions. (Check all that apply). Here are the responses to that question.

The delivery of healthcare services while wearing PPE carries its own physical burdens and requires that healthcare workers adjust the length of time wearing their PPE to allow for breaks to maintain their own well-being. It is hard to say which of the conditions reported in this survey are attributable to general stress, anxiety, fear, exhaustion, PPEs, or other factors. It is apparent that the respondents to this survey are experiencing multiple challenges that impact the delivery of care as well as their own physical and mental well-being, requiring that the individual as well as the organization adapt to the “new normal”. While the results of this survey cannot be generalized, they can open the discussion and collection of data about this important issue to ensure that the proper measures are in place to take care of workers and help workers take care of themselves.

Mental Health

A June 15, 2020 article, “The Impact of the COVID-19 Pandemic on the Mental Health of Healthcare Professionals”[6] , takes a look at the impact that prior pandemics had on healthcare professionals as well as early research on the topic coming out of China, and makes observations about the range of mental health issues being experienced during this crisis. Similar to prior pandemics, healthcare professionals may be experiencing a range of mental health issues including “feelings of loneliness and helplessness, or a series of dysphoric emotional states, such as stress, irritability, physical and mental fatigue, and despair The work overload and the symptoms related to stress make health professionals especially vulnerable to psychological suffering, which increases the chance of developing psychiatric disorders.”[7]

In a May 20, 2020 article from JAMA entitled “Prioritizing Physician Mental Health as COVID-19 Marches On”[8] based on an interview with Dr. Eileen Barrett, she states, “The people who carry explicit leadership positions have very explicit duties. There are ethical and administrative duties. Some of those are to provide people with the tangible, but also the intangible, support that they need. It’s not just about having your PPE. It’s also about having the childcare and the connections to mental health services. I think that every leader has a duty to create systems for people to have peer support, in addition to having access to telemedicine for mental health services.”[9]

Before COVID-19 hit, stress and burnout were a growing problem with suicide rates climbing particularly among doctors. The problem of stigma among healthcare professionals needs to be addressed so that they can access mental health support without the risk of being viewed in a negative light or having their employment or advancement opportunities damaged.

According to Dr. Katherine Gold[10], a mental health researcher, “There’s definitely a stigma inside medicine around mental health,” she says. She has found that physicians as a group tend to hold themselves to high standards, so a mental health issue is often perceived as a weakness. “Physicians don’t want to appear as if they can’t do their job,” says Gold. New attitudes about mental health are more important than ever during this pandemic.

Many healthcare providers are responding to the needs of their staff; more can be done. Services and support can include:

  • Providing a safe environment to discuss physical, emotional, and mental issues
  • Clear communication and education about symptoms and available services
  • Create psychological intervention teams – psychologists, counselors
  • Create/provide access to hotlines, chats, virtual consultations

About the Author:

A pioneer in health travel as President & Founder of Medical Tourism Training, Elizabeth Ziemba delivers consulting, training, and assessment services for clients in the wellness, health, medical, and hospitality sectors with innovative, practical, evidence-based solutions for business and economic growth. Ms. Ziemba helps clients build strong organizations at the cross-roads of health & hospitality to compete locally and globally.
Contact us today for more information about our services:

Contact Ms. Ziemba at eziemba@medicaltourismtraining.com, Tel/WhatsApp: +1 857 366 1315

Download This Article in PDF Format

[1] https://www.aa.com.tr/en/europe/90-000-healthcare-workers-infected-with-covid-19-icn/1831765, accessed 6 June 2020

[2] The Guardian https://www.theguardian.com/us-news/2020/jun/06/us-health-workers-dying-coronavirus-stats-data, accessed 17 June 2020

[3] https://www.who.int/news-room/detail/03-03-2020-shortage-of-personal-protective-equipment-endangering-health-workers-worldwide, accessed 17 June 2020

[4] https://www.adb.org/sites/default/files/publication/579121/ppe-covid-19-supply-chains-bottlenecks-policy.pdf, accessed 17 June 2020

[5] https://www.dentistryiq.com/covid-19/article/14177630/headaches-exhaustion-anxiety-the-physical-and-emotional-challenges-of-returning-to-work-during-the-pandemic?utm_source=DEC_DIQ+Morning+Briefing&utm_medium=email&utm_campaign=CPS200615068&o_eid=1439B5897612C7U&rdx.ident%5Bpull%5D=omeda%7C1439B5897612C7U&oly_enc_id=1439B5897612C7U,, accessed 11 June 2020

[6] The impact of the COVID-19 pandemic on the mental health of healthcare professionals, Cad. Saúde Pública vol.36 no.4 Rio de Janeiro 2020 Epub Apr 30, 2020

[7] Ibid.

[8] Abbasi J. Prioritizing Physician Mental Health as COVID-19 Marches On, JAMA. 2020;323(22):2235-2236. doi:10.1001/jama.2020.5205

[9] Ibid

[10] Physician Mental Health and Stigma https://www.aafp.org/membership/benefits/physician-health-first/phf/mental-health-suicide.html#:~:text=%E2%80%9CThere’s%20definitely%20a%20stigma%20inside,their%20job%2C%E2%80%9D%20says%20Gold.

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Elizabeth Ziemba

Elizabeth Ziemba

President at Medical Tourism Training
With a diverse background in public health, law and business, Elizabeth brings a unique set of skills and experience to Medical Tourism Training with services including assessment tools, online and onsite training, workshops, and consulting services for governments, providers, facilitators, associations and others involved in medical travel.