COVID-19 continues to spike in Philadelphia. It is exhausting. Winter looms, cold weather, and isolation. The pandemic is frustrating.
I am an emergency physician here in Philadelphia, and I share the moments of frustration and exhaustion. The men and women who work in health care, like all Philadelphians, have grit. Grit sustains us. It helps us navigate catastrophes and tragedies. Despite the chaos and the heartache, I am surrounded by people powered by grit.
But I am worried about how much grit is left and how long will it last. Are we on the verge of proving that, even in a city built on grit, it can run out? COVID-19 is wearing on the physical and mental health of the health-care workforce. If we act now, there are ways we can support the health-care workforce now, and for the years to come.
Research has demonstrated the emotional highs and lows of dealing with disasters are significant and long-lasting. Each wave brings about new record highs and uncertainty as to when these spikes will peak. These waves can act as triggers for stress, anxiety, and depression for the workforce and building upon mental health strain. These strains impact the individuals and the care they provide.
Focus has been placed on the numbers, be it hospital beds or ventilators. Though these numbers remain important, we need a specific focus on the people in health care and their well-being. Facing an unrelenting influx of COVID cases is not what many of us have ever seen. We can steel ourselves for random, or even inevitable, tragedies based on genetics, lifestyle, or accident. Seeing rapidly progressive death across the city is different and draining. Compounding this, we watch battles around public health guidelines unfold as we attempt to save lives.
We need to think critically about how to support health-care providers. The challenges are felt by us all, but the nature of health care is threatening the mental health of the workforce.
First, we must instill confidence and trust back into medicine and science. The public discourse around how to combat the pandemic must be led by science and data. This is important as the voice of health-care providers is at risk of being lost in a crowd of noise. Leading a scientific approach guided by health-care professionals will reempower the workforce.
Second, connections remain vital. Health-care workers have been proclaimed heroes. Though well-intentioned, these images may not reflect the mental state of those at the bedside. The stigma of accessing mental health care has been long-standing and is increased for those in health care. The stoicism entwined in medicine creates an additional barrier. Thus, it is important and valuable to reach out and engage friends, family, neighbors who work in health care. A quick check-in on their mental health may provide inertia to spark conversations and relieve stress.
Last, our infrastructure to support mental health must be bolstered. The expansion of telemedicine has helped workflows for individuals to access care and connect to support. Providing access to care and encouraging individuals, in health care and outside of it, to seek care to support their short- and long-term mental health is urgently needed. Stress, anxiety, and depression will wax and wane with the spikes in cases, and be even more prominent in health-care providers. Investing in care now will only help sustain the workforce for years to come.
Grit has defined Philadelphia. We have relied on it. As we continue to fight through the pandemic, the health-care workforce is faced with a challenge unlike any we’ve seen before. We can build more ventilators, erect tents, and create extra spaces to treat people in hospitals to face a surge. We cannot do the same for the individuals caring for our families and friends. Health-care providers’ grit is being tested and at risk of running out. Now is the time we must work together to protect and sustain their mental health for the years to come.
Anish K. Agarwal is an assistant professor in the department of emergency medicine at the University of Pennsylvania’s Perelman School of Medicine.