Binge drinking alcohol and circadian misalignment in night shift nurses is associated with decreased resiliency to COVID-19 infection

Background: Nurses and other first responders are at high risk of exposure to the SARS-CoV2 virus, and many have developed severe COVID-19 infection. A better understanding of the factors that increase the risk of infection after exposure to the virus could help to address this. Although several risk factors such as obesity, diabetes, and hypertension have been associated with an increased risk of infection, many first responders develop severe COVID-19 without established risk factors. As inflammation and cytokine storm are the primary mechanisms in severe COVID-19, other factors that promote an inflammatory state could increase the risk of COVID-19 in exposed individuals. Alcohol misuse and shift work with subsequent misaligned circadian rhythms are known to promote a pro-inflammatory state and thus could increase susceptibility to COVID-19. To test this hypothesis, we conducted a prospective, cross-sectional observational survey-based study in nurses using the American Nursing Association network. Method(s): We used validated structured questionnaires to assess alcohol consumption (the Alcohol Use Disorders Identification Test) and circadian typology or chronotype (the Munich Chronotype Questionnaire Shift -MCTQ-Shift). Result(s): By latent class analysis (LCA), high-risk features of alcohol misuse were associated with a later chronotype, and binge drinking was greater in night shift workers. The night shift was associated with more than double the odds of COVID-19 infection of the standard shift (OR 2.67, 95% CI: 1.18 to 6.07). Binge drinkers had twice the odds of COVID-19 infection of those with low-risk features by LCA (OR: 2.08, 95% CI: 0.75 to 5.79). Conclusion(s): Working night shifts or binge drinking may be risk factors for COVID-19 infection among nurses. Understanding the mechanisms underlying these risk factors could help to mitigate the impact of COVID-19 on our at-risk healthcare workforce.Copyright © 2023 The Authors. Alcohol: Clinical and Experimental Research published by Wiley Periodicals LLC on behalf of Research Society on Alcohol.

Clinical characteristics of post-vaccination COVID-19 infection in health care workers exposed to Delta and Omicron variants in a COVID-19 dedicated facility from Qatar

Background: Evidence suggests that vaccines efficacy lies on the prevention of severe symptomatic disease. We aim to describe the clinical characteristics of COVID-19 infection among healthcare professionals (HCPs) after vaccination, during periods of transmission of SARS CoV-2 variants in a COVID-19 dedicated facility. Methods: A retrospective observational study of HCPs confirmed with COVID-19 during the period March 2021 to Jan 2022 was conducted. Delta period (March-August 2021), and Omicron period (Dec 2021-Jan 2022) were defined. Clinical, laboratory, radiology and vaccination history was collected from electronic medical records. Results: COVID-19 infection was reported in 16 and 138 HCPs during the Delta and Omicron period respectively. By category the nurses predominate, and a significant contribution of the healthcare related transmission against the community-related one. Higher frequency of loss of taste (37.5% vs 4.3%), and loss of smell (43.8% vs 3.6%) was observed during Delta period. Myalgia (12.5% vs 37.7%), and sore throat (6.3% vs 55.8%) predominated in Omicron period. Bilateral ground-glass appearance of the lung was observed in 28.6% and 7.1% in the Delta and Omicron period, respectively. Higher cycle threshold values of the polymerase chain reaction test during Omicron period, in comparison with Delta period, was observed (22.98 vs 25.98). Time from previous vaccine dose to positive laboratory test was longer during the Delta period (131 vs 98.26 days). Conclusion: SARS CoV-2 viral variants infections in HCPs were associated to selected clinical and epidemiological characteristics, with less severe disease for Omicron variant, and potential shorter duration of the immune response to vaccination. © 2020 The author (s)..

How Governor Directives Changed Health Workforce Flexibility in Response to the COVID-19 Pandemic.

OBJECTIVES: In times of heightened population health needs, the health workforce must respond quickly and efficiently, especially at the state level. We examined state governors' executive orders related to 2 key health workforce flexibility issues, scope of practice (SOP) and licensing, in response to the COVID-19 pandemic. METHODS: We conducted an in-depth document review of state governors' executive orders introduced in 2020 in all 50 states and the District of Columbia. We conducted a thematic content analysis of the executive order language using an inductive process and then categorized executive orders by profession (advanced practice registered nurses, physician assistants, and pharmacists) and degree of flexibility granted; for licensing, we indicated yes or no for easing or waiving cross-state regulatory barriers. RESULTS: We identified executive orders in 36 states containing explicit directives addressing SOP or out-of-state licensing, with those in 20 states easing regulatory barriers pertaining to both workforce issues. Seventeen states issued executive orders expanding SOP for advanced practice nurses and physician assistants, most commonly by completely waiving physician practice agreements, while those in 9 states expanded pharmacist SOP. Executive orders in 31 states and the District of Columbia eased or waived out-of-state licensing regulatory barriers, usually for all health care professionals. CONCLUSION: Governor directives issued through executive orders played an important role in expanding health workforce flexibility in the first year of the pandemic, especially in states with restrictive practice regulations prior to COVID-19. Future research should examine what effects these temporary flexibilities may have had on patient and practice outcomes or on permanent efforts to relax practice restrictions for health care professionals.

Barriers to the Engagement of Complementary and Integrative Health Providers in Public Health Responses to COVID-19: Recommendations From a Multidisciplinary Expert Panel.

OBJECTIVE: The purpose of this project was to explore barriers to the involvement of complementary and integrative health (CIH) providers in the public health response to COVID-19 and potential solutions for future involvement in public health crises. METHODS: An expert panel of 10 people, which included doctors of chiropractic, naturopathic doctors, public health practitioners, and researchers from the United States, was convened for a day-long online panel discussion. Facilitators asked panelists how CIH practitioners could contribute and be mobilized. We summarized themes and recommendations from the discussion. RESULTS: Despite their skills and resources, few CIH providers participated in public health efforts like testing and contact tracing during the COVID-19 pandemic. Panelists described that CIH professionals may not have participated in those efforts due to the CIH providers possibly not having sufficient public health training and limited contact with public health professionals, as well as policy and financial challenges during the pandemic. Panelists proposed solutions to these barriers, including more public health training, stronger formal relationships between CIH and public health organizations, and improved financial support for both CIH care and public health efforts. CONCLUSION: Through an expert panel discussion, we identified barriers that hindered the involvement of CIH providers in the public health response to the COVID-19 pandemic. During future pandemics in the United States, public health planners should recognize CIH providers as part of the existing labor resource, with clinical expertise and community-level connections that can be called upon in a crisis. During future events, CIH professional leaders should be more proactive in seeking out a supportive role and sharing their knowledge, skills, and expertise.

Politics and the Public Health Workforce: Lessons Suggested from a Five-State Study.

Policy Points The United States public health system relies on an inadequate and inefficient mix of federal, state, and local funding. Various state-based initiatives suggest that a promising path to bipartisan support for increased public health funding is to gain the support of local elected officials by providing state (and federal) funding directly to local health departments, albeit with performance strings attached. Even with more funding, we will not solve the nation's public health workforce crisis until we make public health a more attractive career path with fewer bureaucratic barriers to entry. CONTEXT: The COVID-19 pandemic exposed the shortcomings of the United States public health system. High on the list is a public health workforce that is understaffed, underpaid, and undervalued. To rebuild that workforce, the American Rescue Plan (ARP) appropriated $7.66 billion to help create 100,000 new public health jobs. As part of this initiative, the Centers for Disease Control and Prevention (CDC) distributed roughly $2 billion to state, local, tribal, and territorial health agencies for use between July 1, 2021, and June 30, 2023. At the same time, several states have enacted (or are considering enacting) initiatives to increase state funding for their local health departments with the goal of ensuring that these departments can deliver a core set of services to all residents. The differences in approach between this first round of ARP funding and theseparate state initiatives offer an opportunity to compare, contrast, and suggest lessons learned. METHODS: After interviewing leaders at the CDC and other experts on the nation's public health workforce, we visited five states (Kentucky, Indiana, Mississippi, New York, and Washington) to examine, by means of interviews and documents, the implementation and impact of both the ARP workforce funds as well as the state-based initiatives. FINDINGS: Three themes emerged. First, states are not spending the CDC workforce funding in a timely fashion; although the specifics vary, there are several organizational, political, and bureaucratic obstacles. Second, the state-based initiatives follow different political paths but rely on the same overarching strategy: gain the support of local elected officials by providing funding directly to local health departments, albeit with performance strings attached. These state initiatives offer their federal counterparts a political roadmap toward a more robust model of public health funding. Third, even with increased funding, we will not meet the nation's public health workforce challenges until we make public health a more attractive career path (with higher pay, improved working conditions, and more training and promotion opportunities) with fewer bureaucratic barriers to entry (most importantly, with less reliance on outdated civil service rules). CONCLUSION: The politics of public health requires a closer look at the role played by county commissioners, mayors, and other local elected officials. We need a political strategy to persuade these officials that their constituents will benefit from a better public health system.

Health worker registries: managing the health care workforce

Registries play an instrumental role in facilitating the transfer, aggregation, and analysis of standardized data in health information exchange (HIE). One such example is a health worker registry (HWR), a central, authoritative registry that maintains the unique identities of health workers according to a defined, minimum data set. Currently, data comprising workers' information—such as education, licensure, and place of employment—are collected through disparate methods and maintained in a variety of information systems. Harmonization of these data via an HWR can support interoperability and comparability of worker information across systems, thereby facilitating efficient workforce enumeration, planning, regulation and deployment, verification of training and education, identification of workforce shortages, and rapid communication and coordination of emergency response. In fact, HWR technologies played a role in coordinating response to both Ebola in West Africa in 2014 and more recently in response to COVID-19, making a HWR integral to nations' infrastructure upgrades postpandemic. This chapter identifies who is considered a "health worker” and why a registry of these individuals is a useful component of an HIE, especially in the wake of the COVID-19 pandemic. It also provides guidance on selection of data elements and standards to include in the development of an HWR. © 2023 Elsevier Inc. All rights reserved.

"We are the ones who will have to make the change": Cuban health cooperation and the integration of Cuban medical graduates into practice in the Pacific.

BACKGROUND: This paper responds to Asante et al. (in Hum Resour Health, 2014), providing an updated picture of the impacts of Cuban medical training in the Pacific region based on research carried out in 2019-2021, which focused on the experiences of Pacific Island doctors trained in Cuba and their integration into practice in their home countries. METHODS: The research focussed on two case studies-Solomon Islands and Kiribati. Study methods for this research included multi-sited ethnographic methods and semi-structured interviews as well as qualitative analysis of policy documents, reports, and media sources. RESULTS: The Cuban health assistance programme has had a significant impact on the medical workforce in the Pacific region increasing the number of doctors employed by Pacific Ministries of Health between 2012 and 2019. Qualitatively, there have been some notable improvements in the medical workforce and health delivery over this period. However, the integration of the Cuban-trained doctors into practise has been challenging, with criticisms of their clinical, procedural and communication skills, and the need for the rapid development of bridging and internship training programmes (ITPs) which were inadequately planned for at the outset of the programme. CONCLUSIONS: The Cuban programme in the Pacific is an important model of development assistance for health in the region. While Cuba's offer of scholarships was the trigger for a range of positive outcomes, the success of the programme has relied on input from a range of actors including support from other governments and institutions, and much hard work by the graduates themselves, often in the face of considerable criticism. Key impacts of the programme to date include the raw increase in the number of doctors and the development of the ITPs and career pathways for the graduates, although this has also led to the reorientation of Cuban graduates from preventative to curative health. There is considerable potential for these graduates to contribute to improved health outcomes across the region, particularly if their primary and preventative health care skills are utilised.

Using Grand Rounds to Train and Prepare a Local Public Health Workforce To Manage COVID-19 Outbreaks During the 2020-2021 Pandemic Winter Upsurge.

In response to the coronavirus disease 2019 (COVID-19) pandemic, the Los Angeles County Department of Public Health (DPH) expanded its workforce by >250 staff during Fall 2020 to manage the expected volume of outbreaks, which ultimately peaked. The workforce included reorganized groups of physicians, nurses, outbreak investigators from several DPH programs, and a 100+ member data science team tasked with designing and operating a data system and information flow process that became the backbone infrastructure of support for field investigation and outbreak management in real-time. The accelerated workforce expansion was completed in 3 months. To prepare new and reassigned permanent staff for fieldwork, DPH and several faculty from the Emory University Rollins School of Public Health adopted a flexible, skills-based series of medical Grand Rounds. These 16 sessions were grounded in practice- and problem-based learning principles using case studies, interactive scenarios, and didactic presentations based on scientific and public health practice information to teach knowledge and skills that were needed to manage COVID-19 outbreaks in different sectors. The evaluation suggests positive experience with the training series as well as impact on job performance.

The 'haves' and 'have-nots' of personal protective equipment during the COVID-19 pandemic: the ethics of emerging inequalities amongst healthcare workers.

The COVID-19 pandemic has exacerbated inequalities, including among the healthcare workforce. Based on recent literature and drawing on our experiences of working in operating theatres and critical care in the UK's National Health Service during the pandemic, we review the role of personal protective equipment and consider the ethical implications of its design, availability and provision at a time of unprecedented demand. Several important inequalities have emerged, driven by factors such as individuals purchasing their own personal protective equipment (either out of choice or to address a lack of provision), inconsistencies between guidelines issued by different agencies and organisations, and the standardised design and procurement of equipment required to protect a diverse healthcare workforce. These, we suggest, have resulted largely because of a lack of appropriate pandemic planning and coordination, as well as insufficient appreciation of the significance of equipment design for the healthcare setting. As with many aspects of the pandemic, personal protective equipment has created and revealed inequalities driven by economics, gender, ethnicity and professional influence, creating a division between the 'haves' and 'have-nots' of personal protective equipment. As the healthcare workforce continues to cope with ongoing waves of COVID-19, and with the prospect of more pandemics in the future, it is vital that these inequalities are urgently addressed, both through academic analysis and practical action.

The Institute of Medicine's call to action revisited: assuring access to public health education for U.S. college students.

The Educated Citizen and Public Health initiative promotes that an understanding of public health issues is a principal component of an educated population and is necessary to develop social responsibility and promote civic dialog. This initiative supports the Institute of Medicine's (now the National Academy of Medicine) recommendation that "all undergraduates should have access to education in public health." The purpose of our work is to examine the extent to which 2- and 4-year U.S. state colleges and universities offer and/or require a public health course. Select indicators identified include the presence and type of public health curriculum, public health course requirement, presence of public health graduate program offering, pathways to public health, Community Health Worker training, as well as demographic information for each institution. An analysis was also conducted for the historically Black colleges and universities (HBCUs), and the same select indicators were examined. The data suggest that there is an imperative need for a public health curriculum across the nation's collegiate institutions with 26% of 4-year state institutions lacking a full undergraduate public health curriculum; 54% of 2-year colleges not offering a pathway to public health education; and 74% of HBCUs not offering a public health course or degree. In the age of COVID-19, syndemics, and considering the post-pandemic phase, we argue that expanding public health literacy at the associate and baccalaureate level can help prepare an educated citizenry who is both public health literate and one that can demonstrate resilience in the face of public health challenges.

Building health service management workforce capacity in the era of health informatics and digital health - A scoping review.

INTRODUCTION: Health informatics and digital health, two rapidly growing disciplines, are becoming increasingly important to the sustainability of health service provision, highlighted especially through the COVID-19 pandemic. To maximise the benefits of the adoption and growth of health informatics and digital health, health service managers play a critical role in leading and managing the implementation and transformation of the system, both strategically and operationally, whilst still needing to manage 'business as usual'. OBJECTIVES: The objectives of the paper are to present and discuss the findings from a scoping review identifying: 1) competencies required for health service managers leading the implementation and transformation of informatics and digital technology in the health sector; and 2) factors that are critical to building the management workforce capacity in the era of health informatics and digital health. METHODS: A scoping review of the literature was conducted in 2020 focussing on identifying empirical articles published in the English language since the year 2000 using a number of keywords such as 'health informatics', 'digital health', 'electronic health', 'competencies', 'capability', 'proficiency', 'qualification', 'certification', 'health manager', 'health executive' and 'health administrator'. The literature search was guided by a PRISMA approach searching within eight databases: Scopus, ProQuest, Web of Science, ACM Digital Library, CINAHL, PubMed, Google Scholar and ProQuest Dissertations. RESULTS: After duplicates were removed, 941 publications were included for title screening as the result of an initial review. Title screening selected 185 articles to be included for abstract screening by two reviewers confirming 19 papers relevant to the focus of the current paper which were included in data extraction and content analysis. The analysis identified the additional competency of 'information and data management' be included as a core competency for health service managers. The analysis also confirmed additional elements for the following four core management competencies that are important to health service managers working in the digital health context, including: 1) leadership; 2) operational and resource management; 3) personal, interpersonal and professional qualities, and 4) understanding the industry and environment. Factors that are critical to developing the system and organization capacity in the use of health informatics and digital health technology, and leading and managing the adoption in the healthcare organizations were identified in three categories: 1) policy/system; 2) organizational structure and processes; and 3) people factors. CONCLUSIONS: This paper has taken an important step in confirming the competency requirements for health services managers that are relevant to leading and managing in the health informatics and digital health space, consequently indicating the directions for developing a competent workforce in meeting the existing and emerging healthcare delivery challenges, both now and in the future.

Pandemic preparedness of diagnostic radiographers during COVID-19: A scoping review.

INTRODUCTION: As chest imaging is a tool for detecting coronavirus disease 2019 (COVID-19), diagnostic radiographers are a key component of the frontline workforce. Due to its unforeseen nature, COVID-19 has challenged radiographers' preparedness in combating its effects. Despite its importance, literature specifically investigating radiographers' readiness is limited. However, the documented experiences are prognostic of pandemic preparedness. Hence, this study aimed to map this literature by addressing the question: 'what does the existing literature reveal about the pandemic preparedness of diagnostic radiographers during COVID-19?'. METHODS: Using Arksey and O'Malley's framework, this scoping review searched for empirical studies in MEDLINE, Embase, Scopus, and CINAHL. Consequently, 970 studies were yielded and underwent processes of deduplication, title and abstract screening, full-text screening, and backward citation searching. Forty-three articles were deemed eligible for data extraction and analysis. RESULTS: Four themes that reflected pandemic preparedness were extrapolated: infection control and prevention, knowledge and education, clinical workflow, and mental health. Notably, the findings highlighted pronounced trends in adaptation of infection protocols, adequate infection knowledge, and pandemic-related fears. However, inconsistencies in the provision of personal protective equipment, training, and psychological support were revealed. CONCLUSION: Literature suggests that radiographers are equipped with infection knowledge, but the changing work arrangements and varied availability of training and protective equipment weakens their preparedness. The disparate access to resources facilitated uncertainty, affecting radiographers' mental health. IMPLICATIONS FOR PRACTICE: By reiterating the current strengths and weaknesses in pandemic preparedness, the findings can guide clinical practice and future research to correct inadequacies in infrastructure, education, and mental health support for radiographers in the current and future disease outbreaks.

Comparing the Psychological Problems Among the Health Care Workers Across Two Waves of SARS-CoV-2 (COVID-19) Pandemic: An Observational Study from India.

OBJECTIVE: Literature investigating the change in psychological problems of the health care workers (HCWs) throughout the coronavirus disease (COVID-19) pandemic is lacking. We aimed at comparing the psychological problems and attitudes toward work among HCWs over two waves of the COVID-19 pandemic in India. METHODS: A survey was conducted involving HCWs (n = 305, first wave, 2020; n = 325, second wave, 2021). Participants' demographic and professional and psychological characteristics (using attitude toward COVID-19 questionnaire [ATCQ]; Depression, Anxiety, and Stress Scale - 21 Items and impact of event scale - 22) were recorded. The unpaired t-test/chi-squared test was used for comparison. RESULTS: Significant improvements (χ2(1) = 7.3 to 45.6, P < 0.05) in level of depression (42.2% vs 9.6%), anxiety (41.3% vs 16.3%), stress (30.1% vs 6.7%), event-related stress symptoms (31.2% vs 27%), work-related stress (89.8% vs 76.8%), and stigma (25.9% vs 22.8, though marginally significant) were found among the participants of the second wave (vs first wave). However, on subgroup analysis, allied-HCWs (housekeeping staff and security personnel) reported lesser concerns over the domains of the ATCQ vis-a-viz frontline-HCWs (doctors and nurses). CONCLUSION: This improvement could be attributed to greater awareness about the illness, better coping skills, vaccination, and so forth; however, more research is warranted to investigate these determinants.

[Implementation of the plan of action for human resources for health and the COVID-19 pandemic responseImplementação do plano de ação sobre recursos humanos para a saúde e a resposta à pandemia de COVID-19]. / Implementación del plan de acción de recursos humanos en salud y la respuesta a la pandemia por la COVID-19.

Objectives: Systematize and analyze the response actions related to human resources for health during the pandemic, reported by 20 countries of the Region of the Americas in the mid-term evaluation of the Plan of Action on Human Resources for Universal Access to Health and Universal Health Coverage 2018-2023 (Pan American Health Organization, 2018), and assess the importance of the policies on human resources for health (HRH) and on HRH management expressed in the Plan of Action and in the Strategy on Human Resources for Universal Access to Health and Universal Health Coverage during health emergencies and in normal times. Methods: Reports on actions taken in 20 countries of the Region against COVID-19 and for HRH were selected and systematized. These were classified as immediate contingency actions, actions related to installed capacities, and emerging actions. Results: The capacity to plan and manage HRH in countries depends on their installed, functional structures and competencies. The pandemic highlighted the need to have new job profiles, improve precarious working and contractual conditions, emphasize the gender perspective, and address numerical gaps in certain areas and levels of care. Conclusions: Linking the monitoring of the Plan of Action with the COVID-19 response demonstrated the importance of HRH governance, management, and installed capacities when responding to health emergencies and in normal times. The analysis suggests a need to review existing public policies, models of care that can guide current and future needs in HRH, the profiles required, working conditions, and ways to close numerical gaps, among other issues. The pandemic enabled countries to innovate in response to demands. The Strategy and the Plan of Action remain in place to guide and strengthen the performance of human resources for health.

Objetivos: Sistematizar e analisar as ações de resposta relacionadas aos recursos humanos para a saúde durante a pandemia, relatadas por 20 países da Região das Américas na avaliação intermediária do Plano de ação sobre recursos humanos para o acesso universal à saúde e a cobertura universal de saúde 2018-2023 (Organização Pan-Americana da Saúde, 2018), e avaliar a importância das políticas e da gestão de recursos humanos expressas na estratégia e no plano durante emergências de saúde e em tempos normais. Métodos: Foram selecionados e sistematizados relatórios sobre ações contra a COVID-19 e recursos humanos para a saúde de 20 países da Região. As ações foram classificadas em ações imediatas de contingência, ações relacionadas às capacidades instaladas e ações emergentes. Resultados: As capacidades de planejamento e gestão de recursos humanos para a saúde nos países dependem das estruturas e das competências instaladas e funcionais. A pandemia tornou visível a necessidade de ter novos perfis de trabalho, melhorar as precárias condições de trabalho e contratuais, tornar visível a perspectiva de gênero e solucionar lacunas numéricas em determinadas áreas e níveis de atenção. Conclusões: A vinculação das ações contra a COVID-19 com o monitoramento do plano demonstrou a importância da governança, da gestão e das capacidades instaladas relacionadas aos recursos humanos para a saúde, para responder a emergências de saúde e em tempos normais. A análise convida à revisão das políticas públicas existentes, dos modelos de atenção necessários para orientar as necessidades atuais e futuras dos recursos humanos para a saúde, os perfis exigidos, as condições de trabalho e a cobertura das lacunas numéricas existentes, entre outras questões. A pandemia permitiu inovações nos países para responder à demanda. A estratégia e o plano continuam vigentes para orientar e fortalecer o desempenho dos recursos humanos para a saúde.

COVID-19-Induced Post-Traumatic Stress Symptoms in Palliative Medicine Professionals (Sci218)

Outcomes: 1. Define the factors contributing to increased PTSD incidence due to COVID-19 among hospice and palliative medicine professionals. 2. Implement measures to screen and proactively mitigate workplace related factors associated with increased risk of PTSD in pandemic- and potentially non-pandemic-related situations. The COVID-19 pandemic has affected more than 557 million people globally. In order to assess its psychological effect on healthcare workers in hospice and palliative medicine, a survey was solicited to AAHPM members. Participation was voluntary and anonymous, with all responses kept in confidence. The survey consisted of three parts: demographics, attitudes/sentiments relating to COVID-19, and the DSM-IV-TR Post-Traumatic Stress Disorder (PTSD) Checklist-Specific (PCL-S). The PCL-S has clinical and research utility to screen for PTSD in response to a specific stressor, in this case COVID-19. A total of 323 AAHPM members participated, of which 290 (89.8%) completed the PCL-S. Utilizing the most conservative and reliable scoring method for the PCL-S, 16.6% (48/290) met diagnostic criteria for symptomatic PTSD. Demographic factors including age, relationship status, child status, years of experience, geographical location, and gender did not affect odds of PTSD symptomology, yet non-male gender was associated with higher PCL-S scores (3.2 +/- 1.5;p = 0.38). Attitudes surrounding the use and perceived efficacy of telemedicine did not impact the incidence of PTSD. Those providing critical care services (33/156;21.2%) were at greater risk of symptomatic PTSD than those not providing critical care services to COVID-19 patients (15/135;11.1%;RR = 1.9[1.08-3.35];p=0.026). Furthermore, PCL-S scores increased as a function of the number of patients where critical care (but not non-critical care) was provided (p=0.0006). Increased workload (p=0.009) and having to perform new job duties (p=0.004) as a result of COVID-19 were also associated with symptomatic PTSD. Personal stress was also a contributory factor;the risk of symptomatic PTSD was higher among respondents reporting a friend, family member, or colleague's death from COVID-19 (23.8% vs. 13.1%;RR = 1.82[1.08-3.05]). As COVID-19 continues to impact us all, understanding factors affecting the mental health of an integral part of the healthcare workforce is crucial.Copyright © 2023