Polish medical students facing the pandemic-Assessment of resilience, well-being and burnout in the COVID-19 era.

INTRODUCTION: Recent reports indicate that COVID-19 pandemic has significant influence on medical professionals' mental health. Strict limitations in clinical practice and social interactions within academic community, which had to be introduced, could lead to significant psychological distress in medical students. The aim of the study was to assess resilience, well-being and burnout among Polish medical students in the COVID-19 era. METHODS: The online survey consisting of validated questionnaires assessing resilience (Resilience Scale 14; RS-14), well-being (Medical Student Well-Being Index) and burnout (Maslach Burnout Inventory) as well as self-created survey concerning mental health problems, use of stimulants, SARS-CoV-2 infection, work in COVID-19 units, medical education and social attitude towards health care professionals in the pandemic era was distributed via Facebook and other online students' platforms. 1858 MSs from all polish medical schools agreed to fill in the survey. RESULTS: 'Very low', 'low' and 'on the low end' levels of resilience were found in 26%, 19.1% and 26.9% of the study group, respectively. Students with higher resilience level presented better attitude towards online and hybrid classes. 16.8% of respondents stated that they worked, currently work or plan to work voluntarily at the pandemic frontline. In terms of burnout, these respondents presented lower exhaustion (p = 0.003) and cynicism (p = 0.02), and higher academic efficacy (p = 0.002). That group also showed greater resilience (p = 0.046). The SARS-CoV-2 infection among respondents, their relatives and friends did not influence the results. 39.1% of respondents declared the need of the psychological or psychiatric consultation in relation to pandemic challenges. 231 (26.4%) participants previously diagnosed with mental health disorders noticed worsening of their symptoms. Increased intake of alcohol, cigarettes or other stimulants was noticed by 340 (28.6%) respondents. 80.2% of respondents thought that social aversion and mistrust towards doctors increased during the pandemic and part of them claimed it affected their enthusiasm toward medical career. CONCLUSIONS: The majority of medical students presented low levels of resilience and high burnout at the time of pandemic. Providing necessary support especially in terms of mental health and building up the resilience of this vulnerable group seems crucial to minimize harm of current pandemic and similar future challenges.

Modelling long-term COVID-19 impacts on the U.S. workforce of 2029.

While ensuring employment opportunities is critical for global progress and stability, workers are now subject to several disruptive trends, including automation, rapid changes in technology and skill requirements, and transitions to low-carbon energy production. Yet, these trends seem almost insignificant compared to labor impact of the COVID-19 pandemic. While much has been written about the pandemic's short-term impacts, this study analyzes anticipated long-term impacts on the labor force of 2029 by comparing original 2029 labor projections to special COVID-adjusted projections recently published by the US Bureau of Labor Statistics. Results show that future demand for nearly every type of labor skill and knowledge will increase, while the nature of work shifts from physical to more cognitive activities. Of the nearly three million jobs projected to disappear by 2029 due to COVID, over 91% are among workers without a bachelor's degree. Among workers with a degree demand shifts primarily from business-related degrees to computer and STEM degrees. Results further show that the socialness of labor, which is important for both innovation and productivity, increases in many more industries than it decreases. Finally, COVID will likely accelerate the adoption of teleworking and slightly decrease the rate of workforce automation. These impacts, combined with a shift to more cognitive worker activities, will likely impact the nature of workforce health and safety with less focus on physical injuries and more on illnesses related to sedentary lifestyles. Overall, results suggest that future workers will need to engage more often in training and skill acquisition, requiring life-long learning and skill maintenance strategies.

Rethinking the Paradigm and Practice of Occupational Health in a World Without Decent Work: A Perspective From East and Southern Africa.

The global political economy is generating new forms and growing shares of informal, insecure, and precarious labor, adding to histories of insecure work and an externalization of social costs. The COVID-19 pandemic has highlighted the consequences of ignoring such signals in terms of the increased risk and vulnerability of insecure labor. This paper explores how such trends are generating intersecting adverse health outcomes for workers, communities, and environments and the implications for breaking siloes and building links between the paradigms, science, practice, and tools for occupational health, public health, and eco-health. Applying the principle of controlling hazards at the source is argued in this context to call for an understanding of the upstream production and socio-political factors that are jointly affecting the nature of work and employment and their impact on the health of workers, the public, and the planet.

Employee psychological well-being during the COVID-19 pandemic in Germany: A longitudinal study of demands, resources, and exhaustion.

Many governments react to the current coronavirus/COVID-19 pandemic by restricting daily (work) life. On the basis of theories from occupational health, we propose that the duration of the pandemic, its demands (e.g., having to work from home, closing of childcare facilities, job insecurity, work-privacy conflicts, privacy-work conflicts) and personal- and job-related resources (co-worker social support, job autonomy, partner support and corona self-efficacy) interact in their effect on employee exhaustion. We test the hypotheses with a three-wave sample of German employees during the pandemic from April to June 2020 (Nw1  = 2900, Nw12  = 1237, Nw123  = 789). Our findings show a curvilinear effect of pandemic duration on working women's exhaustion. The data also show that the introduction and the easing of lockdown measures affect exhaustion, and that women with children who work from home while childcare is unavailable are especially exhausted. Job autonomy and partner support mitigated some of these effects. In sum, women's psychological health was more strongly affected by the pandemic than men's. We discuss implications for occupational health theories and that interventions targeted at mitigating the psychological consequences of the COVID-19 pandemic should target women specifically.

Family medicine practitioners' stress during the COVID-19 pandemic: a cross-sectional survey.

BACKGROUND: The COVID-19 pandemic has shaken the world in early 2020. In France, General Practitioners (GPs) were not involved in the care organization's decision-making process before and during the first wave of the COVID-19 pandemic. This omission could have generated stress for GPs. We aimed first to estimate the self-perception of stress as defined by the 10-item Perceived Stress Score (PSS-10), at the beginning of the pandemic in France, among GPs from the Auvergne-Rhône-Alpes, a french administrative area severely impacted by COVID-19. Second, we aimed to identify factors associated with a self-perceived stress (PSS-10 ≥ 27) among socio-demographic characteristics of GPs, their access to reliable information and to personal protective equipment during the pandemic, and their exposure to well established psychosocial risk at work. METHODS: We conducted an online cross-sectional survey between 8th April and 10th May 2020. The self-perception of stress was evaluated using the PSS-10, so to see the proportion of "not stressed" (≤20), "borderline" (21 ≤ PSS-10 ≤ 26), and "stressed" (≥27) GPs. The agreement to 31 positive assertions related to possible sources of stress identified by the scientific study committee was measured using a 10-point numeric scale. In complete cases, factors associated with stress (PSS-10 ≥ 27) were investigated using logistic regression, adjusted on gender, age and practice location. A supplementary analysis of the verbatims was made. RESULTS: Overall, 898 individual answers were collected, of which 879 were complete. A total of 437 GPs (49%) were stressed (PSS-10 ≥ 27), and 283 GPs (32%) had a very high level of stress (PSS-10 ≥ 30). Self-perceived stress was associated with multiple components, and involved classic psychosocial risk factors such as emotional requirements. However, in this context of health crisis, the primary source of stress was the diversity and quantity of information from diverse sources (614 GPs (69%, OR = 2.21, 95%CI [1.40-3.50], p < 0.001). Analysis of verbatims revealed that GPs felt isolated in a hospital-based model. CONCLUSION: The first wave of the pandemic was a source of stress for GPs. The diversity and quantity of information received from the health authorities were among the main sources of stress.

The challenge of maintaining necessary vascular and endovascular services at a referral center in Northern Italy during the COVID-19 outbreak.

OBJECTIVES: The Padova Hospital Vascular Surgery Division is located in Veneto, one of the area of the Northern Italy most hit by the Coronavirus disease 2019 outbreak. The aim of this paper is to describe the protocols adopted and to evaluate their impact during the acute phase of Coronavirus spread, focusing on the management of elective and urgent/emergent surgery, outpatients activity, and also health staff preservation from intra-hospital Coronavirus disease 2019 infection. METHODS: Several measures were progressively adopted in the Padova University Hospital to front the Coronavirus disease 2019 outbreak, with a clear strong asset established by 9 March 2020, after the Northern Italy lockdown. Since this date, the Vascular Surgery Unit started a "scaled-down" activity, both for elective surgical procedures and for the outpatient Clinical activities; different protocols were developed for health preservation of staff and patients. We compared a two months period, 30 days before and 30 days after this time point. In particular, emergent vascular surgery was regularly guaranteed as well as urgent surgery (to be performed within 24 h). Elective cases were scheduled for "non-deferrable" pathology. A swab test protocol for COVID-19 was applied to health-care professionals and hospitalized patients. RESULTS: The number of urgent or emergent aortic cases remained stable during the two months period, while the number of Hospital admissions via Emergency Room related to critical limb ischemia decreased after national lockdown by about 20%. Elective vascular surgery was scaled down by 50% starting from 9 March; 35% of scheduled elective cases refused hospitalization during the lockdown period and 20% of those contacted for hospitalization where postponed due to fever, respiratory symptoms, or close contacts with Coronavirus disease 2019 suspected cases. Elective surgery reduction did not negatively influence overall carotid or aortic outcomes, while we reported a higher major limb amputation rate for critical limb ischemia (about 10%, compared to 4% for the standard practice period). We found that 4 out of 98 (4%) health-care providers on the floor had an asymptomatic positive swab test. Among 22 vascular doctors, 3 had a confirmed Coronavirus disease 2019 infection (asymptomatic); a total of 72 swab were performed (mean = 3.4 swab/person/month) during this period; no cases of severe Coronavirus disease 2019 (deaths or requiring intensive care treatment) infection were reported within this period for the staff or hospitalized patients. CONCLUSIONS: Elective vascular surgery needs to be guaranteed as possible during Coronavirus disease 2019 outbreak. The number of truly emergent cases did not reduce, on the other side, Emergency Room accesses for non-emergent cases decreased. Our preliminary results seem to describe a scenario where, if the curve of the outbreak in the regional population is flattened, in association with appropriate hospitals containment rules, it may be possible to continue the activity of the Vascular Surgery Units and guarantee the minimal standard of care.

The impact of COVID-19 pandemic on mental health of Nurses.

COVID-19 pandemic affected the psychological health of nurses. Numerous nurses have been facing mental complications associated with quarantine such as psychological distress and fear. The gravity of COVID-19 pandemic is triggering further mental health challenges among nurses. The continuous stress nurses are facing, could trigger post-traumatic stress symptoms, poor service delivery, suicide ideation and suicide. Assessing and preserving the mental health of nurses and the health care workers in general is necessary for optimal disease control. Psychiatric interventions are needed to attend to the psychological need of nurses treating COVID-19 patients. Such interventions imply using E-learning and video platforms to educate nurses on communication skills, case handling skills and problem-solving tactics to deal with the possible psychological problems that might arise from treating COVID-19 patients.

We must rigorously follow basic infection control procedures to protect our healthcare workers from SARS-CoV-2.

Because severe acute respiratory coronavirus virus 2 (SARS-CoV-2) spreads easily and healthcare workers are at increased risk of both acquiring and transmitting infection, all healthcare facilities must rapidly and rigorously implement the full hierarchy of established infection controls: source control (removal or mitigation of infection sources), engineering and environmental controls, administrative controls, and personal protective equipment.

Attending to the Emotional Well-Being of the Health Care Workforce in a New York City Health System During the COVID-19 Pandemic.

The COVID-19 pandemic has placed an enormous strain on health care workers, and its potential impact has implications for the physical and emotional well-being of the workforce. As hospital systems run well over capacity, facing possible shortages of critical care medical resources and personal protective equipment as well as clinician deaths, the psychological stressors necessitate a strong well-being support model for staff. At the Mount Sinai Health System (MSHS) in New York City, health care workers have been heroically providing frontline care to COVID-19 patients while facing their own appropriate fears for their personal safety in the setting of contagion. This moral obligation cannot be burdened by unacceptable risks; the health system's full support is required to address the needs of its workforce.In this Invited Commentary, the authors describe how an MSHS Employee, Faculty, and Trainee Crisis Support Task Force-created in early March 2020 and composed of behavioral health, human resources, and well-being leaders from across the health system-used a rapid needs assessment model to capture the concerns of the workforce related to the COVID-19 pandemic. The task force identified 3 priority areas central to promoting and maintaining the well-being of the entire MSHS workforce during the pandemic: meeting basic daily needs; enhancing communications for delivery of current, reliable, and reassuring messages; and developing robust psychosocial and mental health support options. Using a work group strategy, the task force operationalized the rollout of support initiatives for each priority area. Attending to the emotional well-being of health care workers has emerged as a central element in the MSHS COVID-19 response, which continues to be committed to the physical and emotional needs of a workforce that courageously faces this crisis.