Résumé
Study Objective: The DSM-5 defines post-traumatic stress disorder (PTSD) as the development of certain characteristic symptoms after direct, witnessed, or secondhand “exposure to actual or threatened death, serious injury, or sexual violence.” The COVID-19 pandemic has been compared to the 2003 SARS outbreak;health care workers (HCWs) during that crisis experienced increased levels of emotional distress. As of March 2021, there have been over 830,000 cases of COVID-19 and 24,000 mortalities in New Jersey (NJ). Our study aimed to identify the point prevalence of PTSD and sub-threshold PTSD in HCWs across NJ during the second wave of the pandemic. Methods: We conducted a prospective survey study that was distributed electronically to physicians (attendings, fellows, and residents) and mid-level practitioners (MLPs) working in emergency departments across NJ from December 2020 – March 2021 using a secure, online survey platform. Results: All collected participant demographics are shown by training level in Table 1. There are several provisional diagnostic determinations of PTSD currently in use (Table 2). For continuous total severity score, the mean score and standard deviation (SD) for attending physicians was 13.9 (12.6), for resident/fellow physicians it was 15.4 (18.2), and for MLPs it was 20.4 (14.9), causing a statistically significant difference between the groups (p=0.01). Following the DSM-5 criteria, a total of 27 individuals were diagnosed with PTSD, where a significantly high proportion of those were MLPs (n (%) = 20 (25);p=0.02). DSM-5 criteria B-E (Table 2) is used to evaluate subthreshold PTSD. Regardless of whether two or three criteria were used for diagnosis, the proportion met was greatest for the MLPs, with criterion D being significantly associated with training level (p=0.01). Discussion: Physician burnout is well documented in the U.S. Current second-year emergency medicine residents had the highest contiguous severity score, most likely because their intern year was completely consumed by the COVID-19 crisis. The pandemic put a dent in the movement for physician wellness. Attending physicians in teaching hospitals are responsible for, in addition to patient care, the training of residents. The burden of navigating a mentorship role while managing the high volume of critical ill patients suffering from a novel disease can't be ignored. MLPs, along with their physician colleagues, experienced shortages in PPE, redeployment into other subspecialists, furlough and/or termination from their positions, and COVID morbidity. Conclusions: The COVID-19 pandemic has caused significant psychological trauma for HCWs. Regardless of training level, physicians and mid-level practitioners report symptoms suggestive of PTSD and sub-PTSD. MLPs were particularly affected by the trauma of the novel coronavirus and more research must be done to fully elucidate why this particular group of providers has been so negatively impacted. [Formula presented]