COVID-19 from the frontlines: Reports from over 14,000 ICU clinicians

ABSTRACT

INTRODUCTION: Global cases of COVID-19 continue to increase despite mitigation and containment efforts. As a large proportion of COVID-19 patients require hospitalization and treatment in an intensive care unit (ICU), understanding the impact on ICU clinicians remains an essential component of meeting current and projected needs during pandemic care. In order to capture the ongoing impact on COVID-19 patient care on ICU resources and clinicians, the Society of Critical Care Medicine (SCCM), an international organization of healthcare professionals including physicians, nurses, pharmacists, respiratory therapists, and others deployed a series of rapid cycle surveys. METHODS: A descriptive cross-sectional survey methodology was used. Three national web-based anonymous surveys launched beginning March 18, 2020. The brief (12 question) rapid cycle (open for 2 weeks) descriptive surveys assessed ICU clinician's perceptions of the impact of the ongoing COVID-19 pandemic on ICU care and demographic information related to respondent profession, geographic location, and if they had cared for a suspected or confirmed COVID-19 patient. SurveyMonkey® was used to distribute the surveys via email and newsletter blasts. RESULTS: Collectively, over 14,000 multi-professional ICU clinicians practicing in all 50 United States (U.S.) responded, including ICU physicians (n=876, 7.1%), nurses (n=10,201, 83%), advanced practice providers [nurse practitioners and physician assistants] (n=668, 5.5%), respiratory therapists (n=267, 2.2%), and pharmacists (n=109, 0.9%). Majority (n=8762;62.6%) reported having cared for a patient with presumed or confirmed COVID-19. ICU clinicians report that the most challenging aspects of COVID-19 are related to caring for critically ill patients, minimizing staff exposure to SARS-CoV-2 during the course of direct care, and communication with patient's family members while visitation is restricted, among others. CONCLUSIONS: As the ICU workforce represents the foundation for caring for critically ill COVID-19 patients, monitoring the impact of sustained stress on the critical care workforce warrants surveillance and the elaboration of mitigation strategies in order to ensure critical care clinician health, and the ability to continue to serve at the frontlines of COVID-19 patient care.