The COVID-19 pandemic significantly intensified the demands placed on health workers, leading to unprecedented challenges across various settings. Early in the pandemic, health workers in public health, laboratory, and clinical settings rapidly mobilized to understand, detect, and prevent the transmission of the virus while providing essential patient care (World Health Organization [WHO], 2020). Despite stay-at-home orders and social distancing guidelines, the virus spread rapidly, overwhelming health systems and leaving workers without adequate personal protective equipment (PPE), which increased the risk to their own health and that of their families (Centers for Disease Control and Prevention [CDC], 2021).

Health workers faced extreme pressures, often working long hours without breaks, treating critically ill patients, including their colleagues, who were isolated from loved ones. The politicization of the pandemic further complicated their roles, exposing them to hostility, threats, and violence fueled by misinformation about the virus (National Institute for Occupational Safety and Health [NIOSH], 2021).

Throughout the pandemic, high levels of stress, frustration, exhaustion, isolation, and feelings of being undervalued were reported among health workers. Surveys conducted between June and September 2020 found that 93% of over 1,100 health workers experienced stress, 86% reported anxiety, 76% reported exhaustion and burnout, and 41% reported loneliness (Shanafelt et al., 2020). These mental health challenges were not limited to clinicians; non-clinical health workers, including operations staff and public health workers, also reported significant burnout and mental health issues (Pappa et al., 2020).

Research in October 2020 highlighted that 49% of health workers, including nursing assistants, medical assistants, social workers, and housekeepers, reported burnout, and 38% experienced anxiety or depression (Evanoff et al., 2020). Inpatient workers, women, persons of color, and social workers reported higher stress levels, though these impacts were mitigated when workers felt valued (Blake et al., 2021).

The mental health impacts extended to public health workers in governmental roles, with over 50% reporting symptoms of at least one mental health condition early in the pandemic, including elevated levels of PTSD compared to pre-pandemic rates (NIOSH, 2021). These mental health challenges are expected to have long-lasting effects (Greenberg et al., 2020).

Health workers who were caregivers faced additional challenges at home, such as managing virtual schooling for children and ensuring the safety of older relatives. A survey indicated that 76% of health workers with children worried about exposing them to COVID-19, and 50% reported lacking quality time with their children (Gordon et al., 2020). Another survey found that half of the health workers reported no childcare assistance, and among them, 75% experienced moderate or severe stress in meeting their children's needs (Niedzwiedz et al., 2021).

The pandemic led to significant disruptions in healthcare services, with hospitals closing departments, delaying treatments, and filling vacancies with travel nurses. Workforce shortages impacted both health workers and patients, with 69% of the general U.S. population reporting delayed care for serious problems due to nonfinancial access barriers (Kates et al., 2020). A survey of 20,665 health workers in 2020 revealed that approximately one-third of physicians, advanced practice providers, and nurses intended to reduce their work hours, and a significant portion planned to leave their practice altogether (Sinsky et al., 2021). By the end of the first year of the pandemic, one-third of health workers considered leaving their jobs, with younger nurses and those with less tenure being the most likely to quit (American Association of Critical-Care Nurses [AACN], 2021).

Workplace violence, which had been increasing even before the pandemic, saw a sharp rise during this period. Nearly a quarter of public health workers reported feeling bullied, threatened, or harassed at work (NIOSH, 2021). A national survey in mid-2021 found that 80% of health workers experienced some form of workplace violence, with two-thirds being verbally threatened and one-third of nurses reporting increased violence compared to the previous year (Edmonson et al., 2021). By October 2021, at least 300 health department leaders had left their posts due to threats, intimidation, lack of funding, and insufficient support from government leaders (Redlener et al., 2021).

In conclusion, while the pandemic has universally affected health workers, certain groups have faced disproportionate impacts based on unique circumstances, highlighting the need for targeted support and interventions to address these disparities and build a resilient health workforce for the future.

References

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