IMPACT OF COVID-19 ON MENTAL HEALTH

OF HEALTH CARE WORKERS

Session: 2019-20
MBA (FT)-B (II-Sem.)

Subject – Business Research Methods

GUIDED BY - DR. DEEPAK JAROLIYA SIR
PREPAIRED BY -

Namita Gupta(1121212648)
Nehal Malviya (1121212583)
Parv Rai (1121212613 )
Sakshi Rajput (1121213412)
Saniya jain (1121213422)
 DECLARATION BY THE STUDENTS

We hereby declare that the Minor Research Project report on IMPACT

OF COVID-19 ON MENTAL HEALTH OF HEALTHCARE
WORKERS is a record of original work carried out by us under the
supervision of Dr. Deepak Jaroliya, towards partial fulfilment of the
requirements for MBA (Full Time) course of Prestige Institute of
Management and Research, Indore. We further declare that to the best
of our knowledge this work is not submitted anywhere else for the award
of any degree or diploma.

Namita Gupta(1121212648)
Nehal Malviya (1121212583)
Parv Rai (1121212613 )
Sakshi Rajput (1121213412)
Saniya jain (1121213422)

MBA Full Time II Semester (Section A)

 CERTIFICATE BY THE FACULTY GUIDE

This is to certify that the Minor Project Report entitled “A Study on

impact of Covid-19 on mental health of healthcare workers” is being
submitted by Nehal Malviya, Parv Rai, Saniya Jain, Namita Gupta and
Sakshi Rajput under my supervision. During this project work, I found
the group members responsible, sincere and hard working. I
recommend this piece of work for its acceptance as minor project of
Business Research Methods Course of MBA (Full Time) of Prestige
Institute of Management and Research, Indore.

Dr. Deepak Jaroliya

Professor, PIMR, INDORE

 ACKNOWLEDGEMENT

We would like to express our special thanks of gratitude to our teacher,

Dr. Deepak Jaroliya as well as our director, Dr. Yogeshwari Phatak
who gave as the golden opportunity to do this wonderful project on the
topic “COVID-19 Impact on mental health of Healthcare workers”,
which also helped us in doing a lot of research and we came to know
about so many new things we are really thankful to them.

Secondly, we would also like to thank parents and friends who helped us
a lot in finalizing this project within the limited time frame.

Namita Gupta(1121212648)
Nehal Malviya (1121212583)
Parv Rai (1121212613 )
Sakshi Rajput (1121213412)
Saniya jain (1121213422)

MBA Full Time II Semester (Section A)

 INTRODUCTION

The Healthcare Professions Experience Higher Levels Of Work Stress

Than The General Population, Even Under Normal Circumstances, And
Stress In Doctors Is Associated With Both Physical And Mental Health
Problems. Healthcare Professionals Also Have A Higher Likelihood Of
Suicidality Relative To Other Occupational Groups And Work-Related
Stress Is A Common Factor In Those Who Complete Suicide. Studies
Have Also Shown That Many Doctors Find It Difficult To Tell Their
Colleagues Or Employers About Their Mental Health Difficulties. The
Most Commonly Cited Reasons Are Perceived Stigma And Anticipated
Damage To Future Career Prospects. Suicidal Ideation In Doctors Can
Present Particularly Strong Fears Of Stigmatisation. Such Concerns May
Be Underpinned By Feelings Of Shame And Professional Failure, And
Associated Worries About Fitness To Practise And Licence Restrictions.
Not Only Do Doctors Find It Difficult To Share Mental Health Concerns
With Colleagues, They Are Also Often Reluctant To Get Professional
Help. Research Shows That Many Doctors Would Rather Seek Help
From Friends And Family Than Look For Psychological/Psychiatric
Consultation. Again, The Same Worries About Career Prospects And
Stigma Underpin These Preferences. Furthermore, There Is Evidence
That Many Doctors Are Even Reluctant To Disclose Mental Health
Problems To Their Friends And Family
The Mental Health Challenges Faced By Doctors During
The COVID-19 Crisis

During Acute Health Crises, Healthcare Services Are Placed Under

Excess Pressure, Making Working Life Even More Stressful Than
Normal. In A Pandemic, The Number Of Patients Requiring Treatment
Increases Significantly, Placing Strain On Healthcare Resources And On
Personnel Alike. Additionally, Doctors Perceive A Greater Risk To Self-
Owing To Their Exposure To The Patients Who Are Most Poorly –
Adding Further Stress. Compounding This Stress Is The Shortage Of
Personal Protective Equipment (PPE) That Can Arise During A
Pandemic. The Perceived Risk Of Infection Is Warranted: A Meta-
Analysis Of The Occupational Risk From The 2009 Swine Flu
Pandemic (Influenza A (H1N1)) Reports That The Odds Of Healthcare
Personnel Contracting The Virus Were Twice Those Of Comparison
Groups. This Heightened Risk For Doctors And Nurses Might Be Due
To Their Greater Exposure To The Respiratory Secretions Of Patients. A
Further Stressor Is The Increased Risk Of Infection For The Families Of
Healthcare Professionals On The Front Line.Data From The 2009 Swine
Flu Pandemic Shows That 20% Of Doctors And Nurses With Symptoms
Reported Symptoms In At Least One Of Their Family Members. One
Way For Frontline Doctors To Mitigate Infection Risk To Their
Families Is Through Social Distancing. However, Although The
Protective Benefits Of Social Contact And Support At Times Of Stress
Are Well Demonstrated Social Distancing Deprives The Individual Of A
Crucial Buffer Against Mental Health Difficulties Precisely When They
Are At Greater Risk Of Stress. Research From Previous
Epidemics/Pandemics (Such As The SARS Outbreak From 2003, The
MERS Epidemic From 2012 Or Ebola Outbreaks In West Africa) Shows
That Healthcare Professionals Can Experience A Broad Range Of
Psychological Morbidities, Including Trauma Which Might Endure For
Many Months After The Outbreak. The Relationship Between Traumatic
Life Events And Suicide Is Well Documented And Trauma From
Disaster Events Can Increase Suicidal Ideation In Emergency Workers.
Fears Over Risk To Health And Social Isolation Contribute To
Psychological Distress As Do Perceptions Of ‘Infection Stigma’ From
The Community. However, The Negative Effects On Mental Health Can
Be Found In Doctors Irrespective Of Whether Or Not They Worked
Directly With Infected Patients. Although The Strains Of Front-Line
Healthcare During An Infectious Outbreak Can Lead To Sickness
Absence And Higher Staff Turn-Over Most Evidence Suggests That
Doctors And Nurses Feel A Strong Professional Obligation To Continue
Working In Spite Of The Danger. However, Given The Pressures Of
Needing To Maintain High-Quality Healthcare Provision During A
Pandemic, Combined With Doctors’ Reluctance To Seek Help Or
Disclose Their Difficulties, It Is Possible That This Kind Of Professional
Commitment Might Relate Strongly To Presenteeism. Indeed, A Recent
Review Reported That Physicians Were At The Highest Risk Of
‘Infectious Illness Presenteeism’ When Compared With A Range Of
Other Occupational Groups. Having To Balance Their Own Safety With
The Needs Of Patients, Family And Employers And In The Face Of
Limited Resources Can Lead To Distressing Ethical Dilemmas For
Doctors And, Potentially, To Moral Injury. Moral Injury Can Arise
When One Feels Compelled To Make Decisions That Conflict With
One’s Ethical Or Moral Values. The Effect Of Moral Injury On
Subsequent Mental Health Can Depend On The Quality Of Support
Provided To Employees During And After Such Events.
Month After Month Of Working In The High-Stakes Environment Of
Covid-19 Has Had A Huge Impact On The Mental Health And Well-
Being Of Nurses.
Eight Out Of Ten Nurses Responding To A Nursing Standard Survey
Told Us Their Mental Health Had Been Affected By The Pandemic,
While Six In Ten Said Their Physical Health Was Suffering. The
Survey, In November 2020, Had 1,650 Nurse Participants.
Long Hours Caring For Patients, Fears About Contracting The Virus,
Separation From Loved Ones, And Redeployment – The Pressure On
Nurses Has Been Unrelenting Since March Last Year.
And, Of Course, Nursing Staff Have Died. But Nurses Report For Work
In The Most Challenging Of Circumstances Anyway, Because That Is
The Job

 What Are Some Of The Particular Anxieties Facing

Nursing Staff?
The Sheer Scale Of Patient Mortality, Exhaustion, Personal Safety
Worries, Workload, Case Complexity, Skills Mix, And Loved Ones’
Health Are Among A Vast Range Of Stressors That Cut Across
Professional Settings, But Are Perhaps Most Clearly Seen In Intensive
Care Units (Icus).
British Association Of Critical Care Nurses Chair Nicki Credland Told
Nursing Standard Recently: ‘We Are Hearing Of Numerous Stories
About Staff Being Off Sick, Needing Mental Health Counselling And
Being Diagnosed With Post-Traumatic Stress. We Have Also Heard Of
Staff Who Have Been Sectioned Under The Mental Health Act.
‘Nurses Are Suffering The Brunt Of The Covid-19 Pandemic. They Are
Physically And Mentally Exhausted. Particularly, Within Critical Care,
There Are Significant Levels Of Post-Traumatic Stress Evident, Which Is
Extremely Worrying. This Is Simply Not Sustainable’

 Coronavirus Impact On Indian Healthcare Sector

 The Coronavirus Pandemic Has Sent Shockwaves To
The Health System, Societies, And Economies Around The World. The
Impact Of The Coronavirus Pandemic Is Clearly Visible In Financial
Markets. But There Is Still No Clarity On The Deeper Impact That It Is
Having Across Various Sectors.  

The Healthcare Sector Is At The Epicenter Of This Unprecedented

Global Pandemic Challenge And The Pandemic Is Likely To Cost
Huge To The Health Sector. Though Private Hospitals Are Extending
Full Support To The Government In Terms Of Equipment, Isolation
Wards, And Workforce, The Health Industry Is Bound To Face
Challenges. The Pandemic Has Decreased The Surgeries, International
Patients, And Opd Footfall. It Will Impact The Cash Flows Of
Hospitals As 80% Of The Costs Are Fixed. That Apart, The Crisis Has
Hit Hard The Medical Devices Industry. The Situation In China Has
Disrupted The Exports Of Critical Raw Materials And The Export Of
Medical Devices.

Coronavirus impact on private healthcare

providers
Unlike other sectors, this sector is facing a twin-burden:

(A) Investing Additional Manpower, Equipment, Consumables, And

Other Resources To Ensure 100 Percent Preparedness For Safety In
The Hospital(S) And Eventual Treatment Of Patients, If Needed.

(B) Experiencing A Sharp Drop In OP Footfalls, Elective Surgeries,

And International Patients.

While They Have Been Feeling The Burden Of Covid-19, Private

Hospitals And Nursing Homes That Constitute More Than 60 Percent
Of Beds At 8.5-9 Lakh, 60 Percent Of In-Patients And 80 Percent Of
Doctors In India Have Been Investing Heavily In Manpower,
Equipment, Consumables And Other Resources To Ensure 100 Percent
Preparedness For Safety In The Healthcare Facilities And Eventual
Treatment Of Patients, If Needed.

The Industry Has Been Witnessing A Loss Of Business And This

Trend Is Expected To Continue For The Foreseeable Future (At Least
3-6 Months), And The Fact That The Sector’s Costs Are Predominantly
(Around 80 Percent) Fixed, It Is Expected That There Will Be Losses
And Severe Impact On Cash Flows.

The Private Healthcare Sector Would Need Liquidity Infusion, Indirect

And Direct Tax Benefits, And Fixed Cost Subsidies From The
Government To Address The Disruption. It Is Likely That Whenever
The Government Announces Any Fiscal Stimulus, This Industry Will
Be Looked At Favorably. The Industry Is Also Likely To Benefit From
Increase Awareness About Healthcare And The More Government
Focus That This Endemic Is Likely To Result In.

 Coronavirus Impact On The Medical Devices

Industry

The Medical Devices Industry Has Also Taken A Hit. The Country
Imports Consumables, Disposables And Capital Equipment Including
Orthopedic Implants, Gloves, Syringes, Bandages, Computed
Tomography And Magnetic Resonance Imaging Devices From China.
Due To The Current Crisis In China, The Medical Device
Manufacturers Across India Are Finding It Difficult To Source
Important Raw Materials And Electronic Components From Chinese
Factories. Even Though Some Of The Factories In China Have
Restored Operation, Shortage Of Some Critical Electronic Parts And
Raw Material Still Exists. This Is Adversely Affecting The Margins
And Profitability Of Indian Companies Importing Medical Devices
And Small Components To Manufacture Finished Products. This Can
Also Put Upward Pressure On The Prices Of Medical Devices In The
Short Term.

 Coronavirus Impact On Pharmaceuticals

Pharmaceutical Drugs Made In India Are Known For Quality Standards
And Are Exported To Developed Economies. However, The Indian
Pharmaceutical Industry Is Facing Fierce Competition From China As
It Has More Significant Cost Advantages. The Disruptions In The
Supply Of Low-Cost API From China Have Decreased The Efficiency
Of The Operations Of The Pharmaceutical Industry. The Supply-Side
Disruption Will Cut 10-15% Of Their Revenue. However, The Sector
Will Revive Soon As The Government Extends Full Support. Also,
Resumption In China’s Drug Production Will Alleviate The Supply
Chain As India Imports 85% Of Pharmaceuticals Ingredients From
China.  

Overall, The World Is In A Dramatic Shock, Facing A Series Of

Challenges. Therefore, The Government Must Make A Balance
Between Lives And Livelihood To Reboot The Economy In The Right
Way.  

If You Are Battling With Anxiety And Stress Because Of The

Pandemic, Spare A Minute To Imagine How Healthcare Workers Must
Be Feeling. Doctors And Nurses Do Not Have The Luxury Of Holding
Themselves Up In Their Homes To Protect Themselves From The
Outbreak. They Must Get Up Every Day And Go To Work Knowing
Very Well That They Must Expose Themselves To Risk. A Lot Of
Them Have Voluntarily Separated Themselves From Their Families To
Keep Them Safe.
  COVID-19 and Healthcare workers

Not Only Do Healthcare Workers Suffer The Anxiety Of Caring For The
Sick While Facing A Shortage Of PPE Kits And Changing Medical
Protocols, But They Also Must Forge A Calm Companionship With
Their Partners And Children. The Level Of Stress They Put Themselves
Through Daily Is Immense, And It Should Come As No Surprise That
Their Mental Health Is In Jeopardy.

 COVID-19: Healthcare Professionals Experiencing

Anxiety, Depression

A large proportion of healthcare professionals are experiencing

symptoms of anxiety, depression, insomnia, and psychological distress.
Nurses report severe symptoms, which should not come as a surprise, as
they often must engage in a lot of emotional labor, like reassuring
patients while keeping their own emotions in check. Frontline healthcare
workers in hotspots exhibit a higher degree of a psychological burden
compared to ones further away from them.
Ensuring the safety and protection of medical professionals should be an
integral part of the public health measures for addressing the outbreak.
We need specialized interventions to promote the mental wellbeing of
doctors and nurses who are exposed to COVID-positive patients, with a
focus on frontline workers and nurses.
  COVID-19: Stigma And Support

It Is Not Easy For Healthcare Professionals To Admit To Mental

Distress Either. Even Though Burnout And Depression Are Quite
Commonplace Among Doctors, The Healthcare Industry Has Done Very
Little To Provide Them With Institutional Support So That They Can
Seek Out Mental Health Treatment. If A Doctor Admits That They Are
Undergoing Treatment For A Mental Health Condition, Patients Do Not
Trust Them To Treat Their Condition. Our Prevalent Attitudes Towards
Mental Illness Exacerbate The Psychological Distress Faced By Medical
Professionals.
However, The Right Kind Of Mental Health Support Can Help Foster
Resilience, Giving Healthcare Workers The Ability And Confidence To
Manage Stressors In The Future. It Is Essential To Understand That
Expanding Mental Health Services Is An Ongoing Process. We Need To
Address Many Factors, Such As The Nationwide Shortage Of Mental
Health Professionals And The Regulatory Hurdles That Limit The
Offering Of Telemedical Services. Teletherapy, Virtual Mental Health
Services, And Meditation Apps Have Started To Make Inroads After
The Central Government Imposed The Nationwide Lockdown, And
They Should Be Leveraged To Reach Healthcare Workers Too.
In Countries Across The World, People Under Lockdown Gathered At
Their Balconies To Applaud And Cheer For Healthcare Workers Who
Are Putting Their Lives In Line To Save Others. Social Media Posts Are
Rife With People Expressing Their Gratitude To Healthcare Workers.
While These Gestures Can Boost The Morale To A Certain Extent, It Is
Crucial To Understand That Hero-Worship Alone Is Not Going To
Protect Them From The Mental Anguish They Face Daily. Like Soldiers
Returning From The War, It Is Going To Take Time For Them To
Process Everything They Are Going Through And Heal. Once The
Medical Crisis Comes To An End, We Need To Brace Ourselves For A
Mental Health Crisis. Meditation And Inner Journey, Mindfulness Can
Play An Important Role In Bringing The Inner Peace And Restoring The
‘Restfulness’ Amidst This Chaos.

 COVID-19: Doctors forced to make tough

decisions

Doctors across the world are being forced to make difficult decisions
like choosing which patients for ventilator access, a heart-breaking
choice that may leave a lasting psychological impact. Doctors are trying
to keep up, but the leadership is just as confused as the ground workers.
They lack crucial information, face a shortage of essential equipment,
and must battle public panic. The last one, especially, takes many forms,
from gossip and social rejection to denial of essential services and
physical assaults, all of which can compound their mental burden.
 LITERAUTER REVIEWS

1. Armocida Et Al., 2020; Xie Et Al.,2020 Research Held During An

Epidemic Of A Novel Infectious Disease, Many Healthcare
Workers Suffer From Mental Health Problems. The Aims Of This
Study Were To Test The Following Hypotheses: Stigma And
Hardiness Exert Both Direct Effects On Mental Health And Also
Indirect (Mediated) Effects On Mental Health Through Stress In
Nurses Working At A Government-Designated Hospital During
A Middle East Respiratory Syndrome Coronavirus Epidemic. A
Total Of 187 Participants Were Recruited Using A Convenience
Sampling Method. The Direct And Indirect Effects Related To The
Study Hypotheses Were Computed Using A Series Of
Ordinary Least-Squares Regressions And 95% Bootstrap
Confidence Intervals With 10,000 Bootstrap Resamples From The
Data.

2. Sun, Luoqun Wei Et Al.,2020 Research On The Coronavirus

Niuniu Disease 2019 (COVID-19) Is Spreading Rapidly, Bringing
Pressure And Challenges To Nursing Staff. The Survey Were
Conducted Face-To-Face Or By Telephone And Were Analyzed
By Colizzi’s 7-Step Method. As A Result, The Psychological
Experience Of Nurses Caring For COVID-19 Patients Can Be
Summarized Into 4 Themes. First, Negative Emotions Present In
Early Stage Consisting Of Fatigue, Discomfort, And Helplessness
 Was Caused By High-Intensity Work, Fear And Anxiety, And
Concern For Patients And Family Members. Second, Self-Coping
Styles Included Psychological And Life Adjustment, Altruistic
Acts, Team Support, And Rational Cognition. Third, We Found
Growth Under Pressure, Which Included Increased Affection And
Gratefulness, Development Of Professional Responsibility, And
Self-Reflection.

3. Sofia Pappa, Vasiliki Ntella Et All 2020 Study On COVID-19

Pandemic Has The Potential To Significantly Affect The Mental
Health Of Healthcare Workers (Hcws), Who Stand In The
Frontline Of This Crisis. The Aim Of This Review Is To
Synthesize And Analyze Existing Evidence On The Prevalence Of
Depression, Anxiety And Insomnia Among Hcws During The
Covid-19 Outbreak A Systematic Search Of Literature Databases
Was Conducted Up To April 17th, 2020. Two Reviewers
Independently Assessed Full-Text Articles According To
Predefined Criteria. Risk Of Bias For Each Individual Study Was
Assessed And Data Pooled Using Random-Effects Meta-Analyses
To Estimate The Prevalence Of Specific Mental Health Problems.
Anxiety Was Assessed In 12 Studies, With A Pooled Prevalence
Of 23·2% And Depression In 10 Studies, With A Prevalence Rate
Of 22·8%. A Subgroup Analysis Revealed Gender And
Occupational Differences With Female Hcps And Nurses
Exhibiting Higher Rates Of Affective Symptoms Compared To
Male And Medical Staff Respectively.

4. Huang Et Al., 2020; This Study's Aim Was To Evaluate The

Impact Of The COVID-19 Pandemic In March 2020 On German
Psychiatrists And Neurologists. An E-Mail And Fax-Based Short
Survey Of 2,072 Practice-Based Psychiatrists And Neurologists
 Was Performed Including Likert-Type Questions On Personal
Burden And Concerns, Anticipated Risk Of Infection, Practice
Management As Well As Anxiety And Sleep Problems. 396
Physicians Returned The Questionnaire (19%). More Than 60% Of
The Participants Felt Restricted Strongly Or Very Strongly, More
Than 30% Were Strongly And Very Strongly Concerned. They
Anticipated A High Own Risk Of Infection. However, 91% Did
Not Report Any Contact With Patients Positively Screened For
COVID-19, Which They Were Aware Of. One Third Felt
Financially Threatened And Loss Of Business Volume Was
Anticipated. 18% Reported, That The Pandemic Triggers
Substantial Anxiety. Sleep Problems, Which Occur At Least
Almost Every Night, Were Rarely Reported (9%). Practice-Based
Psychiatrists And Neurologists Are Negatively Affected By The
COVID-19 Pandemic.

5. Philip K Louie, Garrett K Harada Et Al,.2020, The Current Study

Addressed The Multi-Dimensional Impact Of COVID-19 Upon
Healthcare Professionals, Particularly Spine Surgeons, Worldwide.
Secondly, It Aimed To Identify Geographical Variations And
Similarities. A Multi-Dimensional Survey Was Distributed To
Surgeons Worldwide. Questions Were Categorized Into Domains:
Demographics, COVID-19 Observations, Preparedness, Personal
Impact, Patient Care, And Future Perceptions.902 Spine Surgeons
Representing 7 Global Regions Completed The Survey. 36.8%
Reported Co-Morbidities. Of Those That Underwent Viral Testing,
15.8% Tested Positive For COVID-19, And Testing Likelihood
Was Region-Dependent; However, 7.2% Would Not Disclose
Their Infection To Their Patients. More Than 33% Of Clinical
Practice Was Via Telemedicine. Research Output And
Teaching/Training Impact Was Similar Globally. 96.9% Were
 Interested In Online Medical Education. 94.7% Expressed A Need
For Formal, International Guidelines To Manage COVID-19
Patients. In This First, International Study To Assess The Impact
Of COVID-19 On Surgeons Worldwide, We Identified
Overall/Regional Variations And Infection Rate. The Study Raises
Awareness Of The Needs And Challenges Of Surgeons That Will
Serve As The Foundation To Establish Interventions And
Guidelines To Face Future Public Health Crises.

6. Philip K Louie, Garrett K Harada Et Al,.2020The Current Study

Addressed The Multi-Dimensional Impact Of COVID-19 Upon
Healthcare Professionals, Particularly Spine Surgeons, Worldwide.
A Multi-Dimensional Survey Was Distributed To Surgeons
Worldwide. Questions Were Categorized Into Domains:
Demographics, COVID-19 Observations, Preparedness, Personal
Impact, Patient Care, And Future Perceptions.902 Spine Surgeons
Representing 7 Global Regions Completed The Survey. 36.8%
Reported Co-Morbidities. Of Those That Underwent Viral Testing,
15.8% Tested Positive For COVID-19, And Testing Likelihood
Was Region-Dependent; However, 7.2% Would Not Disclose
Their Infection To Their Patients. Family Health Concerns Were
Greatest Stressor Globally (76.0%), With Anxiety Levels
Moderately High. Loss Of Income, Clinical Practice And Current
Surgical Management Were Region-Dependent, Whereby 50.4%
Indicated Personal-Protective-Equipment Were Not Adequate.
82.3% Envisioned A Change In Their Clinical Practice As A
Result Of COVID-19. More Than 33% Of Clinical Practice Was
Via Telemedicine. Research Output And Teaching/Training
Impact Was Similar Globally. 96.9% Were Interested In Online
Medical Education. 94.7% Expressed A Need For Formal,
International Guidelines To Manage COVID-19 Patients. In This
 First, International Study To Assess The Impact Of COVID-19 On
Surgeons Worldwide, We Identified Overall/Regional Variations
And Infection Rate. The Study Raises Awareness Of The Needs
And Challenges Of Surgeons That Will Serve As The Foundation
To Establish Interventions And Guidelines To Face Future Public
Health Crises.

7. Cao Et Al.,2020; Hong Et Al., 2020,  Called It A “Comprehensive

Psychological Intervention” For Frontline Workers Undergoing A
Mandatory Two-Week Quarantine In A Vocational Resort,
Following Two- To Three-Week Hospital Shifts. The Quarantine
Itself Was Also Described As Part Of The Intervention, Explicitly
Intended “To Alleviate Worries About The Health Of One's
Family”. Other Elements Included Shortened Shifts; Involvement
Of The Labour Union To Provide Support To Healthcare Workers’
Families; And A Telephone-Based Hotline That Allowed
Healthcare Workers To Speak To Trained Psychiatrists Or
Psychologists. This Hotline Had Already Been Available To
Healthcare Workers For Four Hours Per Week Prior To The
Pandemic, But Was Made Available For Twelve Hours, Seven
Days A Week.

8. Chen Et Al. (2020), Reported A That Attempted To Address

Individual Complaints And Facilitate Collegial Support. A
Telephone Hotline Was Set Up To Provide Immediate
Psychological Support, Along With A Medical Team That
Provided Online Courses To Help Healthcare Workers Handle
Psychological Problems, And Group-Based Activities To Release
Stress. However, Uptake Was Low, And When Researchers
Conducted Interviews With The Healthcare Workers To
Understand This, Healthcare Workers Reported Needing Personal
 Protective Equipment And Rest, Not Time With A Psychologist.
They Also Requested Help Addressing Their Patients’
Psychological Distress. In Response, The Hospital Developed
More Guidance On Personal Protective Equipment, Provided A
Rest Space, And Provided Training On How To Address Patients’
Distress.

9. Schulte Et Al. (2020) Targeted Collegial Support And Building

Individual Strategies Through One-Hour Video “Support Calls”
For Healthcare Workers Called In From Their Homes. To Describe
The Impact Of The Pandemic On Their Lives, To Reflect On Their
Strengths, And To Brainstorm Coping Strategies. This Intervention
Was Implemented As A Response To The Hospital Redeploying
Pediatric Staff To Work As Covid-19 Frontline Staff, And
Reorganizing Pediatric Space To Accommodate More Pediatric
And Adult Covid-19 Patients.

10. Lv Et Al. (2020) Surveyed Healthcare Workers Before And

During The Outbreak, Reporting No Further Information About
The Timeline. The Study Included Both Those Working On The
Frontline And Those With Unclear Exposure To Covid-19.
However, It Is Unclear Whether Respondents Were The Same At
Both Time Points. The Prevalence Of Anxiety, Depression, And
Insomnia Increased Over Time, Whether Mild, Moderate,
Moderate To Severe, Or Severe. During The Outbreak, One Out
Of Every Four Healthcare Workers Reported At Least Mild
Anxiety, Depression, Or Insomnia.

11. Yuan Et Al. (2020) Also Administered A Survey Twice To

939 Respondents During The Pandemic (In February 2020), With
Two Weeks Between The Surveys, And No Attrition Reported.
 Each Respondent Answered The Same Questions: I Feel Worried,
I Feel Anxious, Fidgeting And Not Knowing What To Do, I Feel
Frightened, I Feel Nervous And Uneasy, I Don't Think I Can
Succeed Even If I Try Hard, And I've Been Smoking Or Drinking A
Lot Lately. The Authors Presented The Changes Per Item After
Two Weeks, Rather Than Answers At Both Time Points, And The
Answer Scale Was Not Reported. Worry Worsened For 30% Of
Participants, Anxiety For 12%, Fidgeting For 9%, Fear For 15%,
Feeling Nervous And Uneasy For 13%, Not Thinking One Can
Succeed For 4%, And An Increase In Smoking And Drinking For
Only 1%. The Proportion Reporting Improvement Was Similar For
Fidgeting, Fear, And Feeling Nervous And Uneasy, And More
Improved In Not Thinking One Can Succeed And For A Reduction
In Smoking And Drinking.

12. Mohindra Et Al. (2020), Cross-Sectional Survey Also

Reported Experiences Of Mental Health Promotion Narratively,
With Similar Results As Yin Et Al.: More Knowledge Of Covid-
19 Could Strengthen Motivation, As Could Emotionally Support.
Affecting Them Negatively Were Fears Of Infecting Their
Families, Particularly Because Their Families Would Suffer More
Financially From Needing To Be Quarantined Than They Already
Were Suffering Under The Lockdown; Fears Of Using Personal
Protective Equipment Incorrectly; And Feeling Unequipped To
Handle Patients’ Non-Medical Needs. Healthcare Workers
Reported That Stigma Suppressed Patients’ Provision Of Accurate
Travel And Quarantine History. This Was An Issue They Were Ill-
Equipped To Help Patients Address When They Returned To The
Community. Healthcare Workers Also Reported That They Were
Stigmatized, Because They Were Potential Sources Of Infection.
13. Yin And Zeng (2020) Used A Framework Of Existence,
Relatedness, And Growth Theory To Analyze Nurses’
Psychological Needs. They Reported Nurses’ Identification
Of Existence Needs As Primarily Health And Security: Their Own
Physical And Mental Health, Personal Protective Equipment, And
Emotional Stability For Their Family. Their Need
For Relatedness Was Represented By Needs For Relationships
And Affection, As Well As For Care, Help, And Support From
Colleagues And Bosses, As Well As From Outside The Hospital.
Finally, Growth Needs Referred To Needing Knowledge Of
Covid-19 Infection Prevention And Control, Particularly From The
Authorities

14. Kang Et Al. (2020), Found Slightly Higher Levels Of Interest

In Professional Resources. When Asked From Whom They Prefer
To Receive “Psychological Care” Or “Resources”, 40% Answered
Psychologists Or Psychiatrists, 14% Answered Family Or
Relatives, 15% Answered Friends Or Colleagues, 2% Answered
Others, And 30% Said They Did Not Need Help. The Authors
Found That The Preferred Sources Of Psychological Resources
Were Related To The Level Of Psychological Distress. In A
Structural Equation Model That Uncovered Clusters Of Healthcare
Workers With Different Distress Levels (Subthreshold, Mild,
Moderate, And Severe), Those With Moderate And Severe
Distress More Often Preferred To Receive Care From
Psychologists Or Psychiatrists, While Those With Subthreshold
And Mild Distress More Often Preferred To Seek Care From
Family Or Relatives.
15. Bilal Javed, Abdullah Sarwer, & Erik B. Soto, This Research
Paper Talks About The How Badly This Pandemic Effects The
Mental Health Of Doctors And Nurses. A Pandemic Is Not Just A
Medical Phenomenon; It Affects Individuals And Society And
Causes Disruption, Anxiety, Stress, Stigma, And Xenophobia. The
Behavior Of An Individual As A Unit Of Society Or A
Community Has Marked Effects On The Dynamics Of A
Pandemic That Involves The Level Of Severity, Degree Of Flow,
And Aftereffects. 1 Rapid Human‐To‐Human Transmission Of
The SARS‐Cov‐2 Resulted In The Enforcement Of Regional
Lockdowns To Stem The Further Spread Of The Disease.
Isolation, Social Distancing, And Closure Of Educational
Institutes, Workplaces, And Entertainment Venues Consigned
People To Stay In Their Homes To Help Break The Chain Of
Transmission. 2 However, The Restrictive Measures Undoubtedly
Have Affected The Social And Mental Health Of Individuals From
Across The Board.

16. Johannes H. De Kock, 2021, This Rapid Review Confirms

That Front Line Health Care Workers ( Hcws ) Are At Risk Of
Significant Psychological Distress As A Direct Result Of The
COVID-19 Pandemic. Published Studies Suggest That Symptoms
Of Anxiety, Depression, Insomnia, Distress And OCD Are Found
Within The Healthcare Workforce. However, Most Studies Draw
Only From Work In Secondary Care And None Draw From The
Primary Care Or Social Care Setting. Published Studies So Far Are
Predominantly From China (18 Out Of 24 Included Studies) And
Most Of These Have Sampled Hospital Staff In Wuhan - The
 Epicenter. Findings In This Review Suggest That The Study Of
Different Contexts And Cultures May Reveal Different Findings
And We Recommend More Research In Primary Care And Social
Care Settings And To Monitor Rapidly Emerging Evidence From
Across The World. This Should Include Analysis Of Wider
Societal Factors Including Gender, Racial And Socio-Economic
Disparities That May Influence Mental Health Outcomes In Hcws

17. Elisabeth Mahase, 2020 , The Paper Brought Together These

Concerns With Currently Available Evidence—Specifically On
The 2003 Epidemic Of Severe Acute Respiratory Syndrome
(SARS), Which Had A Higher Case Fatality Rate (10%) Than Is
Estimated For Covid-19 (1-2%) But Was Less Transmissible, With
8098 Cases And 774 Deaths. The Researchers Highlighted That
The SARS Outbreak Was Associated With A 30% Increase In
Suicide In People Aged Over 65, While Around 50% Of
Recovered Patients Remained Anxious And 29% Of Healthcare
Workers Experienced Probable Emotional Distress. Meanwhile,
Those Who Survived Severe And Life Threatening Illness Were At
Risk Of Post-Traumatic Stress Disorder And Depression. The
Authors Wrote, “Many Of The Anticipated Consequences Of
Quarantine And Associated Social And Physical Distancing
Measures Are Themselves Key Risk Factors For Mental Health
Issues. These Include Suicide And Self-Harm, Alcohol And
Substance Misuse, Gambling, Domestic And Child Abuse, And
Psychosocial Risks (Such As Social Disconnection, Lack Of
Meaning Or Anomie, Entrapment, Cyberbullying, Feeling A
Burden, Financial Stress, Bereavement, Loss, Unemployment,
Homelessness, And Relationship Breakdown).
18.  Gil Zalsman, 2021, The Spread Of Epidemics Resulting In
Many Deaths Has Been Known Since The Dawn Of Civilization,
For Example, The Typhus And Smallpox Epidemics And The
Plague. Early In The Previous Century There Was An Outbreak Of
The Spanish Flue And Towards The End Of The 60's, The AIDS
Epidemic (HIV). Since The Start Of The Current Century, Several
Epidemics Broke Out And Spread To Various Places Around The
World, For Instance, SARS (Severe Acute Respiratory Syndrome),
The Avian Influenza And The Swine Influenza. In 2014 There
Was An Outbreak Of Ebola (Ebola Virus Disease) And In 2015
The Zika Virus Emerged And There Were More. Epidemics Cause
Havoc And Impact All Areas Of Life. Each Epidemic Takes An
Unfathomable Price In Lives. It Is Estimated, For Example, That
The AIDS Epidemic Took The Lives Of Some 30 Million People.
The Corona Virus (Covid-19) Broke Out In China, Towards The
End Of 2019 And Spread To Most Parts Of The World. The
Implications Of The Outbreak Are Similar In Many Countries,
Among Others, Due To The Uncertainty Regarding The Way The
Virus Spreads, The Appropriate Treatment, The Lack Of
Vaccination And The High Rate Of Deaths. Naturally, At Such
Times Physical Protection Is A Top Priority. However, Coping
With The Implications To People's Mental Health Is No Less
Important And These May Result In Long-Term Negative Impacts.

19.  Rashin Razavi, Khashayar Maroufi, 2020, Studies Focused

On The Psychological Effects Of The COVID‐19 Pandemic
Among Hcws. Some Of Which Declared That Health Authorities
Should Consider The Conditions And Methods To Provide
 Psychological Support To Both Patients And Hcws. These
Methods May Consist Of Using The Internet, Telephone Or Web
Applications, To Assess And Monitor Stress, Depression And
Anxiety (Spoorthy Et Al., 2020). We Want To Look At This Issue
From Another Perspective. Previous Studies, American Sports
Medicine Association (ACSM) And World Health Organization
(WHO) Have Suggested Regular Physical Activity To Eliminate
Inappropriate Mental Conditions. Regular Exercise And Physical
Activity Can Alter The Prevention And Treatment Of Anxiety And
Depression (Maroufi, 2021). Regular Physical Activity Regulates
Brain‐Derived Neurotrophic Factor (BDNF), Which Increases
Cognitive Function And The Ability To Face Depression And
Anxiety (Hu Et Al., 2020). Studies Showed That All Types Of
Exercise, Such As Aerobic, Resistance Or High‐Intensity Training,
Effectively Reduced Psychological Disorders. 

20. Amit Lakhani, 2020, We Want To Look At This Issue

From Another Perspective. Previous Studies, American Sports
Medicine Association (ACSM) And World Health Organization
(WHO) Have Suggested Regular Physical Activity To Eliminate
Inappropriate Mental Conditions. Regular Exercise And Physical
Activity Can Alter The Prevention And Treatment Of Anxiety And
Depression (Maroufi, 2021). Regular Physical Activity Regulates
Brain‐Derived Neurotrophic Factor (BDNF), Which Increases
Cognitive Function And The Ability To Face Depression And
Anxiety (Hu Et Al., 2020). Studies Showed That All Types Of
Exercise, Such As Aerobic, Resistance Or High‐Intensity Training,
Effectively Reduced Psychological Disorders .We Want To Look
At This Issue From Another Perspective. Previous Studies,
American Sports Medicine Association (ACSM) And World
Health Organization (WHO) Have Suggested Regular Physical
Activity To Eliminate Inappropriate Mental Conditions. Regular
Exercise And Physical Activity Can Alter The Prevention And
Treatment Of Anxiety And Depression (Maroufi, 2021). Regular
Physical Activity Regulates Brain‐Derived Neurotrophic Factor
(BDNF), Which Increases Cognitive Function And The Ability To
Face Depression And Anxiety (Hu Et Al., 2020). Studies Showed
That All Types Of Exercise, Such As Aerobic, Resistance Or
High‐Intensity Training, Effectively Reduced Psychological
Disorders We Want To Look At This Issue From Another
Perspective. Previous Studies, American Sports Medicine
Association (ACSM) And World Health Organization (WHO)
Have Suggested Regular Physical Activity To Eliminate
Inappropriate Mental Conditions. Regular Exercise And Physical
Activity Can Alter The Prevention And Treatment Of Anxiety And
Depression (Maroufi, 2021). Regular Physical Activity Regulates
Brain‐Derived Neurotrophic Factor (BDNF), Which Increases
Cognitive Function And The Ability To Face Depression And
Anxiety (Hu Et Al., 2020). Studies Showed That All Types Of
Exercise, Such As Aerobic, Resistance Or High‐Intensity Training,
Effectively Reduced Psychological Disorders We Want To Look
At This Issue From Another Perspective. Previous Studies,
American Sports Medicine Association (ACSM) And World
Health Organization (WHO) Have Suggested Regular Physical
Activity To Eliminate Inappropriate Mental Conditions. Regular
Exercise And Physical Activity Can Alter The Prevention And
Treatment Of Anxiety And Depression (Maroufi, 2021). Regular
Physical Activity Regulates Brain‐Derived Neurotrophic Factor
(BDNF), Which Increases Cognitive Function And The Ability To
Face Depression And Anxiety (Hu Et Al., 2020). Studies Showed
 That All Types Of Exercise, Such As Aerobic, Resistance Or
High‐Intensity Training, Effectively Reduced Psychological
Disorders .

 
21. Zoe Siegel, B.S. Kathleen, Systems-Level Interventions May
Alleviate Distress For Most Providers Without The Need For
Specialized Mental Health Intervention. Psychotherapeutic Support
And Referral To Specialty Care Should Be Available To Health
Workers With Severe And Intense Adverse Psychological
Outcomes During And Beyond The COVID-19 Pandemic.
Evidence-Based Interventions Are Urgently Needed To Better
Serve Health Workers Both During And Following
Epidemics/Pandemics. The COVID-19 Pandemic Has Abruptly
Triggered Extreme Changes And Challenges In The Delivery Of
Health Services. Frontline Health Workers Responding To This
Pandemic Are Encountering Many Sources Of Stress, And
Emerging Evidence Indicates That The COVID-19 Outbreak Has
Already Taken A Toll On These Workers’ Mental Health. In
China, Health Care Workers Who Directly Cared For Patients
With COVID-19 Had Higher Rates Of Depression, Insomnia, And
Distress Than Health Care Workers Who Were Not On The Front
Lines (1). In Wuhan Specifically, Health Care Workers Were
Twice As Likely As Administrative Staff To Experience Anxiety
And Depression (2). Irrespective Of The Source, Psychological
Distress Of Health Workers Is Associated With Poor-Quality Care
And Reduced Safety For Patients (3). Health Crises Are
Associated With Health Care Provider Burnout And An Increased
Likelihood Of Providers Leaving The Health Care Profession (4).
Together, These Observations Underscore That Addressing The
 Mental Health Needs Of COVID-19 Health Care Workers Is Of
High Priority.

22. Ravi Philip Rajkumar, Though There Are Few Large-Scale

Observational Studies Available In This Field To Date, It Is Clear
That The COVID-19 Pandemic Has Led To A Vigorous And
Multifaceted Response From Psychiatrists And Allied
Professionals, And That Mental Health Is Clearly Being Taken
Into Consideration At Multiple Levels – In The General
Population, Among Healthcare Workers, And In Vulnerable
Populations. Though The Quality Of Evidence In The Available
Literature Is Relatively Low, It Still Contains Numerous Valuable
Observations And Suggestions For All Professionals Working In
This Field, Whether They Are Associated With Psychiatric Or
General Hospitals Or Working In The Community. As The
Number Of Patients Affected By This Pandemic Continues To
Increase, The Psychiatric Profession – Particularly In Asian
Countries – Faces Both A Challenge And An Opportunity; The
Challenge Of Addressing The Numerous Barriers And Limitations
Identified In The Above Literature, But Also The Opportunity To
Implement Those Suggestions Or Recommendations Which Are
Feasible At A Local Or Regional Level.

23. Tarik Hasan, Though There Are Few Large-Scale

Observational Studies Available In This Field To Date, It Is Clear
That The COVID-19 Pandemic Has Led To A Vigorous And
Multifaceted Response From Psychiatrists And Allied
Professionals, And That Mental Health Is Clearly Being Taken
Into Consideration At Multiple Levels – In The General
 Population, Among Healthcare Workers, And In Vulnerable
Populations. Though The Quality Of Evidence In The Available
Literature Is Relatively Low, It Still Contains Numerous Valuable
Observations And Suggestions For All Professionals Working In
This Field, Whether They Are Associated With Psychiatric Or
General Hospitals Or Working In The Community. As The
Number Of Patients Affected By This Pandemic Continues To
Increase, The Psychiatric Profession – Particularly In Asian
Countries – Faces Both A Challenge And An Opportunity; The
Challenge Of Addressing The Numerous Barriers And Limitations
Identified In The Above Literature, But Also The Opportunity To
Implement Those Suggestions Or Recommendations Which Are
Feasible At A Local Or Regional Level.

24. Andrew T. Gloste, 2021, This Study Assessed Nearly 10,000

Participants Across Many Countries To Examine The Impact Of
The Pandemic And Resultant Governmental Lockdown Measures
On Mental Health. During The Height Of The Lockdown, The
Pandemic Was Experienced As At Least Moderately Stressful For
Most People, And 11% Reported The Highest Levels Of Stress.
Symptoms Of Depression Were Also High, Including 25% Of The
Sample Indicating That The Things They Did Were Not
Reinforcing, 33% Reporting High Levels Of Boredom, And Nearly
50% Indicating They Wasted A Lot Of Time. Consistent With
Symptoms Of Stress And Depression, 10% Of Participants Were
Psychologically Languishing. These Results Suggest That There Is
A Subgroup Of People Who Are Especially Suffering And That In
About 50% Of The Respondents’ Levels Of Mental Health Was
Only Moderate.