Survey: ED doctors stressed over workplace COVID-19 exposures
Early in the COVID-19 pandemic, US emergency department (ED) physicians said they were stressed by exposures to infected patients to the point that it impinged on their home lives and female ED doctors reported higher stress levels than their male counterparts, according to survey results published today in Academic Emergency Medicine.
A total of 426 respondents to an emailed survey sent to all ED physicians at seven academic healthcare facilities in seven cities from Feb 23 to Apr 10 reported that their stress levels were a median of 5 on a scale of 1 to 7 (1 indicating not at all, 7 indicating extremely).
Levels of emotional exhaustion and burnout increased from a median of 3 before the pandemic to 4. About 91% of physicians said that they had changed their behavior toward family and friends as a result of worries about infecting them, with 77% reporting that they had been less affectionate.
Respondents cited measures that would help relieve their emotional and mental burdens at work, the most common of which were the provision of adequate personal protective equipment (PPE), rapid COVID‐19 testing at physician discretion, clearer hospital communication about COVID‐19 protocol changes, and assurance that physicians can take a leave of absence to care for themselves and their families.
More respondents were men (55% vs 45%), but women reported that the pandemic hit them harder at work and home (median score, 6) than men (median score, 5). Of the 419 respondents (98%) who reported patient contact from Feb 15 to their survey time, 410 (98%) reported seeing patients whom they suspected of having coronavirus infections.
In addition to the anxiety generated by inadequate PPE, the authors noted that physicians have experienced additional stressors as the pandemic has progressed, including "childcare and homeschooling demands, the economic impact of declining ED volumes, and changes in health care delivery (lack of personal connections with patients because of limited time in rooms)."
Jul 22 Acad Emerg Med study
1 in 5 US homes lack resources to self-isolate over COVID-19, study finds
Home isolation or quarantine after a diagnosis of or exposure to COVID-19 is impossible in 25.3 million US homes (21% of all US dwellings and 30% of units with more than one occupant) because of an insufficient number of bedrooms, bathrooms, or both, according to a research letter published yesterday in the Annals of Internal Medicine.
The finding means that about 81 million Americans, if infected by or exposed to the novel coronavirus, can't follow recommendations from the World Health Organization and the US Centers for Disease Control and Prevention to stay in a separate bedroom with its own bathroom, if possible.
The researchers used data from the most recent (2017) American Housing Survey from the US Census Bureau to identify 57,984 homes with roughly 303 million residents. On average, the homes had 2.8 bedrooms, 1.8 bathrooms, and 2.5 residents.
Native American and Hispanic residents were two or three times more likely than others to live in homes unsuitable for isolation or quarantine, while blacks and Asians were 1.7 times more likely. More low-income residents than those with higher incomes lived in homes that lack sufficient space and plumbing for isolation. Apartments, older buildings, and residences in the Northeast were most likely to be unsuitable.
The authors said that the racial and socioeconomic pattern found in the survey mirrors that of both the high incidence of COVID-19 infections in those groups and persistent racial discrimination in housing access.
"Policymakers should consider offering (but not requiring) persons needing isolation or quarantine the option of staying at no cost in underutilized hotels, under medical supervision, with free meal delivery and internet and telephone access," they wrote. "This might reduce medical costs and economic damage from work absenteeism and job loss, as well as the risks to and burdens on many families."
Jul 21 Ann Intern Med research letter