The Dangers of Burnout
Prior to COVID-19 concerns, reviews have highlighted that up to 54% of medical professionals in the UK are emotionally exhausted.17 Alongside fatigue and frustration, emotional exhaustion is a core symptom of burnout in clinicians. Vijendren et al, found that within a cohort of 108 ENT Surgeons in the UK, 56.5% of respondents were classified at high risk of developing psychological morbidity, with 28.9% of reported scores suggesting burnout.18 As such, given the additional stresses and disruption caused by COVID-19, clinicians have a greater likelihood of developing burnout in the long-term.19
Burnout has several harmful ramifications including substance misuse, absenteeism and medical errors,20-22 which can escalate to mental health difficulties such as increased suicidal ideation and depression.23,24 Surprisingly, the sole study investigating burnout prevalence in clinicians during COVID-19 epidemic found a lower frequency of burnout in healthcare professionals working on the frontline comparatively to those who were working on wards for uninfected patients.25 Several limitations were revealed inclusive of small sample size and selection bias of responses (i.e. distressed medical professionals may have not responded to the survey). Critically, the authors point out that the timing of their study (March 2020) was not a peak period for COVID-19 in Wuhan, China.
Furthermore, a cross-sectional study by Cai et al explored the psychological burden and coping strategies over 500 frontline medical staff in Hunan. Specifically, researchers found the core facets associated with stress were concerns for their families, personal and patient safety. Comparatively to other healthcare workers, doctors felt a higher degree of social and moral responsibility in their vocation and greater scores of anxiety associated with working overtime.26
The aforementioned factors (summarised in Table 2), highlights the detrimental impact of burnout on mental health. A surgeon should ideally be in a strong and stable frame of mind to focus on the work at hand, once the various coping mechanisms have been adopted to deal with possible emotional effects of the current pandemic. Irrespective of specialty, Cai et al discovered that knowledge of COVID-19 prevention and transmission, social isolation measures, exhibiting positive self-attitude and seeking family and peer support were all essential facets that significantly reduced stress and burnout in clinicians.26 Hereinafter, key coping strategies as recommended by health services are discussed in greater depth.