HealthManagement, Volume 20 - Issue 3, 2020

COVID-19: New Pandemic Offers a New Chance to be Well Together

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Summary: A physician examines how the COVID-19 pandemic is impacting the health of patients and healthcare workers, and proposes strategies to improve wellbeing.

The COVID-19 pandemic of 2020 offers a new challenge for the world community not seen since the Spanish Flu pandemic of 1918 (Bernhardt 2020). The world community, in large part, has come together in this crisis to share ideas, crowdsource, and innovate to contain this viral pandemic until a vaccine and/or established treatments become available (Piore 2020).

Governments, industry, scientists and private individuals have united to rapidly overcome challenges, and are sharing ideas to develop vaccines, 3D print personal protective equipment for frontline workers, and sew protective masks for one’s community (Jacobs and Abrams 2020). The worldwide community response has demonstrated the best of the human spirit.

Enduring this protracted challenge and maintaining resilience becomes even more important as people are put into new situations that run counter to the human condition such as being asked to socially distance to protect one’s community. Human beings by nature are social individuals, and this creates new stressors (Leader 2020; Chen 2015).

Healthcare workers who have not been trained for war, are working around the clock to save lives in wartime conditions without sufficient protective gear, and without established treatments to save patient’s lives. This forces healthcare workers to make ethical decisions about rationing limited healthcare resources like ventilators for their patients. Healthcare workers who are trained to save lives are being forced to make ethical choices regarding “who lives and who dies,” and this can cause moral injury for the clinician (Emanuel et al. 2020; BBC 2020).

Prior to the COVID-19 pandemic, a large societal wellbeing initiative had already begun to help individuals be healthier given the increasing incidence of depression and suicide in our society (Fox 2018; Healy 2019). Healthcare workers, in particular, have faced new challenges in their workplace that has led to an increasing incidence of burnout (Dyrbye 2017). Of concern, is that clinicians are leaving a critical need profession after taking a Hippocratic Oath to heal others (USA.gov 2012). They are being forced to leave a profession (a calling for many) to heal themselves after sustaining moral injury caused by external stressors such as overwhelming clinical volume, a lack of autonomy and perceived ineffective leadership (Carville et al. 2020).

Organisations, professional medical societies and individuals have recently come together, across the world, to heal the healers. Here are several examples. The National Academy of Medicine has recently published a landmark consensus study report in 2019 called Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being since supporting clinician wellbeing is critical to improving patient care (National Academy of Medicine 2020). A Charter on Physician Well-Being was recently published through the Journal of the American Medical Association (JAMA) in 2018 to promote the wellbeing of healthcare professionals by establishing societal, organisational, and interpersonal/individual guidelines (Gold Foundation 2018). Contemporary thought leaders in the area of wellbeing such as Tait Shanafelt MD have raised awareness, and have made recommendations regarding healing the professional culture of medicine (Shanafelt et al. 2019).

Professional medical societies like Radiology have become involved, and in 2018 and 2019 convened an Intersociety Meeting to foster a roadmap to wellness and engagement (Kruskal 2019). Recently, in 2019 the American College of Radiology (ACR) developed a Wellbeing Programme that contains a rich collection of webinars and articles curated by a team of dedicated radiologists and ACR staff intent on improving the wellbeing of their colleagues and patients (ACR 2020). Social media has become an important form of communication allowing the exchange of new ideas through open dialogue, and through vehicles like Tweet Chats on Clinician Well-Being such as one conducted in May of 2019 through the Journal of the American College of Radiology (Wakelet 2019).

These innovative and proactive wellbeing resources, recently developed, have allowed professional medical societies, like radiology, to quickly pivot and build on these positive initiatives by curating and sharing new wellbeing resources that specifically address the challenges of COVID-19 such as a sense of isolation caused by necessary temporary social distancing. These COVID-19 specific resources address important behavioral health areas such as improving mindfulness, fitness, and sleep, and are freely available for all to review on the ACR’s WellBeing Programme website (ACR 2020).

Together, we will overcome this new pandemic challenge through improved communication across the world, and by sharing new proactive strategies to optimise patient care as well as effective mentoring, mindful listening and empathy for our colleagues and patients.

This COVID-19 challenge has given us a tremendous opportunity to be well together now, and for the future. 

Key Points

  • The COVID-19 crisis has led to heightened cooperation within healthcare and the wider community for better care.
  • The medical community has given more focus to staff wellbeing through innovative online resources.
  • These positive resources are available now to decrease the risk of burnout and moral injury to patients and healthcare workers during this pandemic crisis.

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References:

ACR (2020) Combating the COVID-19 Pandemic: A Collection of Well-Being Resources for Radiologists. Available from acr.org/Member-Resources/Benefits/Well-Being/COVID-19-Well-Being-Resources

ACR (2020) Radiology Well-Being Program. Available from acr.org/Member-Resources/Benefits/Well-Being

Barnhardt D (2020) How the Spanish flu compares to COVID-19: Lessons learned, answers still being pursued. Available from cbc.ca/news/canada/manitoba/spanish-flu-covid-coronavirus-canada-manitoba-1.5523410?__vfz

BBC (2020) Coronavirus: Why healthcare workers are at risk of moral injury. Available from bbc.com/news/world-us-canada-52144859

Carville O et al. (2020) Hospitals Tell Doctors They’ll Be Fired If They Speak Out About Lack of Gear. Available from bloomberg.com/news/articles/2020-03-31/hospitals-tell-doctors-they-ll-be-fired-if-they-talk-to-press

Chen A (2015) Loneliness May Warp Our Genes, And Our Immune Systems. Available from npr.org/sections/health-shots/2015/11/29/457255876/loneliness-may-warp-our-genes-and-our-immune-systems

Dyrbye L (2017) Burnout Among Health Care Professionals: A Call to Explore and Address This Underrecognized Threat to Safe, High-Quality Care. Available from nam.edu/burnout-among-health-care-professionals-a-call-to-explore-and-address-this-underrecognized-threat-to-safe-high-quality-care/

Emanuel E et al. (2020) Fair Allocation of Scarce Medical Resources in the Time of Covid-19. Available from nejm.org/doi/full/10.1056/NEJMsb2005114

Fox M (2016) Major depression on the rise among everyone, new data shows. Available from nbcnews.com/health/health-news/major-depression-rise-among-everyone-new-data-shows-n873146

Gold Foundation (2018) CHARM-Gold Charter on Physician Well-being now published in JAMA. Available from gold-foundation.org/newsroom/news/charm-gold-charter/

Healy M (2019) Suicides and overdoses among factors fueling drop in US life expectancy. Available from chicagotribune.com/lifestyles/health/sc-hlth-drop-in-life-expectancy-1211-20191204-o2uxisqknza7jfenhu3tg3dyim-story.html

Jacobs A, Abrams R (2020) Hive Mind of Makers Rises to Meet Pandemic.Available from nytimes.com/2020/03/30/health/coronavirus-innovators.html

Kruskal J et al. (2019) A Road Map to Foster Wellness and Engagement in Our Workplace—A Report of the 2018 Summer Intersociety Meeting. Available from jacr.org/article/S1546-1440(18)31413-3/fulltext

Leader G (2020) Why Social Distancing Feels So Strange. Available from sapiens.org/evolution/covid-19-social-distancing/

National Academy of Medicine (2020) Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. Available from nam.edu/systems-approaches-to-improve-patient-care-by-supporting-clinician-well-being/

Piore A. (2020) How Frontline Doctors Are Saving Coronavirus Patients with Innovative New Techniques, Sharing Advice. Available from newsweek.com/how-frontline-doctors-are-saving-coronavirus-patients-innovative-new-techniques-sharing-advice-1497263

Shanafelt, T et al. (2019) Healing the Professional Culture of Medicine. Available from doi.org/10.1016/j.mayocp.2019.03.026

USA Government (2012) Greek Medicine. Available from nlm.nih.gov/hmd/greek/greek_oath.html

Wakelet (2019) Clinician Well-Being: Why it Matters to You and Your Patients. Available from wakelet.com/wake/c702c04d-fd08-4adb-9763-39b17bf07c2e




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