Preparing for disease X: A look at the psychological impact of COVID-19 on frontline healthcare workers and responses to reduce their burden

The coronavirus 2019 (COVID-19) pandemic placed enormous strain on healthcare workers (HCWs) and systems. With over 766 million cases, a high risk of workplace-acquired infection, and a constantly evolving disease trajectory, COVID-19 placed an incredible burden on frontline HCWs. Studies on previous pandemics have highlighted the presence of significant psychological distress in HCWs; yet, mental health remained a secondary consideration in many hospitals’ pandemic responses. This review explores the psychological impact of COVID-19 on frontline HCWs during the early stages of the pandemic and describes responses implemented by health services to reduce it. In addition, it aims to provide a structure for the implementation and evaluation of future evidence-based programs that support the well-being of frontline HCWs helping to prepare for disease X. A narrative review with a systematic approach was completed using the MEDLINE, Cumulative Index to Nursing and Allied Health Literature, and Cochrane databases. Twenty publications were included in the study. Symptoms of psychological distress were reported in up to 70% of frontline HCWs, with as many as 50% suffering depression, 62% reporting anxiety, and 45% of those who required quarantine experiencing insomnia. Mindfulness training, safe rest areas, mental health practitioners, and pandemic rostering are responses that were implemented across health services during the pandemic. While the impact of COVID-19 has been enormous, its final toll remains unknown. High rates of psychological distress among frontline HCWs mean that the impact will extend far beyond the virus itself. Health services must implement evidence-based resilience strategies to ensure the safety of their frontline staff now and in the future.