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Health care employees are overworked and exhausted more than a year into the pandemic


Seven hundred thousand people in the United States have died from COVID-19, an astonishing number that was hard to even imagine at the start of the pandemic. While new cases have fallen over the past few weeks, the battle - and that might be exactly the word to use here - goes on for health care workers, who for more than a year and a half have been overworked and exhausted in all ways. Dr. Marwah Abdalla is assistant professor of medicine at NewYork-Presbyterian/Columbia University Irving Medical Center. She led one of the first studies to look at psychological distress among New York City health care workers and joins us now.

Thanks so much for being with us.

MARWAH ABDALLA: Thank you for having me.

SIMON: You found, Dr. Abdalla, that substantially more than 50% of New York City workers experienced what's called acute stress.

ABDALLA: That's correct.

SIMON: Which is what?

ABDALLA: So what we were trying to decide and figure out very early on in the pandemic when New York City was the epicenter was really, what was the mental health impact of the pandemic? And acute stress can sometimes be a precursor or a potential precursor for post-traumatic stress disorder. Now, we know from other epidemics, like the SARS epidemic back in 2000, that people who have trauma exposure in infectious disease epidemics do, for a portion of them, develop long-term complications and post-traumatic stress disorder, which we know is linked to both heart disease and increased mortality down the line.

SIMON: So to be blunt about it, we're talking about health care workers increasing their own mortality by trying to help people recover from this vicious disease.

ABDALLA: Absolutely. I think, you know, if we were to pretend that tomorrow - let's just dream - COVID-19, the pandemic ended. No one else had any more symptoms. The problem is our bodies remember the trauma and the acute stress that we've gone through. For some, that will heal quickly over time. And for others, that's going to manifest 10 to 20 years down the line.

SIMON: I have to ask, is it difficult for health care workers to ask for help? And I'm casting back to my days as a young crime reporter, when we'd go to emergency rooms and doctors and nurses would work through unimaginable trauma. And like a soldier or a police officer or a firefighter, they were just - they were very proud of being tough.

ABDALLA: Yeah. I think what you're getting at is there's a problem with our system, the occupation itself and what we teach, you know, young trainees what we've also gone through. And it's one of the few professions where we demand vulnerability from our patients. And what do I mean by that? With their bodies, we ask them to be vulnerable. With their - sometimes, our patients tell us the most confidential things they've never told anyone else. We as health care workers cannot show that vulnerability, right? We need to have this toughened exterior, right? That's what we've taught in order to get through our days - right? - sort of the old model of thinking.

And I think what the pandemic really taught us is that - this idea that we can only continue to give, give, give. Well, guess what? Our tanks are near empty. For some of us, it is completely empty. To continue running a sprint for 19 months when we really should have been thinking of this as a marathon has been and continues to be the problem. It's very difficult for some people to be - to break down that wall and rethink and to ask for help. The other problem is we're now running out of people to ask help to, right? And we saw that in New York City during the epicenter. We had to ask for help. The first time we had to mobilize so many people, and people showed up. Guess what? The longer this has gone on, there are no further people to ask for help. We can't just replace health care workers, you know, with a snap. And that's the problem we're facing. We are in an occupational health crisis.

SIMON: What can be done, especially in the middle of a pandemic?

ABDALLA: I think there can be several things done at different levels. Most importantly, I would say we need to have more creative solutions. There can be national policies in place regarding foreign medical graduates and increasing spots of trainees. We can also see expansion of bills currently passed in Senate, such as the Dr. Lorna Breen Health Care Provider Act. That's one step. There can be more. I would love to see the new foundations and initiatives that have been spearheaded recently by those outside of medicine focusing on mental health, truly expand and focus attention to the mental health of health care workers. And lastly, I think there can be things done at the state level and the health care system level, such as reevaluating the way that we license individuals and credential individuals and allow health care workers to access mental health resources.

SIMON: And I come back to this. It sounds like we should understand that this is not just a matter of health care workers being exhausted, tired, burned out, having nightmares - all of which they're certainly entitled to - but damaging their health.

ABDALLA: That's correct.

SIMON: Damaging their own health for the sake of their patients.

ABDALLA: That's correct. I think we really need to have a reevaluation of how we show up for ourselves, our team members and our patients, right? That old sort of model of give, give, give - well, we need to start receiving for ourselves and protecting on our own health. You know, how do we show for our patients and tell them, you know, you need to change your behaviors, but we haven't changed our own behaviors? And by we, I mean the whole health care system, not just at the individual level, right? That's really what I would love to see happen.

SIMON: Dr. Marwah Abdalla, who's a cardiologist and assistant professor of medicine at Columbia.

Doctor, thank you so much for being with us.

ABDALLA: Thank you so much for having me. Transcript provided by NPR, Copyright NPR.