Pandemic could affect mental health of frontline staff and patients for years, Abu Dhabi study warns

Research by government hospital operator Seha found young female medics were most affected

Dr Mohamad Karima, who works at Al Zahra Hospital, Sharjah. All those pictured have recovered and all photos by Chris Whiteoak / The National

Dr Ashar Jamal, from Al Zahra Hospital, was in hospital for a week after his health deteriorated because of Covid-19.

Renu Venugopal, who is a nurse at Al Zahra Hospital. The frontline staff at hospitals bore the brunt of the pandemic.

Seema Mary, a nurse at Medcare hospital, Sharjah. Her Covid-19 ordeal helped patients believe they too could recover, she said.

Dr Davinder Singh a cardiologist at the NMC Royal Hospital in Dubai. The first few days after being diagnosed were scary, he said.

Joslin Coelho, who is a nurse at the NMC Royal Hospital in Dubai Investments Park.

Silpa Suresh also a nurse at the NMC Royal Hospital. She has returned to work.

Keshar Bahadur a laboratory ward assistant at the NMC Royal Hospital, DIP. Hospitals filled with patients during the peak of the pandemic.

Dr Iffat Sultana, an internal medicine specialist at the NMC Royal Hospital, Dubai Investments Park. There was a lot of anxiety among hospital staff, she said.

Aldrian Tomas, a customer care representative at the NMC Royal Hospital, Dubai Investments Park.

Jephy Antony, who also works as a nurse at the NMC Royal Hospital. Like his colleagues, Mr Antony has also gone back to work.

Jomon Joy, a ward attendant at the NMC Royal Hospital. Hospitals have since seen a reduction in the number of patients.

Biji Mathew, nursing supervisor at the NMC Royal Hospital. Staff knew early in the year the virus had a good chance of reaching the UAE.

Ruth Kiruba, a nurse at the NMC Royal Hospital. She is back to work treating patients and expecting a child.

Related: Stressed out medics and patients at risk of developing dementia later in life, study says

Frontline health workers could take years to recover from mental scars suffered from treating seriously ill patients during the coronavirus pandemic, UAE officials said.

The warning came from Seha, the Abu Dhabi Health Services Company, which is responsible for operating Covid-19 testing centres and hospitals across the country.

Patients with long-term symptoms or who spent several weeks in hospital recovering from the virus are also likely to suffer some form of post traumatic stress disorder, psychologists said.

The UAE’s behavioural health council - operated by Seha - conducted dual studies to evaluate the mental heath impact on care staff and patients.

The number of medics and patients who have been surveyed as part of the ongoing study was not disclosed.

“Our preliminary data analysis from healthcare workers’ surveys completed since the start of the pandemic shows young, single, female expatriates working in healthcare are the most affected,” said Dr Nahida Nayaz Ahmed, a consultant physician involved in the analysis at the Al Maqta Healthcare Centre in Abu Dhabi.

“In the general population, the study is ongoing, but results so far have shown middle-aged men and women with pre-existing conditions are most likely to suffer from stress and anxiety.”

Doctors said psychological symptoms vary depending on the severity of infection.

Some signs are clear, such as anxiety and insomnia whereas other more longer lasting symptoms like depression have also been noted in patients.

'A conundrum on a scale never experienced'

“We will be able to define demographic details further when the analysis is completed,” Dr Ahmed said.

“It is hard to predict the timeline of the psychological impact caused by this pandemic, it is a conundrum on a scale never experienced before.

“However, past studies from similar outbreaks have shown symptoms of post-traumatic stress can be experienced for as long as 18 months after the outbreak ceases to exist.”

Treatment varies between cases, but proactive screening and subsequent counselling has proven to prevent conditions worsening.

Self-help, counselling and medication

“At Seha, we have tried to be proactive from the very beginning of the pandemic,” said Dr Ahmed. 

“For staff dealing with Covid-19 patients, we rolled out psychological support through a telephone helpline, series of educational webinars on dealing with emotional impact from pandemic and group support.

“In the case of our patients, we have proactively distributed self-help booklets when they entered isolation, screened them actively for symptoms of depression, anxiety and stress.

“We also provided proactive counselling and medication intervention when necessary.”

Recovering patients received follow up care after leaving hospital in the form of home visits and consultations via telephone and online meetings.

Doctors and nurses working with high-risk patients on Covid wards at the height of the pandemic were most vulnerable to mental trauma, experts said.

Infection rates have been on the rise in recent weeks, hitting a new high of 1,007 on September 12.

Authorities have stressed the need to to support healthcare workers key to the fight against Covid-19.

More than 80,000 frontline workers have been identified for a new nationwide programme.

The project, overseen by the Frontline Heroes Office, will ensure there is a support system in place and benefits for their families.

This is expected to include help with mental health services and schooling, where needed, and extend to benefits and discounts.

The economic impact of the pandemic with lost jobs, isolation and business closures is predicted to have a lasting impact on rates of depression and anxiety.

Isolated patients struggling to move on

Dr Adel Mohamed Yasin Alsisi, a critical care consultant at Prime Hospital in Dubai, was working long shifts on a ward dedicated to treating the most seriously ill covid patients.

“Patients admitted to ICU for a long period of time were under different circumstances to other patients,” he said.

“They often lost track of time and could not differentiate between day and night.

“Visitors were restricted so they had to come to terms with the effects of isolation.”

Other signs of stress were triggered by minimal contact with the outside world, as patients in ICU only saw staff in full protection suits or scrubs for weeks at a time.

Those attached to ventilators for long periods also suffered mentally, Dr Alsisi said.

“We tried to educate them to make them aware the outside world was still there and that life would carry on, but some showed early signs of psychosis,” he said.

“There were many unknowns with the virus in the early days, so of course that attracted some degree of fear.

“When these patients returned to other wards their mental health improved.

“It was a temporary experience for them, but at the time it felt severe.”