Bringing the invisible battle into view

The COVID-19 pandemic has caused unprecedented stress in health care workers, from physicians and nurses to food services and sanitation workers.¹ And buried within these health care stressors is an unusual combination of pressure and ambiguity: The timeline to recovery is unclear; as people are still trying to understand how best to treat COVID-19, and caregivers are faced with the reality that they can transmit the disease to loved ones and one another due to greater levels of exposure.

Our team conducted virtual focus groups with US-based clinicians on the front lines and secondary research to understand the key stressors that frontline caregivers are facing within the broader context of the pandemic. This point of view details how COVID-19 has amplified preexisting challenges of burnout, distress, and maintaining well-being and provides a list of proactive approaches that health care organizations can leverage to help better support caregiver well-being.

The COVID-19 pandemic has placed an unprecedented responsibility on caregivers, from physicians, nurses, and respiratory therapists to food services and sanitation workers in health care facilities. Caregivers are often treating the influx of COVID-19 patients under extraordinary pressure and ambiguity: The timeline to recovery is unclear, as people are still trying to understand how best to treat COVID-19, and caregivers are faced with the reality that they can transmit the disease to loved ones and one another due to greater levels of exposure. Even before the pandemic, caregivers experienced high levels of distress, and these challenges have been magnified over the past few months. A JAMA study looking at the early mental well-being tolls of the COVID-19 crisis on health care workers in China found that 71.5 percent reported distress, 50.4 percent reported symptoms of depression, and 44.6 percent reported symptoms of anxiety.¹
 
These early statistics paint a concerning picture of the potential effects the pandemic could have on the mental well-being of caregivers in the United States. As the pandemic evolves and caregivers' ability to cope is depleted, they are more likely to experience acute stress disorder (ASD), post-traumatic stress disorder (PTSD), chronic burnout, and/or an exacerbation of existing mental illnesses.² As caregivers around the country continue to address immediate needs related to the pandemic, health care organizations should proactively consider how they can support caregivers' psychological recovery, as well as the potential short-term and long-term implications of the pandemic on caregiver well-being.

All caregivers are facing numerous stressors, from the immediate concerns ranging from access to personal protective equipment³ (PPE) to the longer-term financial disruption of health systems. These stressors can be even more pronounced for women and people of color, who comprise the majority of patient-facing health care workers. In the United States, for example, women make up 91 percent of the nursing population.⁴ In New York public hospitals alone, Black and Latinx caregivers make up 44 percent of medical staff and 79 percent of nonmedical caregivers.⁵  In the below graphic we take into consideration different challenges based on geography and prevalence of the virus in a specific area:

Source: Deloitte Consulting LLP, 2020

Even after a vaccine is developed, the hardship won’t necessarily end for patient-facing workers. As the parameters of the pandemic evolve and symptoms of exhaustion and acute stress disorder set in, organizations should address the longer-term severe implications of workers, from depression and anxiety to post-traumatic stress disorder and psychological distress.² Prioritize now the mental well-being of those who man the front lines—as well as those who don’t but experience its effects.

To learn more about how you can move quickly to implement interventions that boost caregiver well-being, download Deloitte’s full report here. By deepening your empathy and putting effective strategies in place, you can recreate a culture that makes your entire staff feel known, heard, cared for, and nurtured—the very same values they practice, every day.
 

Jen Radin, MPH, MBA, principal, Deloitte Consulting LLP
Ken Abrams, MD, MBA, managing director, Deloitte Consulting LLP

Acknowledgments: 
Janani Hariharan, Emma Knoesen, Harish Patel, Michelle Nicholson, Sophia Zeinu, Antara Anand, and Eli Makovetsky
 

Innovation starts with insight and seeing challenges in a new way. Amid unprecedented uncertainty and change across the health care industry, stakeholders are looking for new ways to transform the journey of care. Our US Health Care practice helps clients transform uncertainty into possibility and rapid change into lasting progress. Comprehensive audit, advisory, consulting, and tax capabilities can deliver value at every step, from insight to strategy to action. Our people know how to anticipate, collaborate, innovate, and create opportunity from even the unforeseen obstacle.

Learn more at www.deloitte.com/future.