Abstract
The coronavirus disease (COVID-19) imposes an unusual risk to the physical and mental health of healthcare workers and thereby to the functioning of healthcare systems during the crisis. This study investigates the clinical knowledge of healthcare workers about COVID-19, their ways of acquiring information, their emotional distress and risk perception, their adherence to preventive guidelines, their changed work situation due to the pandemic, and their perception of how the healthcare system has coped with the pandemic. It is based on a quantitative cross-sectional survey of 185 Swiss healthcare workers directly attending to patients during the pandemic, with 22% (n = 40) of them being assigned to COVID-19-infected patients. The participants answered between 16th June and 15th July 2020, shortly after the first wave of COVID-19 had been overcome and the national government had relaxed its preventive regulations to a great extent. The questionnaire incorporated parts of the “Standard questionnaire on risk perception of an infectious disease outbreak” (version 2015), which were adapted to the case of COVID-19. Clinical knowledge was lowest regarding the effectiveness of standard hygiene (p < 0.05). Knowledge of infectiousness, incubation time, and life-threatening disease progression was higher, however still significantly lower than regarding asymptomatic cases and transmission without physical contact (p < 0.001). 70% (95%-confidence interval: 64-77%) of the healthcare workers reported considerable emotional distress on at least one of the measured dimensions. They worried significantly more strongly about patients, elderly people, and family members, than about their own health (p < 0.001). Adherence to (not legally binding) preventive guidelines by the government displayed patterns such that not all guidelines were followed equally. Most of the participants were faced with a lack of protective materials, personnel, structures, processes, and contingency plans. An increase in stress level was the most prevalent among the diverse effects the pandemic had on their work situation. Better medical equipment (including drugs), better protection for their own mental and physical health, more (assigned) personnel, more comprehensive information about the symptoms of the disease, and a system of earlier warning were the primary lessons to be learned in view of upcoming waves of the pandemic.
Highlights
Several types of human coronaviruses with low pathogenicity had been studied before the severe acute respiratory syndrome (SARS) emerged in 2002 in China (Drosten et al, 2003; Ksiazek et al, 2003; Peiris et al, 2003)
Knowledge was high regarding the unavailability of a COVID19 vaccine, the ineffectiveness of influenza vaccines against COVID-19 (K8), the occurrence of symptoms (K1), and transmission without physical contact (K3), with over 92% (confidence intervals (CIs) over 87%) answering correctly. 76% of the participants answered correctly that COVID19 was more infectious (K5) and 72% that it had a longer incubation time (K6) than common influenza. 69% correctly indicated that COVID-19 cases more often had a life-threatening disease progression than common influenza (K7)
Among “other causes” (4%, Confidence intervals (CIs) 2-8%), mutation of SARS, improper hygiene in the food sector, politics, economics, overpopulation of the planet and overconsumption of natural ressources, ignorance, and denial were specified. This survey explored the knowledge of Swiss healthcare workers on COVID-19, how the first pandemic wave impacted their work situation, and how they reacted both emotionally and regarding their adherence to preventive guidelines
Summary
Several types of human coronaviruses with low pathogenicity had been studied before the severe acute respiratory syndrome (SARS) emerged in 2002 in China (Drosten et al, 2003; Ksiazek et al, 2003; Peiris et al, 2003). The virus that causes the presently spreading human coronavirus disease, named COVID-19, was first noticed in Wuhan, China, in December 2019, and it resembles the prior SARS As of 22nd December 2020, 76,023,488 cases and 1,694,128 deaths have been reported due to COVID-19 worldwide (World Health Organization, 2020a). For Switzerland, there have been 402,264 cases and 5,981 COVID-19related deaths reported to this date (World Health Organization, 2020b) compared to a resident population of 8.606 million (by the end of 2019, Federal Statistical Office, 2020). By 23rd March, the effective reproductive number (Re) had decreased below one (95%confidence interval below one), as depicted, and the first wave was overcome by late May 2020, in the sense that daily new cases had decreased to single digits (Our world data, 2020).
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