Long Term Pandemic Response: Recognizing Burnout & Maintaining Perspective.

By Justin Koper, M.S., GSP, MTSP-C, FP-C. Safety Officer, HealthNet Aeromedical Services

When COVID-19 began impacting our service areas in early March, it seemed that the number of confirmed cases were low, and we would have no issues combatting further spread. As more was learned about the virus, we quickly discovered that the scope of this pandemic will likely be measured in years rather than days, weeks, or months.

There is now a serious concern about the personal and performance-related consequences of “COVID burnout.” Symptoms of this burnout that impact the provider personally could be the impacts of constant PPE use, health effects of long-term stress, constant worry about the safety of their loved ones, and fear of personal exposure, among others. Work-related symptoms of burnout include a failure to adequately report details of COVID-19 related transports, complacency regarding PPE, non-compliance with facial covering requirements at base sites, and missed opportunities to control the spread of infection at the source (i.e. providing non-intubated patients with surgical masks and using HEPA-rated filters on intubated patients).

To mitigate the risk of burnout it is important to know where our organization currently is in this pandemic and the outcomes of everything that you as front-line healthcare workers have accomplished. As of August 14, 2020, our organization has performed 556 COVID-19 related transports which include persons under investigation for COVID-19, patients with pending COVID-19 test results, and known positive patients (Note: this data tracking started in early March). Of those 556 patients a total of 101 have been either positive at the time of transport or tested positive after transport (see figure 1 for a full breakdown). Out of all these transports we have had zero instances of providers contracting COVID-19 from a patient. Also, we have had zero workplace transmission of COVID-19 at any of our base sites. This is an important fact to remember as there have been numerous other healthcare entities within our service areas that have had significant outbreaks related to workplace exposure.

We are acutely aware that communication breakdowns are common in stressful situations which is why we have purposely designed our system to have multiple layers of redundancy so if there is a communication failure it does not adversely impact crew safety (i.e. we have designed the system to tolerate predictable failure without exposing team members to any risk of harm or exposure). When such countermeasures have been proven amid a pandemic, it is easy to see their importance.

As for where we are going with this pandemic it is nearly impossible to determine. Many of the large-scale models have come close but few have been accurately able to predict one important variable, human behavior. Until this variable becomes 100% predictable, it will be nearly impossible to create any data models with high confidence. Based on our organization’s data throughout this pandemic, we are reasonably anticipating a slight increase of COVID-19 related transports in the coming weeks with a higher percentage of these patients being known positives. This anticipated increase is due to a few factors such as community transmission rates, increased testing availability, and decreased turn-around times for test results. So, moving forward it will be important to remember one thing: “Be brilliant in the basics” (Ret. Gen. Mattis). Maintaining a high level of proficiency and attention to detail for each individual task will help eliminate preventable errors which can reduce undesirable outcomes.

If you are facing personal stressors in these difficult and unpredictable times it is important to remember the resources that are available to you.