The inevitability of Covid-19 related distress among healthcare workers: findings from a low caseload country under lockdown

Objectives: To characterize psychological distress and factors associated with distress in healthcare practitioners working during a stringent lockdown in a country (Jordan) with one of the lowest incidence rates of Covid-19 globally. Methods: A cross-sectional online survey sent to physicians, nurses and technicians, and pharmacists working in various hospitals and community pharmacies. Demographic, professional and psychological characteristics (distress using Kessler-6 questionnaire, anxiety, depression, burnout, sleep issues, exhaustion) were measured as were potential sources of fear. Descriptive and multivariable statistics were performed using level of distress as the key outcome. Results: We surveyed 1,006 practitioners (55.3% females). Approximately 63%, 13%, 17% and 7% were nurses/technicians, physicians, pharmacists, and other nonmedical personnel (respectively). 32% suffered from high distress while 20% suffered from severe distress. Exhaustion, anxiety, depression, and sleep disturbances were reported (in past seven days) by approximately 34%, 34%, 19%, and 29% of subjects (respectively). Being older or male, perception of effective protective institutional measures, and being satisfied at work, were significantly associated with lower distress. Conversely, suffering burnout; reporting sleep-related functional problems; exhaustion; being a pharmacist (relative to a physician) and working in a cancer center; harboring fear about virus spreading; fear that the virus threatened life; fear of alienation from family/friends; and fear of workload increases, were significantly associated with higher distress. Conclusion: Despite low caseloads, Jordanian practitioners still experienced high levels of distress. Identified demographic, professional and psychological factors influencing distress should inform interventions to improve medical professional resilience and distress likelihood, regardless of the variable Covid-19 situation.