BARCELONA, Spain (AP) – The relentless rise in COVID-19 infections in Spain after the holiday season is once again overwhelming hospitals, threatening the mental health of doctors and nurses who have been at the forefront of the pandemic for almost a year.
At the Hospital del Mar in Barcelona, the capacity for intensive care has more than doubled and is almost full, with 80% of the ICU beds occupied by patients with coronavirus.
“There are young people in their 20s and older people in their 80s, all age groups,” said Dr. Joan Ramon Masclans, who runs the ICU. “This is very difficult and it is one patient after another”.
Although the authorities allowed meetings of up to 10 people for the Christmas and New Year celebrations, Masclans chose not to join the family and spent the holidays at home with his partner.
“We did this to preserve our health and the health of others. And when you see that this is not being done (by other people), it causes significant anger, added to tiredness, ”he said.
A study released this month by Hospital del Mar looking at the impact of the spring COVID-19 outbreak on more than 9,000 health workers across Spain found that at least 28% suffered from severe depression. This is six times higher than the rate in the general population before the pandemic, said Dr. Jordi Alonso, a leading researcher.
In addition, the study found that almost half of the participants had a high risk of anxiety, post-traumatic stress disorder, panic attacks or alcohol and drug abuse problems.
Spanish health professionals are far from the only ones who have suffered psychologically from the pandemic. In China, levels of mental disorders among doctors and nurses were even higher, with 50% reporting depression, 45% reporting anxiety and 34% reporting insomnia, according to the World Health Organization.
In the UK, research released last week by the Royal College of Physicians found that 64% of doctors reported feeling tired or exhausted. One in four sought mental health support.
“It is very terrible at the moment in the medical world,” said Dr. Andrew Goddard, president of the Royal College of Physicians, in a statement accompanying the study. “Hospital admissions are at the highest level ever, employees are exhausted and, although there is light at the end of the tunnel, that light seems very far away.”
Dr. Aleix Carmona, a third-year anesthesiologist residing in northeastern Catalonia, Spain, did not have much experience in ICU before the pandemic. But, with the cancellation of the surgeries, Carmona was summoned to the ICU of the Moisès Broggi hospital, outside Barcelona, to fight a virus that the world knew very little about.
“At the beginning we had a lot of adrenaline. We were very scared, but we had a lot of energy ”, recalls Carmona. He went through the first few weeks of the pandemic without having much time to process the unprecedented battle that was unfolding.
Only after the second month did he begin to feel the price of seeing first hand how people slowly died while they were out of breath. He considered what to say to patients before intubating them. His initial reaction was always to reassure them, to say that everything would be fine. But in some cases he knew it was not true.
“I started to have difficulty sleeping and a feeling of anxiety before each shift,” said Carmona, adding that he would return home after 12 hours feeling beaten.
For a while, he was only able to sleep with the help of medication. Some colleagues started taking antidepressants and anxiolytics. What really helped Carmona, however, was a support group at her hospital, where her co-workers unloaded the experiences they had kept inside.
But not everyone joined the group. For many, asking for help would make them appear unsuitable for the job.
“In our profession, we can handle a lot,” said David Oliver, a spokesman for the Catalonia section of the SATSE nurses union. “We don’t want to take time off because we know that we will increase the workload of our colleagues.”
The most affected group of health professionals, according to the study, were nursing assistants and nurses, who are mostly women and often immigrants. They spent more time with dying patients with COVID-19, faced poor working conditions and wages, and feared infecting family members.
Desirée Ruiz is a nurse supervisor at the intensive care unit at Hospital del Mar. Some nurses on her team have excused themselves from work, unable to cope with constant stress and all deaths.
In order to prevent infections, family visits to patients are rarely allowed, which increases their dependence on nurses. Delivering a patient’s last wishes or words to relatives on the phone is especially challenging, said Ruiz.
“This is very difficult for … the people who are holding these patients’ hands, even though they know they will end up dying,” she said.
Ruiz, who organizes nurses’ shifts and makes sure that the ICU always has an adequate team, is increasingly difficult.
Unlike summer, when the number of cases dropped and health professionals were encouraged to take a vacation, doctors and nurses have worked tirelessly since the fall, when virus cases intensified again.
The most recent resurgence almost doubled the number of daily cases seen in November, and Spain now has the third highest rate of COVID-19 infection in Europe and the fourth highest death rate, with more than 55,400 confirmed deaths.
But, unlike many European countries, including neighboring Portugal, the Spanish Minister of Health has ruled out the possibility of a new blockade for now., with less drastic restrictions that are not so harmful to the economy, but take longer to decrease the rate of infections.
Alonso fears that the latest wave of patients with viruses could be as damaging to the mental health of medical staff as the shock of the first months of the pandemic.
“If we want to be cared for properly, we also need to take care of health professionals, who have suffered and still suffer,” he said.
___
Follow the coverage of the coronavirus pandemic AP at:
https://apnews.com/hub/coronavirus-pandemic
https://apnews.com/hub/coronavirus-vaccine
https://apnews.com/UnderstandingtheOutbreak