Healthcare Workers’ Attitudes Towards Working During A Pandemic

The World Health Organisation (WHO) describes an influenza pandemic as an event in which “a new influenza virus appears against which the human population has no immunity, resulting in several, simultaneous epidemics worldwide with enormous numbers of deaths and illness”. Estimates of the impact of such an event vary, but the WHO offers this guidance:

It is estimated that this pandemic could lead to the loss of between 2 to 7.4 million lives worldwide. In just countries with high incomes, making up 15% of the total world population, projections show that there will be between 134 – 233 million consultations and 1.5 – 5.2 million hospitalizations. It is probable that the next epidemic will have the most destructive aftermath in poorer countries due to the varying demographic traits and existing health care problems there.

Despite the UK’s level of development and wealth, the repercussions of a flu pandemic would surely be significant. It is not feasible to anticipate precisely the outcome of the following epidemic, yet the Department of Health anticipates that up to half of Britain (30 million individuals) could contract the virus, with 50,000 to 750,000 additional fatalities. Planning to handle COVID-19 cases anticipated up to half of the population being affected, and 4% of those affected requiring hospitalization (equaling around 1.2 million people). It is estimated that between 0.2 and 2.5% of cases will result in death, which is based off of past pandemic events. Even if the expectations of the impact of an influenza pandemic are less severe, it would still put the UK’s medical care system under tremendous pressure.

Healthcare personnel will be highly important in any answer to pandemic flu and will have to confront the virus first. Getting an efficient response to a pandemic depends on the vast majority of NHS personnel continuing to conduct business as usual. It is assumed that healthcare services in the UK will operate at the same level of performance as before the pandemic began. Once the pandemic has been declared in the UK, the National Health Service has protocols in place for caring for high volumes of individuals, with only necessary treatments being offered. Roughly twice as many members of staff are absent compared to usual, including those who must look after ill relatives. It is wholly up to the HCWs that are still working to see that the NHS has the capacity to deliver basic necessities of care.

It is not safe to assume that healthcare workers will be eager to go about their regular duties even if they are physically able to. As an example, early on during the Human Immunodeficiency Virus (HIV) epidemic, medical professionals discussed whether it was okay to reject care for those with HIV; while during the Severe Acute Respiratory Syndrome (SARS) epidemic, some healthcare workers were unwilling to care for SARS sufferers. The question of whether or not professionals must continue working during a pandemic or other emergency is open for debate, as is the issue of how much control should be exerted over that responsibility.

The available evidence about circumstances that could affect regular operation is scant, such as loyalty to former employers, potential risk to oneself and one’s family, and whether or not they are part of disaster preparedness plans. In Germany, Ehrenstein et al discovered that almost one-third (28%) of clinical and non-clinical professionals may decide to leave their job in order to ensure the safety of their families and themselves. Quereshi et al ascertained that the largest hindrance to healthcare workers being eager to work was their dread over their own and their families’ wellbeing. The research of Balicer et al. suggests that up to fifty percent of healthcare workers (HCWs) in the U.S. could avoid showing up to work, with clinical workers being more likely to be present than non-clinical employees. This was based on a survey of a combined group of clinical and non-clinical workers. The findings of these studies may not be transferable to the situation in the UK, and the data collected is not enough to be able to effectively change people’s attitudes before a pandemic situation arises.

Expert codes of conduct do not demand regular working if there is potential danger, and standards of professional morality might have to be put on hold during a pandemic, which could increase the level of stress for healthcare workers. For instance, limited supplies and lack of personnel may cause the standard of service to be less than desirable given the circumstances. Staff may need to deny assistance to people whom they would typically be able to assist easily. The normal consent procedures that may take a long time to complete may need to be disregarded. The actions taken under extreme circumstances might be justifiable on an ethical level, but might cause distress for health care workers. Confidence in the administration and leadership may affect health care workers’ opinions and behaviour in response to a pandemic due to two causes. Believing that the pandemic is being dealt with effectively and that the advice being given is true could give people confidence that the actions they are being asked to do are helpful for controlling the virus. Individuals might modify their willingness to take additional risks based on how they view the source of those risks in regard to their managers/the government – whether they are due to actions or inactions.

Devising a plan for unanticipated events and furthering patient care could advance if we are able to understand the factors that may impact UK healthcare workers’ capacity and interest to work, and recognize the reasons this workforce has to continue doing their jobs. The research will identify the attributes of people who could resist participating in pandemic work, and consequently provide information about personnel allocation. Additionally, it will suggest measures for altering the outlook of those who might be hesitant. This research could also figure out what kind of resources (like accommodation near hospitals for healthcare workers) can be provided to make sure appropriate staff is always nearby, reduce the need for travel, and decrease the chance of virus exposure to HCW workers’ families. If perceived ideas that are widespread are based on untrue beliefs, a program of raising awareness for health care workers could be made to try to put an end to those misconceptions and make sure that more people attend their duties than if the myths were still believed.

This study places special emphasis on what motivates healthcare workers during pandemics. Recently, the traditional way of conducting focus groups has been modified to uncover what reasons people have for their perspectives. This technique not only records participants’ opinions, but it also puts their beliefs to the test and pressures them to make clear their points and back them up with explanations. This tactic will be helpful in working out how strong HCWs feel the necessity, or the lack of necessity, to work as usual.

 

The Views of Emergency Medical Service Providers

One-third of the worldwide population were affected by the Spanish influenza epidemic of 1918-1919 and a tremendous 50 million people perished. Since this coronavirus pandemic – the most deadly health crisis known to man – there have been other disease outbreaks too, such as SARS in 2003 and Ebola in 2014.

A disproportionate amount of healthcare providers fell ill or died during recent epidemics. An example of this is that 21 percent of people who contracted SARS turned out to be medical personnel, and some of these sufferers gave the virus to their relatives (Smith et al. 2009). Alongside this, out of the 850 paramedics involved in Toronto, Canada at the time of the SARS virus, 436 (51%) of them were exposed and obligated to self-isolate at their workplace or home for a period of 10 days. 62 people became ill with the same type of illness as SARS, and 4 of them needed to be admitted to the hospital (Silverman, Simor, and Loutfy 2004). A report from the World Health Organization has revealed that healthcare professionals have a 21 to 32 times greater chance of contracting Ebola than members of the public (WHO 2015). This research illustrates that approximately two-thirds of healthcare personnel who were afflicted passed away.

The recent issues of the SARS and Ebola epidemics have drawn the spotlight back to a dilemma that medical workers have to address: Is it worth it for them to assist with treating the diseases if it jeopardizes their and their family’s health?

Healthcare workers are commonly known to put the needs of their patients above their own needs, interests, and safety, especially during times of crisis. Concerning disease problems, this isn’t invariably accurate. Investigations have demonstrated that apart from radiation catastrophes, healthcare professionals exhibit the least enthusiasm for working during epidemics (Qureshi et al. 2005). The protection of family and self, anxiousness, and a mistrust of an employer’s action to a health crisis can be linked to refusing to report for duty during these occurrences (Ives et al. 2009; Devnani 2012). Devnani (2012) found that certain factors needed to be better explored and understood, but this has yet to be fully addressed in existing research.

Investigations of healthcare workers’ capability and eagerness to show up during times of disaster or public health matters primarily center on doctors, nurses, and hospital chiefs (Damery et al. 2010). Very few studies have been done regarding emergency medical personnel, yet they remain an important part of the larger healthcare system (Watt et al. 2010). I chose to look into the EMS providers’ perspectives on working in the time of a pandemic in contrast to those when responding to a natural disaster, as more information is needed on this topic. My aim was to discover the crucial elements that may influence their determination to remain on duty for these occurrences.

Responding to Natural Disasters vs. Disease Outbreaks: Is there a difference?

Emergency Medical Services (EMS) personnel are the leading responders when faced with disasters or public health crises, showing great courage by offering their services. EMS personnel obtain substantial education regarding employing the Incident Command System (ICS) in reaction to catastrophes. They are educated to deliver instantaneous attention, evaluate the seriousness of injuries, and conduct search-and-rescue activities based on the nature of the emergency. Despite disasters, not everybody is capable or enthusiastic about attending work and offering their assistance. Connor (2014) determined that a vast majority of healthcare providers (83 to 90 percent) are eager to offer assistance during natural catastrophes. It is possible that certain employees may be unable to work due to health issues or difficulties traveling brought about by the disaster. These are viewed as obstructions to capacity, not obstacles to a desire to show up for work.

Natural Disasters: The Thrill-Seeking

When I requested that members share their perspectives regarding working during natural disasters versus routine tasks, various opinions and observations were revealed. Many asserted they are perfectly accustomed to responding to natural disasters and they have the necessary training to tackle such incidents. Some of the attendees viewed dealing with catastrophes as an exciting portion of their employment.

EMTs are comparable to adrenaline junkies because they seek out the thrill of excitement which come from being in highly intense situations. They yearn to be in the thick of it, desiring that thrill.

Interestingly, previous research into healthcare providers did not observe the same emphasis on exhilaration that this survey found. It is essential to be familiar with the typical duties of an EMS practitioner in order to comprehend this outlook.

The majority of Emergency Medical Services’ activities are geared towards non-urgent, not life-threatening cases; this necessitates only minimal medical attention and transporting them to the right center (Goldstein 2014). This type of work can be somewhat mundane and uninteresting for those providing it. Emergency medical service workers would normally take care of sudden occurrences of illness and injury, as this is something they specialize in and enjoy doing. This may explain why the tasks that the participants performed during and after natural disasters were described as being enjoyable.

Not everyone was as eager to assist in times of an emergency. They expressed worries about their own protection and the protection of their loved ones. The greatest worry for the provider is the lack of experience in unfamiliar circumstances. Nevertheless, these worries did not prevent them from completing their tasks. The findings of this feedback are consistent with a research project conducted on EMS in Australia. In Smith et al. (2009), Australian paramedics were interviewed and found to be determined to fulfil their duties despite their worries concerning working in disasters.

EMS staff experience dangerous circumstances on a regular basis. For example, an EMS provider who was assigned to a typical call could unexpectedly find themselves in the middle of an active shooting situation. The workers considered that there was not much distinction between carrying out everyday tasks and working during emergencies.