Dr Dayaprasad G Kulkarni, the founder of Aarogya Seva, Global Health Volunteer Alliance, is barely getting his forty winks in a makeshift space in his office, ever since the second wave of COVID-19 hit India. That he is burnt out, is an understatement.
In his 15 years of voluntary relief work all over the world, he has never quite come across such an endless stretch of excessive emotional, physical, and mental exhaustion among medical workers. COVID-19 fatigue is causing Post Traumatic Stress Disorder (PTSD) among medical and frontline workers of the kind seen during war, according to Dr Sudarshan Ballal, Chairman, Manipal Hospitals.
PTSD is usually seen in people who have experienced a traumatic event. More than a year of the pandemic has taken a toll on their health. PTSD symptoms have only just started emerging. They are constantly battling guilt for not being able to save patients.
There is crushing remorse of unknowingly infecting family members. Then there is the emotional burden of moral responsibility towards the nation.
Such factors amount to long periods of stress, leading to behavioural changes such as irritability and hypervigilance, psychological manifestations such as fear and mistrust, and sleep disturbances, most commonly insomnia. "These impair their ability to continue working in stressful situations," says Delhi-based therapist Rachit Saxena.
"Realistically speaking, there is no difference between the battered state of a frontline worker and soldiers in combat. Such dire circumstances bring out the same kind of psychological response," he adds.
Medical nurse Vinod, who was admitted to the ICU after severe PTSD in April, recalls his nightmare. "Even when I was battling for my life, I was worried about my colleagues. We don’t have enough staff and it is hard to find people at this time," He quit his job out of sheer exhaustion.
"When I was working, it was fine. But when I was back home, it hit me hard. It was tough to lift and turn patients, adjust the ventilators, and hold the phone for the family members to talk to the patient, sometimes for the last time. I just couldn’t take it," he says.
As more and more medical staff members fall ill or quit, along with those who still have their jobs but are having to fill in for those who have left, is bound to bring the healthcare system down. This is a recipe for more PTSD patients in the future.
How can the medical fraternity cope with it
Watch the triggers and counter them with positive reinforcement
Set boundaries between work and personal life
Self-soothe with the help of deep breathing, meditation, walks, gardening, taking up a hobby, journaling
Join a social support group
Take professional help
Dr Satish Kumar, Consultant Clinical Psychologist, Manipal Hospitals, points to their national study on 2,000 healthcare professionals. Doctors showed more secondary traumatic stress than nurses and other healthcare professionals.
"The reasons attributed for PTSD and pessimism in healthcare professionals could be long working hours, reduced sleep, stress, fear of infection, rising number of deaths, giving out news of death, and refusing admissions into hospitals," he says.