The "Wounded Healer" - Anxiety and Sleep Disturbance Amongst Healthcare Workers Facing COVID-19 Pandemic in India: A Cross-sectional Online Survey.

BACKGROUND The pandemic of novel coronavirus (COVID-19) infection caused by SARS-CoV-2 has become a serious concern in the medical community and has resulted in an unprecedented psychological impact on health care workers (HCWs), already working under high stress levels. The viral infection expanded internationally and World Health Organization announced a Public Health Emergency of International Concern. OBJECTIVE We aimed to identify and measure the effects of this pandemic on anxiety levels and sleep disturbance and the availability of personal protective equipment (PPE) among the HCWs in India. METHODS We conducted an online cross-sectional study using piloted structured questionnaires with self-reported responses from 368 volunteer males and females HCWs from India. Study participants were identified through social networking sites: Facebook and WhatsApp. The degree of symptoms of anxiety, sleep quality and the availability of PPE was assessed by the 7-item Generalized Anxiety Disorder (GAD) scale, Single Sleep Quality scale and questions on availability of PPE. RESULTS Majority of the study subjects were in the age group 45-60 years and 52.2% were doctors. Severe anxiety scores (GAD>10) were observed in 7.3%; moderate, mild and minimal anxiety was observed in 12.5%, 29.3% and 50.8% HCWs respectively, and 31.5% had poor to fair sleep scores (<6). Univariate analysis showed female gender and inadequate availability of PPE significantly associated with higher anxiety levels (P= 0.01 and 0.01). Sleep disturbance was significantly associated with age<30 years (P=0.04) and inadequate PPE (P<0.001). Multivariable analysis showed that poorer quality of sleep was associated with higher anxiety levels (P<0.001). CONCLUSIONS COVID-19 pandemic has potentially caused a significant level of anxiety and sleep disturbance amongst HCWs, associated with female gender, younger age group, and availability of inadequate PPE, which puts HCWs at constant risk of contracting the infection themselves or transmitting it to their families. Early detection of at-risk HCWs and institution of situation-tailored mitigation measures will enable alleviation of the risk of long term, serious psychological sequelae as well as reduce HCWs' current anxiety. CLINICALTRIAL