BARCELONA, Spain (AP) – The steady rise in COVID-19 infections in Spain after the holiday season is once again straining 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 critical care capacity has doubled and is almost full, with 80% of ICU beds being occupied by coronavirus patients.
“There are young people in their 20s and people in their 80s, all ages,” said Dr. Joan Ramon Masclans, who heads the ICU. “This is very difficult and one patient after another.”
Although authorities allowed gatherings of up to 10 people for the Christmas and New Year holidays, Masclans chose not to join his family and spent the holidays at home with his partner.
“We did it to keep our health and the health of others. And when you see that this is not done (by others), it causes significant anger, added to fatigue, “he said.
A study published this month by the Hospital de Mar, which analyzes the impact of the increase in COVID-19 in the spring on more than 9,000 health workers throughout Spain, found that at least 28% suffered from major depression. This is six times the general population rate before the pandemic, said Dr. Jordi Alonso, one of the lead researchers.
In addition, the study found that almost half of the participants had a high risk of anxiety, post-traumatic stress disorder, panic attacks or substance and alcohol abuse problems.
Spanish health workers are far from the only ones who have suffered psychologically from the pandemic. In China, the 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, a poll published 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’s pretty awful right now in the world of medicine,” said Dr. Andrew Goddard, president of the Royal College of Physicians, in a statement accompanying the study. “The hospitals are at the highest level, the staff is exhausted and, although there is light at the end of the tunnel, that light seems far away.”
Dr. Aleix Carmona, anesthesiologist from year III, resident in the northeastern region of Spain in Catalonia, did not have much experience in intensive care before the pandemic hit. But because the surgery was canceled, Carmona was summoned to the ICU at the Moisès Broggi Hospital outside Barcelona to fight a virus that the world knew very little about.
“In the beginning, I had a lot of adrenaline. We were very scared, but we had a lot of energy “, Carmona remembered. He showed up in the first weeks of the pandemic without much time to process the unprecedented ongoing battle.
It was not until the second month that he began to feel the urge to see firsthand how people were dying slowly while out of breath. He thought about what to tell the patients before intubating them. His initial reaction was always to reassure them, to tell them he would be fine. But in some cases, he knew that wasn’t true.
“I started to have difficulty sleeping and a feeling of anxiety before each change,” Carmona said, adding that she would return home after 12 hours, feeling beaten.
For a while he could only sleep with the help of medication. Some colleagues have started taking antidepressants and anti-anxiety drugs. However, what really helped Carmona was a support group at her hospital, where her colleagues downloaded the experiences they had bottled inside.
But not everyone joined the group. For many, asking for help would make them seem unfit for the job.
“In our profession, we do a lot,” said David Oliver, a spokesman for the Catalonia chapter of the SATSE nurses’ union. “We don’t want to relax because we know we will add to the workload of our colleagues.”
The most affected group of health workers, according to the study, were nurses, who are overwhelmingly women and often immigrants. They spent more time with dying COVID-19 patients, faced poor working conditions and wages, and feared infecting family members.
Desirée Ruiz is a supervising nurse in the critical care unit of Hospital del Mar. Some nurses on her team asked her to take time off, unable to cope with the constant stress and all the deaths.
To prevent infections, patients are rarely allowed family visits, increasing their dependence on nurses. Transmitting a patient’s last wishes or words to relatives over the phone is particularly difficult, Ruiz said.
“This is very difficult for … people holding the hands of these patients, even if they know they will end up dying,” she said.
Ruiz, who organizes the exchange of nurses and ensures that the ICU always has adequate staff, is finding it increasingly difficult to do so.
Unlike in the summer, when the number of cases decreased and health workers were encouraged to take leave, doctors and nurses worked non-stop since the autumn, when cases of the virus reappeared.
The latest rebirth has almost doubled the number of daily cases seen in November, and Spain now has the third highest COVID-19 infection rate in Europe and the fourth highest death toll, with more than 55,400 confirmed deaths.
But unlike many European countries, including neighboring Portugal, the Spanish health minister has ruled out a new blockade for the time being., relying instead on less drastic restrictions, which are not as harmful to the economy, but take longer to reduce the rate of infections.
Alonso fears that the latest wave of patients with the virus 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 properly cared for, we must also take care of health workers, who have suffered and still suffer,” he said.
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