Assessment of COVID-19 management and its consequences on healthcare professionals: a cross-sectional study from Bangladesh

Abstract

Objective: This explorative study aims to identify the gaps in COVID-19 management and their consequences on physicians in terms of contracting infection and psychological well-being during the early phase of the pandemic.

Design, settings and participants: We conducted a nationwide cross-sectional online study to collect information from 420 intern doctors who were at their internship in government medical colleges from February to August 2020.

Methods: We performed univariate and bivariate analyses to assess COVID-19 management. We investigated the consequences of COVID-19 management on infection risk, experiencing stress, developing anxiety, depression and sleep disturbance using five sets of multivariable logistic regression analyses.

Results: Findings indicate a delay in first-case detection and identify people's tendency to hide COVID-19 symptoms as one of the possible causes of that delay. About 56% of the intern doctors experienced that patients were trying to hide COVID-19 symptoms in the earlier phase of the pandemic. More than half of the respondents did not get any training on COVID-19 from their working institutions. About 30% and 20% of the respondents did not use personal protective equipment (PPE) and masks while treating patients. Respondents who treated patients without PPE, masks, face shields and gloves were almost two times as likely to be infected by COVID-19. The odds of experiencing COVID-19-related stress was almost twofold among respondents who treated patients without wearing PPE and masks. Experiencing COVID-19-related stress was further associated with an increased risk of developing anxiety and depression that led to sleep disturbance.

Conclusion: Ensuring the maximum utilization of limited resources during any public health crisis such as COVID-19 needs developing coping mechanisms by projecting future demand. Ensuring proper training and safety measures can reduce physical and psychological hazards among physicians.

Keywords: Adult psychiatry; COVID-19; Health policy; Infection control; MENTAL HEALTH; Public health.

Figure 1

Delay in COVID-19 case detection.

Figure 2

COVID-19 training measures.

Figure 3

Comorbidity and safety measure adoption when treating patients with COVID-19. CKD, chronic kidney disease; CLD, chronic lung disease; COPD, chronic obstructive pulmonary disease; DM, diabetes mellitus; NCDs, non-communicable diseases; PPE, personal protective equipment.