THE coronavirus disease 2019 (COVID-19) pandemic brings about an unprecedented time of uncertainty. While the direct morbidity and mortality of the virus is unquestionable, the ongoing psychological impacts on health care workers and the community will likely be significant, but their scope is yet to be appreciated.
We do not know how long our public health and frontline health care staff will be facing the virus. We do not know how long our educational institutions and workplaces will be affected. We do not know how long we will have to socially isolate, away from support systems such as friends, co-workers and family. There are just so many unknowns facing Australian health care staff at present.
Health care workers are indisputably heroes. Every day around the globe, they are putting themselves at significant risk of work-related infection and psychological trauma during this crisis. Recognising this, there has been a huge outpouring of community support for Australian health care workers. The community has rallied, and Facebook community pages such as Adopt a Healthcare Worker offer kind-hearted gestures of the most simple things to make lives easier. Meals, groceries, child-minding, even offers of accommodation for health care workers with sick or elderly people at home. Private companies have also rallied. Even if it’s just coffee, those simple gestures are appreciated.
But there will be tragedies. There has been a COVID-19-related death in a health care worker in Australia and this weighs heavily on those in frontline work. Health care workers in Italy, the US, China, the UK, France, Spain and Iran have lost their lives to this virus. In Italy, at the time of writing, 100 doctors have died of COVID-19. Every country has a different battle to face, and we have fought to prevent our situation becoming as dire as what we see across the world and we are making valid progress. Despite this, we know that Australian health care workers have faced hardships and distress as a result of this pandemic.
Even before COVID-19, Australian doctors have seen exclusions, or exorbitant premiums, on their income protection and health insurance policies from seeking help for their mental health. While we would argue that this is unacceptable at any time, it becomes particularly pertinent when considered during this pandemic. Although the true extent on the impacts on Australian health care workers is not yet known, it should be expected that we will see a spike in mental health problems in this population. The World Health Organization recognised this and in their statement on Mental health and psychosocial considerations during the COVID-19 outbreak specifically outlined the increased risk placed on health care workers.
An amnesty on insurance practices that decrease help-seeking behaviour is urgently needed for any consultations with psychologists, GPs and psychiatrists when related to issues arising from their work during COVID-19. Issues and consequences of hardship and illness that increase the need for mental health support should not have an impact on the cost of future income protection or other relevant insurance in the future. This is particularly true for our doctors at the beginning of their career, interns and residents who may not have established coverage.
In this time of immense uncertainty, it would be unconscionable for insurers to use mental health issues arising from COVID-19 as a way to increase premiums or loading on health insurance or income protection for health care workers in the coming years.
Dr Emily Shao is an executive member of the Australian Medical Association Queensland Council of Doctors in Training. She is currently a PhD candidate at the University of Queensland.
Dr Rhys Thomas is an executive member of the Doctors’ Health Advisory Service Queensland. He is a Psychiatry registrar at the Royal Brisbane and Women’s Hospital.
Dr Kate Engelke is Company Secretary of Queensland Doctors’ Health Program. She is currently working as a General Surgery Principal House Officer at Townsville Hospital and is a Lecturer with James Cook University.
Dr Margaret Kay is a Senior Lecturer at UQ and is a GP in Brisbane. She is the Medical Director of the Queensland Doctors’ Health Program.
The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.