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“Two of my primary care patients have died of COVID. Both were in intensive care units. And, both basically died alone, without support of their families—which seems to me probably the worst way to die,” Dr. Colleen Surlyn, MD & MPH and the Medical Director of Care Coordination of the San Francisco Health Network, said to NPQ.

The United States has reached close to 230,000 deaths from COVID-19, and this is most likely an undercount; the true number could be as high as 500,000. That includes the rate of “excess deaths,” which is up 26.5 percent from previous years, according to the Centers for Disease Control and Prevention. Many who are dying are doing so alone, away from their loved ones.

A May 2020 Census Bureau poll found one-third of Americans are exhibiting signs of clinical anxiety or depression, and healthcare workers are taking the brunt of this exposure, bearing witness to immense uncertainty, trauma, tragedy, and loss of human life. Having patients die may be a reality of care work, but the scale in 2020 is extraordinary. To put this impending wave of intergenerational trauma in perspective, it would take over 23 years, working 24/7 without any breaks, to provide a single hour of counseling for every person affected by the lives officially counted as lost.

“Just thinking about the pain and suffering of that person and of their families is really a lot to bear,” says Surlyn, who, reflecting on the mental health toll on health care professionals, added, “But I think for people that are in the hospital lot, seeing that degree of human suffering is incredibly hard and a huge psychological burden.”

Not being able to say goodbye, share final moments together, and express love has detrimental effects on grieving family members, but healthcare personnel in proximity to those who have passed are not unaffected. Nurses or nursing assistants are often the last line for FaceTimes, phone calls, and emotional support as patients pass away, all while wearing layers of protective equipment to protect them from the virus, but not the emotional toll.

The pandemic has placed healthcare personnel across roles at particular mental, physical, social-emotional, and psychological risks. If these realities are not acted on by national, local, and health system leadership, this community of caretakers is on track to experience a widespread mental health crisis for years to come, in tandem with fighting the pandemic.

Primed for Burnout

Many aspects of the American healthcare landscape primed healthcare workers across roles to be particularly at risk for exposure to various forms of trauma and career burnout. These risks exist for a variety of reasons tied to longstanding issues in the field, such as mental health stigmatization, lack of supportive services or resources, as well as “warrior” or “pr