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. 2021 May;36(5):1319-1326.
doi: 10.1007/s11606-020-06529-z. Epub 2021 Mar 10.

Impact of the Early Phase of the COVID-19 Pandemic on US Healthcare Workers: Results from the HERO Registry

Christopher B Forrest  1 , Haolin Xu  2 , Laine E Thomas  2 , Laura E Webb  2 , Lauren W Cohen  2 , Timothy S Carey  3 , Cynthia H Chuang  4 , Nancy M Daraiseh  5 , Rainu Kaushal  6 , James C McClay  7 , François Modave  8 , Elizabeth Nauman  9 , Jonathan V Todd  10 , Amisha Wallia  11 , Cortney Bruno  12 , Adrian F Hernandez  2 , Emily C O'Brien  2 ; HERO Registry Research Group
Affiliations

Impact of the Early Phase of the COVID-19 Pandemic on US Healthcare Workers: Results from the HERO Registry

Christopher B Forrest et al. J Gen Intern Med. 2021 May.

Abstract

Background: The HERO registry was established to support research on the impact of the COVID-19 pandemic on US healthcare workers.

Objective: Describe the COVID-19 pandemic experiences of and effects on individuals participating in the HERO registry.

Design: Cross-sectional, self-administered registry enrollment survey conducted from April 10 to July 31, 2020.

Setting: Participants worked in hospitals (74.4%), outpatient clinics (7.4%), and other settings (18.2%) located throughout the nation.

Participants: A total of 14,600 healthcare workers.

Main measures: COVID-19 exposure, viral and antibody testing, diagnosis of COVID-19, job burnout, and physical and emotional distress.

Key results: Mean age was 42.0 years, 76.4% were female, 78.9% were White, 33.2% were nurses, 18.4% were physicians, and 30.3% worked in settings at high risk for COVID-19 exposure (e.g., ICUs, EDs, COVID-19 units). Overall, 43.7% reported a COVID-19 exposure and 91.3% were exposed at work. Just 3.8% in both high- and low-risk settings experienced COVID-19 illness. In regression analyses controlling for demographics, professional role, and work setting, the risk of COVID-19 illness was higher for Black/African-Americans (aOR 2.32, 99% CI 1.45, 3.70, p < 0.01) and Hispanic/Latinos (aOR 2.19, 99% CI 1.55, 3.08, p < 0.01) compared with Whites. Overall, 41% responded that they were experiencing job burnout. Responding about the day before they completed the survey, 53% of participants reported feeling tired a lot of the day, 51% stress, 41% trouble sleeping, 38% worry, 21% sadness, 19% physical pain, and 15% anger. On average, healthcare workers reported experiencing 2.4 of these 7 distress feelings a lot of the day.

Conclusions: Healthcare workers are at high risk for COVID-19 exposure, but rates of COVID-19 illness were low. The greater risk of COVID-19 infection among race/ethnicity minorities reported in the general population is also seen in healthcare workers. The HERO registry will continue to monitor changes in healthcare worker well-being during the pandemic.

Trial registration: ClinicalTrials.gov identifier NCT04342806.

Keywords: COVID-19; SARS-CoV-2; burnout; disparities; healthcare worker; registry; well-being.

PubMed Disclaimer

Conflict of interest statement

Dr. Hernandez, Nauman, Thomas, O’Brien, and Forrest report grants from PCORI, during the conduct of the study. Dr. Forrest reports additional grants from FDA, CDC, NIH, AHRQ, and Lily; none of these grants relates to the content of this work. Dr. O’Brien also reports grants from BMS, Novartis, and Amgen.

Figures

Figure 1
Figure 1
State of residence for 14,600 healthcare workers enrolled in the HERO registry. The map shows the count of healthcare workers who enrolled in the HERO research community via a web-based registry. Recruitment methods included communications done within healthcare systems that participate in PCORnet (pcornet.org), a national network-of-networks devoted to conducting clinical research; media articles and televised stories; social media; and professional societies. The count of the number of participants by state is based on individuals’ recorded 5-digit zip codes of residence.
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