Intended for healthcare professionals

Opinion

Caring for the carers: understanding long covid in our diverse healthcare workforce

BMJ 2022; 377 doi: https://doi.org/10.1136/bmj.o1152 (Published 06 May 2022) Cite this as: BMJ 2022;377:o1152
  1. Amani Al-Oraibi, PhD student12,
  2. Katherine Woolf, professor of medicine education research3,
  3. Laura B Nellums, associate professor in global health2,
  4. Carolyn Tarrant, professor of health services research4,
  5. Habib Naqvi, director of the NHS Race and Health Observatory5,
  6. Manish Pareek, professor of infectious diseases16
  1. 1Department of Respiratory Sciences, University of Leicester, UK
  2. 2Lifespan and Population Health, School of Medicine, University of Nottingham, Nottingham, UK
  3. 3University College London Medical School, UK
  4. 4Department of Health Sciences, University of Leicester, UK
  5. 5NHS Race and Health Observatory, London, UK
  6. 6Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, UK

In the United Kingdom (UK), there have been over 21.4 million confirmed cases of covid-19 as of April 2022.1 Evidence has emerged that some patients are experiencing long term symptoms and complications that extend beyond the acute infection phase, which is now widely known as long covid.23 According to the most recent UK Government’s Office for National Statistics data (April 2021), approximately 1.7 million individuals in the UK reported experiencing covid-19 symptoms for longer than four weeks.4 Of these, 690% had covid-19 for the first time at least 12 weeks previously, and 45% had covid-19 at least a year ago.4

As the covid-19 pandemic has progressed, there has been increasing evidence that healthcare workers, especially those from ethnic minority backgrounds, may be at particularly high risk of poor physical and mental health outcomes.5 This is likely to be attributed to the many challenges that healthcare workers face while working in these circumstances, including the high work demand, shortage of staff, lack of personal protective equipment (PPE), rapid changes in protocols and guidance, and long working hours, as well as their increased risk of covid-19 infection and severe disease.56 As a result, healthcare workers may also be more likely than the general population to be affected by long covid, with a disproportionate burden among ethnic minorities.

In response to the potential consequences of long covid, a wide range of nationally funded research studies have been initiated in the UK to better understand the long term impact of SARS-CoV-2 infection on physical and mental health, and how to enhance the diagnosis and treatment of long covid.7 However, these studies have largely, to date, focused on the general population, with a critical gap in research on long covid among healthcare workers, and ethnic minority groups in particular.

Healthcare workers from diverse ethnic backgrounds play a vital role in our response to the covid-19 pandemic, comprising around 42% of doctors and more than 19% of other clinical staff (e.g., nurses, paramedics, midwives), within the NHS workforce.8 The disproportionate impact of covid-19 on healthcare workers has serious implications for the effective operation of the health system. However, up until now, there has been limited attention to how post acute illness and long covid are affecting the home and work lives of healthcare workers, and those from ethnic minority backgrounds in particular. Furthermore, the burden of long covid and its ongoing mental, physical, and occupational impacts on this population are still unknown. This scarcity of literature is particularly problematic for this novel and poorly understood condition, with critical implications for the sustainable delivery of safe and high quality care.

The recent omicron wave has resulted in an increase in covid-19 cases in the UK since early March. Data from the Office for National Statistics (ONS) suggest that in March and early April covid-related deaths in England were at the highest level since mid February. NHS hospitals are once again under pressure as the number of patients admitted to hospital with covid-19 is high. In addition, staff absences from covid-19 are also high. Protecting the occupational health of NHS staff in light of the ongoing pandemic is therefore crucial. Research in this area, looking at the prevalence of long covid among healthcare workers will be vital in generating key recommendations and personalised interventions for addressing social and health inequities. It will also provide critically needed evidence on the physical, mental, and occupational health needs of the diverse NHS workforce, and associated interventional studies, to improve public health as well as the design and delivery of health services for long covid. Research that enables the promotion of progressive and equitable policy interventions in this area will go a long way in helping us achieve this ambition.

Footnotes

  • Competing interests: The authors are involved in the UK-REACH project. UK-REACH project is funded by UKRI-MRC and NIHR. REACH-OUT is funded by the NHS Race and Health Observatory.

References

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