Following the beginning of the COVID-19 pandemic, governments across the world implemented measures focused on containing the COVID-19 virus and flattening the curve. Examples of the measures encompassed countrywide lockdowns including requiring people to stay at and work from home. Essential workers such as sanitation workers, bus drivers, food service and grocery store workers, and healthcare support staff among others were exempted from these measures because of their inability to work from home. They are the frontline workers against the virus. A majority of them have never experienced potential health risks, increased workload, or increased levels of stress while performing their roles. In turn, this increases their vulnerability to burnout, which can further lead to different mental health issues.
The current paper examines the issue of burnout among essential workers and the related mental health problems that emerge during the existing COVID-19 pandemic. The paper focuses on describing the concept of burnout and integrating and synthesizing the concept concerning essential workers dealing with the COVID-19 situation.
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Burnout is defined as a low personal achievement, depersonalization, and emotional tiredness (Morgantini et al., 2020). Employee burnout occurs due to emotional and physical fatigue and stress from working for extended periods. This usually results when workers focus too much effort on their work as they perform their roles but get limited time to recover (Maddux & Winstead, 2016). The three main features of burnout are job discontent, lack of energy, and emotional fatigue. Burnout is caused by the absence of constructive feedback, inadequate training or resources, inconsistent roles, and overwhelming job demands. Among workers, burnout can affect their health, safety, and productivity (Maddux & Winstead, 2016). It also results in reduced job satisfaction, ineffectiveness, team disruption, and decreased commitment to the organization.
The COVID-19 pandemic across the world threatens human health both domestically and globally, which significantly affects frontline workers. The increasing number of cases overwhelms the already strained resources, which also increases the demands of essential workers. The demand is particularly high for frontline workers in the health care sector who are involved directly in the diagnosis and treatment of COVID-19 patients (Lai et al., 2020). The pandemic has also challenged existing public health systems due to its rapid spreading and potential to cause fatalities. Concerning this challenge, essential workers must greatly increase their efforts when accomplishing their roles for longer periods and suffer from inadequate knowledge regarding an unpredictable and emerging issue. Additionally, the constant need to practice safety precautions such as wearing masks or PPEs increases the mental pressures on the workers (Talaee et al., 2020). Generally, a major disease outbreak results in an overall environment of anxiety that results in adverse effects on mental health.
Burnout among essential workers during the COVID-19 situation is now a severe issue. While the issue is not limited to a specific time and can occur at any time, it is now more prevalent among essential workers because of several reasons. Essential workers perform roles requiring them to be very close to others at extended periods (Talaee et al., 2020). As frontline workers, they cannot avoid contact with others and can only practice social distance measures some of the time. They must also go to work every day. Employees at nursing homes, for instance, work in areas that are prone to COVID-19, which exposes them to sick COVID-19 patients in addition to those dying from the virus within short times without adequate grieving, sick leave, or rest time (Yourish et al., 2020). Besides, environmental service employees at health care organizations who perform the roles of disinfecting hospital rooms housing COVID-19 patients and sanitation employees who must deal with trash coming from all directions are also exposed to risks every day given the lack of enough hand sanitizers or personal protective equipment (Ducharme, 2020). Workers at stores such as Walmart must also face aggressive customers and an overwhelming number of customers due to understaffing (Sainato, 2020). These factors combined with widespread infections and fatalities among the essential workers, particularly the healthcare workers, imposes significant levels of mental and social pressures on the workers. Whereas most people can work from home and decide whether or not to go outside, this is not the case for essential employees. In addition to challenges such as inadequate protective equipment and understaffing, a majority of the workers must work away from home. The intensified level of work affects their mental health.
Studies show that essential personnel are struggling with burnout, which leads to poor mental health (Hammonds & Kerrissey, 2020). Among health care professionals or workers, burnout is related to factors such as high workload or feelings of being pushed past training, high time pressure or work affecting their ability to engage in household chores, high job stress or the need to reach tough decisions, and limited support from the organization or lack of enough PPE (Talaee et al., 2020). Others are struggles when enforcing safety precautions such as safety protocols and social distancing and stress concerning anxieties due to COVID-19.
The essential workers are also exposed to unpredictable, high risk, and changing conditions. The need to engage with a highly infectious and fatal disease, emergency conditions, and traumatic incidents while having less time to recover leads to a constant experience of pressures related to the job. Many essential employees have also been forced to perform unusual and sensitive roles that require them to participate in the decision-making process involving emotionally exhausting choices. For instance, health care workers can be required to be involved with anguished relatives or families who cannot visit their loved ones due to social isolation (Almeida, 2021). These may not be the typical responsibilities of most of the workers. Additionally, increasing cases of the COVID-19 outbreak in health care organizations constrain the capacities of these organizations, which lead to extra stress among employees.
Essential personnel must also work hard during emergencies or under stressful conditions, which increases their susceptibility to burnout and issues such as sleep deprivation (Sultana et al., 2020). Besides, governments consider frontline employees to be essential, which results in less rest time and contribute to burnout. They must remain resilient for their communities, friends, families, and patients. The high risk they place themselves in to ensure the health and safety of others, however, adversely affects their mental health. Whereas some essential workers such as health care employees may be used to dealing with stressful and high-intensity work environments, they are facing new challenges today such as increased number of severely ill patients, anxiety regarding their health and spreading the virus, and inadequate access to the required medical resources (Barello et al., 2020). The combination of these factors, which are mostly, experienced concurrently lead to severe burnout and the related mental health outcomes.
During normal conditions, daily stressors can still significantly affect workers’ mental health. When, however, employees experience burnout due to stressful shifts or long working days without breaks, mental health issues emerge. Research shows that adverse mental reactions to epidemics such as COVID-19 can lead to mental health issues such as insomnia, decreased safety feelings, and increased substance abuse (Sultana et al., 2020). Recent studies have also identified increased mental health issues such as depression and anxiety among health care employees dealing with the current pandemic (Sultana et al., 2020). They may also experience post-traumatic stress disorder.
Common symptoms of mental health issues among essential personnel include angry or irritable feelings, a desire to withdraw or isolate, shame, guilt, depressed moods, anxiety, sadness, and grief reactions (Talaee et al., 2020). People can also experience hopeless feelings or unpleasant thoughts concerning exposure to potentially distressing events; and concentration and memory difficulties (Talaee et al., 2020). All these symptoms also relate to reduced job outcomes and prescription errors. Dominant sources of mental issues include inadequate access to reliable communication and information, insufficient testing, unknowingly carrying the infection to homes, and inadequate access to protective equipment, which relate to factors associated with burnout (Morgantini et al., 2020). It is, therefore, crucial to evaluate and address the needs of essential workers to assist in the mitigation of these challenges.
Studies suggest that non-governmental and governmental stakeholders including hospitals can address or reduce burnout and mental health issues through targeting modifiable factors (Morgantini et al., 2020). They can, for instance, offer extra mental health resources and training, reinforce support measures for the emotional and physical needs of essential employees, acquire the needed equipment such as PPE, and help workers with things such as wages, temporary housing, transportation, or childcare.
Although essential personnel deal with the COVID-19 at the frontline, they face stressful situations and demands that adversely affect their physical and emotional well-being leading to burnout and other mental health issues. The main causes of burnout and the related mental issues include increasing work demands, inadequate safety equipment, lack of rest, facing traumatic events, dealing with an unpredictable infection and anxiety over acquiring the infection or infecting loved ones. Concerned stakeholders can address the issue by supporting essential workers through extra training, offering adequate mental health resources, and supporting their families.
References
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