Cited by 1,498Healthcare Systems and ChallengesInfection Control and VentilationInfection Control in Healthcare

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Supporting the Health Care Workforce During the COVID-19 Global Epidemic

Adams, James G., Walls, Ron M.·2020·JAMA

DOI 10.1001/jama.2020.3972

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Abstract

This Viewpoint discusses the importance of protecting health care workers caring for patients with coronavirus disease 2019 (COVID-19) and measures that can be taken in and out of the hospital to prevent their and their families' exposure to SARS-CoV-2.

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Crossref · 10.1001/jama.2020.3972

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Research works printed but not linked: 5

Del Rio, COVID-19—new insights on a rapidly changing epidemic., JAMA
Bai, Presumed asymptomatic carrier transmission of COVID-19., JAMA
Radonovich, 2019, N95 respirators vs medical masks for preventing influenza among health care personnel: a randomized clinical trial., JAMA, 322, 824, 10.1001/jama.2019.11645 · DOI · Paper page
Ong, Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient., JAMA
JAMA Network. Coronavirus disease 2019 (COVID-19). https://jamanetwork.com/journals/jama/pages/coronavirus-alert

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Martino, M. D., Septiem, J. G., González, R. M., de Nova, J. L. M., Rodríguez, Á. D. L. H., Bonito, A. C., & Martín-Pérez, E. (2020) · Cirugia Espan~ola · doi:10.1016/j.cireng.2020.06.005 · Cited by 31
“Since the first cases of the SARS-CoV-2 (COVID-19) infection occurred in late December 2019 in Wuhan, China, the exponential growth of this disease has led to a pandemic, declared as such by the World Health Organization (WHO) on 11th March 2020.(1,2) Spain, and specifically the community of Madrid, has been one of th…”
Background
Practitioners specialized in oral health and coronavirus disease 2019: Professional guidelines from the French society of stomatology, maxillofacial surgery and oral surgery, to form a common front against the infectious risk
Anonymous (2020) · Journal of Stomatology Oral and Maxillofacial Surgery · doi:10.1016/j.jormas.2020.03.011 · Cited by 31
“Finally, the precautionary principles mentioned above will remain valid for future microbial agents to which practitioners specialized in oral health will, probably more than others, always be exposed [44].”
Health anxiety to COVID-19 virus infection and its relationship to quality of life in a sample of health care workers in Egypt: a cross-sectional study
Abdelghani, M., Mahdy, R. S., & Elgohary, H. M. (2021) · Archives of Psychiatry and Psychotherapy · doi:10.12740/app/130304 · Cited by 33
“The situation would be the same during Covid-19 pandemic; studies have found that HCWs working with patients with COVID-19 have greater risks of psychiatric disturbances, such as anxiety, depression, insomnia, and stress [7-9].”
Background
The mental health status among nurses from low‐risk areas under normalized COVID‐19 pandemic prevention and control in China: A cross‐sectional study
Chen, X., Arber, A., Gao, J., Zhang, L., Ji, M., Wang, D., Wu, J., & Du, J. (2021) · International Journal of Mental Health Nursing · doi:10.1111/inm.12852 · Cited by 31
“This result is consistent with other studies showing that mental health training is an effective measure to reduce the psychological pressure of the medical staff (Adams & Walls, 2020).”
Result
Emergency Medicine Telehealth for COVID-19
Russi, C., Heaton, H., & Demaerschalk, B. (2020) · Mayo Clinic proceedings · doi:10.1016/j.mayocp.2020.07.025 · Cited by 30
“Hospitals in densely populated urban locales of the United States are overwhelmed with new cases that exceed their ability to provide safe efficient care to everyone while simultaneously conserving personal protective equipment (PPE) for their workforce.(3-7)”
Elective cardiac surgery during the COVID-19 pandemic: Proceed or postpone?
Shehata, I. M., Elhassan, A. O., Jung, J. W., Urits, I., Viswanath, O., & Kaye, A. D. (2020) · Best practice & research. Clinical anaesthesiology · doi:10.1016/j.bpa.2020.07.005 · Cited by 34
The Impact of the Coronavirus Disease 2019 Outbreak on the Attendance of Patients with Surgical Complaints at a Tertiary Hospital Emergency Department
Anteby, R., Zager, Y., Barash, Y., Nadler, R., Cordoba, M., Klang, E., Klein, Y., Ram, E., Gutman, M., & Horesh, N. (2020) · Journal of laparoendoscopic & advanced surgical techniques. Part A · doi:10.1089/lap.2020.0465 · Cited by 30
Risk factors affecting COVID-19 case fatality rate: A quantitative analysis of top 50 affected countries
Goh, H., Mahari, W. I., Ahad, N. I., Chaw, L., Kifli, N., Goh, B.-H., Yeoh, S. F., & Long, C.-A.-M. (2020) · medRxiv · doi:10.1101/2020.05.20.20108449 · Cited by 30
“Recognizing the risk of 295 healthcare workers shortages and ensuring them to have adequate rest and to feel supported are 296 important to maintain individual and team performance in overcoming challenges presented by 297 COVID-19 (24).”
Background
Telemedicine and the Use of Korean Medicine for Patients With COVID-19 in South Korea: Observational Study
Jang, S., Kim, D., Yi, E., Choi, G., Song, M., & Lee, E. (2020) · JMIR Public Health and Surveillance · doi:10.2196/20236 · Cited by 38
Extubation barrier drape to minimise droplet spread
Montoya, M. P., & Chitilian, H. V. (2020) · British Journal of Anaesthesia · doi:10.1016/j.bja.2020.03.028 · Cited by 27
“Furthermore, there is an acute shortage of N95 masks and personal protective equipment (PPE), with the existing inventory being rationed for the care of symptomatic or confirmed patients.(4) In this setting, it is necessary to consider adjunctive approaches to minimise droplet spread.”
Health Workers’ Burnout and COVID-19 Pandemic: 1-Year after—Results from a Repeated Cross-Sectional Survey
Gambaro, E., Gramaglia, C. M., Marangon, D., Probo, M., Rudoni, M., & Zeppegno, P. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20126087 · Cited by 32
Telemedicine and Digital Health Applications in Vascular Surgery
Lareyre, F., Chaptoukaev, H., Kiang, S. C., Chaudhuri, A., Behrendt, C., Zuluaga, M. A., & Raffort, J. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11206047 · Cited by 46
“In addition, the novel coronavirus (COVID-19) has imposed a severe strain on healthcare systems worldwide [25].”
Background
Nurse's Psychological Experiences of Caring for Severe COVID-19 Patients in Intensive Care Units: A Qualitative Meta-Synthesis
Han, P., Duan, X., Zhao, S., Zhu, X.-P., & Jiang, J.-X. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.841770 · Cited by 29
“Their safety should be a priority, and they should be appropriately rewarded to provide positive support when a similar situation occurs in the future (48, 49).”
Background
Clinical characteristics and risk factors for mortality among COVID-19 hospitalized patients in UAE: Does ethnic origin have an impact
Aburuz, S., Al-Azayzih, A., ZainAlabdin, S., Beiram, R., & Hajjar, M. A. (2022) · PLoS ONE · doi:10.1371/journal.pone.0264547 · Cited by 29
“Moreover, the overwhelming burden of this crisis has been associated with high pressure on the capacity of the healthcare systems, which in turn negatively affects the healthcare workers [11].”
Background
Correlation between anxiety and resilience of healthcare workers during COVID-19 pandemic in the southwest of Iran
Rayani, S., Rayani, M., & Najafi-Sharjabad, F. (2021) · Environmental Science and Pollution Research · doi:10.1007/s11356-021-17284-x · Cited by 28
“During a pandemic, one of the major concerns for medical personnel is the possibility of infecting others, particularly family members (Adams and Walls 2020).”
Background
Burnout on the frontline: the impact of COVID-19 on emergency department staff wellbeing
Sheehan, O., Sheehan, M., Rau, R. I., Sullivan, Í. O., McMahon, G., & Payne, A. (2021) · Irish Journal of Medical Science · doi:10.1007/s11845-021-02795-w · Cited by 29
Perceptions and experiences of healthcare providers during COVID-19 pandemic in Karachi, Pakistan: an exploratory qualitative study
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Affordable measures to monitor and alarm nosocomial SARS‐CoV‐2 infection due to poor ventilation
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COVID-19 Disrupted Provision and Utilization of Health and Nutrition Services in Uttar Pradesh, India: Insights from Service Providers, Household Phone Surveys, and Administrative Data
Nguyen, P. H., Kachwaha, S., Pant, A., Tran, L. M., Walia, M., Ghosh, S., Sharma, P. K., Escobar‐Alegria, J., Frongillo, E. A., Menon, P., et al. (2021) · Journal of Nutrition · doi:10.1093/jn/nxab135 · Cited by 36
“FLWs responding to COVID-19 are reported to be at increased risk of contracting the virus (9, 12) and experience fatigue, uncertainty, attacks, and sometimes conflicts about serving patients or securing their own lives and families (13, 14).”
Background
Evaluation of infection prevention and control preparedness in acute care nurses: Factors influencing adherence to standard precautions
Lim, S. H., Bouchoucha, S., Aloweni, F., & Suhari, N. '. B. (2020) · Infection Disease & Health · doi:10.1016/j.idh.2020.11.005 · Cited by 29
“It is of high priority to determine and understand the behaviours and adherence to infection prevention and control practices, to evaluate the preparedness of health care workers in the current pandemic context [1,7].”
Background
Practical Considerations When Performing Neurodiagnostic Studies on Patients with COVID-19 and Other Highly Virulent Diseases
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“…led to a worldwide shortage of personal protective equipment (PPE) (Baker and Sullivan 2020; CDC March 12, 2020a) and an increased stress on hospital resources (Kamal et al. 2020; Root 2020), which has resulted in a spike in the anxiety of the frontline healthcare workers (Adams and Walls 2020).”
Background
Considerations in mandating a new Covid-19 vaccine in the USA for children and adults
Reiss, D., & Caplan, A. (2020) · Journal of Law and the Biosciences · doi:10.1093/jlb/lsaa025 · Cited by 29
Heterogeneous interventions reduce the spread of COVID-19 in simulations on real mobility data
Wang, H., Ghosh, A., Ding, J., Sarkar, R., & Gao, J. (2021) · Scientific Reports · doi:10.1038/s41598-021-87034-z · Cited by 28
New Graduate Nurses Navigating Entry to Practice in the Covid-19 Pandemic
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“…of the Covid-19 pandemic, psychological distress increased for nurses, as did moral distress, moral suffering, compassion fatigue, and burnout (Adams & Walls, 2020; Crowe et al., 2021; Duong, 2021; Hubert & Eichenberger, 2021; Lai et al., 2020; Manzano García & Ayala Calvo, 2021; Stelnicki et…”
Background
Rwanda’s community health workers at the front line: a mixed-method study on perceived needs and challenges for community-based healthcare delivery during COVID-19 pandemic
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Mask consumption and biomedical waste generation rate during Covid-19 pandemic: A case study of central India
Singh, D., Aryan, Y., Chavan, D., Tembhare, M., Dikshit, A., & Kumar, S. (2022) · Environmental Research · doi:10.1016/j.envres.2022.113363 · Cited by 28
Impact of the COVID‐19 pandemic on pediatric oncology providers globally: A mixed‐methods study
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“Provision of adequate PPE 33 , vaccines, and ensuring adequate rest breaks and time off 34 can mitigate physical impacts.”
Background
The Roles of Community Health Nurses’ in Covid-19 Management in Indonesia: A Qualitative Study
Akbar, M., Juniarti, N., & Yamin, A. (2021) · International Journal of Community Based Nursing and Midwifery · doi:10.30476/ijcbnm.2021.90884.1739 · Cited by 28
Healthcare professionals’ experiences during the initial stage of the COVID-19 pandemic in the intensive care unit: A qualitative study
Mortensen, C., Zachodnik, J., Caspersen, S. F., & Geisler, A. (2021) · Intensive & Critical Care Nursing · doi:10.1016/j.iccn.2021.103130 · Cited by 28
Challenges for Healthcare Workers Caring for COVID-19 Patients in Indonesia: A Qualitative Study
Setiawan, H. W., Pratiwi, I. N., Nimah, L., Pawanis, Z., Bakhtiar, A., Fauziningtyas, R., & Ramoo, V. (2021) · INQUIRY The Journal of Health Care Organization Provision and Financing · doi:10.1177/00469580211060291 · Cited by 31
“It is estimated that 3000 HCWs have been infected with COVID-19 in China, and 22 have died.(11,12) In Indonesia, at least 40 HCWs have died, which has affected the psychological health of other HCWs.”
Background
Telecritical Care Clinical and Operational Strategies in Response to COVID-19
Singh, J. R., Green, M. B., Lindblom, S. C., Reif, M. S., Thakkar, N. P., & Papali, A. C. (2020) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2020.0186 · Cited by 43
Corona Virus Infection among Healthcare Workers in a COVID Dedicated Tertiary Care Hospital in Dhaka, Bangladesh
Yasmin, R., Parveen, R., Azad, N. A., Deb, S., Paul, N., Haque, M., Haque, M., & Azad, S. (2020) · doi:10.3329/jbcps.v38i0.47442 · Cited by 28
Psychiatric‐mental health nursing leadership during coronavirus disease 2019 (COVID‐19)
Kameg, B. N. (2020) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.12662 · Cited by 28
“be encouraged to engage in self-care (Adams & Walls, 2020).”
Background
Deepening of In Silico Evaluation of SARS-CoV-2 Detection RT-qPCR Assays in the Context of New Variants
Gand, M., Vanneste, K., Thomas, I., Gucht, S. V., Capron, A., Herman, P., Roosens, N. H. C., & Keersmaecker, S. C. J. D. (2021) · Genes · doi:10.3390/genes12040565 · Cited by 29
Gender Differences in Psychological and Behavioral Responses of Infected and Uninfected Health-Care Workers During the Early COVID-19 Outbreak
Huang, Q., Luo, L.-S., Wang, Y.-Y., Jin, Y.-H., & Zeng, X.-T. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.638975 · Cited by 27
“Multiple support systems, such as separated living space, sufficient PPE, and supportive conversation should be established by the government and hospital management to relieve frontline workers’ anxieties (40).”
Background
Anxiety, depression and quality of life (QOL) related to COVID-19 among frontline health care professionals: A multicentric cross-sectional survey
Sharma, S., Mudgal, S., Thakur, K., Parihar, A., Chundawat, D., & Joshi, J. (2021) · Journal of Family Medicine and Primary Care · doi:10.4103/jfmpc.jfmpc_2129_20 · Cited by 27
“A recent study has reported that in around 3000 health care workers were contracted with this novel coronavirus and 22 of them lost their life[18] and such sort of data enhances distress and therefore, anxiety along with somatic symptoms are commonly experienced by nurses.”
Background

Authors: Adams, J. G., & Walls, R. M.
Affiliations: Northwestern University (US)
Brigham and Women's Hospital (US)
Corresponding author: Adams, James G.
ORCID: Adams, James G.
Venue: JAMA
Publisher: American Medical Association (AMA)
Published: 2020-04-21
Volume: 323
Issue: 15
Pages: 1439
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.2020.3972
OpenAlex: W3010574983
Cited by: 1,498
References: 0
Citations by year: 2026: 18 · 2025: 41 · 2024: 79 · 2023: 142 · 2022: 265 · 2021: 420 · 2020: 526
FWCI: 353.03
Type: journal article
Language: en
Open access: closed
Locations: JAMA (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Challenges
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
Keywords: COVID-19 pandemic, SARS-CoV-2, healthcare workers, occupational exposure, infection control, personal protective equipment, family exposure
MeSH terms: Betacoronavirus, Workforce, COVID-19, SARS-CoV-2, Health Personnel, Humans, Pneumonia, Viral, Infectious Disease Transmission, Patient-to-Professional, Coronavirus Infections, Disease Transmission, Infectious, Pandemics

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Supporting the Health Care Workforce During the COVID-19 Global Epidemic

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