Connect with us

International

High rates of COVID-19 burnout could lead to shortage of health-care workers

Rates of burnout have increased alarmingly among health-care workers during the pandemic. Unless the system provides more support to its already depleted workforce, staff shortages may get worse.

Published

3 years ago

on

Intensive care nurse Kathryn Ivey's Tweet illustrates the impact of the pandemic on health-care workers. Used with permission. @kathryniveyy/Twitter, Author provided

During the pandemic’s third wave, researchers interviewed nurses to see how their perceptions had changed over the preceding year. Early in the pandemic, nurses had reported optimism about supporting one another through the pandemic, but by the third wave, this had been replaced by anger and exhaustion.

One source of resentment was how employers were managing a depleted workforce. Clinical psychologist Dana Ménard found that incentives for new hires caused anger among those who had been on the front lines for a year with no retention rewards. Vicki McKenna, president of the Ontario Nurses Association, expressed concerns about staffing, telling a reporter, “I fear that it is going to be devastating to the workforce. I’m very worried about the future of the nursing workforce.”

Meanwhile, other sources warned of a potential shortage of nurses. “Canadian nurses are leaving in droves,” ran a Globe and Mail headline.

Understanding burnout

Appreciating what is happening to these nurses and how to respond hinges on understanding burnout, which may be the primary occupational hazard of health-care work. This is especially true in a pandemic. Burnout, as it is typically measured, has three components: emotional exhaustion, depersonalization (indifference or emotional distance) and a diminished sense of professional achievement.

Burnout occurs in many occupations, but health care exposes its professionals to unusual types of stress, including moral distress. This arises when professionals feel constrained from providing the best care. Examples include situations when care may be too aggressive at the end of life, or when one health-care worker is concerned about care provided by another. Moral distress has increased during the pandemic due to scarce resources and the inability to comfort families.

Consequences of burnout

Nurses close the curtains of a patients room in the COVID-19 Intensive Care Unit at Surrey Memorial Hospital in Surrey, B.C.
Burnout occurs in many occupations, but health care exposes its professionals to unusual types of stress. THE CANADIAN PRESS/Jonathan Hayward

Burnout is bad for everyone. It is associated with diminished safety and quality of care for patients, and mental health problems and poor quality of life for professionals.

Read more: Heroes, or just doing our job? The impact of COVID-19 on registered nurses in a border city

For the health-care system, burnout is associated with absenteeism, reduced productivity and thoughts of leaving one’s job. During a time when nurses and doctors are in short supply, we cannot afford to lose more because of burnout.

Burnout is rising

Burnout was common before COVID-19 and is now rampant. For example, rates of severe emotional exhaustion were often in the range of 20 to 40 per cent prior to the pandemic, with higher rates in intensive care units and emergency medicine. Compare that to Canadian surveys later in the pandemic reporting rates of 62 per cent, 63 per cent and 72 per cent.

It should be no surprise that working in health care during a pandemic that is unprecedented in our lifetimes has increased burnout.

In addition to risking their own health, many health-care professionals have been, for example, working longer hours and are often understaffed if colleagues are in quarantine or ill. Many maintained their full-time job while their children were unable to attend school. They must also manage uncertainty as policies change and a virus mutates, while providing care to critically ill individuals who chose not to be vaccinated.

Burnout may deplete the health-care workforce

Surveys of health-care workers reveal an extraordinary challenge. A survey of members of the Registered Nurses Association of Ontario found 43 per cent were considering leaving, more among those who felt burnt out. Another Canadian study reported 50 per cent of nurses surveyed intended to leave.

Signing bonuses for new nurses, which angered the nurses Dr. Ménard’s team interviewed, suggest that the intention to leave is translating into action. Indeed, reports of shortages related to pandemic burnout continue to appear in the news.

Since understaffing is both a cause and consequence of burnout, the health-care system may be entering the downward spiral of a particularly vicious circle.

Solutions

A woman walks by a street mural of a health-care worker in protective equipment, flexing her bicep
Instead of optimism about supporting one another, nurses are now reporting anger and exhaustion. THE CANADIAN PRESS/Nathan Denette

The solution should match the problem. Evidence indicates that burnout is more a consequence of work conditions than of the workers’ vulnerabilities: of long hours, high workload, moral distress and violence and abuse in the workplace, among other systemic problems.

And yet, most research studying interventions to prevent and reduce burnout focuses instead on individuals by teaching things like coping skills and stress reduction techniques. Although providing individual interventions may be moderately helpful, as the sole response to an occupational hazard, it is perverse — like teaching the residents of a flood zone how to swim instead of elevating their homes or helping them to move.

The health-care system urgently needs system-level measures that protect its professionals from harm, and compensate them for hazards. These may include manageable hours, adequate time off, appropriate staff-to-patient ratios and workplace safety measures. Some organizations will try to recruit new health professionals to manage shortages, but recruitment into a harmful environment is not sustainable.

Which brings us to leadership. Evidence supports the value of leadership in reducing burnout in health care, especially leaders who are transparent, ethical, respectful, reflective and informed. We need health-care leaders who are committed to protecting the health of providers and organizations as well as patients. System level support is needed to prevent the COVID-19 pandemic from causing an exodus of professionals from health care.

Robert Maunder receives funding from the Canadian Institutes of Health Research and is a member of the Mental Health Working Group of the Ontario COVID-19 Science Advisory Table.

Gillian Strudwick receives funding from the Canadian Institutes of Health Research and is a member of the Mental Health Working Group of the Ontario COVID-19 Science Advisory Table. She also works at the Centre for Addiction and Mental Health.

Read More

Related Topics:
Continue Reading

International

AI can help predict whether a patient will respond to specific tuberculosis treatments, paving way for personalized care

People have been battling tuberculosis for thousands of years, and drug-resistant strains are on the rise. Analyzing large datasets with AI can help humanity…

Published

1 hour ago

on

March 20, 2024

By

Tuberculosis typically infects the lungs but can spread to the rest of the body. stockdevil/iStock via Getty Images Plus

Tuberculosis is the world’s deadliest bacterial infection. It afflicted over 10 million people and took 1.3 million lives in 2022. These numbers are predicted to increase dramatically because of the spread of multidrug-resistant TB.

Why does one TB patient recover from the infection while another succumbs? And why does one drug work in one patient but not another, even if they have the same disease?

People have been battling TB for millennia. For example, researchers have found Egyptian mummies from 2400 BCE that show signs of TB. While TB infections occur worldwide, the countries with the highest number of multidrug-resistant TB cases are Ukraine, Moldova, Belarus and Russia.

The COVID-19 pandemic set back progress in addressing many health conditions, including TB.

Researchers predict that the ongoing war in Ukraine will result in an increase in multidrug-resistant TB cases because of health care disruptions. Additionally, the COVID-19 pandemic reduced access to TB diagnosis and treatment, reversing decades of progress worldwide.

Rapidly and holistically analyzing available medical data can help optimize treatments for each patient and reduce drug resistance. In our recently published research, my team and I describe a new AI tool we developed that uses worldwide patient data to guide more personalized and effective treatment of TB.

Predicting success or failure

My team and I wanted to identify what variables can predict how a patient responds to TB treatment. So we analyzed more than 200 types of clinical test results, medical imaging and drug prescriptions from over 5,000 TB patients in 10 countries. We examined demographic information such as age and gender, prior treatment history and whether patients had other conditions. Finally, we also analyzed data on various TB strains, such as what drugs the pathogen is resistant to and what genetic mutations the pathogen had.

Looking at enormous datasets like these can be overwhelming. Even most existing AI tools have had difficulty analyzing large datasets. Prior studies using AI have focused on a single data type – such as imaging or age alone – and had limited success predicting TB treatment outcomes.

We used an approach to AI that allowed us to analyze a large and diverse number of variables simultaneously and identify their relationship to TB outcomes. Our AI model was transparent, meaning we can see through its inner workings to identify the most meaningful clinical features. It was also multimodal, meaning it could interpret different types of data at the same time.

Microscopy image of rod-shaped TB bacteria stained green
Mycobacterium tuberculosis spreads through aerosol droplets. NIAID/NIH via Flickr

Once we trained our AI model on the dataset, we found that it could predict treatment prognosis with 83% accuracy on newer, unseen patient data and outperform existing AI models. In other words, we could feed a new patient’s information into the model and the AI would determine whether a specific type of treatment will either succeed or fail.

We observed that clinical features related to nutrition, particularly lower BMI, are associated with treatment failure. This supports the use of interventions to improve nourishment, as TB is typically more prevalent in undernourished populations.

We also found that certain drug combinations worked better in patients with certain types of drug-resistant infections but not others, leading to treatment failure. Combining drugs that are synergistic, meaning they enhance each other’s potency in the lab, could result in better outcomes. Given the complex environment in the body compared with conditions in the lab, it has so far been unclear whether synergistic relationships between drugs in the lab hold up in the clinic. Our results suggest that using AI to weed out antagonistic drugs, or drugs that inhibit or counteract each other, early in the drug discovery process can avoid treatment failures down the line.

Ending TB with the help of AI

Our findings may help researchers and clinicians meet the World Health Organization’s goal to end TB by 2035, by highlighting the relative importance of different types of clinical data. This can help prioritize public health efforts to mitigate TB.

While the performance of our AI tool is promising, it isn’t perfect in every case, and more training is needed before it can be used in the clinic. Demographic diversity can be high within a country and may even vary between hospitals. We are working to make this tool more generalizable across regions.

Our goal is to eventually tailor our AI model to identify drug regimens suitable for individuals with certain conditions. Instead of a one-size-fits-all treatment approach, we hope that studying multiple types of data can help physicians personalize treatments for each patient to provide the best outcomes.

Sriram Chandrasekaran receives funding from the US National Institutes of Health.

Read More

Continue Reading

International

IVI starts technology transfer to Biological E. Limited to manufacture oral cholera vaccine for India and global markets

  Credit: IVI IVI will complete the technology transfer by 2025 Oral Cholera Vaccine to be manufactured by Biological E. Limited for India and international…

Published

8 hours ago

on

March 20, 2024

By

 

Credit: IVI

  • IVI will complete the technology transfer by 2025
  • Oral Cholera Vaccine to be manufactured by Biological E. Limited for India and international markets

 

March 20, 2024, SEOUL, Republic of Korea and HYDERABAD, India — The International Vaccine Institute (IVI), an international organization with a mission to discover, develop, and deliver safe, effective, and affordable vaccines for global health, today announced that it has commenced a technology transfer of simplified Oral Cholera Vaccine (OCV-S) to Biological E. Limited (BE), a leading India-based Vaccines and Pharmaceutical Company.

 

Following the signing of a technology license agreement in November last year, IVI has begun providing the technical information, know-how, and materials to produce OCV-S at BE facilities and will continue to support necessary clinical development and regulatory approvals. IVI and BE entered this partnership during an unprecedented surge of cholera outbreaks worldwide and aim to increase the volume of low-cost cholera vaccine in India as well as the global public market.

 

IVI will complete the technology transfer by 2025 and the oral cholera vaccine will be manufactured for India and international markets by Biological E. Limited.

 

Dr. Jerome Kim, Director General of IVI, said: “In an era of heightened risk of poverty-associated infectious diseases such as cholera, the world needs a sustainable source of high-quality, affordable vaccines and committed manufacturers to supply them. We are pleased to partner with Biological E., a company with a proven history of making life-saving vaccines accessible globally, to address this supply gap and protect communities from this deadly, though preventable, disease.”

 

Ms. Mahima Datla, Managing Director, Biological E. Limited, said: “We are glad to be in collaboration with IVI for the manufacture of simplified Oral Cholera Vaccine. Our efforts are aimed to not only combat the disease but to also be part of a sustained legacy of innovation, collaboration, and health stewardship. Together with IVI, we are happy to be shaping a healthier and more resilient future by making this vaccine accessible globally.”

 

This technology transfer and licensing agreement is the sixth of its kind for IVI, transferring such technology to manufacturers in India, the Republic of Korea, Bangladesh, and South Africa. All these partnerships have led to or seek to achieve, pre-qualification (PQ) from the World Health Organization, a designation that enables global agencies such as UNICEF to procure the vaccine for the global market. BE already has 9 vaccines with WHO PQ in its portfolio, and IVI and BE will pursue WHO PQ for OCV-S as well, following national licensure in India.

 

Dr. Julia Lynch, Director of IVI’s Cholera Program, said: “The cholera situation is dire, and the availability and use of oral cholera vaccine is an essential part of a multifaceted approach to cholera control and prevention, especially as outbreaks increase and the global vaccine supply remains strained. With more manufacturers like BE entering the market, the future supply situation looks strong. IVI remains committed to ensuring the availability of the oral cholera vaccine and to developing new and improved vaccines that are equally safe, effective, and affordable and made around the world, for the world.”

 

OCV-S is a simplified formulation of OCV with the potential to lower production costs while increasing production capacity for current and aspiring OCV manufacturers. IVI’s development of OCV-S and ongoing technology transfers are part of an institutional strategy to confront cholera with 3 main goals: 1) Ensure supply of OCV 2) Improve cholera vaccines 3) Support OCV use and introduction. The Bill & Melinda Gates Foundation has been supporting IVI’s cholera program since 2000 and is funding this latest technology transfer to BE.

 

###

 

About the International Vaccine Institute (IVI)

The International Vaccine Institute (IVI) is a non-profit international organization established in 1997 at the initiative of the United Nations Development Programme with a mission to discover, develop, and deliver safe, effective, and affordable vaccines for global health.

IVI’s current portfolio includes vaccines at all stages of pre-clinical and clinical development for infectious diseases that disproportionately affect low- and middle-income countries, such as cholera, typhoid, chikungunya, shigella, salmonella, schistosomiasis, hepatitis E, HPV, COVID-19, and more. IVI developed the world’s first low-cost oral cholera vaccine, pre-qualified by the World Health Organization (WHO), and developed a new-generation typhoid conjugate vaccine that also achieved WHO prequalification in early 2024.

IVI is headquartered in Seoul, Republic of Korea with a Europe Regional Office in Sweden, an Africa Regional Office in Rwanda, a Country Office in Austria, and a Country and Project Office in Kenya. IVI additionally co-founded the Hong Kong Jockey Club Global Health Institute in Hong Kong and hosts Collaborating Centers in Ghana, Ethiopia, and Madagascar. 39 countries and the WHO are members of IVI, and the governments of the Republic of Korea, Sweden, India, Finland, and Thailand provide state funding. For more information, please visit https://www.ivi.int.

 

 

About Biological E. Limited

Biological E. Limited (BE), a Hyderabad-based Pharmaceuticals & Biologics Company founded in 1953, is the first private sector biological products company in India and the first pharmaceutical company in Southern India. BE develops, manufactures and supplies vaccines and therapeutics. BE supplies its vaccines to more than 130 countries and its therapeutic products are sold in India, the USA and Europe. BE currently has 8 WHO-prequalified vaccines and 10 USFDA approved Generic Injectables in its portfolio. Recently, BE has received Emergency Use Listing (EUL) from the WHO for CORBEVAX®, the COVID-19 vaccine. Recently, DCGI has approved BE’S 14-Valent Pneumococcal Conjugate vaccine.

In recent years, BE has embarked on new initiatives for organizational expansion such as developing specialty injectable products for global markets as a means to manufacture APIs sustainably and developing novel vaccines for the global market.

Please follow us on Facebook, LinkedIn and Twitter

 

 

MEDIA CONTACTS

IVI

Aerie Em, Global Communications & Advocacy Manager
+82 2 881 1386 | aerie.em@ivi.int

 

Biological E. Limited

K. Vijay Amruth Raj
Email: Vijay.Kammari@biologicale.com
www.biologicale.com/news

Read More

Continue Reading

International

Bolsonaro Indicted By Brazilian Police For Falsifying Covid-19 Vaccine Records

Bolsonaro Indicted By Brazilian Police For Falsifying Covid-19 Vaccine Records

Federal police in Brazil have indicted former President Jair…

Published

23 hours ago

on

March 19, 2024

By

Bolsonaro Indicted By Brazilian Police For Falsifying Covid-19 Vaccine Records

Federal police in Brazil have indicted former President Jair Bolsonaro for falsifying his Covid-19 vaccine card in order to travel to the United States and elsewhere during the pandemic.

Federal prosecutors will review the indictment and decide whether to pursue the case - which would be the first time the former president has faced criminal charges.

According to the indictment, Bolsonaro ordered a top deputy to obtain falsified Covid-19 vaccine records of himself and his 13-year-old daughter in late 2022, right before he flew to Florida for a three-month stay following his election loss.

Brazilian police are also waiting to hear back from the US DOJ on whether Bolsonaro used said cards to enter the United States, which would open him up to further criminal charges, the NY Times reports.

Bolsonaro has repeatedly claimed not to have received the Covid-19 vaccine, but denies any involvement in a plan to falsify his vaccination records. A previous investigation by Brazil's comptroller general concluded that Bolsonaro's vaccination records were false.

The records show that Bolsonaro, a COVID-19 skeptic who publicly opposed the vaccine, received a dose of the immunizer in a public healthcare center in Sao Paulo in July 2021. [ZH: hilarious, Reuters calling the vaccine an 'immunizer.']

The investigation concluded, however, that the former president had left the city the previous day and didn't leave Brasilia until three days later, according to a statement.

The nurse listed in the records as having applied the vaccine on Bolsonaro denied doing so and was no longer working at the center. The listed vaccine lot was also not available on that date, the comptroller general's office said. -Reuters

"It's a selective investigation. I'm calm, I don't owe anything," Bolsonaro told Reuters. "The world knows that I didn't take the vaccine."

During the pandemic, Bolsonaro panned the vaccine - and instead insisted on alternative treatments such as Ivermectin, which has antiviral properties against Covid-19. For this, he was investigated by Brazil's congress, which recommended that the former president be charged with "crimes against humanity," among other things, for his actions during the pandemic.

In May, Brazilian police raided Bolsonaro's home, confiscating his cell phone and arresting one of his closest aides and two of his security cards in connection to the vaccine record investigation.

Brazil's electoral court ruled that Bolsonaro can't run for public office until 2030 after he suggested that the country's voting system was rigged. For that, he has to sit out the 2026 election.

Tyler Durden Tue, 03/19/2024 - 11:00

Read More

Continue Reading

Trending