The coronavirus disease 2019 (COVID-19) pandemic has taken a substantial toll on human life, not to mention our way of life. With over 14 million confirmed global cases and the death toll approaching 612,000, it is one of the most significant crises in recent history. In the United States (US), the country with the most cases and deaths, confirmed cases exceed 3.8 million and over 141,000 deaths have been reported as a result of this outbreak. As cases surge in certain parts of the country and the world, safe and effective vaccines and therapies are crucial to combatting this virus.  

Currently, there are no US Food and Drug Administration (FDA)-approved treatments or vaccines for SARS-CoV-2, the virus that causes COVID-19. Over 200 agents are being evaluated to treat the virus. These include new emerging molecular entities as well as approved drugs that are already available to treat other conditions and now being repurposed for COVID-19. According to the World Health Organization (WHO), 24 vaccine candidates have entered human trials and over 140 vaccine hopefuls are in preclinical evaluation.

Scientists around the world are working tirelessly to discover a vaccine for COVID-19. Vaccines candidates go through many stages of study. The average time to develop a vaccine ranges from 10 to 15 years. The Ebola vaccine, newly-minted in December 2019, only took about 6 years to be approved, whereas an HIV/AIDS vaccine has still not come to market after about 40 years. Given this pandemic’s magnitude, extraordinary measures from public and private stakeholders have been introduced to accelerate vaccine development.

COVID-19 has presented us with many challenges. Mitigation measures and safe and effective vaccines and treatments are key to restoring a new normalcy.

Fear and anxiety about a disease can be overwhelming and cause strong emotions in adults and children. The Social Distancing concept, which is intended to reduce disease transmission and currently being practiced by communities at large, can be very isolating and lead to increase in stress levels. How you respond to the outbreak can depend on your background, the things that make you different from other people, and the community you live in.

People who might have more difficulty responding effectively to the stress of a crisis include:

• Those who have mental health conditions including problems with substance use
• Children and teens

If you, or someone you care about, are feeling overwhelmed with emotions like sadness, depression, or anxiety, and feel like you want to harm yourself or others please call 911.

In general, health impacts from stress during an infectious disease outbreak can include:

• Fear and worry about your own health and the health of your loved ones
• Changes in sleep or eating patterns
• Difficulty sleeping or concentrating
• Worsening of chronic health problems
• Increased use of alcohol, tobacco, or other drugs

People with physical and mental health conditions should continue with their treatment and be aware of new or worsening symptoms. Make sure you continue to take your medications as prescribed and contact your healthcare provider if you find you are starting to feel worse.

Taking care of yourself, your friends, and your family can help you cope with stress. You can do this remotely through phone or video.

Things you can do to support yourself

• Take breaks from watching, reading, or listening to news stories, including social media.
• Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
• Make time to unwind. Try to do some other activities you enjoy.
• Connect with others over phone or video. Talk with people you trust about your concerns and how you are feeling.

Look out for these common signs of distress:

• Feelings of numbness, disbelief, anxiety or fear.
• Changes in appetite, energy, and activity levels.
• Difficulty concentrating.
• Difficulty sleeping or nightmares and upsetting thoughts and images.
• Physical reactions, such as headaches, body pains, stomach problems, and skin rashes.
• Worsening of chronic health problems.
• Anger or short-temper.
• Increased use of alcohol, tobacco, or other drugs.

Reduce stress in yourself and others

1. Take breaks from watching, reading, or listening to news stories, including social media.
2. Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
3. Make time to unwind. Try to do some other activities you enjoy.
4. Connect with others over phone or video. Talk with people you trust about your concerns and how you are feeling.
5. Use trusted sources for information such as the U.S. Centers for Disease Control & Prevention (CDC), The World Health Organization and state health department websites and encourage others to do the same.

For Parents

Not all children and teens respond to stress in the same way. Some common changes to watch for include

• Excessive crying or irritation in younger children
• Returning to behaviors they have outgrown (for example, toileting accidents or bedwetting)
• Excessive worry or sadness
• Unhealthy eating or sleeping habits
• Irritability and “acting out” behaviors in teens
• Difficulty with attention and concentration
• Avoidance of activities enjoyed in the past
• Unexplained headaches or body pain
• Use of alcohol, tobacco, or other drugs

There are many things you can do to support your child, including:

• Take time to talk with your child or teen about the COVID-19 outbreak. Answer questions and share factual information about COVID-19 from the aforementioned trusted sources in a way that your child or teen can understand.
• Reassure your child or teen it is ok if they feel upset. Share with them how you deal with your own stress so that they can learn how to cope from you.
• Limit your family’s exposure to news coverage of the event, including social media. Children may misinterpret what they hear and can be frightened about something they do not understand.
• Try to keep up with regular routines. If schools are closed, create a schedule for learning activities and relaxing or fun activities.
• Be a role model.  Take breaks, get plenty of sleep, exercise, and eat well. Connect with your friends and family members over the phone or through video.

Call your healthcare provider if stress gets in the way of your daily activities for several days in a row.

To learn more about what Magellan Healthcare is doing to support clients during the COVID-19 pandemic, visit MagellanHealthcare.com/COVID-19.

To learn more about Magellan Health’s corporate response to the COVID-19 pandemic and to view Magellan’s available resources click here: https://www.magellanhealth.com/news/covid-19/

As the pandemic grows, healthcare workers are experiencing a new level of stress and fear. Since our first piece about healthcare workers and mental health, the toll that COVID-19 cases have taken on them has become more difficult than any could have imagined.

First, let us again say thank you to all of you, from EMTs who answer the first calls to the doctors and nurses who tend to the sickest. Your selflessness and heroism is inspiring.

We’ve set up a counseling hotline for healthcare workers and first responders at 1-800-327-7451 (TTY 711). Your call will be answered by our licensed mental health clinicians. Our team is trained and ready to listen and help during this difficult time.

There are so many things that are out of our control. We are dependent on others to address many aspects of the big picture, but there are things outlined below that we can do for ourselves and those close to us. No single recommendation is enough by itself, but when taken together, they may help.

Talk about it

Acknowledge your anxiety, fear and grief, and talk about it.

Many of our colleagues and friends say that leaning on fellow healthcare workers is very difficult. Everyone’s heart beats a little bit faster when they greet a COVID-19-positive patient, so how can we ask them to support one another? Yet this is what we do as a medical community daily. Peer support is key.

• If a compassion fatigue group isn’t available at your workplace, work with your employer to put one together.
• If a group option isn’t available, talk to your co-workers about what you are seeing and how it is affecting you. You’ll be surprised at how many share your feelings but have been afraid to say anything. Hospital workers have talked about how a quick meeting at the beginning of their shift, during a break or at other times—to talk, pray, or have a moment of silence—has helped them tremendously.¹
• Many hospital systems have been deploying their psychiatric workforce as volunteers to help colleagues who need it.² Ask your employer if this is available.
• If you don’t want to talk about it at work, find a former co-worker or friend from school or training to talk to, or contact Magellan Healthcare at the phone number above.
• Finally, if you are at a point where your feelings impact your ability to perform or feel comfortable in your role, talk to your supervisor or your organization’s human resources group about your employee assistance programs. Monitor your physical and mental symptoms. You may reach a position that you need to be treated by a behavioral health professional. If that happens, contact one as soon as possible.

Make your voice heard

Some healthcare workers are feeling betrayed by their employers and others.² Whether it’s lack of PPE, feeling unappreciated or being expected to work excessive hours, these feelings can make an already untenable situation worse. While there is much you cannot control, don’t let that stop you from advocating for yourself and others.

• Ask for more PPE or the protocols for how it is allocated. Understanding why things are happening can help people accept them and enable you and your colleagues to offer suggestions from the front lines.
• If you are frustrated about things that you see, think about how you would make them better. Make a list and discuss them with coworkers to come up with solutions. Once things slow down, you’ll have strong suggestions for improving your work environment.

Maintain focus

• Remember why you became a healthcare worker. Maybe you watched a family member battle an illness, or you felt a calling to help people. Think about that during these times.
• Remind yourself that what you are doing is noble. The cognitive impact of recognizing the value you offer will help you serve your patients in a positive way.
• Consistent with your training and dedication, keep your focus on the patient in front of you, on protecting yourself to the best of your abilities and extending those protections to the home setting when you are off work.
• When you are off work, turn your focus to what is happening in the moment.

Take care of yourself

• We acknowledge that recommending meditation or focusing on breathing in the midst of chaos and fear may not seem helpful for some. Think about how you breathe when you are stressed. Some of us hold our breath without realizing it; others breathe very shallowly. We don’t realize it until we get around to taking a real breath.
• As you work around people with COVID-19, you might be afraid to breathe deeply. If you can, try to go to a place where you feel comfortable doing so, and take a few deep, slow breaths. Something as simple as this can release stress and clear your mind.
• Exercising may feel like a lofty goal as well. Try to find 10 minutes for a brisk walk, or a quick set of jumping jacks, sit-ups and push-ups.
• If you don’t have time or energy to cook, find easy-to-eat fresh foods like bananas, oranges and carrots.
• To help you relax and get to sleep, try apps like Headspace, Calm and Balance. AMA members can access these for free.
• Finally, if you are on medications for a pre-existing behavioral health condition, don’t stop taking them, and contact your provider if your symptoms are getting worse.

For more information and tips, visit www.MagellanHealthcare.com/COVID-19.

The COVID-19 global pandemic is taking a physical, mental and emotional toll on doctors, nurses, healthcare workers and caregivers. The long work hours and limited resources are causing overwork, exhaustion and in some cases, compassion fatigue. Not to mention balancing your work with the concerns for your own family and loved ones.

What is compassion fatigue?

Compassion fatigue is a state of chronic physical and mental distress and exhaustion. People with this fatigue often describe a negative shift in their world view and a preoccupation with the illness of others. They may experience stress and burnout, affecting their ability to be effective in their jobs and relate to their loved ones and friends.

Tips for preventing compassion fatigue:

• Make self-care a priority. Despite your workload, do your best to practice healthy habits. Focus on making sure you are staying hydrated, sleeping as much as possible, eating nutritious meals and getting exercise when you can. Follow the COVID-19 CDC guidelines on keeping yourself and your family’s risk low.
• Boost your emotional resilience. Deep breathing, meditation, being grateful and allowing yourself some down time are ways to keep your life in balance, so you are better able to handle stress, setbacks and crises.
• Get social support. Reaching out over the phone or through a text message to supportive loved ones, friends and colleagues can be a calming influence and shift your perspective on what you are dealing with every day.
• Be proud of your profession. Your work is important. You are caring for people during the first-ever pandemic caused by a coronavirus and giving them hope and strength.
• Seek professional help. If you are experiencing distress and/or symptoms of burnout, take advantage of your healthcare and employee assistance benefits and meet with a behavioral health professional who can help.

We wholeheartedly thank you for all you are doing to care for others and combat this outbreak.

For more information and tips, visit MagellanHealthcare.com/COVID-19.