Health care workers from 2003 SARS outbreak more resilient during COVID-19

Health care workers with prior work experience during the 2003 SARS outbreak did not have worse mental health outcomes during COVID-19 compared with those without this experience.

Researchers reported these results in a study published in PLOS One.

“Many health care workers who had worked during the SARS outbreak in 2003 in Toronto would often talk about their experience and reflect on how frightening it had been, and how they did not anticipate that they could go through another outbreak/pandemic,” Rima Styra, MD, MEd, of the Centre for Mental Health at the University Health Network, Toronto, told Healio Psychiatry. “We wanted to find out how this group of health care workers were coping during this pandemic given that they had already been previously distressed by working during SARS.

“To our knowledge, our study is the first to examine the effects of previous work experience during a previous outbreak on health care workers working during COVID-19,” Styra added.

Styra and colleagues conducted a cross-sectional, multicentered hospital online survey of health care workers in the Greater Toronto Area. They examined mental health outcomes of 3,852 participants who worked during the COVID-19 pandemic and the SARS outbreak via the Impact of Events Scale-Revised (IES-R), generalized anxiety disorder 7 (GAD-7) questionnaire and patient health questionnaire (PHQ-9).

Results showed moderate/severe scores for symptoms of PTSD (50.2%), anxiety (24.6%) and depression (31.5%). A total of 1,116 participants (29.1%) reported work during the 2003 SARS outbreak, and they had lower scores for symptoms of PTSD (P = .002), anxiety (P < .001) and depression (P < .001) vs. participants who had not worked during the SARS outbreak. Nonclinical health care workers during this pandemic had increased risk for anxiety (OR = 1.68; 95% CI, 1.19–2.15) and depressive symptoms (OR = 2.03; 95% CI, 1.34–3.07), according to results of multivariable logistic regression analysis.

The researchers noted increased risk for moderate/severe PTSD symptoms among health care workers who used sedatives (OR = 2.55; 95% CI, 1.61–4.03), those who cared for only two to five patients with COVID-19 (OR = 1.59; 95% CI, 1.06–2.38) and those who had been in isolation for COVID-19 (OR = 1.36; 95% CI, 0.96–1.93). Further, they noted deterioration in sleep correlated with symptoms of PTSD (OR = 4.68; 95% CI, 3.74–6.3), anxiety (OR = 3.09; 95% CI, 2.11–4.53) and depression (OR = 5.07; 95% CI, 3.48–7.39).

“Previous work experience during the 2003 SARS outbreak, which was traumatizing and distressing for many, did not result in increased psychological distress in these health care workers during COVID-19,” Styra said. “This provides a path forward for future pandemics, knowing that health care workers do have resilience upon which they can call when they need to step up to care for patients.”