Introduction
Singapore was one of the earliest countries affected the Novel Coronavirus-2019 (COVID-19) outbreak. In times of infectious disease outbreak, the country utilizes the ‘Disease Outbreak Response System Condition’ (DORSCON), a colour-coded framework to show the current disease condition. On 7th February 2020, the Ministry of Health in Singapore stepped up its alert level from Yellow to Orange – signifying that the disease is severe and spreads easily from person to person, although the disease is being contained1.
Following the escalation to DORSCON Orange, the Department of Obstetrics and Gynaecology at KK Women’s and Children’s Hospital, the largest women’s hospital in Singapore, which delivers more than 11000 babies annually, established isolation teams consisting of dedicated doctors and nurses assigned to care for patients with suspected or confirmed COVID-19 infection following screening at triage and during admission to hospital. Each team comprised of two doctors (one registrar and one medical officer) and between one to two nurses dependent on patient volume per shift. Two teams were on-site at all times, caring for two main clinical areas; the labour ward and urgent obstetrics and gynaecology centre (UOGC) which provides combined emergency gynaecology and early pregnancy care while additionally caring for isolated ward patients. These teams rotated on 12-hour shifts, over seven consecutive days and segregated themselves from other colleagues and clinical areas.
Healthcare workers (HCW) face intense demands daily, from arduous shifts to constant pressure to perform, and increasing levels of responsibility. It is unsurprising that HCW experience a higher prevalence of burnout than the general population. This psychological pressure and emotional stress among HCW appeared to be heightened during a pandemic, as seen from studies conducted following the outbreak of severe acute respiratory syndrome (SARS) in 20032. Burnout is a syndrome characterized by emotional exhaustion, depersonalization, and a diminished sense of personal achievement. Resilience, defined as the ability to adapt successfully in the face of trauma, adversity, tragedy, or significant threat, may be critical in helping to combat trainee and physician burnout3. Resilience building becomes critical especially in the face of COVID-19 pandemic. Understanding the emotional and psychological effects of working during the COVID-19 outbreak can improve the well-being of large numbers of HCW. Additionally, this information has wider relevance to health systems in planning for emerging infections and potential bioterrorism2.
This study aims to explore the impact of COVID-19 outbreak on the resilience and emotions of frontline HCWs in obstetrics and gynaecology during this pandemic.