Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 150 No. 4950 (2020)

Physical and psychological health of medical students involved in the COVID-19 response in Switzerland

DOI
https://doi.org/10.4414/smw.2020.20418
Cite this as:
Swiss Med Wkly. 2020;150:w20418
Published
11.12.2020

Summary

AIMS

Involvement of medical students in the coronavirus disease 2019 (COVID-19) response remains a matter of debate. The main argument against involvement relates to potential physical and psychological health risks. Hence, we aimed to compare the physical and psychological health of Swiss medical students involved in the COVID-19 response with their non-involved peers. Among those involved, we also compared frontline (working in a dedicated COVID-19 unit) and non-frontline students. In addition, we compared frontline medical students with frontline residents.

METHODS

We conducted a cross-sectional anonymous online study in Switzerland between 9 and 14 May 2020. Recruitment was through hospital, faculty and student societies mailing lists using a snowball technique. Exposure to COVID-19 patients, personal protective equipment (PPE) access, support and information by employer, as well as COVID-19 symptoms and diagnosis were collected with a self-reported questionnaire. Anxiety and depression were assessed using the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). Burnout was assessed using two single items derived from the Maslach Burnout Inventory.

RESULTS

550 medical students (66.7% women, median age 23 years) and 227 residents (70.5% women, median age 30 years) were included in the analyses. Approximately half of the medical students were involved in the COVID-19 response and 30% were frontline workers. Of the residents, 61.7% were frontline workers. Both medical students and residents reported high access to PPE, support and information by employer. Students involved in the COVID-19 response reported a similar proportion of COVID-19 symptoms or confirmed diagnoses (p = 0.81), but lower levels of anxiety (p <0.001), depression (p <0.001) and burnout (p <0.001 for depersonalisation item), compared with their non-involved peers. Health outcomes of frontline students did not differ significantly compared with their non-frontline peers. Frontline students had lower levels of burnout than frontline residents (p <0.01 for emotional exhaustion item); the remaining health outcomes did not significantly differ.

CONCLUSIONS

In a snowball sample of Swiss medical students involved in the response to the first wave of the COVID-19 pandemic, we observed similar physical and psychological health outcomes compared with their non-involved peers. The context in which medical students are involved is certainly critical. Access to PPE, perceived support by employers and perceived passage of information by employers could explain these findings. Further research is needed to better understand the role of these contextual factors on student physical and psychological health.

References

  1. Klasen JM, Vithyapathy A, Zante B, Burm S. “The storm has arrived”: the impact of SARS-CoV-2 on medical students. Perspect Med Educ. 2020;9(3):181–5. doi:.https://doi.org/10.1007/s40037-020-00592-2
  2. Riva M, Paladino M, Belingheri M. Ethical consideration on the role of medical students in During the COVID-19 Pandemic. Answer to Miller DG, Pierson L, Doernberg S. The Role of Medical Students During the COVID-19 Pandemic. Ann Intern Med. 2020:M20-1281. doi:.https://doi.org/10.7326/M20-1281
  3. Rasmussen S, Sperling P, Poulsen MS, Emmersen J, Andersen S. Medical students for health-care staff shortages during the COVID-19 pandemic. Lancet. 2020;395(10234):e79–80. doi:.https://doi.org/10.1016/S0140-6736(20)30923-5
  4. Baker DM, Bhatia S, Brown S, Cambridge W, Kamarajah SK, McLean KA, et al.; Representatives of the STARSurg Collaborative, EuroSurg Collaborative, and TASMAN Collaborative. Medical student involvement in the COVID-19 response. Lancet. 2020;395(10232):1254. doi:.https://doi.org/10.1016/S0140-6736(20)30795-9
  5. Li Y, Wang Y, Jiang J, Valdimarsdóttir UA, Fall K, Fang F, et al. Psychological distress among health professional students during the COVID-19 outbreak. Psychol Med. 2020;1-3:1–3. doi:.https://doi.org/10.1017/S0033291720001555
  6. Halbert JA, Jones A, Ramsey LP. Clinical placements for medical students in the time of COVID-19. Med J Aust. 2020;213(2):69–69.e1. doi:.https://doi.org/10.5694/mja2.50686
  7. Medical Deans Australia and New Zealand. Principles to support medical students’ safe and useful roles in the COVID-19 health workforce 2020 [updated 2020 Mar 20]. Available from: //medicaldeans.org.au/md/2020Available from: /03/2020-March-20_principles-for-medical-student-roles-in-COVID-19-health-workforce.pdf.
  8. Liu J, Zhu Q, Fan W, Makamure J, Zheng C, Wang J. Online Mental Health Survey in a Medical College in China During the COVID-19 Outbreak. Front Psychiatry. 2020;11:459. doi:.https://doi.org/10.3389/fpsyt.2020.00459
  9. Cao W, Fang Z, Hou G, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287:112934. doi:.https://doi.org/10.1016/j.psychres.2020.112934
  10. Chong MY, Wang WC, Hsieh WC, Lee CY, Chiu NM, Yeh WC, et al. Psychological impact of severe acute respiratory syndrome on health workers in a tertiary hospital. Br J Psychiatry. 2004;185(2):127–33. doi:.https://doi.org/10.1192/bjp.185.2.127
  11. Marjanovic Z, Greenglass ER, Coffey S. The relevance of psychosocial variables and working conditions in predicting nurses’ coping strategies during the SARS crisis: an online questionnaire survey. Int J Nurs Stud. 2007;44(6):991–8. doi:.https://doi.org/10.1016/j.ijnurstu.2006.02.012
  12. Rossi R, Socci V, Pacitti F, Di Lorenzo G, Di Marco A, Siracusano A, et al. Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in Italy. JAMA Netw Open. 2020;3(5):e2010185. doi:.https://doi.org/10.1001/jamanetworkopen.2020.10185
  13. Chi X, Becker B, Yu Q, Willeit P, Jiao C, Huang L, et al. Prevalence and Psychosocial Correlates of Mental Health Outcomes Among Chinese College Students During the Coronavirus Disease (COVID-19) Pandemic. Front Psychiatry. 2020;11:803. doi:.https://doi.org/10.3389/fpsyt.2020.00803
  14. Aiyer A, Surani S, Ratnani I, Surani S. Mental Health Impact of COVID-19 on Healthcare Workers in the USA: A Cross-Sectional Web- Based Survey. J Depress Anxiety. 2020. doi:.https://doi.org/10.35248/2167-1044.20.9.373
  15. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3(3):e203976. doi:.https://doi.org/10.1001/jamanetworkopen.2020.3976
  16. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7. doi:.https://doi.org/10.1001/archinte.166.10.1092
  17. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13. doi:.https://doi.org/10.1046/j.1525-1497.2001.016009606.x
  18. Spiller TR, Méan M, Ernst J, Sazpinar O, Gehrke S, Paolercio F, et al. Development of health care workers’ mental health during the SARS-CoV-2 pandemic in Switzerland: two cross-sectional studies. Psychol Med. 2020;1-4:1–4. doi:.https://doi.org/10.1017/S0033291720003128
  19. West CP, Dyrbye LN, Sloan JA, Shanafelt TD. Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals. J Gen Intern Med. 2009;24(12):1318–21. doi:.https://doi.org/10.1007/s11606-009-1129-z
  20. Iversen K, Bundgaard H, Hasselbalch RB, Kristensen JH, Nielsen PB, Pries-Heje M, et al. Risk of COVID-19 in health-care workers in Denmark: an observational cohort study. Lancet Infect Dis. 2020:S1473-3099(20)30589-2. doi:.https://doi.org/10.1016/S1473-3099(20)30589-2
  21. Korth J, Wilde B, Dolff S, Anastasiou OE, Krawczyk A, Jahn M, et al. SARS-CoV-2-specific antibody detection in healthcare workers in Germany with direct contact to COVID-19 patients. J Clin Virol. 2020;128:104437. doi:.https://doi.org/10.1016/j.jcv.2020.104437
  22. Garcia-Basteiro AL, Moncunill G, Tortajada M, Vidal M, Guinovart C, Jiménez A, et al. Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a large Spanish reference hospital. Nat Commun. 2020;11(1):3500. doi:.https://doi.org/10.1038/s41467-020-17318-x
  23. Chen Y, Tong X, Wang J, Huang W, Yin S, Huang R, et al. High SARS-CoV-2 antibody prevalence among healthcare workers exposed to COVID-19 patients. J Infect. 2020;81(3):420–6. doi:.https://doi.org/10.1016/j.jinf.2020.05.067
  24. https://www.chuv.ch/fr/chuv-home/liste-des-actualites/detail/news/47388-covid-19 10-de-seroprevalence-chez-les-collaborateurs-du-chuv/ 2020 [2020 Aug 28].
  25. https://www.corona-immunitas.ch/program 2020 [2020 Aug 28].
  26. Chou R, Dana T, Buckley DI, Selph S, Fu R, Totten AM. Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers: A Living Rapid Review. Ann Intern Med. 2020;173(2):120–36. doi:.https://doi.org/10.7326/M20-1632
  27. Lopes CS, Rodrigues LC, Sichieri R. The lack of selection bias in a snowball sampled case-control study on drug abuse. Int J Epidemiol. 1996;25(6):1267–70. doi:.https://doi.org/10.1093/ije/25.6.1267

Most read articles by the same author(s)