With the workload only increasing on the COVID-19 frontline in the district, stress and anxiety among health workers have grown, but only a small proportion of workers seems to actively reach out for help.

“After an initial round of counselling we did with doctors and other health workers after the lockdown was imposed, only about 5% to 10% of them have reached out to us,” said Soumya Raj, district nodal officer, Mental Health Programme. “They are often too busy now to reach out for help, take some time out for themselves and seek counselling. For some of them, when we called, it was the first time in their professional lives that they were being asked if they were okay or not,” she said. A team of about 15 volunteers was deployed to handle helplines for health workers in the district.

During the lockdown, health workers had problems with transport and accommodation, besides the issue of functioning in a PPE kit for hours, she said. Now, problems of being overworked and consequent burnout, and being demotivated as a result of the constant stress of contact tracing and the increasing number of cases have popped up among doctors, ASHA workers, health inspectors and junior public health nurses.

“Apart from the workers actually treating COVID-19 patients, the rest of us work with patients every day with the uncertainty of whether or not they might be carriers of the disease,” said Dr. Deepa K.H., a physician at the Piravom taluk hospital. “Only about 10% of the work we do now is medical. Clerical work and contact tracing, or coordinating a patient’s transport from home to hospital after they might have tested positive in the night, takes up much of our time,” said Dr. Deepa, district president of the Kerala Government Medical Officers’ Association, who has been assisting the district surveillance unit.

More recently, doctors have also had to take up additional charges of first-line treatment centres. With health workers, both at private and government facilities, turning positive for SARS-CoV-2 in the past few days, several others, including workers at the Chellanam and Keezhmad primary health centres, have had to go into quarantine.

“At primary health centres, the staff is now engaged in setting up first-line treatment centres. The need for additional staff is obvious and recruitment will have to be made,” said a doctor at a PHC, who did not want to be named.

The District Mental Health Programme was also planning to reach out to police personnel and government officials like Revenue Department staff, said Dr. Soumya.