Mental health of healthcare workers during the first year of the COVID-19 pandemic in the Netherlands

Abstract Purpose In March 2020, the WHO declared COVID-19 a pandemic. Previous virus outbreaks, such as the SARS outbreak in 2003, appeared to have a great impact on the mental health of healthcare workers. The aim of this paper is to study to what extent mental health of healthcare workers differed from non-healthcare workers during the first year of the COVID-19 pandemic. Methods We used data from a large-scale longitudinal online survey conducted by the Corona Behavioral Unit in the Netherlands. Eleven measurement rounds were analyzed, from April 2020 to March 2021 (N = 16,657; number of observations=64,316). Mental health, as measured by the 5-item Mental Health Inventory, was compared between healthcare workers and non-healthcare workers over time, by performing linear GEE-analyses. Results Mental health scores were higher among healthcare workers compared to non-healthcare workers during the first year of the pandemic (1.29 on a 0-100 scale; 95%-CI=0.75-1.84). During peak periods of the pandemic, with over 100 hospital admissions or over 25 ICU admissions per day and subsequently more restrictive measures, mental health scores were observed to be lower in both healthcare workers and non-healthcare workers. Conclusions During the first year of the COVID-19 pandemic, we observed no relevant difference in mental health between healthcare workers and non-healthcare workers in the Netherlands. To be better prepared for another pandemic, future research should investigate which factors hinder and which factors support healthcare workers to maintain a good mental health. Key messages • During the first year of the COVID-19 pandemic, we observed no relevant difference in mental health between healthcare workers and non-healthcare workers in the Netherlands. • During peak periods of the pandemic, mental health was observed to be poorer in both healthcare workers and non-healthcare workers.


Background:
Previous research conducted in 2020 by our team examined the progress made by food manufacturers in reformulation between 2014 and 2017 (i.e., improving the nutrition profile of food staples by reducing salt, sugar, saturated fat and overall energy contribution). Our previous study showed improvements in salt and sugars levels across many food staples, but we found rising energy levels, total fat, and saturated fat in many food categories.

Methods:
This study aimed to explore the ongoing progress in reformulation between 2017 to 2021. We photographed the labels of food staples in supermarkets with the leading market share in the Republic of Ireland (Tesco's, Dunnes, SuperValu, Lidl, Centra, Aldi, and M&S). We extracted the data, collated it in an excel spreadsheet, and analysed it to examine the nutrients of interest to the study (i.e., salt, sugar, fat, saturated fat, energy, carbohydrates, protein, fibre, and micronutrients). We compared the levels captured at this time point with those previously recorded in 2017.

Results:
Eight hundred and seventy-two products were directly compared, including 80 spreads, 34 cereal snacks, 87 fruit juices, 193 cereals, 210 breads, 88 milks, and 169 yoghourts. This study shows that previously reported improvements in salt and sugar levels now appear to be going in the wrong direction.

Conclusions:
Fat and saturated fat levels that were once on the increase now appear to be reducing, possibly implying that as salt and sugar go up, fat levels go down and vice versa. This may relate to product taste and palatability.

Key messages:
This study shows that previously reported improvements in salt and sugar levels now appear to be going in the wrong direction.
Fat and saturated fat levels that were once on the increase now appear to be reducing, as salt and sugar go up, fat levels go down.
3.L. Pitch presentations: Health of health care workers appeared to have a great impact on the mental health of healthcare workers.

Background:
This study analyses how healthcare workers (HCWs) perceived risks, protection and preventive measures during the COVID-19 pandemic in relation to medically approved risks and organisational measures. We aim to explore 'blind spots' of pandemic protection and identify mental health needs.

Methods:
A German multi-method hospital study at Hannover Medical School serves as an 'optimal-case' scenario of a high-income country, well-resourced hospital sector and an organisation with low HCW infection rate serves to explore governance gaps in HCW protection. Document analysis, expert information and survey data (n = 1163) were collected as part of a clinical study into SARS-CoV-2 serology testing during the second wave of the pandemic (November 2020-February 2021). Selected survey items included perceptions of risks, protection and preventive measures. Descriptive statistical analysis and regression were undertaken for gender, profession and COVID-19 patient care.

Results:
Our study reveals a low risk of 1% medically approved infections among participants, but a much higher mean personal risk estimate of 15%. The majority (68.4%) expressed 'some' to 'very strong' fear of acquiring infection at the workplace. Individual protective behaviour and compliance with protective workplace measures were estimated as very high. Yet only about half of the respondents felt strongly protected by the employer; 12% even perceived 'no' or 'little' protection. Gender and contact with COVID-19 patients had no significant effect on the estimations of infection risks and protective workplace behaviour, but nursing was correlated with higher levels of personal risk estimations and fear of infection.

Conclusions:
A strong mismatch between low medically approved risk and personal risk perceptions of HCWs brings stressors and threats into view, that may be preventable through improved information, risk communication and inclusion of mental health support in pandemic preparedness. Key messages: Healthcare workers' perceptions of COVID-19 infection risks are much higher than medically approved infection risk. Pandemic preparedness and protection plans must pay greater attention to information, risk communication and mental health needs.