STRESS AMONGST HEALTHCARE PROFESSIONALS AND MIGRANT WORKERS DURING COVID-19 PANDEMIC

As the entire nation is battling against covid-19, millions of us are experiencing high level of stress and it is damaging our health as stress is one of the great public health challenges in this time. Stress is a natural physical and mental reaction to life experiences. Anything from everyday responsibilities like work and family to serious life events such as illness, accident, pandemic or death of a loved one can trigger stress. Healthcare professionals and migrant workers are among the most vulnerable groups at risk of stress, anxiety and depression. The present paper focuses on the stress issues during Covid-19 outbreak for healthcare professionals and migrant workers. The paper also gives suggestive measures for coping with stress in the current scenario. Individually, we need to understand what is causing us stress and learn what steps we can take to reduce it for ourselves and those around us.

There are two main types of stress-Acute stress and chronic stress. Acute stress happens to everyone. This is a momentary stress that disappears rapidly. It helps us managing dangerous situations. It also occurs when we do something new or exciting. Therefore, all people have acute stress at one time or other. However, stress can become chronic if a person does not find ways to manage it. Chronic stress lasts for a more extended timeframe as it continues for weeks, months or years. We may have chronic stress if we have financial problem, unhappy marriage or inconvenience at work. Some people become so used to chronic stress that they don't even realize that it is an issue and if they don't discover ways to manage their stress, it may lead to serious health problems ("Stress and your Health", n.d.). If we tend to get stressed out frequently, in the same way as many of us in today's demanding world, our body may exist in a heightened state of stress most of the time and that can prompt serious health problems like depression & anxiety, pain of any kind, sleep problems, autoimmune diseases, digestive problems, heart disease, weight problems, reproductive issues, thinking & memory problems, etc. In this manner, we can say that chronic stress disrupts nearly every system in our body. It can even rewire the brain, leaving us more vulnerable to anxiety, depression and other emotional well-being issues ("Stress Symptoms, Signs and Causes", n.d.).

Main Causes of Stress
Fear, worry and stress are normal responses to perceived or real threats, and at times when we are confronted with uncertainty or the unknown. So, it is normal and justifiable that people are experiencing fear in the context of the Covid-19 pandemic. A lot of stress among the people all over the world can be seen nowadays and it is not unnatural to feel increasing stress and panic in such a pandemic. We may have anxiety and fear because of a great deal issues such as dealing with at-risk family members or patients, trying to keep kids occupied while being indoors all day, figuring out how to get work done while at home, home-schooling of children, temporary unemployment, absence of physical contact with other family members, friends and colleagues, or simply acclimating to the new situation (Narayana Health, 2020; WHO, 2020. However, these actions are necessary to reduce the spread of Covid-19. Coping with stress in a healthy way will make us, the people we care about and our community stronger ("Mental Health and Coping during Covid-19.", 2020).
As indicated by a survey of Express Scripts enumerating how the pandemic has prompted a distinct rise in mental health prescriptions that were previously on decline, stress can profoundly effect on a myriad of population. Its continuous association with sleep deprivation, wretchedness and anxiety are now more noticeable than ever before. In the survey titled "America's State of Mind Report", researchers highlighted that from February 16 to March 15, prescriptions filled per week for antidepressant, anti-anxiety and anti-insomnia medications expanded by 21 percent. Prior to the pandemic, use of anti-anxiety and anti-insomnia medications were both on decline from 2015 to 2019. However, during pandemic, the new prescriptions for anti-anxiety medications exhibited a 37.7 percent expansion, stressing the vital need for therapeutic intervention (Gavidia, 2020).
The present paper focuses on the stress issues during Covid-19 outbreak for healthcare professionals and migrant workers. The whole paper is divided into four parts. Part I presents the challenges faced by healthcare professionals during Covid-19. Part II deals with the hardships faced by migrant workers. Strategies to combat with stress are discussed in Part III. Part IV concludes the paper.

Challenges faced by Healthcare Professionals during Covid-19
While the entire nation is battling against Covid-19 emergencies, the ones on the frontline, doctors and healthcare workers, are working excruciatingly hard for the welfare of patients and to limit the damage to the society due to pandemic. They are working day and night to minimize the damage due to pandemic with constant checks on the patients. The absence of definite cure for the infection makes their work additionally tough and there is also the added pressure of calming the nerves of the patients and their families. For this, doctors not only have to attend the patients in person but they also need to remain associated with them over phone and through video conferencing (Bagchi, 2020; Business Standard, 2020).
The threat of catching the disease and infecting their own families likewise poses a potential threat over them, because of which most of the doctors have given up going homes and have shifted to solitary accommodations when they go to rest after their duty hours which could stretch to 15 to even 18 hours per day. Personal Protective Equipment (PPE) is an essential gear that health workers have been mandatorily instructed to wear to shield themselves from harmful biological agents or contaminated surfaces (Bagchi, 2020; Business Standard, 2020).
Dr. Suresh, Nodal Officer, Head of Special Task Force (STF) COVID-19, LNJP & Maulana Azad Medical College, said that, "given the present weather conditions, wearing PPE for more than 5 to 6 hours is unendurable. It is not possible to wear PPE kit for more than 7 hours. One cannot even use toilet with this kit, but wearing it is must for our safety" (Bagchi, 2020; Business Standard, 2020).
In the words of Dr. Rakesh Garg, Additional Professor, Department of Onco-Anaesthesia & Palliative Medicine who is working at Covid-19 facility, National Cancer Institute, AIIMS Jhajjar' "The disease is very contagious and till now we do not have any concrete solutions on how to manage it effectively which for us is a primary challenge. We always have to keep in mind that whatever we are doing for the patients should not be harmful, if it is not beneficial. We had to remodel the infrastructure into Covid ward keeping in mind various aspects" (Bagchi, 2020; Business Standard, 2020).
Recently there have been several reports from various parts of the country of medical staffers being assaulted and abused. Numerous healthcare workers have also been asked to leave their rented accommodations either by the landlords or by the people in their societies. Numerous doctors and healthcare workers have been infected with the virus while treating the patients (Bagchi, 2020; Business Standard, 2020).
Decisions making under condition of uncertainty can create significant psychological pressure. The decisions that healthcare workers will face broadly fall under four categories: Source: Greenberg et al., 2020.

Migrant Workers during Covid-19 Pandemic
The Covid-19 impact on migrant workers cannot be overlooked or ignored. In India a large portion of the lowest paid jobs are in sectors like construction, hospitality, textiles and domestic workers. The vast majority of the labour force includes the informal or unorganized sector of the economy and migrant workers are a big part of it (Yadav, 2020). According to the World Bank (2020), amidst the Covid-19 pandemic and lockdown, India's 40 million migrant workers are confronting major brunt of the situation. This pandemic has created major issues like starvation, being stranded away from the family, loss of jobs and so on (Yadav, 2020).
Indian migrant workers have witnessed several difficulties with factories and workplaces shut down because of the lockdown imposed in the nation, a large number of them had to manage with the loss of income, food deficiencies and vulnerability about their future (Slater & Niha, 2020). Following this, many of them and their families went hungry (Maria & Sameer, 2020). Thousands of them started strolling back home, without any means of transport because of lockdown (Omar et al., 2020). More than 300 migrant workers died with reasons ranging from starvation, suicides, exhaustion, road and rail mishaps and so forth ("Indian Migrant Workers during Covid-19 Pandemic", 2020).

Suggestive Measures for Coping with Stress
Our mind makes decision based on the raw facts that are based on the things that we easily remember. The easier it is to remember something, the more likely it is that we are get stuck with these thoughts and have a harder time coping with it. In case of corona virus the images that are coming up from the news are from the worst scenarios such as people being evacuated and dealing with it and also watching really scary movies where an outbreak is there and many people dies, those images are very easy to remember and causes a lot of stress and fear amongst people with the concern about getting sick and something bad happening to us. The other thing that fuels stress is the uncertainty about what is going to happen in future.
The very first thing one has to do to cope with the stress is to limit the media influence as much as we can. The more we watch news channels or go through social media, the more likely we see and create images that are scary. So, if you watch T.V. for news watch it once a day, if you go online in search of news, read it once a day. We should limit our social media or consider even muting notifications or muting our timeline for terms related to corona virus.
Media plays a very important role and has a great influence on the minds of people. So, media should also take a step forward and maintain a column in newspapers and magazines which helps people in dealing with stress by describing the stress buster techniques and its importance.

Conclusion:-
The current situation is really a challenging one for all of us. As the corona virus pandemic sweeps across the world, it is causing widespread concern, fear, stress, all of which are natural and normal reactions to the changing and uncertain situation that everyone find themselves in. Insomnia, backaches, restlessness, stress and anxiety are among the side effects people are facing from prolonged work from home to prevent the spread of novel corona virus. The Covid-19 situation has presented lots of challenges for healthcare professionals and migrant labor. Therefore, there is an urgent need to focus and talk about the stress related issues resulting from such a pandemic and find appropriate measures for coping with this situation immediately.
Individually, we need to understand what is causing us stress and learn steps to reduce it for ourselves and those around us. We should be nice to the people around us and look after ourselves as we all need to think more about self-care. Take time out of our day to relax or do something that we enjoy. We should not forget to exercise daily and eat well and if something has worked for us then it is good to share with others also. 231 Secondly, we have to be compassionate towards ourselves and with the people around us. We should stick to our daily routine as much as we can. In case you don't have a routine then make some decisions regarding what you are going to do in the morning, afternoon and in the evening. All this requires a proper time management.
Talk to your friends, family and colleagues because talking about your issues helps in reducing stress. Get more rest and complete your sleep schedule. Keep doing stuffs that helps in dealing with the stress and anxiety like exercise, mediation, playing videogames, watching TV and movies, listening to music, reading novels, doing prayers, gardening, etc. If even after all these things you are still struggling with stress and anxieties then talk to your healthcare provider or a psychiatrist.
Another thing in dealing with the stress is that we can look for the lessons we learnt in the situation. In any difficulty or problem, one thing we can do to eliminate the stress is to see as what we can learn from this experience.
There are some scientific techniques that can help people in dealing with stress such as autogenic training, cognitive therapy, fractional relaxation, cranial release technique, etc. One of the very famous is the Japanese technique which can be done anywhere in about five minutes. In this each finger of our hand represents the different feeling and attitude. Where the thumb helps combat anxiety and worry, the index combats fear, the middle finger helps control anger and resentment, the ring finger helps in fighting depression and sadness and the smaller one helps in calming anxiety and increases optimism and confidence. So, here what we have to do is to grasp each finger one by one with the opposite hand wrapping all the fingers and thumb around it. We have to hold each finger for 1 to 2 minutes. It starts working when we feel pulsating sensation. If we want to calm our mind then we should slightly press in the centre of the palm with the thumb of opposite hand and hold it for at least 1 minute.