This is a timely study conducted in Singapore and India between mid-February to mid-April 2020. The sample size is even from the two countries. This study reveals headaches, insomnia, throat pain, lethargy/fatigue, and anxiety as the five most common symptoms experienced by participants. Depression, anxiety, stress, and PTSD were adverse psychological outcomes. The relationship between the physical symptoms and psychological symptoms was bi-directional.
It should be noted that in the time frame when data were gathered, Singapore was at a stage in the pandemic when the number of cases was peaking. They have had a second surge since then in the recent past. In India at that point the prevalence of COVID-19 was low and so was the case rate. New cases are surging now in India starting mid-May and have not peaked as yet. Hence the Indian numbers may not be a true representation. Both countries were at different phases of the pandemic in terms of new infections and COVID-19 cases.
Headache was the most common symptom reported in about a third of the cases. Interestingly lack of smell and taste were not noted or asked about in this group of symptoms. These are now common screening questions.
This study suggests that HCWs need support and treatment depending on the intensity of the symptoms and dysfunction. They need recognition of their work as well, like the fact they are on the frontlines. HCWs may have a greater fear of getting a contagious disease as a result of exposure.
Summary: Health care workers need to be screened for depression, anxiety, and stress. The primary care physicians as well as psychiatrists and other mental health providers should consider the diagnosis of depression and anxiety in HCWs presenting with physical symptoms especially headaches. Post-traumatic stress disorder also needs to be in our differential diagnosis. Hence clinical scales such as PHQ-9 and GAD-7 are excellent screening methods at intake in addition to a good clinical history.