Supporting Resident and Health Care Worker Mental Health in a Pandemic: A Multifaceted Approach.

A fter the COVID-19 surge abated in New York City, many were optimistic that stayat-home orders and social distancing could spare the rest of the country the kind of crisis experienced there. Field hospitals set up in convention centers and stadiums were disassembled, and a collective sense of relief accompanied the hope that perhaps most of the country had avoided the devastation New York City faced. But as states have reopened, cases have skyrocketed, particularly in the Sun Belt region and now the Midwest. Hospitalizations are rising, and ICUs in some areas are filling to capacity and beyond. In the face of this surge, attention to the physical and psychological health needs of residents and other health care workers is vital. Medical centers must work in strategic, comprehensive ways to address these needs and mitigate the potential harm to their residents and other clinical and non-clinical staff. Two guides have recently been posted that can help inform that work. The first, the Accreditation Council for Graduate Medical Education’s (ACGME’s) Guidebook for Promoting Well-Being During the COVID-19 Pandemic, is based on trauma-informed, evidence-based interventions drawn from the work of humanitarian organizations such as the World Health Organization, Doctors Without Borders, and the Red Cross, as well as from work in the military and the Veterans Affairs system. The second resource, from the Mount Sinai Health System, is evidence-based and informed by direct experience from those on the frontlines of the COVID-19 surge in New York City. While the virus is surging nationally, local impact remains highly variable. Some health centers are already overloaded, while others may be relatively quiet—and many hospitals are somewhere along this continuum. No matter the local circumstances, multifaceted interventions are necessary to support residents and other health care staff as the pandemic shows no sign of abating. Some institutions may have implemented many of the approaches suggested in the guides already, but potential gaps in support warrant immediate and concerted action from administration.