The Covid-19 HEalth caRe wOrkErS (HEROES) Study

Since December 2019 the world has been shaken with an enormous global threat: the Covid-19
pandemic. This new kind of coronavirus is generating an unprecedented impact both on the
general population and on the healthcare systems in most countries. Health services are
trying to expand their capacity to respond to the pandemic, taking actions such as increasing
the number of beds; acquiring necessary equipment to provide intensive therapy (ventilators),
and calling retired health professionals and health students so they can assist the
overwhelmed health care workforce. Unfortunately, these organizational changes at health
facilities, along with the fears and concerns of becoming ill with the virus or infecting
their families, put an enormous emotional burden on workers in health services which may lead
to negative outcomes on mental health in this population. Based on the literature to date,
Covid-19 is significantly larger than previous pandemics in terms of the number of affected
people worldwide, its spread across countries, its impact on healthcare systems and the
severity of measures that have been taken by governments. Immediate consequences are palpable
in the health care system. Many healthcare workers are overwhelmed by the increased workload;
the lack of supplies and materials to provide appropriate treatment; the lack of clinical
guidelines on prioritization and triage; and the increased feelings of isolation and
loneliness. Previous research indicates that these negative effects can last over time and
lead to the development of serious mental health problems such as post-traumatic stress
disorder.

Recent cross-sectional studies in China indicate that health service workers exposed to
people with Covid-19 reported higher rates of depressive and anxious symptoms. This negative
impact on mental health among health workers in China has also been informally reported in
other countries where the Covid-19 pandemic has been devastating in its effects (such as
Spain and Italy), as well as in countries where the pandemic is becoming a growing public
health problem. This is particularly relevant in regions with fewer resources (Latin America,
North Africa), where there are limited means and the response from the health system is
usually insufficient. Moreover, it is necessary to study these negative effects
longitudinally considering that some effects will appear over time (post-traumatic stress).
Also, it is necessary to take into account the nature and the extent of the health response
(e.g., deployment, increased workload) in order to advance our understanding of these complex
phenomenon and to inform policy and develop the kind of supports that this population deems
useful.

The COVID-19 HEalth caRe wOrkErS (HEROES) study is a large, bottom-up, South-North initiative
aimed to evaluate the impact of the COVID-19 pandemic on the mental health of health care
workers (HCWs). HEROES encompasses a wide variety of academic institutions in 19 LMICs and 8
HICs, in partnership with the Pan American Health Organization (PAHO) and with support from
the World Health Organization (WHO). The HEROES study is led by Dr. Rubén Alvarado at
University of Chile, and Dr. Ezra Susser and Franco Mascayano at Columbia U Mailman School of
Public Health.

Participants will complete an online questionnaire, which will be completely
self-administered. It will take approximately 12 minutes and includes sociodemographic data,
questions on work activity, training, fears and concerns related to Covid-19, as well as the
GHQ-12 and a series of questions on other mental health issues (e.g., suicide, acute stress),
resilience and psycho/social factors (e.g., formal and informal support).