Distress can manifest as physical symptoms, and when you’re a healthcare worker during Covid-19, sometimes it’s hard to tell whether you’re experiencing psychological symptoms or those of the disease. Now, we have a little insight into how distress can manifest in frontline healthcare workers, thanks to a multinational, multicenter study of 906 healthcare workers, including doctors, nurses, allied healthcare workers, administrators, clerical staff, and maintenance workers in Singapore and India.

The Psychological and Physical Symptoms

According to the results of the survey answers, many participants screened positive for mental health conditions. Specifically:

• 48 (5.3%) for moderate to very severe depression.

• 79 (8.7%) for moderate to extremely severe anxiety.

• 20 (2.2%) for moderate to extremely severe stress.

• 34 (3.8%) for moderate to severe levels of psychological distress.

As for the physical symptoms accompanying these mental health conditions, headache was the most common symptom reported 32.3% of the time. However, researchers point out a recent study where 81% reported PPE-related headaches, which could explain its prevalence here. Similarly, migraine was the most commonly reported comorbidity. “Hence, the common presenting complaint of headache may be related to the increased adverse psychological impact or an exacerbation of a pre-existing condition,” the researchers write.

What’s more: a third of the participants reported more than four physical symptoms, which could include anxiety, insomnia, lethargy, joint/muscle pain, nausea/vomiting, neck stiffness, poor appetite, and throat pain. Lethargy was another commonly reported symptom. “Although fatigue and headache may be vague and often unsubstantiated, these physical symptoms should not be neglected as they may be a reflection of underlying psychological distress,” the researchers write.

Is It Psychological or Covid-19 Symptoms?

While this study found a significant association between psychological outcomes and physical symptoms, it’s not as simple as the cause being psychological and the effect being physical. A significant reason for this is that the symptoms of Covid-19 are wide-ranging and mirror many physical symptoms that can be the outcome of mental health conditions.

This alone can cause stress as healthcare workers fear transmitting the disease to friends, family, co-workers, and patients; needing to take a prolonged sick leave; thus, causing strain on an already limited healthcare system.

This is why the researchers see the prevalence of physical symptoms and psychological outcomes among healthcare workers during the Covid-19 outbreak as possibly bi-directional. Therefore, they suggest that timely psychological interventions for healthcare workers with physical symptoms should be considered once a Covid-19 diagnosis has been ruled out.