COVIC-HA Study

The COVID-19 pandemic has significantly impacted all Victorians, given the prolonged lockdowns that have been required. Since the start of the pandemic, individuals working in health care and aged care have shouldered a large burden, making it crucial to monitor and support their health and wellbeing.

The COVIC-HA project commenced in March 2021 and has now enrolled more than 1000 Victorian health care workers (HCW)s across hospital, ambulance, aged care and primary care settings. Extending into the year 2022, survey data is being collected over time to monitor mental health changes, impacts on physical health, and workplace responses to support HCWs. Workplace preparedness and responses are also being investigated in order to identify strategies that mitigate adverse outcomes.

Findings are being communicated to the Victorian Department of Jobs, Precincts and Regions, WorkSafe Victoria, Workers Union, Australian Nursing & Midwifery Federation and other key stakeholders to inform evidence-based responses that are matched to the needs of HCWs and safeguard their health and wellbeing in the context of COVID-19 and future health threats.

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April 2023

We are pleased to announce that two further research papers from the COVIC-HA cohort study have been published in peer-reviewed journals.

The first paper, titled ‘Longitudinal mental health and wellbeing findings for an Australian healthcare and aged care worker cohort, May 2021 to June 2022’ appears in the Medical Journal of Australia (MJA).In this paper, we compared data collected from around 1000 Victorian healthcare and aged care workers (HCWs) across three timepoints during the second and third years of the pandemic to look for changes in mental health and wellbeing outcomes over time. Overall, we observed that burnout, optimism, wellbeing and resilience progressively worsened over time, while depression, anxiety and post-traumatic stress peaked in late-2021 before returning to mid-2021 levels. We also found an increase in the proportion of HCWs considering leaving their profession (from 32% in mid-2021 to 54% in mid-2022) and a high proportion of HCWs seeking mental health support during the pandemic. Our findings suggest that the mental health and wellbeing of HCWs continues to be adversely affected by COVID-19. This work highlights the need for ongoing monitoring of the status of HCW mental health and wellbeing and investment in evidence-based, sector-wide support programs for HCWs. Click here to access the paper online.

The second paper, titled ‘Organisational responses to the COVID-19 pandemic in Victoria, Australia: a qualitative study across four healthcare settings’ appears in Frontiers in Public Health as part of a collection of articles reflecting on learnings from Australia’s Health Services Response to the COVID-19 Pandemic. In this paper, we analysed qualitative data from interviews with frontline HCWs and key personnel across different healthcare settings and identified three major themes, centred around navigating a changing and uncertain environment; maintaining service delivery during a pandemic and meeting the psychological; and safety needs of staff. We found that HCWs valued proactive responses, such as efforts to engage openly and honestly with staff and strategies to enhance workplace safety. Suggestions for improvement included greater involvement of HCWs in decision-making, increased investment in staff wellbeing initiatives and sustainable approaches to strengthen the healthcare workforce. Click here to access the paper online.

And we’re not done just yet! We are currently analysing qualitative data from a second round of interviews with frontline workers and key personnel, to examine changes in the impacts of, and responses to the pandemic over time. Additionally, in collaboration with researchers at the Monash Centre for Occupational and Environmental Health, we are analysing COVID-19 related workers’ compensation claims to compare claim rates and types between the healthcare sector and other industries. Lots of work still to be done so stay tuned for further updates!

The COVIC-HA Investigator Group would like to thank all members of the Australian healthcare workforce for their significant ongoing efforts to keep us safe during these times. In particular, we would like to say a big thank you to the Victorian healthcare and aged care workers who have taken time out of their busy schedules to contribute to our research.

April 2022

We are pleased to announce that the first research paper from the COVIC-HA Cohort Study has been published in the International Journal of Environmental Research and Public Health in April 2022. The article entitled ‘Mental health outcomes in Australian healthcare and aged-care workers during the second year of the COVID-19 pandemic’ describes results from the first COVIC-HA survey that was distributed between May to July 2021 and which assessed experiences of healthcare and aged-care workers (HCWs) during second year of the COVID-19 pandemic.

A total of 984 HCWs completed the first survey, comprising workers from differing healthcare settings and occupations. Overall findings demonstrate that about one in five had clinically significant symptoms of depression or post-traumatic stress, one in seven was experiencing clinically significant anxiety, and over half reported emotional exhaustion related to burnout. While these data are concerning, and despite difficulties with comparing results across studies, the levels of mental health morbidity did not seem to be worse than has been reported from other surveys conducted in the first year of the pandemic. Our results also showed that the resilience levels among respondents were high, and roughly a third expressed high optimism.

Click here to access the full manuscript of the publication online.

Our second survey was distributed between October 25^th to December 6^th, 2021. More than 73% of participants who completed the first survey responded, and over 430 new participants were recruited, resulting in approximately 1150 completed surveys. We have continued with an open cohort design for our third survey, which is currently active. Comparison of findings between these surveys will enable a comprehensive exploration of the psychological impacts of the COVID-19 pandemic on Victorian HCWs over time.

May 2021

The COVIC-HA study is underway and has successfully recruited over 1000 Victorian healthcare workers (HCW) across varying workplaces and professions, from hospital-based clinical staff including doctors and nurses, through to ambulance workers, administrative staff, and aged care workers. Led by infectious disease physicians Professor Karin Leder and Dr Sarah McGuinness, together with a team of experts from hospitals, Ambulance Victoria, and primary care, the study aims to examine how HCWs across different sectors are being impacted by the COVID-19 pandemic and to capture their experiences of anxiety, depression, and stress over time.

In order to achieve this, a mixed-methods approach has been adopted through online surveys focusing on the physical and psychological impacts on workers, as well as via semi-structured interviews scoping both organisational and worker perspectives on the major challenges being faced by healthcare and aged care workers, and on identifying mitigation strategies.

The first wave of quantitative survey responses was collected between 7 May and 18 July 2021, exploring COVID impacts on workload and on mental health, past and current COVID-19 infection status, and quarantine/furlough history. Participation rates were highest among workers in hospital settings, with nurses and non-clinical support staff best representing the occupational groups across all settings. Preliminary results from these surveys have shown that nearly a quarter of respondents have experienced symptoms of moderate-severe depression, and approximately one in seven have experienced moderate-severe anxiety. Less than one third of workers recorded high levels of optimism. Prior COVID-19 infection or at least one episode of quarantine were reported by one in five respondents, with heightened levels of depression, anxiety and emotional exhaustion experienced among this group.

Interviews with workers and organisational key informants have also recently been completed. Emergent challenges include fear of infection, concerns regarding impacts on patient care, difficulties dealing with frequent policy changes, and the importance of providing streamlined up to date communication. Additionally, respondents revealed optimism regarding the use of technology in healthcare settings, citing greater uptake of telehealth consults and provision of e-scripts as silver linings to the pandemic, as well as a sense of shared adversity and togetherness amongst colleagues.

Further analyses are ongoing, so stay tuned! Additionally, ongoing quantitative and qualitative data capture will enable continued monitoring of COVID-19 impacts as the pandemic evolves through different stages and brings new challenges. Findings and lessons learnt will be disseminated to inform improvements in organisational and policy responses to the current pandemic and to future pandemics.

COVIC-HA draws upon the diverse expertise across Monash University’s School of Public Health and Preventive Medicine and complementary experience from trusted research collaborators from Ambulance Victoria, Alfred and Monash Health and other areas within Monash University.

Our investigators include experts in infectious diseases, mental health, biostatistics, epidemiological modelling, implementation science, occupational medicine and health economics. They also have experience and access to networks across trauma, intensive care, rehabilitation, primary care, allied health, aged care and first responders.