The impact of COVID-19 on health care workers in Hawaii is highlighted

Hawaii healthcare workers surveyed in 2020 were primarily concerned about contracting COVID-19 at work and passing it on to their families, according to a recently published University Hawaii in the Manoa Public Health Study. The survey was conducted between July and October 2020 by Anna D. David and Amelia R. Areshiwho received their Bachelor of Public Health degrees in December 2020 and May 2021, respectively.

“As essential workers on the front lines of a pandemic, healthcare workers are unable to shelter in place and treat patients, often unable to follow physical distancing guidelines, leaving them highly exposed and vulnerable to infection,” said David.

According to national statistics, 93% of healthcare workers were stressed in 2020, and 76% of healthcare workers with children reported being worried about exposing their families to COVID-19.

David added: “However, we were unaware of the impact of COVID-19 on the physical and emotional health of Hawaii health workers, or how health workers in Hawaii may have experienced the COVID-19 pandemic differently than those in less isolated geographic regions – this study works to change that.”

The study also highlights several findings about how the pandemic has affected the local health community:

• Solo practitioners in outpatient clinics report increased financial challenges and greater difficulty obtaining personal protective equipment than those employed by hospitals or group practices.
• Almost all participants noted increased use of telehealth options to access health care.
• Disparities in access to telehealth services among kūpuna (elders) and underserved populations, including those with poor internet connectivity and low technology literacy.
• Participants expressed concern that the new “forgiving” attitudes in the workplace that have emerged from the pandemic will be diminished once the spread of COVID-19 subsides.
• Additional mental health support and resources are needed from employers.

Research methods

Data for the study were collected through qualitative interviews and demographic surveys. Davide and Arechy recruited two cohorts for the interview portion, which consisted of 15 participants in Cohort 1 (July–August) and 16 participants in Cohort 2 (September–October), all aged between 18–60+ years. Seven themes were identified among participants through thematic analysis: 1) Emotional Effects 2) Physical Effects 3) Workplace Effects 4) Telehealth and Patient Care 5) Challenges in Private Practice 6) Mental Health Resources and 7) Regional attitude.

Survey demographics were self-reported and included 28 physicians and three registered nurses. Participants were asked about their level of anxiety about the COVID-19 pandemic, their overall well-being at the start of the pandemic, and their level of anxiety during the study.

“I thought the most interesting finding was the increase in the use of telehealth among physicians and the perceived impact it will have in the future. It appears that the COVID-19 pandemic may have helped change medicine in the Hawaii by encouraging hospitals and clinics to provide virtual care and increase accessibility for patients,” said Areshi.

“I was proud of Ms. Areshi and Ms. David’s decision to use their undergraduate capstone project to contribute to our understanding of the impact of the pandemic on the healthcare community. Their work is an outstanding example of our students’ passion for public health,” they said Opal V. BuchtalAssistant Professor of Public Health.

In general, the availability of personal protective equipment, good communication and leadership from employers, and new information about best practices against COVID-19 contributed to the sense of safety of healthcare workers. The results of the study help to better understand the effect of the pandemic on healthcare workers. Further research on the effects of COVID-19, specifically on nurses in Hawaiiis recommended by the researchers.

Davide and Arechy’s co-authors on the paper also include Buchthal and Prof Joseph Keaweʻaimoku Kaholokula and an assistant Andrea H. Beauty from the Department of Native Hawaiian Health at the John A. Burns School of Medicine.