When stress exceeds the resilience capacity, the professional burnout syndrome appears that not only damages the physical and mental health of those who suffer it, but also impairs their ability to respond and adapt to everyday circumstances. Even before the pandemic broke out, the Spanish health system, and particularly primary care, were under considerable stress due to a chronic gap between available resources and a growing demand for care. In the almost two years of the pandemic, health centers have faced successive waves of infections with the consequent overload and, although they have received reinforcements, these have always been below needs. And when the light was already visible at the end of the tunnel, a sixth wave has arrived that has multiplied the stress.
With an incidence of almost 3,000 cases per 100,000 inhabitants, and more than 300,000 infections in a single day, health centers have to deal with a flood of diagnoses that are added to ordinary pathologies. To all this must be added an increase in sick leave due to contagion among the professionals themselves, which has an added burden on those who remain active. It is not surprising, therefore, that professional desertions have begun in the form of sick leave due to depression, early retirement or dropouts.
Many professionals feel insecure practicing minimal, rushed and chaotic medicine, which brings them no satisfaction and keeps them on the verge of collapse. Saturated daily agendas, a large bureaucratic burden and a lack of staff cause physical exhaustion and emotional exhaustion that is difficult to manage without help. Working under such pressure increases the probability of committing medical errors, to which must be added the management of discontent among patients, who perceive that care is deteriorating and transfer their anger to front-line professionals. Thus, the ideal conditions exist to trigger the typical picture of burnout syndrome in many professionals: anxiety, insomnia and depression. Some studies carried out last year indicated that up to 45% of health workers had one of these three symptoms.
A critical part of responding to the pandemic is caring for caregivers. When the organization itself shows the symptoms of stress, more forceful and effective measures must be taken than those adopted to date. The health system should emerge strengthened, and not weakened, from this issue. Some communities have used retired professionals and recent medical and nursing students to strengthen teams. If, as the WHO secretary general has warned, half of Europeans will be infected by omicron in the coming weeks, it is foreseeable that the pressure will continue. On the other hand, there are still no studies on what percentage of patients infected by this variant develop persistent covid, or post-covid syndrome, but, although it was lower than in the previous variants, given the enormous expansion of this virus, it must be anticipated that there may be many cases, whose follow-up will fall back on primary care. It is very likely that the approved health budgets are short to meet all these contingencies, given the spending of the previous years. You cannot look the other way. Government and autonomies must explain their position on the need for a national shock plan capable of reinforcing the professional structures of public health.