Mascha et al1 have made a very valuable contribution for those of us trying to determine optimal intensive care unit (ICU) staffing systems as a consequence of the coronavirus disease 2019 (COVID-19) pandemic. Sophisticated simulations presented in their article guide optimal staffing in intensive care units. While conventional staffing allocations do not keep a cohort protected, staffing aligned with the pandemic’s epidemiology does. We have considered a similar method to one the authors’ advocate.
Besides “joint efforts from people all around the world,”2 it appears to be absolute key that leaders attend to the psychological and emotional well-being of our clinicians in addition to the physical well-being of our staffs “to protect health care workers better, to save more lives.”2
Necessary protective measures interfere with the camaraderie that each of us tries to create at work. While literally getting-in-touch is a caring physician’s “first language,”3 the interactions with our patients now through masks and with personal protective equipment (PPE) create barriers which are new to them and to us. We can no longer lunch with colleagues, gather in groups, or have collective conferences. There is a heightened anxiety for both our personal welfare and the people with whom we work and the concern we might bring infections back to our families.
Speaking with other American Chairs of Anesthesiology, every department is facing the same issues. We must work to ensure that no member in our departments is “left behind.” We need to be more vigilant for psychological signs of burnout,4,5 inattention to proper use of PPE, and withdrawal from video participation in departmental functions. Our department has created a buddy system with daily check-ins. The academic anesthesia chairs of departments with whom I speak maintain as “normal” an atmosphere within the department as possible and send communication updates to keep everyone informed of the latest pertinent news. People have only so much psychic energy, and it is important to allow them to focus on the critical tasks at hand and to minimize extraneous duties.6 We must calculate the COVID-19 equation with the people’s energy as key variable in mind!