Nearly half of doctors working in high-pressure conditions during the first wave of coronavirus face ongoing distress, research suggests. A study based on responses from more than 5,400 doctors in the UK and Ireland found that 45% reported psychological distress as the pandemic accelerated to its initial peak in 2020. Researchers from the Royal College of Emergency Medicine (RCEM) and psychologists from the University of Bath surveyed emergency, anaesthetics and intensive care professionals during the lead up to, peak and post-peak of the first wave of infections last year. A total of 5,440 doctors – 16% of the 34,188 working in the field – responded to the “acceleration” survey. In the “peak” survey, 3,896 professionals subsequently responded and 3,079 to the “deceleration” survey. Survey results, released early as a pre-print study and not yet peer-reviewed, put the prevalence of psychological distress at 44.7% of respondents in the build-up to the first wave’s peak, 36.9% at the peak and 31.5% as it declined. Prevalence of trauma was found among 23.7% of respondents at the first pandemic peak, and 17.7% as it decelerated. Probable post-traumatic stress disorder was also found in 12.6% of respondents at the peak and 10.1% afterwards, the research suggested. The study also found that “worry of family infection due to clinical work” was most strongly associated with both distress and trauma. The researchers concluded: “Our findings reflect a pattern of elevated distress during the acceleration and peak phase of the current pandemic, some degree of natural recovery and a significant minority continuing to experience residual ongoing distress.” Dr Tom Roberts from the RCEM, who led the research, said: “Our findings highlight the stark realities for many doctors across the UK and Ireland in responding to the public health crisis and the toll this has placed on their mental health. “The extent of the challenge has at times been overwhelming and we see from our results the real-life impact this has on individuals’ wellbeing.” Dr Jo Daniels, a clinical psychologist and senior lecturer from the University of Bath’s department of psychology, added: “We now know that doctors are working on the frontline while carrying the heavy burden of fear of infecting themselves, or critically, family members, while some continue to battle high levels of psychological distress. “This distress was evident in the lead up to the first peak, but our study shows it sustained well beyond this time point. “It is now a pressing and urgent concern; doctors are at breaking point and cannot continue to work effectively in these very high pressured, high risk environments without psychological support to address their mental health needs. “What is at stake not only affects the long-term mental health of this vital workforce, but their ability to function and deliver the services we depend on.” Researchers argued that it was essential that policymakers and professional bodies provided doctors with equipment to “mitigate both physical and psychological harm”, increased awareness of the signs of psychological distress and developed clear pathways to provide effective care. This could include formalised peer and team support structures and access to cognitive behavioural therapy (CBT), they said. Prof Edd Carlton from the RCEM said: “Workers across the NHS have responded to Covid-19 with incredible bravery, commitment and dedication. Over and above warm words, what we need most is proper support to help deal with impacts this has had on us all.”