COVID-19 pandemic in Italy: Social distress and gender imbalance among health care professionals
Authors: Rossana Berardi, Mariangela Torniai, Maria Silvia Cona, Fabiana Cecere, Rita Chiari, Valentina Guarneri, Nicla La Verde, Laura Locati, Domenica Lorusso, Erika Martinelli, Marina Garassino
Journal: Clinical Cancer Research (2020)

Introduction: During the last months coronavirus disease 2019 (COVID-19) has spread abruptly to nearly everycountry, taking on pandemic proportions  The Italian government ordered a nationwide lockdown to hinder thespread of the contagion with unavoidable social isolation and substantial changes in lifestyle habits  Therefore, COVID-19 affected not only physical but also psychological health and well-being  Health care professionals fightingthe epidemic represent the most involved category, resulting in more physical and emotional involvement  The aimof this study is to assess the social stress level of health care workers in Italy  Materials and Methods: In this online, totally anonymous survey, 24 multiple-choice questions were broadcast tomedical staffs employed in the Italian health care system during COVID-19 pandemic  Data collection wasperformed from 30th March to 24th April 2020  Descriptive statistics have been applied to describe and summarizeour findings and the correlation analyses between categorical variables were performed using Pearson's Chi-Square  Results: A total of 600 health care professionals completed the questionnaire with a prevalence of young (32 3%between 36 and 45 years old), female (74 0%) oncologists (58 8%)  Participants mainly belong to Lombardy (31 3%)and Marche (30 3%), two of the most affected regions, but almost all the Italian regions contributed to the survey  The majority of respondents expressed the fear of being at higher risk of contagion than the general population(83 3%) and the weighty concern of infecting their own families (72 5%)  An insufficient supply of personal protectiveequipment (p = 0 0003) and inadequate training about procedures to follow (p = 0 0092) significantly correlated withthese worries  Furthermore, more than two thirds declared a change in family organization and daily life, showing asignificant correlation with worry about infecting their own relatives (p < 0 0001)  Discussion: This is the first Italian survey on social distress among health care professionals during the COVID-19pandemic  The unavailability of personal protective equipment, periodic screening procedures, adequate training, and the correct spread of information strongly conditioned health care professionals' emotional status, familyorganization, and daily life  With this survey we underlined the social impact that this health emergency has onhealth care workers, especially on women, who deal with “caring” in the hospital as well as at home, juggling to fulfillmultiples roles of professionals, mothers, wives, and caregivers for elderly parents  We wish that institutions couldinvolve themselves concretely to guarantee that health care professionals safely perform their work in a contextappropriate to proper professional skills and with the adequate social and psychological support  Reducing workers'fear of contagion and psychological distress will certainly bring significant positive repercussions for the nationalhealth system