Academic Emergency Medicine Physicians' Anxiety Levels, Stressors and Potential Stress Mitigation Measures during the Acceleration Phase of the COVID-19 Pandemic.

OBJECTIVE: To assess anxiety and burnout levels, home life changes and measures to relieve stress of United States academic emergency medicine (EM) physicians during the COVID-19 pandemic acceleration phase. METHODS: We sent a cross-sectional email survey to all EM physicians at seven academic emergency departments. The survey incorporated items from validated stress scales and assessed perceptions and key elements in the following domains: numbers of suspected COVID-19 patients, availability of diagnostic testing, levels of home and workplace anxiety, severity of work burnout, identification of stressors, changes in home behaviors, and measures to decrease provider anxiety. RESULTS: 426 (56.7%) EM physicians responded. On a scale of 1-7 (1= not at all, 4 = somewhat, and 7=extremely), the median (interquartile range) reported effect of the pandemic on both work and home stress levels was 5 (4,6). Reported levels of emotional exhaustion/burnout increased from pre-pandemic median 3 (2,4) to since the pandemic started median 4 (3,6); difference in medians = 1.8 (95% confidence interval 1.7-1.9). Most physicians (90.8%) reported changing their behavior towards family and friends, especially by decreasing signs of affection (76.8%). The most commonly cited measures cited to alleviate stress/anxiety were increasing personal protective equipment availability (PPE), offering rapid COVID-19 testing at physician discretion, providing clearer communication about COVID-19 protocol changes, and assuring that physicians can take leave for care of family and self. CONCLUSIONS: During the acceleration phase, the COVID-19 pandemic has induced substantial workplace and home anxiety in academic EM physicians and their exposure during work has had a major impact on their home lives. Measures cited to decrease stress include enhanced availability of PPE, rapid turnaround testing at provider discretion, and clear communication about COVID-19 protocol changes.