Junior doctors' wellbeing at peak and post-peak pandemic: a repeated cross-sectional study.

Introduction: The impact of the COVID-19 pandemic on healthcare professionals has been significant. The aim of this study was to explore the mental state and wellbeing of UK junior doctors at different phases of the initial outbreak.

Methods: This is a cross-sectional study of UK-based junior doctors' perceptions of threat and support during and after the first wave of the COVID-19 pandemic. Levels of anxiety, depression, post-traumatic stress disorder symptoms and use of coping mechanisms were explored through a Google questionnaire.

Results: 196 participants were included in this study (93 in period A and 103 in period B). Junior doctors reported feeling increased risk (=0.001) and increased fear of contracting the virus (<0.001) during period A. Increased levels of severe anxiety (Generalized Anxiety Disorder-7 score >15) along with increased cases level of depression (Patient Health Questionnaire-9 score >10) were reported for both periods. Junior doctors described suffering more frequently with flashbacks (=0.006) and nightmares (=0.024) in comparison with senior colleagues during period A. During period A, 21.4% of participants felt isolated at work (<0.001), whereas 13% reported being easily annoyed on a daily basis, 11.7% reported very low morale (<0.001) and 66% were not aware of any psychological support being available. The use of exercise, peer support and mindfulness apps increased during period B (=0.023).

Conclusions: Healthcare systems need to urgently establish robust psychological support mechanisms and infrastructure to protect junior doctors and provide institutional resilience against the adverse consequences of the long physical and mental battle with COVID-19.