Letter to editor:
  In recent months, the COVID-19 outbreak, as an emerging disease, has been considered by healthcare providers all around the world (1). There is currently no vaccine for the virus and people on the front lines risk their lives every day (2). The profound psychological effects of this outbreak are also far-reaching and unprecedented and may have impact on everyone in the world (3). Health care providers are particularly vulnerable to current psychological problems, due to the risk of exposure to the virus, concerns about contamination, lack of personal protective equipment, longer working hours and dilemma for participation in ethical and emotional decision making. Thus, prevention measures such as screening for mental health problems and emotional support should focus on this vulnerable group (4) and all countries must ensure the existence of systems and processes in the path of epidemics to support their staff (2).
The psychological consequences of COVID-19 in healthcare providers include some negative emotions such as stress, depression, irritability, insomnia, fear, confusion, anger, frustration, boredom, and stigma (4) which can lead to the need for leave and will have a negative impact on the health capacity of the service delivery system in times of crisis. Medical protocols should consider the physiological and psychological needs of healthcare providers by providing emotional support in order to reduce the burden of illness and ensure their mental health and well-being (5).
According to the World Health Organization (WHO), in the current situation, feeling of being under pressure is a possible and completely natural reaction among healthcare providers, but not a reflection of their weakness or their inability to do their duties (6). Thus, mental health management is just as important during this time as physical health. The helpful coping strategies may include resting at work or between shifts, eating enough healthy food, exercising, and contacting family and friends. However, ineffective coping strategies such as smoking, alcohol or other drugs should be avoided because they can worsen mental and physical health.
On the other hand, some healthcare providers may avoid visiting their family or the community due to fear or stigma which can make their current situation much more difficult. Hence, it is recommended that they stay in touch with their families or loved ones through digital methods and maintain their relationships (6). They should also be encouraged to move forward without fear of blame (5).
At the community level, video conferencing, online forums, smartphone apps, texting and sending email are some useful communication methods for providing mental health services for all people (5). For people at higher risk for COVID-19 including healthcare providers, “Tele-mental Health Services” should be given priority (7).
Psychological consequences of COVID 19 can be lasting even after the end of the epidemic. As a result, we can state that only by strengthening the psychological defense, especially the psychological support of the vulnerable people such as health care providers, the nations will be able to succeed in this long-lasting battle (5).