The British medical journal the Lancet recently published an article describing the heavy emotional and physical toll that the coronavirus pandemic has had on frontline health care workers all around the world.

Enduring months of exhaustion, the threat of infection and the loss of countless patients, health care workers have unsurprisingly faced additional problems that have added to their stress and anguish affecting their ability to cope.

The journal outlines how nurses were thrust into emergency settings with insufficient training and lacked personal protective equipment (PPE) despite their protests. Nurses and hospital staff had to keep up with the latest knowledge of the pandemic while at the same time working in facilities that were overwhelmed.

In addition to having to take care of patients, health care workers had to take care of each other when they became sick, console the dying and inform surviving family members remotely about their loved one’s fate. Some nurses were burdened with the responsibility of having to ration limited medical supplies and treatments, as well as tell non-COVID patients that their essential surgeries or appointments had to be either canceled or postponed.

Fear of infection prevented many health care workers from seeing their own families in person for months, contributing to their isolation and loneliness. The stigma of being a health care worker led to some being shunned by their community.

Despite being labeled as “heroes” by the political and media establishment, health care workers saw a real decline in their earnings because of the loss of outpatient visits, elective surgeries and the interruption of training and certification for new nurses and staff.

Home health care workers, who have little or no PPE, have been especially hit hard as they are faced with the agonizing decision of having to choose work and possible infection or unemployment and starvation.

The pandemic’s impact is especially acute in what the Lancet calls low-income and middle-income countries (LMICs), where there has always been a lack of basic medical equipment and supplies. A high burnout rate for nurses may have contributed to worse outcomes for patients with COVID-19. It was not uncommon for nurses to abandon their posts or refuse to attend to patients with the virus.

In countries like Uganda, these workers were targeted by political leaders and hospital administrators for persecution and had their policy decisions met with hostility. This, of course, was also evident in the US, with public health figures such Dr. Anthony Fauci and Rebekah Jones of Florida being attacked publicly for voicing concerns about the government handling of the pandemic.

Under pre-pandemic circumstances, nurses and hospital staff already faced high levels of depression, anxiety and post-traumatic stress disorder (PTSD). Severe burnout syndrome affected as many as 33 percent of critical care nurses and up to 45 percent of critical care physicians.

The experience of SARS in 2003 caused these workers chronic stress for months and years. A recent Chinese study found that among workers treating patients with COVID-19, 50 percent suffered depression, 45 percent had anxiety, 33 percent had insomnia and 72 percent suffered distress. This was based on a review of 13 studies involving more than 33,000 participants.

In Italy and France, studies showed high rates of depression, PTSD and burnout, with symptoms especially prevalent among those who were younger, female, nurses and working with patients infected with COVID-19.

These disproportionate rates among women are due to the fact that they comprise 70 percent of the global health care workforce. These inequalities increased the risk of unemployment and domestic violence. Working-class women not only have to care for patients under extraordinary conditions but also take care of their families, home school children, take care of their elders and still perform household chores.

The Lancet noted positively that social media was an important venue for workers to share their experiences and grievances, reducing the “sense of isolation and normalised conversations about mental health.”

The journal closes with the hope that the pandemic will promote a “redefinition of essential support workers, with recognition of the contribution of all health care workers and appropriate education, protection, and compensation.”

Help for health care workers and their families, however, will not come from the ruling classes, who have viewed the pandemic as an opportunity to make money and sacrifice older, less “productive” members of the population.

Health care workers must base their struggle for protection and compensation on a socialist basis and overturn the capitalist system, which views their lives as “nonessential.”