The daily toll of COVID-19, as measured by new cases and the growing number of deaths, overlooks a shadowy set of casualties: the rising risk of mental health problems among health care professionals working on the frontlines of the pandemic.

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A new study, led by University of Utah Health scientists, suggests more than half of doctors, nurses, and emergency responders involved in COVID-19 care could be at risk for one or more mental health problems, including acute traumatic stress, depression, anxiety, problematic alcohol use, and insomnia. The researchers found that the risk of these mental health conditions was comparable to rates observed during natural disasters, such as 9/11 and Hurricane Katrina.

“What health care workers are experiencing is akin to domestic combat,” says Andrew J. Smith, Ph.D., director of the U of U Health Occupational Trauma Program at the Huntsman Mental Health Institute and the study’s corresponding author. “Although the majority of health care professionals and emergency responders aren’t necessarily going to develop PTSD, they are working under severe duress, day after day, with a lot of unknowns. Some will be susceptible to a host of stress-related mental health consequences. By studying both resilient and pathological trajectories, we can build a scaffold for constructing evidence-based interventions for both individuals and public health systems.”

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