Since late 2019, a worldwide epidemic of Corona Virus Disease 2019 (COVID-19) has been occurring, causing considerable strain on healthcare systems. Although COVID-19 was declared not to be a Public Health Emergency of International Concern (PHEIC) by the World Health Organization in May 2023[1], millions of people continue to be severely impacted by ongoing infection and re-infection, resulting in thousands of deaths each week[2]. Moreover, uncertainty remains regarding the possible emergence of new virus variants, which could potentially trigger fresh outbreaks[1]. Therefore, healthcare systems are required to take on a sustainable approach to COVID-19 infection prevention and control. However, during the past three years, healthcare workers have taken great efforts to rapidly control the epidemic with medical treatment and care, facing excessive workload and psychological stress, leading to a significant increase in the prevalence of burnout. According to a meta-analysis conducted by Ghahramani and colleagues, the prevalence of job burnout among healthcare providers during the epidemic was 52%, which was significantly higher than the rates reported in the previous two decades, ranging from 32–34%[3]. This negative psychological state of healthcare workers may continue or even develop in the post-epidemic era[4], which is not conducive to long-term sustained COVID-19 prevention, control and management efforts.
Job burnout is the response to prolonged work-related emotional, physical and mental stress, characterized by energy depletion or exhaustion, negative mood and reduced professional efficiency[5]. Empirical evidence has demonstrated that the medical profession is particularly susceptible to burnout because of the constant exposure to harsh environments such as mental and physical suffering or death[6, 7]. Lack of organizational support, poor infrastructure, staff shortages, and high workloads contributed to the development of burnout symptoms[8–10]. In addition, moral distress and stress related to the physical and mental environment are also thought to contribute to burnout[11, 12]. Especially in the context of public health emergencies, health services surged in a short period, causing strong psychological and physiological stress on medical staff and increased burnout among medical staff. The most direct impact of job burnout on HCPs is job dissatisfaction, decreased productivity, and high staff turnover[9, 13, 14]. These negative consequences may further adversely affect the quality of patient care as well as the healthcare system's ability to respond to public health emergencies[12, 13]. Consequently, burnout in medicine has become an important public health issue that has attracted a great deal of attention from researchers and managers.
Over the past few years, many studies have been conducted on burnout among medical personnel in the context of COVID-19, however, most studies were conducted prior to the emergence of the Omicron variant. In 2022, China encountered a prevalence of the Omicron variant, resulting in another outbreak of COVID-19[15]. Since March 2022, the epidemic in Jilin Province has expanded rapidly, characterized by multiple sporadic, clustered infected, and widespread[16]. Between March and November, the number of COVID-19 cases (including asymptomatic infections) in Jilin Province increased significantly to more than 87,000 cases, in contrast to less than 1,000 cases recorded in the province before March[17]. The surge in cases has imposed tremendous strain on society, especially the healthcare system. Compared with previous pandemics, COVID-19, especially the Omicron strain, has faster spread, more difficulty in prevention and control, and wider spread. These characteristics correspond to the attributes of event criticality, disruption and novelty[18]. In the COVID-19 pandemic, as the first line of defense, the primary health care (PHC) system confronts unprecedented challenges[19]. Although limited ability to act on the morbidity and mortality of severe cases, PHC can apply multiple interventions to reduce the infection spread and reduce the social and economic impact of social distancing measures[20]. During the COVID-19 pandemic globally, PHC takes on the additional responsibility of COVID-19 screening, referral, monitoring, education and publicity, and also needs to meet citizens' medical care requirements as usual[21, 22]. In response to COVID-19 variants with higher transmissibility, China adopted a new strategy called “Dynamic COVID-zero” from August 2021, and PHC providers play an important role in halting the spread of the epidemic in the community[23]. However, the surge in cases has resulted in medical staff working under high-pressure, high-load, and high-risk circumstances for extended periods, creating conditions conducive to burnout [24, 25].
To date, numerous scholars have conducted research on the present condition and potential mechanisms of job burnout among medical personnel during the COVID-19 pandemic[3, 6, 24, 25]. However, the majority of studies utilize the pandemic as the research background and rarely directly explore the impact of the COVID-19 event itself on medical personnel burnout. Our study used event systems theory to evaluate COVID-19 event strength and to explore its impact on PHC medical staff job burnout as well as potential mechanisms during the Omicron variant outbreak. This research has important implications for current and future emergency response and public policy in the long-term COVID-19 disease management period.