Viral Anxiety Should Be Properly Detected and Managed Among Healthcare Workers in Korea During the COVID-19 Pandemic.

A study by Lee et al.1 conducted among the 329 healthcare workers in a general hospital in Korea reported that factors such as reassurance-seeking behavior, obsession, and intolerance of uncertainty are significant independent correlates of viral anxiety in the linear regression analysis of the psychometric characteristics and sociodemographic. Furthermore, the study states that reassurance-seeking behavior and obsession have significant mediating effects on the association between intolerance of uncertainty and viral anxiety among healthcare workers.

In addition to affecting the mental health of the people, the COVID-19 pandemic has also caused anxiety and fear about their health and that of their families. Many factors can contribute to the onset of mental illness, including quarantine, great changes and inadaptability, lack of psychological coping methods, mental and physical health knowledge, infectious disease information, health behaviors, mental health assessments, and self-judgment methods as well as other variables.2 In short, viral anxiety is both a subjective and objective fear of getting infected with COVID-19 among healthcare workers. Therefore, it is noteworthy that fear of the COVID-19 infection is significantly influenced by subjective characteristics rather than objective ones. Moreover, excessive reassurance seeking has been regarded as an important contributing factor to the maintenance of depression and obsession.3 The intolerance of uncertainty, defined as the negative emotional, cognitive, and behavioral reactions to uncertain events and situations, has been known to play a major role in the maintenance of anxiety.4 Research has reported an inverse relationship between the level of intolerance of uncertainty and reduction of excessive reassurance seeking in cognitive-behavioral therapy (CBT) for patients with depressive or obsessive-compulsive disorder.3

Given that viral anxiety is significantly linked to reassurance seeking, obsession, and intolerance of uncertainty, it can be explained by the complex repertories of ritualistic and repetitive behaviors used to reduce anxiety symptoms. However, it has been a remarkable finding that factors such as psychiatric history, depression symptoms, and insomnia severity index are not significant independent correlates of viral anxiety among healthcare workers. In the COVID-19 pandemic, psychiatric history has been proposed as one of the risk factors to predict mental health problems, which can result in symptoms like depression and insomnia among the general population.5 Thus, the discrepancy can be explained by the hypothesis that viral anxiety is a unique mental health problem among healthcare workers with adequate infectious disease knowledge rather than among the general population.

There is a possibility that most healthcare workers may exhibit subthreshold levels of viral anxiety. In addition to the risk of transmission of COVID-19 and other factors such as overwork, stigma, and isolation—as a result of continuous exposure to COVID positive patients—, healthcare workers have continually suffered from mental health problems during the COVID-19 era6; hence viral anxiety and its related psychic factors should be evaluated and managed among them. Moreover, it has been hypothesized that viral anxiety can be an essential characteristic of mental health problems among healthcare workers in Korea. Although many alternative psychosocial support programs (i.e., telepsychiatry, online CBT) have been developed in the pandemic, to my best knowledge, their uses have been limited to clinical situations.

In conclusion, healthcare workers have continuously suffered (in the past two years of the pandemic) from viral anxiety and its complications, such as obsessive thoughts or behaviors. For most healthcare workers, psychosocial support should be provided for mental health problems (e.g., viral anxiety) as well as access to basic resources (e.g., adequate rest, work-life balance, childcare).