COVID-19 Stress Among Your Workers? Healthy Work Design and Well-Being Solutions Are Critical

Experiencing an infectious disease outbreak can cause fear, anxiety, and stress.^1-5 Along with overwhelming uncertainty and new behavioral ‘norms’ (e.g., cloth face covering or mask wearing, physical distancing), the COVID-19 pandemic has changed how we meet our daily needs, how we socially interact, and whether, how, and where we work.^1,3 Millions of workers have lost their jobs.⁶ Some workers have continued to report to a physical workplace, while others have transitioned to full-time telework, and for many, the demands of work have changed or intensified. The nature of each situation is unique, but undoubtedly some of these changes are contributing to increasing levels of economic insecurity and occupational stress.^3,7 Reducing occupational stress is a fundamental focus of the NIOSH Healthy Work Design (HWD) and Well-Being program. This post is one in a series of HWD-sponsored blogs addressing the effect of COVID-19 on workers. This post generally describes the stress workers may be experiencing and aims to help employers and policy makers better understand and support workers during this pandemic. Other posts in this series address economic and other insecurity, stress associated with jobs that cannot be done remotely, and organizational support.

An outbreak can affect mental health and psychosocial problems comparable to experiencing traumatic incidents.^8,9 People can suffer increased feelings of uncertainty, anxiety, irritation, anger, and denial. It is not uncommon to lack motivation, have trouble sleeping or concentrating and to feel tired, overwhelmed, burned out, sad, and even depressed.² If left unaddressed, experiencing such stress can lead people to engage in maladaptive coping (i.e., increased use of alcohol, tobacco, or other drugs or engaging in other unhealthy behaviors) and chronic health problems and mental health conditions may worsen.^2,4 The exact nature of the risks to worker well-being vary according to personal circumstances and work arrangements. It is important for employers and policy makers to recognize the spectrum of stressors that workers face. Some have had to care for or have lost loved ones. Economic insecurity is affecting the millions who have lost their jobs or have seen their income decrease drastically due to reduced work hours or demand for their services. And those whose jobs are temporarily discontinued may worry about being laid-off and not re-hired, which further impacts emotional health.^10,11

Physical distancing by working at home and avoiding in-person meetings or social gatherings can help reduce disease transmission – but also affects access to social support and can result in feelings of isolation and added stress.¹ Not all jobs are amenable to remote work. Workers who must continue to report to a physical workplace may experience fear about their health and the health of their loved ones, as well as challenges arranging care for elderly or young dependents. Many jobs carry the risk of exposure to sick and asymptomatic individuals with COVID-19 – such as those in healthcare settings and others (i.e., service occupations) that must be done on-site and require frequent contact with the public. Workers’ well-being can be further impaired if they lose access to health-enhancing benefits available at the formal worksite (e.g., access to on-site health clinics and health and well-being programs).^12-15 And those who live or usually work alone may be particularly vulnerable to the “loneliness epidemic” as their infrequent person-to-person contact dwindles further.

Additional concerns can include: the struggle to attend to personal and family needs while working; managing a different workload; lack of access to tools and equipment needed to perform work (including limited or no internet access for remote workers); feelings of not contributing enough to work or guilt about not being on the frontline; uncertainty about the future of the workplace and/or employment; and challenges related to learning new communication tools and dealing with technical difficulties.⁴ Compounding the risk, workers who already struggle with mental health conditions are particularly vulnerable to experiencing additional emotional symptoms and somatoform disorders during an outbreak,¹⁶ and those who must undergo quarantine are at additional increased risk for mental distress compared to workers who are not isolated.^17,18

Working at home could be considered somewhat of a luxury during this time. Yet, telework presents its own risks. And, as the home has become the workplace for many, the issue of stress spilling over from one domain to the other has very likely increased.¹⁹ Many parents feel conflict when juggling dependent care, trying to oversee children’s remote learning, and meet their own work demands. Workers who are not used to telework may be at increased risk of injury if their workspaces are configured without appropriate employer guidance.²⁰ And, while technology use may help workers meet their job demands, it can also extend working hours and further blur work-home boundaries,^21-24 which can be consequential for workers and their families. Specifically, workers’ ability to psychologically detach, or “switch off mentally” at the end of the workday can be compromised,²⁵ which has been associated with many indicators of poor well-being, including anxiety, depression, negative affect, emotional exhaustion, and fatigue.²⁶

In terms of preventing consequences associated with this altered way of working, there are steps that individual workers can take to build resilience and increase their capacity to detach – such as using a journal to set work-related goals²⁷ and participating in mindfulness.^2,4,5,28,29 From an organizational perspective, when supervisors support workers and encourage their efforts to manage work and non-work demands (e.g., increasing control over work and schedule flexibility or offering access to Employee Assistance Programs [EAPs] and paid time off), workers report lower levels of work-family conflict³⁰ and improvements to their sleep,³¹ schedule control,³² job satisfaction, well-being, and physical health.^33,34 Early identification of risk factors, strengthening peer support at work, and promotion of mental health services (i.e., through remote access) could help workers cope with the ongoing challenges and prevent the onset of maladaptive behaviors.³⁵

Policy makers and employers face challenges around determining how to redesign work to protect their workers’ and clients’ health, how to assist workers who may not have caregiving arrangements for their dependents, and how to address workers’ mental health needs. It is always important for employers to support workers’ comprehensive well-being through provision of a safe and health-supportive work environment (e.g., one that supports their financial security, does not cause occupational stress, and that advances well-being)³⁹ and it is especially critical that organizations show value for workers and support them during such an abrupt event.⁴⁰ Additionally, drawing from other countries’ experiences,³⁴ the entire workforce could benefit through flexible scheduling, rest breaks, regular exercise, nutritional meals, and organizational efforts to prepare for future abrupt events (i.e., pandemics, disasters, emergencies).^41,42 Supporting the use of paid time off contributes to workers’ happiness with their job, relationships, employer, and health.³⁶ Finally, some workers will be apprehensive about returning to a physical workplace that could expose them to COVID-19, especially if they have concerns about their physical health.^38,40 Taking measures to improve workplace hygiene and show genuine concern about worker health can reduce their psychological distress.³⁹ Please see the CDC website for up-to-date employer guidance on COVID-19.

Details of how we live, socialize, and work in this new era will emerge in the coming months. There may be less travel, fewer in-person meetings, and for some, more telework and remote learning – especially if employers see a financial benefit to these approaches without a productivity trade-off. This experience will likely have a significant impact on the flexibility of work arrangements.⁴³ There will be new procedures outlining how workers should interact with the public and those they provide services for. How and whether these changes will benefit, or harm workers is unknown and likely to vary by work arrangement, occupation, socioeconomic status, and a number of other factors. By modifying work to support workers in all arrangements, we can prevent further exacerbating an already stressful experience.

This is a part of the series of blogs sponsored by NIOSH’s Healthy Work Design and Well-Being Program on issues impacted by the COVID-19 pandemic. Other blogs include:

Economic Security during the COVID-19 Pandemic: A Healthy Work Design and Well-being Perspective

Improve Sleep: Tips to Improve Your Sleep When Times Are Tough

Jeannie A.S. Nigam, MS, is NIOSH Co-Coordinator of the Healthy Work Design and Well-Being Cross Sector program

Jessica M.K. Streit, PhD, MS,  is a member of the Healthy Work Design and Well-Being Cross-Sector program Steering Committee.

Tapas K. Ray, PhD, is NIOSH Co-Assistant Coordinator for the Healthy Work Design and Well-Being Cross-Sector program

Naomi Swanson, PhD, is NIOSH Co-Manager for the Healthy Work Design and Well-Being Cross-Sector program

Other blogs in this series include: 

Economic Security during the COVID-19 Pandemic: A Healthy Work Design and Well-being Perspective

Improve Sleep: Tips to Improve Your Sleep When Times Are Tough

The Role of Organizational Support and Healthy Work Design

Additional NIOSH blogs related to the COVID-19 pandemic and the workplace are available here.

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