OBJECTIVES: The objective was to provide a longitudinal assessment of anxiety levels and work and home concerns of U.S. emergency physicians during the COVID-19 pandemic .

METHODS: We performed a longitudinal, cross-sectional email survey of clinically active emergency physicians (attending, fellow, and resident) at seven academic emergency departments . Follow-up surveys were sent 4 to 6 weeks after the initial survey and assessed the following: COVID-19 patient exposure, availability of COVID-19 testing, levels of home and workplace anxiety/stress, changes in behaviors, and performance on a primary care posttraumatic stress disorder screen (PC-PTSD-5). Logistic regression explored factors associated with a high PC-PTSD-5 scale score (& #8805; 3), indicating increased risk for PTSD .

RESULTS: Of the 426 surveyed initial respondents, 262 (61.5 %) completed the follow-up survey . While 97.3% (255/262) reported treating suspected COVID-19 patients, most physicians (162/262 , 61.8 %) had not received testing themselves . In follow-up, respondents were most concerned about the relaxing of social distancing leading to a second wave (median score = 6, IQR = 4-7). Physicians reported a consistently high ability to order COVID-19 tests for patients (median score = 6, IQR = 5-7) and access to personal protective equipment (median score = 6, IQR = 5-6). Women physicians were more likely to score & #8805; 3 than men on the PC-PTSD-5 screener on the initial survey (43.3% vs. 22.5% ; & #916; 20.8% , 95% confidence interval [CI] = 9.3% to 31.5 %), and despite decreases in overall proportions, this discrepancy remained in follow-up (34.7% vs. 16.8% ; & #916; 17.9% , 95% CI = 7.1% to 28.1 %). In examining the relationship between demographics, living situations, and institution location on having a PC-PTSD-5 score & #8805; 3, only female sex was associated with a PC-PTSD-5 score & #8805; 3 (adjusted odds ratio = 2.48 , 95% CI = 1.28 to 4.79).

CONCLUSIONS: While exposure to suspected COVID-19 patients was nearly universal, stress levels in emergency physicians decreased with time . At both initial and follow-up assessments, women were more likely to test positive on the PC-PTSD-5 screener compared to men.