Perceived Risk and Distress related to COVID-19: Comparing Healthcare versus non-Healthcare Workers of Pakistan

Background Healthcare workers (HCWs) find themselves susceptible to contracting COVID-19 or being the source of exposure for their family members. This puts them at a high risk of psychological distress which may compromise patient care. In this study we aim to explore the risk perceptions and psychological distress between HCWs and non-healthcare workers (NHCWs) in Pakistan. Methods A cross-sectional study was conducted in Pakistan using an online self-administered questionnaire. Respondents were categorized into HCWs (completed or aspiring to complete education in Medicine or allied fields) and NHCWs. HCWs were further categorized into front-line (direct patient care) and back-end HCWs. Results Data from 1406 respondents (507 HCWs and 899 NHCWs) was analyzed. No significant difference was observed between HCWs and NHCWs’ perception of susceptibility and severity towards COVID-19. Healthcare graduates perceived themselves (66% students vs. 80% graduates, p-value 0.011) and their family (67% students vs. 82% graduates, p-value 0.008) to be more susceptible to COVID-19 than the healthcare students. Frontline HCWs perceived themselves (83% frontline vs. 70% back-end, p-value 0.003) and their family (84% frontline vs. 72% back-end, p-value 0.006) as being more susceptible to COVID-19 than back-end healthcare professionals. Over half of the respondents were anxious (54% HCWs and 55% NHCWs). Female gender, younger age and having COVID-19 related symptoms had a significant effect on the anxiety levels of both HCWs and NHCWs. Conclusion Frontline HCWs, healthcare students, young people, females and individuals with lower income were at a higher risk of psychological distress due to the pandemic. Government policies should thus be directed at ensuring the mental well-being of frontline HCWs, and improving their satisfaction in order to strengthen health care delivery system. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial NA ### Funding Statement The authors did not receive any direct funding for the purpose of this study. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval was obtained from the Ethical Review Committee (ERC) of the Aga Khan University, Pakistan. Participants were asked to present their consent at the beginning of the survey and were free to withdraw at any stage. All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data and materials are in the custody of the University and could be made available on request, keeping the individual identity of the participants confidential.