More than half of all health care workers worldwide are experiencing burnout that, if not addressed, could cause many to leave their fields in favor of less-stressful occupations or choose early retirement. And the COVID-19 pandemic has only made it worse.

That's the warning of a surgeon from The University of Texas Health Science Center at San Antonio in a letter and a call for global action published March 22 in the Lancet journal EClinicalMedicine.

"A recent survey done in Medscape of nearly 7,500 physicians globally showed that burnout has reached a very high rate," said Dharam Kaushik, MD, associate professor of urology in the university's Joe R. and Teresa Lozano School of Medicine and surgeon with the Mays Cancer Center, home to UT Health San Antonio MD Anderson.

Physicians aren't alone. Dr. Kaushik's letter also references a large study of burnout and trauma in nurses during the pandemic.

"I'm talking about global health care workers," he said. "We have to look at the whole health care work force and what we can do in communities and countries to prevent a downward spiral of burnout."

Combination of factors

Health care workers are under tremendous mental distress, with symptoms of loneliness, depression and anxiety. "The rising death toll, post-traumatic stress, long work hours and the initial slow vaccine rollout in different countries are creating a ripple effect of burnout in this vital workforce," Dr. Kaushik said.

Women in health care are suffering the most, his editorial states. "Gender inequity is flourishing, and more female health care workers, especially in critical care and infectious disease, are getting burned out at a very high rate," Dr. Kaushik said.

There is a predicted shortage of health care workers by 2030. The COVID-19 pandemic may amplify the shortfall, cost billions and impact the quality of care.

"I reference a Lancet article that estimates there will be a shortage of 18 million health care workers by 2030 that could cost $47 trillion, and those projections were made before the pandemic," Dr. Kaushik said. "Imagine what the pandemic has done."

The loss of health care workers to other industries and retirement is "unsustainable," he said.

Policymakers need to work with the scientific community to understand the implications of burnout and develop a comprehensive burnout prevention strategy, he said.

"Remember, if there is no health care workforce, we cannot recover from any pandemic," Dr. Kaushik said. "We have to learn the lessons from the current pandemic, have effective burnout prevention strategies in place, and better prepare for the future."