Impact of the Early Phase of the COVID-19 Pandemic on US Healthcare Workers: Results from the HERO Registry

J Gen Intern Med. 2021 May;36(5):1319-1326. doi: 10.1007/s11606-020-06529-z. Epub 2021 Mar 10.


Background: The HERO registry was established to support research on the impact of the COVID-19 pandemic on US healthcare workers.

Objective: Describe the COVID-19 pandemic experiences of and effects on individuals participating in the HERO registry.

Design: Cross-sectional, self-administered registry enrollment survey conducted from April 10 to July 31, 2020.

Setting: Participants worked in hospitals (74.4%), outpatient clinics (7.4%), and other settings (18.2%) located throughout the nation.

Participants: A total of 14,600 healthcare workers.

Main measures: COVID-19 exposure, viral and antibody testing, diagnosis of COVID-19, job burnout, and physical and emotional distress.

Key results: Mean age was 42.0 years, 76.4% were female, 78.9% were White, 33.2% were nurses, 18.4% were physicians, and 30.3% worked in settings at high risk for COVID-19 exposure (e.g., ICUs, EDs, COVID-19 units). Overall, 43.7% reported a COVID-19 exposure and 91.3% were exposed at work. Just 3.8% in both high- and low-risk settings experienced COVID-19 illness. In regression analyses controlling for demographics, professional role, and work setting, the risk of COVID-19 illness was higher for Black/African-Americans (aOR 2.32, 99% CI 1.45, 3.70, p < 0.01) and Hispanic/Latinos (aOR 2.19, 99% CI 1.55, 3.08, p < 0.01) compared with Whites. Overall, 41% responded that they were experiencing job burnout. Responding about the day before they completed the survey, 53% of participants reported feeling tired a lot of the day, 51% stress, 41% trouble sleeping, 38% worry, 21% sadness, 19% physical pain, and 15% anger. On average, healthcare workers reported experiencing 2.4 of these 7 distress feelings a lot of the day.

Conclusions: Healthcare workers are at high risk for COVID-19 exposure, but rates of COVID-19 illness were low. The greater risk of COVID-19 infection among race/ethnicity minorities reported in the general population is also seen in healthcare workers. The HERO registry will continue to monitor changes in healthcare worker well-being during the pandemic.

Trial registration: identifier NCT04342806.

Keywords: COVID-19; SARS-CoV-2; burnout; disparities; healthcare worker; registry; well-being.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • COVID-19*
  • Cross-Sectional Studies
  • Female
  • Health Personnel
  • Humans
  • Male
  • Pandemics*
  • Registries
  • SARS-CoV-2

Associated data