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Leadership through crisis: fighting the fatigue pandemic in healthcare during COVID-19
  1. Dale F Whelehan1,2,
  2. Naomi Algeo3,
  3. Darren A Brown4
  1. 1 Discipline of Surgery, School of Medicine, Trinity College Dublin, Dublin, Ireland
  2. 2 Department of Physiotherapy, Tallaght University Hospital, Dublin, Ireland
  3. 3 Discipline of Occupational Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
  4. 4 Therapies Department, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Dale F Whelehan, Surgery, Trinity College Dublin, Dublin 2, Ireland; whelehd{at}


COVID-19 presents many challenges to healthcare systems internationally, none more so than the significant reporting among healthcare workers (HCWs) of occupational fatigue and burnout or Long COVID related symptoms. Consensus on the extent of HCW fatigue during the pandemic remains largely unknown, as levels of Long COVID related fatigue in HCWs appears to be on the rise. What is known is that, among current levels, impacts of fatigue on HCW well-being and performance is likely. Developing strategies to mitigate fatigue are the responsibilities of all healthcare system stakeholders. Leadership that goes beyond organisational efforts of mitigating fatigue through mandated working hour limits alone are needed. A process to facilitate identification, mitigation and prevention of fatigue is likely to be best suited in this regard. This might involve development of operational systems modelled off successful industries, such as aviation, for performance optimisation. These system-based designs provide the foundation for systematic yet innovative approaches to enable effective design of macro-level to micro-level interventions for fatigue mitigation. Shifts in organisational culture have occurred in healthcare since the onset of the pandemic, with increasing agility and embracing of innovation. Creating a culture whereby we recognise and support people in being malleable through a pandemic and beyond is at the level of leadership. Leveraging this cultural shift allows an opportunity for organisational change. One focus of such a leverage within systems could be the incorporation of the evidence-based practical recommendations informed by the authors of this paper.

  • COVID-19
  • performance management
  • health policy

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  • Contributors DFW conceptualised the commentary piece and conducted a review of the literature on occupational fatigue; contributed to drafts of the manuscript relating to occupational fatigue; authored the evidence based approach to appropriate interventions; edited the manuscript; and submitted the manuscript. NA conducted a review of the literature on non-occupational fatigue; contributed to drafts of the manuscript relating to non-occupational fatigue; and edited the manuscript; DB contributed to drafts of the manuscript from the perspective of living with Long COVID and provided commentary on relevant guidelines and frame works that had contextual relevance.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.