INTERNATIONAL NEWS - Battling to keep intensive care patients alive at a hospital in one of New York City's worst-affected coronavirus neighborhoods is taking a toll on nurse Debbie Sanchez's mental health.
"I have extreme anxiety," said Sanchez, who has been working 12-hour shifts covered head-to-toe in protective clothing since New York became the epicenter of America's COVID-19 outbreak last month.
Sanchez, 57, was working in the emergency room at Montefiore Hospital in the Bronx when she was moved to help the facility's overwhelmed intensive care unit.
She is not a trained ICU nurse and lives in fear she will make a mistake. Sanchez also hasn't seen her granddaughter in over a month for fear of infecting her.
"The whole thing of changing your whole life is what's stressful. I have a hard time sleeping," she admitted to AFP.
New York state accounts for around a third of America's 42,500 COVID-19 deaths. More than 14,000 people in New York City have died, or are likely to have died, from the virus.
As well as the threat of depression and anxiety faced by billions of people under social isolation orders worldwide, health professionals on the front line must deal with death and the high risk of contagion every day.
"This is a time that is really testing our resilience," said Jonathan Ripp, an internist at New York's network of eight Mount Sinai hospitals.
Ripp, the co-author of a study that seeks to understand anxiety among medical staff during the pandemic and which was published this month in the Journal of the American Medical Association (JAMA), said medical staff concerns are numerous.
"Are we going to have enough equipment? How am I going to get to work? Who's going to take care of my kids?" he told AFP, citing some of the worries.
"How am I going to be prepared to take care of patients in a setting that I'm not used to... What if I'm dealing with patients who are critically ill, who are dying?" Ripp added.
In an attempt to help its staff, Mount Sinai provides answers to questions on a dedicated website, created a 24-hour mental health hotline, runs virtual support groups, and offers meditation, yoga, and tai chi classes.
Mental health professionals also contact staff to ask how they are feeling.
Heather Isola, a physician assistant who oversees 900 colleagues, said her worst day was when one of them was diagnosed with COVID-19 and was hospitalized in a serious condition.
"It was probably the peak of the disease as well and the peak in the hospital so that was the breaking day," recalled the 36-year-old.
"The same thing every day... is draining," she added. "What is it going to do to us? The anxieties, the PTSD, the experience of death and dying. Most people haven't seen death and dying like this," she added.
At least 26 employees of public hospitals in the city have died, according to government figures, adding to the anxiety of medical staff and meaning many themselves are in mourning.
"It's impossible not to relate to that 40-year-old or 30-year-old who might just be the exception who didn't have any problems and now has ended up on a ventilator for reasons that we're still trying to understand," says Ripp.
"Seeing that in front of you makes it very real and puts that level of fear and anxiety on a higher stage if you will."
Dawn Brown, director of the National Alliance on Mental Illness (NAMI), which runs a helpline for those struggling to deal with the outbreak, says hospital staff find themselves "in a really tragic situation."
"We are beginning to see signs of trauma," she told AFP, adding that that "has far-reaching consequences."
Sanchez has stopped looking at a WhatsApp chat group with colleagues and tries not to check Facebook because the stories people are sharing are just too stressful.
"Sometimes I feel sad and I want to cry," she said.