Current emergency and response actions are focused on the needs of COVID-19-infected patients. However, it is important to be aware that responses are not limited to the crisis but will extend after we overcome it. Thus, post-crisis actions need to be forethought. This includes organization, planning, scheduling, and coordinating non-urgent care and procedures that have been postponed and that will have accumulated, along with other demands, by the end of the crisis. Appropriate efficient response mechanisms need to be developed by health care institutions, focusing on the expected emotional consequences this crisis will have on the large majority of health professionals and support staff who are now in the frontline fighting against the pandemic.

The collective global nature of this event -contrary to individual traumatic circumstances- possibly contributes to resilience, emotional recovery, and adaptive assimilation of the experience. Nevertheless, the potential consequences on health professionals directly exposed to the situation of this critical extended situation should not be underrated. The daily emotional overload may cause high volume of affective and anxiety reactions and symptoms, including post-traumatic stress among healthcare professionals three months after overcoming the crisis (second victims). According to a study carried out in Hunan and Wuhan (China), the percentage of affected people can be as high as 10 to 15% among the staff in critical services (Intensive Care and Reanimation, Internal Medicine, Pneumatology and Infectious Diseases), with higher prevalence among nursing personnel.

Susan Scott´s team at the University of Missouri Health Care (MUHC) developed the Three-Tiered Intervention Model to address the emotional needs of healthcare professional working with patient safety incidents in patient safety issues (second victims).

This proposal, accompanied by a specific support program, can be appropriately applied for emotional crisis among health care professionals affected by the adverse circumstances regarding the care of COVID-19 infected patients and their deaths. It consist of three levels of support with increasing specialization, based on help between equals (which facilitates the identification between the support provider and professional) and with no need of hiring external personnel. A second support level is made up by a specifically trained team of volunteers, linked with the specialized branch of mental health professionals, who respond to the needs of the professionals not covered by the lower levels of support.

If this type of program is developed, introduced and maintained in the centre, it will be of great help at the post-SARS-CoV-2 crisis period, as well as for potential future emergency situations that could cause acute stress responses and emotional disorders among professional in healthcare centres

Here we present Susan Scott´s model (2010):