Canadian Journal of Public Health

, Volume 99, Issue 6, pp 486–488 | Cite as

Applying the Lessons of SARS to Pandemic Influenza

An Evidence-based Approach to Mitigating the Stress Experienced by Healthcare Workers
  • Robert G. MaunderEmail author
  • Molyn Leszcz
  • Diane Savage
  • Mary Anne Adam
  • Nathalie Peladeau
  • Donna Romano
  • Marci Rose
  • Rabbi Bernard Schulman


We describe an evidence-based approach to enhancing the resilience of healthcare workers in preparation for an influenza pandemic, based on evidence about the stress associated with working in healthcare during the SARS outbreak. SARS was associated with significant long-term stress in healthcare workers, but not with increased mental illness. Reducing pandemic-related stress may best be accomplished through interventions designed to enhance resilience in psychologically healthy people. Applicable models to improve adaptation in individuals include Folkman and Greer’s framework for stress appraisal and coping along with psychological first aid. Resilience is supported at an organizational level by effective training and support, development of material and relational reserves, effective leadership, the effects of the characteristics of “magnet hospitals,” and a culture of organizational justice. Evidence supports the goal of developing and maintaining an organizational culture of resilience in order to reduce the expected stress of an influenza pandemic on healthcare workers. This recommendation goes well beyond the provision of adequate training and counseling. Although the severity of a pandemic is unpredictable, this effort is not likely to be wasted because it will also support the health of both patients and staff in normal times.


Health personnel communicable diseases stress, psychological organizational culture disaster planning 


À la lumière des données sur le stress associé au travail dans le domaine des soins de santé pendant la crise du SRAS, nous décrivons une approche fondée sur les preuves qui vise à améliorer la résilience des travailleurs de la santé en prévision d’une pandémie de grippe. Le SRAS a été associé à un niveau significatif de stress de longue durée chez les travailleurs de la santé, mais pas à une hausse des maladies mentales. Le meilleur moyen de réduire le stress en cas de pandémie serait de prendre des mesures pour améliorer la résilience des personnes saines sur le plan psychologique. Entre autres modèles intéressants pour améliorer la résilience, citons le cadre d’évaluation et d’adaptation au stress de Folkman et Greer, assorti de premiers soins psychologiques. À l’échelle organisationnelle, la résilience est assurée par une formation et un soutien efficaces, la constitution de réserves matérielles et relationnelles, un leadership efficace, les avantages attribuables aux « hôpitaux-aimants » et une culture de justice organisationnelle. Il est prouvé que la création et l’entretien d’une culture organisationnelle de résilience sont des objectifs valables si l’on veut réduire le stress attendu d’une pandémie de grippe sur les travailleurs de la santé. Cette recommandation va plus loin que la simple prestation d’une formation et d’un counseling adéquats. Il est impossible de prédire la gravité d’une pandémie, mais les efforts recommandés ne seront pas vains, car ils favoriseront aussi la santé des patients et du personnel en temps normal.

Mots clés

personnel médical et paramédical maladies transmissibles stress psychologique culture organisationnelle planification antisinistre 


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Copyright information

© The Canadian Public Health Association 2008

Authors and Affiliations

  • Robert G. Maunder
    • 1
    Email author
  • Molyn Leszcz
    • 1
  • Diane Savage
    • 2
  • Mary Anne Adam
    • 3
  • Nathalie Peladeau
    • 1
  • Donna Romano
    • 1
  • Marci Rose
    • 1
  • Rabbi Bernard Schulman
    • 4
  1. 1.Department of Psychiatry, Mount Sinai Hospital, Faculty of MedicineUniversity of TorontoTorontoCanada
  2. 2.Department of Social WorkMount Sinai HospitalCanada
  3. 3.Department of Occupational Health & SafetyMount Sinai HospitalCanada
  4. 4.Mount Sinai HospitalCanada

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