Skip to main content

Verified by Psychology Today


COVID-19 and Vicarious Trauma

Research reveals vicarious trauma in general public and health staff.

 Ashkan Forouzani/Unsplash
Source: Ashkan Forouzani/Unsplash

In this global COVID-19 pandemic, many frontline medical staff are facing incredible amounts of distress as they care for patients who have COVID-19. In one research study, 70% of frontline nurses and doctors working in and near the epicenter of the outbreak in China reported experiencing distress, and about half of them reported experiencing anxiety and depression.

Though the disease and the lack of information about it have had life-threatening consequences, another concern for frontline medical staff caring for patients with COVID-19 is vicarious trauma (VT). VT is a psychological byproduct where a helper is exposed to a patient’s psychological trauma and the helper feels like they experience it too. Symptoms of VT include “loss of appetite, fatigue, physical decline, sleep disorder, irritability, inattention, numbness, fear, and despair” (Li et al, 2020, p.2).

Measuring Vicarious Trauma

Researchers Zhenyu Li, Jingwu Ge, Meiling Yang, and others from several universities in Nanjing, Wuhan, Zhengzhou, Soochow, Changzhou, and Chiba collaborated to assess the levels of VT found in frontline nurses, non-frontline nurses, and the general public. The researchers believe that assessments of VT are important for improving the quality of response and quickening a society’s return to normalcy. They recently published their findings in Elsevier.

The study was conducted using a questionnaire survey app that was circulated through the instant messaging platform WeChat from February 17 to 21, 2020. Isolation policies during this time in China included social distancing and an order to stay at home. There were 740 participants in total: 526 of them were nurses while 214 of them were part of the general populace. The survey included questions about life belief and physical, psychological, emotional, behavioural, and cognitive responses.

Results from the study compared the severity levels of VT experienced by each group mentioned:

“…frontline nurses had significantly lower vicarious traumatization scores than the general public and non-frontline nurses. However, no significant difference was noted in the vicarious traumatization scores between the general public and non-frontline nurses.”

Unexpectedly, the general public and non-frontline nurses reported having higher levels of VT compared to nurses at the frontline confronting COVID-19. Inadvertently, those that are not directly interacting with COVID-19 patients are still being exposed to their trauma and can experience high levels of distress in the form of VT.

If you are not interacting with COVID-19 patients, why might you experience vicarious trauma?

Researchers collaborating on this study suggest a few reasons for higher levels of VT found in the general populace and non-frontline nurses. To account for the exposure to trauma, the researchers propose that the stay-at-home order provides more time for the general public to consume media about patients with COVID-19. Therefore, the general populace would have increased sympathy and concern for patients as well as medical staff confronting the virus. In the case of non-frontline nurses, the researchers suggest that they feel sympathy for patients with COVID-19 and their colleagues at the frontlines. The concern for their colleagues becomes additional stress that increases the severity of VT.

On the other hand, the lower levels of VT found in frontline nurses could imply that:

“the psychological endurance of frontline nurses is stronger. This notion may be due to the fact that frontline nurses are voluntarily selected and provided with sufficient psychological preparation. Secondly, the selected frontline nurses are mainly middle-level backbone staff with working experience and psychological capacity…[they] are more knowledgeable about the epidemic than the general public and non-frontline nurses.”

Protective Measures

Overall, the researchers suggest that frontline nurses, in this case, had more work experience and were better equipped with knowledge because of their direct contact caring for patients that have COVID-19. Their experience and knowledge become protective measures for psychological wellbeing when faced with patients’ trauma. For those who are not directly confronting COVID-19, spending less time-consuming media about patients battling the virus, practicing VT coping strategies, and reading reliable information can help decrease levels of vicarious trauma.

Written by Joy Lee-Ryan, who is a graduate student in the Humanitarian and Disaster Leadership M.A. program at Wheaton College. Her work lives at the intersection of anti-oppressive education, the arts, gender-based violence, and social justice advocacy. She currently leads 1N3, a student organization affiliated with the Humanitarian Disaster Institute that focuses on sparking awareness, education, and activism about global sexual and gender-based violence.


Li, Z., Ge, J., Yang, M., Feng, J., Qiao, M., Jiang, R., … Yang, C. (2020). Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control. Brain, Behavior, and Immunity. doi: 10.1016/j.bbi.2020.03.007