The COVID-19 pandemic and the resulting backlash to public health measures such as mask mandates has negatively affected the mental health of many health care workers charged with curbing the spread of the novel coronavirus, according to a new report in Stateline, a state policy blog published by the Pew Charitable Research Trusts.

The account reveals that a poll conducted by the Centers for Disease Control and Prevention found that 53% of 26,174 state, tribal, local and territorial public health workers exhibited symptoms of one or more serious mental health conditions within two weeks of participating in the survey. These conditions included but were not limited to depression, anxiety and posttraumatic stress disorder (PTSD).

Some experts say the effects of such conditions could impair the nation’s response to the pandemic. Between the stress of toiling overtime in dangerous, high-pressure environments and the constant threat of verbal or physical abuse by individuals who believe that the pandemic is fabricated or vaccines contain microchips, many public health workers are burning out.

Turnover rates often reflect this reality. For example, since the pandemic began, Michael E. Kilkenny, MD, the CEO and chief medical officer of West Virginia’s Cabell-Huntington Health Department, told Stateline that nearly a third of his department’s 30 employees have left. In particular, Kilkenny is worried about the contact tracers—individuals responsible for tracking exposures—among the department’s remaining employees.

“It’s those people who are getting cursed out five times a day every day—those are ones I am concerned about,” Kilkenny said.

In the CDC study, 11.8% of the public health employees and officials surveyed reported receiving threats with respect to their jobs and 23.4% felt bullied or harassed due to their work. Perhaps as a result, 8.4% showed signs of suicidal ideation, 30.3% exhibited signs of anxiety, 32% experienced signs of depression and 36.8% showed signs of PTSD.

“The prevalence of PTSD was 10% to 20% higher for public health workers than for frontline health workers and the general public,” Carol Rao, a coauthor of the report, told Stateline. “And that’s what stood out to us the most.”

Those public health employees and volunteers who said they either could not or did not want to take time away from work were nearly twice as likely to exhibit symptoms of the previously mentioned mental health conditions. In addition, those with a postgraduate education were more likely to suffer from PTSD, and individuals who were under 29 or younger, transgender or nonbinary, or multiracial were more likely to have suicidal thoughts.

For more on mental health in the age of COVID-19, read “Youth With Pandemic-Related Psychiatric Woes Overwhelm ERs” and “Sleepless Nights, Hair Loss and Cracked Teeth: Pandemic Stress Takes Its Toll.”