If the COVID-19 pandemic has demonstrated anything, it is we are all vulnerable to stress. Yet with every crisis, we plan for recovery of facilities, technology, and supplies. The focus seems to be on everything but employees, especially those who appear to be “unaffected.”

Reliance on existing staff to cover for employees directly affected by a crisis, such as those who have lost a home or who have fallen ill, is a necessity. However, what about staff who appear to be fine but are not?

Do we succeed enough at making sure those working through the crisis are not suffering from burnout, anxiety, or stress – which can have long-term effects?


Crisis management is in the forefront of many companies’ activities since the onset of the COVID-19 pandemic. While there is much guidance around mitigation, recovery, and resilience of critical processes, facilities, and technology, there is much less information about dealing with a company’s greatest asset: employees. This article discusses concerns regarding the effect of a prolonged crisis on frontline employees. It describes how to recognize and diffuse potential situations using psychological first aid (PFA) techniques. Additionally, the authors will touch on the value of instituting a pre-crisis employee well-being program to offset the increased stress when a crisis strikes.

COVID-19 has caused several businesses to shutter their doors. Alternatively, other businesses have seen their workload surge dramatically. As the need for, say, healthcare, goods, and financial services rises, there is an increased demand on those industries’ employees to deliver. While this level of demand could potentially be sustained in the short-run and with a full staff, this is hardly the case during the current pandemic. Many employees in these industries have fallen ill or have had to scale back their attendance to take care of sick family members. This leads to increased strain on the remaining workforce. The increase in responsibility is often coupled with personal fears and familial concerns.

Interviews with medical staff showed healthcare professionals, despite having a renewed interest in remaining dedicated to helping patients, also wrestled with exhaustion, fear, frustration, and concern over family members. As an employer, how can you prepare for such a situation? As a manager, how can you spot the signs and be proactive in addressing the situation? The authors believe some techniques used in psychological first aid can be useful.

The Human Factor During a Crisis

During any crisis there are always certain groups or industries whose skills or products are in great demand. The recent pandemic has proven it is not always the obvious. Yes, hospital workers, masks, and ventilators come to mind. However, also in demand are the grocery store employee, delivery person, and bank staff. These groups are inevitably faced with an additional workload and long hours. These “frontline” workers often have to contend with a great deal of stress, not only related to additional workload and hours but also from factors such as the welfare of family or friends, family cohesiveness, financial strain, childcare … the list can go on and on.

Many times, employers will focus on staff who reach out for help or who are clearly affected by the crisis, such as those people who have fallen ill or those who have an ailing family member. However, there is a danger to those not openly affected but who are suffering emotionally. Those employee issues are sometime overlooked or ignored because managers often do not recognize there is a problem. Many do not have a program to address employees’ emotional well-being. The factors which contribute to an employee having emotional angst include fatigue, stress, tension, and depression. After a prolonged period, these stressors can manifest themselves in physical symptoms or post-traumatic stress syndrome (PTSD).

Consider the human function curve in the accompanying graphic. Research has shown that up to a certain point, the more stress one adds to a person, the better that person performs. We all need some stress to work as manifested by job assignment, incentive, need, etc. However, after a certain point, adding more stress is detrimental to the person. Performance starts to decrease, leading to fatigue, exhaustion, and finally a breakdown. Each person’s “hump” stress is different, making the manager’s job even harder.

The Human Function Curve

The COVID-19 Pandemic

Current research has shown anxiety and tension occur during crisis situations where employees have increased workload and pressure yet have little control over outcomes. Today’s news stories are inundated with reports of people experiencing stress, burnout, and anxiety. One particularly disturbing story is about a physician who contracted COVID-19 and beat it. However, she could not handle the stress of losing so many patients to the disease. She subsequently took her own life. While this is a sad and extreme example, it demonstrates the potential for stressors to produce dire results.

What exacerbates the issue is the difficulty in determining which employees are experiencing normal levels of stress/anxiety versus those in a situation which can turn into a full-blown case of burnout or PTSD.

Prior to COVID-19, smart organizations realized the benefit of providing emotional well-being tools to their employees. Many offer an employee assistance program (EAP) or equivalent. The recent pandemic has underscored the importance of this benefit and has caused the trend to soar. A recent survey shows that more than half of the companies studied are providing resources for employees as a means to cope with the stress and tension of the pandemic. This is a great start but is a reactive approach, whereas being more proactive could add additional benefits.

Psychological First Aid (PFA)

The American Psychological Association defines PFA as “an initial disaster response intervention with the goal to promote safety, stabilize survivors of disasters, and connect individuals to help and resources.” This is accomplished in the workplace by addressing the stressors which lead to burnout and PTSD. The main objective of PFA is to establish a human connection which serves to calm and support employees while providing coping mechanisms and access to professional assistance.

Despite the connotations of its name, psychological first aid does not look to diagnose or treat a problem. PFA simply recognizes there is a problem and tries to determine its seriousness. This recognition will provide a person an opportunity to seek additional help if it is required. Many of the activities recommended during PFA are already part of a well-established emotional well-being program. However, regardless of how mature the program is, it is no substitute for professional help if an employee is suffering from acute distress. This recognition and acknowledgement of symptoms is what sets PFA apart from traditional well-being programs.

Protecting Your Employees: What Organizations Should Consider

Employees are an organization’s greatest asset. It makes sense the organization would want to safeguard that resource. Just as companies devise strategies for resiliency for processes, facilities, and technology, they should plan to implement employee resiliency by incorporating stress recognition and reduction into business continuity planning.

People undergoing mental trauma can experience physical changes, emotional changes, cognitive changes, behavioral changes, and spiritual changes. Recognizing the signs can help determine employees who may require some attention. However, while some indicators are readily apparent, others may not be easily identifiable. Some behaviors to look for include

  • confusion or distraction
  • being overly scared or flustered
  • verbalizing despair
  • irritability or agitation
  • lacking motivation
  • hopelessness

Simple PFA techniques can help identify when someone is suffering an acute crisis or are in distress. Providing resources for employees as part of a well-being program can set an employee on the road to recovery. Some recommended actions using PFA are to

  • simply provide a compassionate ear
  • provide measures to increase a feeling of safety – something as simple as providing personal protection equipment (PPE) could foster a feeling of security
  • provide tools for calm and comfort – apps such as “Calm” provide comforting sounds to aid with relaxation and sleep
  • promote feelings of connectedness so employees do not feel they are experiencing something alone
  • foster a feeling of self-efficacy

These actions associated with psychological first aid can be the difference between a person who successfully weathers a crisis versus one who experiences a negative consequence such as burnout.

Once it is recognized an employee could have a serious reaction to the situational stress, organizations should provide information on coping mechanisms and/or provide professional services. These could prevent long-term impacts on the employee and the organization. Many perceptive companies provide counseling sessions for employees whose anxiety is too much for them to handle alone.

To some, the concept of applying PFA may sound somewhat excessive and out of the realm of what an employer should undertake. However, as Forbes recently reported, “(PFA) is better conceptualized as documenting and operationalizing good common sense – those activities that sensible, caring human beings would do for each other anyway.”


The need to incorporate an emotional well-being component into business continuity plans and response is clear. Preparation is the key to successfully weathering a crisis; in this case preparing for employee resilience is beneficial to both employers and employees. Although not a typical topic addressed in the business continuity field, employee wellness is a valid business continuity strategy. Employees are key to an enterprise’s success. Employees drive productivity, generate ideas and possess institutional knowledge; they need a resiliency strategy. While such a program should undoubtedly be driven by human resources, business continuity should have a seat at the proverbial table. The PFA program, like EAP, should be documented in the organization’s business continuity plans.

The realization that stress, anxiety, PTSD, and/or burnout are problems which need to be addressed in the workplace is becoming more and more apparent. One way to take an employee well-being program to the next level is by sharing PFA techniques – before the crisis starts – so managers and employees can recognize an employee in acute crisis. The overriding benefit of using these techniques is to safeguard employees from long-term stress-related impacts. It is important to note that PFA, like EAP, is not labeling, diagnosing, or treating employees; it simply shows compassion. PFA provides tools so an employee can feel safe, calm, supported; it also furnishes them with resources for additional assistance if needed.


The effects on employees of an extended crisis such as COVID-19 – illness, loss of life, and high workload coupled with isolation and anxiety – will have short- and long-term adverse impacts. With advance planning, organizations can prepare to proactively address these issues, thereby lessening their severity on employees. PFA techniques can help lessen the effects of employees in distress. Recognizing the signs an employee is suffering from burnout or PTSD can result in an employee getting the professional care they need to restore their emotional well-being. This outcome will not only benefit the employees but also support the overall welfare and recovery of the organization. Employers who adopt a holistic approach to the overall well-being of their staff realizes numerous benefits. Employees who are physically and emotionally healthy are less absent and more productive. Employers who demonstrate a willingness to care for employees’ total health are appreciated, respected, and supported by their staff. More importantly, it is the right thing to do.


Angela Bellino & Steven Goldman

Angela Bellino is business continuity manager for First Republic Bank in New York, N.Y. She may be contacted at abellino@firstrepublic.com. … Dr. Steven Goldman is senior lecturer of crisis courses at Massachusetts Institute of Technology in Cambridge, Mass. He may be contacted at Goldmans@MIT.edu.

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