As we face the ongoing global pandemic of COVID-19, doctors, and particularly general practitioners and family doctors (GPs), answer the call to serve in time-pressured, unfamiliar, chaotic, and often-traumatic environments. In each part of the world, the roles, resources, responsibilities, advice, and support will be different. Some will be at the forefront, others will be doing telehealth, or may find themselves back in a hospital situation rather than in the community.

Such an ongoing crisis is likely to leave us emotionally overextended, exhausted, feeling alone, hopeless, frustrated, have difficulty concentrating, and unable to access our usual support network. We are in danger of suffering from burnout or vicarious trauma and may respond with irritability, despair, or hopelessness. In particular, we need to prevent compassion fatigue and maintain our self-compassion.

Staying psychologically and physically healthy in this environment will be a challenge. It is imperative that we are intentional in how we look after our psychological and physical health. The COVID-19 pandemic is ‘not a sprint but a marathon’, and we need to ensure that our minds and bodies are healthy enough to endure.

In this article a group of family practitioners from around the world, members of the World Organisation of Family Medicine’s (WONCA) Working Party for Mental Health, share insights into how doctors and other health professionals can look after ourselves and each other during this time.

It is helpful to think about looking after well-being using the five principles of self-care:

Preparation – Pay attention to sleep, diet, exercise, and hobbies and maintain routine as much as possible. This might be with meditation, exercise or sleep apps on our phones. We need to acknowledge our own vulnerability and build a ‘resilience schedule’ that might include a gratitude diary, mindfulness, time with pets, connection to nature, online socialising with friends. Check in with colleagues and encourage them to keep on going with what keeps them well. We are all likely to tire of pushing ourselves and will need encouragement and extra support.

Protection – We know how to protect ourselves physically, but no matter what we do, it will not be perfect, and we might still be exposed to Covid-19. This is not a failure on our part, and we need to ensure we treat ourselves with the same care as we would our patients. We need to monitor our own physical and emotional wellbeing and be aware of early warning signs of being unwell, but also of compassion fatigue, burnout, and vicarious trauma. Be careful to preserve boundaries between work and home environments, especially if working from home. If it is necessary to continue physical separation from family and friends, this does not mean social separation, and we should maintain contact as much as possible, as this is essential to our wellbeing. This may mean meeting with our friends, faith groups or support groups online rather than face-to-face.

Professionalism – Try to limit Covid-19 information to reliable sources and do our best not to infect others with Covid-19, or with hopelessness. Have a ‘growth mindset’ and do not ruminate on ‘failures’, despite all the unknown facts and changing advice.

Promotion of hope, self-sufficiency and care for others – Be a role model and leader for staff, patients and students, with calmness and compassion for self and others. As a leader it is important to keep the team safe, retaining their core principles so they can work efficiently together. This includes looking after each other and supporting those who need ‘time out’ to care for themselves or family members.

Pathway of care when establishing the way into a sustainable future – Have our own family doctor and support people to debrief with. We need to be clear about our own health needs and seek care and advice from health professionals who understand our circumstances, will maintain confidentiality, and will not be judgemental.

Hopefully, on the other side we will be more aware of the importance of our relationships and our small objects of gratitude. We will find new strength, meaning and courage in ourselves and have a deeper awareness and respect for our collective resilience.