Table 2.

Illustrative participant quotes—Appraisal and Coping

Main theme	Sub-theme	Illustrative quote(s)
Appraisal	Initial overall appraisal of the situation	At the time the disease was not well identified, we did not know the symptoms well; they went in all the directions. So the ‘psychosis’a started to settle in our department. We were walking blindly. We did not know how to dance this dance. It was very complicated. There was much pressure, even if people didn’t express it verbally, you could feel it (male medical doctor, emergency, Senegal).
	Overall appraisal of the situation over time	At the moment, I can say that the ‘psychosis’a has passed. At the moment, it is fine. It’s still a bit stressful, but we’re managing to get through it at the moment, compared to the beginning (male nurse, COVID-19, Burkina Faso).
Coping	Problem-focused coping	In private life it was a bit difficult; there were steps you had to take that were almost impossible. How do you create distance at home? (Male nurse, maternity, Burkina Faso) I exercise a lot. I know it’s good in order to boost my immune system. […] Sometimes I just lie down and sleep in my free time and then when I wake up I feel fresh (male biologist, laboratory, The Gambia). We don’t spend that much time with patients, because the longer you stay with the patient the more likely that you may be infected too (male nurse, COVID-19, The Gambia).
	Emotion-focused coping	We did not have a psychologist, but we were psychologist ourselves, we supported each other (female nurse, COVID-19, Senegal). My best therapy is to talk to the family in the evening for at least one or two hours, I tell them what’s going on, my wife cheers me up, I talk to the children, it makes me feel better and the next day I try to get back on track (male doctor, COVID-19, Burkina Faso). They also sent a psychiatrist every day to come and meet with us, to give us a moral boost (male nurse, COVID-19, Burkina Faso). I think is my faith that helps me, I always say Allah will help me, let me do the right thing helping people with clean heart, and God will take care of the rest (female nurse, maternity, The Gambia).
	Meaning-focused coping	The country needs me and if I leave and someone else leaves, there won’t be anyone left here and then everyone will get the virus. Sometimes you have to sacrifice yourself (female hygienist, COVID-19, Senegal).
	Future-oriented coping	[My wife, who is also a doctor, and I] had a discussion and we said, there’s a reasonable chance that we’ll see a lot of COVID-19, and therefore there’s a reasonable chance that we would acquire it. We kind of weighed up our chances and thought to ourselves that actually, our chances of becoming seriously unwell were really very small, and therefore we weren’t too anxious about personally getting COVID-19 (male doctor, COVID-19, The Gambia).

^aSeveral French-speaking respondents spoke about ‘la psychose’ when referring to widespread sentiments in the early days of the pandemic. The term is not meant to refer to the respective psychiatric syndrome.