Table 3.

Illustrative participant quotes—emotion

s

Theme	Illustrative quote(s)
Fear of own infection	The first days were very stressful as we didn’t really know how the illness transmitted. […] This made patient care very very difficult. Our psychological state … a patient needs you, you go to them because you don’t have a choice, it’s your job. But psychologically, you are not prepared, and the [protective] material is not of good quality. It was stressful every second. […] Now, in terms of protection, we feel more at ease (male nurse, COVID-19, Burkina Faso). When I was called to tell me that I was requisitioned for COVID-19 triage, I didn’t sleep. I asked [my supervisor] what I did to get him to give my name. He told me that he just chose at random and reassured us there will be measures so that we are really safe. […] But when they [later] told us that there were now cases in the hospital, it really scared me! I was really, really scared. Now it’s ok, I’m afraid but not like at the very beginning (female nurse, COVID-19, Burkina Faso). We were not trained, we were not given proper equipment. If we had suspected cases, the only thing we used were our mask, and proper handwashing, but other materials we didn’t have. […] Before [COVID-19] started, it was normal … you do see tuberculosis cases in pregnant woman, there are all sorts of diseases that you can get from the patient. But the fear of COVID-19 is too much, different from the others (female nurse, maternity, The Gambia). No, I didn’t feel any worries. I sometimes even tell my colleagues that the safest place is to be in the lab because you are in full PPE and you know exactly what you are dealing with, so you are very careful. Not like when you are out there in the public, when you don’t know who is infected and who is not (male biologist, laboratory, The Gambia). Yesterday somebody said to me ‘I looked at the television, we have 20 or 25 cases, so I am going to remove my mask’. People are completely slacking off. That’s why I’m afraid. And with Tabaski starting soon, I am afraid. I was a little optimistic, but with the religious ceremonies coming up, the virus may return. I don’t know what will follow (female midwife, maternity, Senegal).
Fear of being a risk to others	I don’t want to take the disease and transmit the virus to my family; my biggest worry was that (male nurse, COVID-19, The Gambia). I was quarantined because my mask fell off while I was in the patient area. I developed a fever, and they came to my house to take a sample. It was at this precise moment that I understood that I was a danger for my family and my relatives. Fortunately, I was negative. I moved to find a house where I am alone (male doctor, COVID-19, Burkina Faso).
Guilt	The first days were not easy at all, especially towards my family. I felt guilty, to go and expose myself [at work], and to come back home to be in contact with them. So when I got home, I tended to sit by myself, wear a surgical mask, not wanting them to come near me. With time this anxiety has dissipated, I won’t say totally, but now I feel at ease, it has become a routine for me (female doctor, COVID-19, Burkina Faso).
Compassion	The families are devastated, when someone is sick and you cannot have access to that person, I feel their pain. […] Some of the [patients] are also not taking it easy, the last one we had was so difficult, we had to moved him to the open ward. He was alone in the side room, but there is a glass wall so he was able to see all the nurses and we also able to see him. […] It is very difficult, we actually feel their pain (female nurse, COVID-19, The Gambia).
Anxiety vs optimism regarding the future	I am optimistic, but also anxious because when I go out or when I watch TV, and see how our population behaves, I realize that we [health workers] make efforts to treat those who are ill, but people really don’t respect prevention measures. It’s, excuse my language, like they don’t give a damn (male doctor, emergency, Burkina Faso).
Feeling left alone vs well supported	Towards governments and institutions, particularly emergency and maternity departments: At the beginning of the pandemic we were receiving patients, sometimes there were signs of COVID-19. […] We sounded the alarm and tried to talk to the head of the department, the director, everybody. They told us that it’s paranoia, we’re giving into the psychosisa. There was no preparation. The first confirmed patients went through the emergency room, many doctors took care of them without protection, there was a lot of contamination. I was furious, I think it was negligence. We could have been prepared if we had wanted to, since January we talked about it, but we were not listened to (female doctor, emergency, Burkina Faso). Towards direct managers: Doctor X meets with us, it cheers us up that our superiors really think a lot about us. […] We discuss [our issues], each one gives their ideas. There is much [support] with the superiors, especially with Doctor X (male nurse, emergency, Senegal). Towards team members: We really feel the presence of a team, of a very positive team spirit. Religions, ethnicities, other things, we don’t see the difference. […] Sometimes we pay for a snack for everyone, or we make tea for everyone, to create a positive team spirit, to support each other, because we don’t want to isolate ourselves, because we are also isolated (male hygienist, COVID-19, Senegal).
Feeling unappreciated, devalued and disrespected vs appreciated, valued and respected	Towards governments and institutions: It’s as if we are cannon fodder. […] Why don’t they give us enough protection? (Male doctor, emergency, Senegal) I think that after COVID-19, a lot of doctors will throw in the towel (male doctor, COVID-19, Senegal). We’re not taken into account. There were billions and billions in [the COVID-19 response]. We don’t know at all [what happened to the money]. All this is revolting. We have the impression of wearing ourselves out for very little. You do the maths, you wonder why you are doing it at all (female doctor, emergency, Burkina Faso).
	Towards patients and wider public: With the patients we feel at ease, it is they who give us the strength to continue with their prayers, their encouragement (male nurse, COVID-19, Senegal). It’s revolting, knowing that you risk your life so that this disease doesn’t spread, people allow themselves to say anything. Really, it’s disappointing (male nurse, COVID-19, Burkina Faso).

^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.