Table 9.

Respondents’ comments on the biggest single challenge about COVID-19.

Category	Emergency nurses	Emergency physicians	Paramedics
Public complacency	“People in the community not taking restrictions seriously” (Respondent 3)	“Ignorance of the general public” (Respondent 1)	“People not following the guidelines” (Respondent 61)
	“Complacency as we have avoided the worst of the first wave” (Respondent 28)	“Concern about complacency” (Respondent 60)	“Public fatigue regarding COVID-19” (Respondent 108)
Inconsistent and rapidly changing information	“Discrepancy between directions provided by the ‘COVID team’ and our team leaders” (Respondent 12)	“Challenge of navigating inconsistent/rapidly changing advice in a high scrutiny environment (Respondent 72)	“Unclear, ever-changing guidelines” (Respondent 60)
	“Constantly changing information and situation” (Respondent 37)	“Confusion surrounding rapidly changing policies and practices” (Respondent 98)	“Stress of keeping up-to-date with the constant change in policy, procedure, guidelines (Respondent 133)
Lack of communication	“Changes imposed on work practice without effective communication. We are not given the opportunity to give feedback on any changes” (Respondent 46)	“Receiving clear communication about how to manage the outbreak” (Respondent 28)	“Not getting enough information, not getting the right information” (Respondent 42)
	“We never get told anything about planning until the moment it happens” (Respondent 35)	“Lack of clear written communication about rapidly changing guidelines” (Respondent 100)	“Trying to get a consensus/consistent approach from the doctors in our workplace” (Respondent 76)
Lack of plan	“The under-preparedness of health resources” (Respondent 48)	“It has highlighted pre-existing stresses in the health system” (Respondent 19)	“Reality checks for organisation” (Respondent 12)
	“We are not prepared and not enough manpower” (Respondent 50)	“We were under prepared nationally” (Respondent 85)	“Lacklustre response of the government as a whole” (Respondent 16)
Workflow management (e.g. changes and issues)	“Correctly streaming/identifying and then placing patient in the appropriate location” (Respondent 92)	“Balance between infection control mitigation strategies and providing overall patient care to the (current) vast majority of patients without COVID-19 (Respondent 7)	“All the changes to operating procedures” (Respondent 27)
	“Lack of appropriate space to ensure isolation” (Respondent 112)	“ED design not adequate for infection control” (Respondent 54)	“Expectation that we will rush into a home and not protect ourselves when everyone else is advised to keep a social distance” (Respondent 95)
Changes to staffing and workload	“Adequate staffing and training” (Respondent 49)	“Workload and the system's ability to cope. Caring for my staff” (Respondent 26)	“Doubling of my workload with no additional staffing assistance” (Respondent 131)
	“The constant anxiety and increased workload around every presentation” (Respondent 68)	“Other hospitals closing and the increased workload” (Respondent 39)	“Workload for managers and support staff who are developing and rolling our procedures” (Respondent 147)
PPE issues (e.g. availability and quality)	“Not enough PPE or sanitiser readily available” (Respondent 84)	“Inadequate PPE right from the start” (Respondent 32)	“No fit testing of PPE” (Respondent 13)
	“Lack of access to and knowledge surrounding use of PPE” (Respondent 127)	“Confusion over level of PPE recommended” (Respondent 44)	“Struggle to obtain sufficient PPE” (Respondent 29)
The ‘unknown’	“Unpredictability” (Respondent 74)	“Uncertainty” (Respondent 34)	“Uncertainty” (Respondent 11)
	“Wondering when it will end” (Respondent 124)	“Unpredictable course, makes it hard to plan both at work and in personal life” (Respondent 95)	“Uncertainty of the future” (Respondent 146)
Concern about self/family	“Passing on illnesses to my family” (Respondent 83)	“Risk to elderly relatives” (Respondent 13)	“Contracting diseases and passing it to others” (Respondent 59)
	“I can’t travel home…my mental health is not great” (Respondent 132)	“Getting infected from carriers with no symptoms” (Respondent 18)	“The social isolation” (Respondent 145)