Some of Canada's doctors are feeling high levels of fatigue and anxiety one year into the COVID-19 pandemic according to a survey by the Canadian Medical Association, and concern over the country's vaccine rollout was listed as one of the main reasons.

The CMA survey, conducted on 1,648 practising physicians who responded between Feb. 18 and 22, found 69 per cent felt an increase in fatigue over the last year, with 65 per cent experiencing anxiety around the pandemic.

Canada's vaccine rollout stalled through February as shipping delays affected supply of Pfizer-BioNTech and Moderna's products. But the rollout has ramped up in recent weeks as supply has been restored and new vaccines have been approved. 

Dr. Jennifer Kwan, a family physician in Burlington, Ont., said she wasn't surprised to see the high levels of fatigue and anxiety reported among doctors in the CMA survey, given her own experiences and conversations with peers over the last few months.

"If anything I'm surprised it wasn't higher," she said.

The survey results were released Wednesday, marking nearly one year since the World Health Organization labelled the COVID-19 crisis a global pandemic on March 11, 2020.

Sixty-two per cent of respondents said concerns about Canada's vaccine rollout were contributing negatively to their mental health, while increased time with social restrictions (64 per cent) and continued uncertainty about the future (63 per cent) were the other top concerns.

Family physicians have felt additional stress of altering the care they can provide to patients since the pandemic started, Kwan says, and frustration has built recently as they've fielded calls and emails from patients about vaccine availability, without many clear answers to give them.

Thirty-nine percent of the CMA survey respondents said the lack of engagement with doctors in administering the vaccines has been one of the key challenges of the rollout. Concerns about vaccine supply topped the list at 93 per cent while not having clear direction on priority groups was also a popular answer (52 per cent).

Ontario announced Wednesday that family doctors in six regions -- Toronto, Peel Region, Hamilton, Guelph, Peterborough, and Simcoe-Muskoka -- will start administering COVID vaccines to patients aged 60-64 this weekend.

The rollout is expected to open up to more family doctors' offices as supply grows, something Kwan has been waiting for.

"We want to be able to help our patients, and we know which ones are in need of it," she said. "But I don't have access to the vaccines to do that right now."

CMA President Dr. Ann Collins says family doctors have been underutilized across the country during the rollout. While some physicians have volunteered or been recruited to help administer vaccines at clinics, the lack of immunization being done at their offices has been confounding, she adds.

"They're in a prime position to talk to their patients about it and then deliver it," she said.

Canada's rollout, which began in mid-December, is lagging significantly behind several countries in doses administered per population.

Just over 5.3 per cent of Canadian residents had received at least one dose of a COVID-19 vaccine as of Wednesday afternoon.

The recent approval of vaccines from Oxford-AstraZeneca and Johnson & Johnson is expected to allow Canada's inoculation plan to expand in the coming weeks, however.

Dr. Sumon Chakrabarti, an infectious disease expert in Mississauga, Ont., says that while the percentage of doctors who reported fatigue and anxiety is alarming, there may be more reason for optimism now than there was last month, when the survey was conducted.

Chakrabarti says he's noticed a shift among his own colleagues to a "bit more of a positive outlook."

"We know that mental health is a huge issue in COVID, whether it's for people in health care or people in the community," he said. "But what I find interesting is right now, we're in the best position we've been in since the beginning of the pandemic."

While Chakrabarti acknowledged legitimate concerns with Canada's rollout, he worries some people may be "disproportionately emphasizing the difficulties compared to the good parts."

"We're getting some good news -- Johnson & Johnson (being approved), a million doses of vaccines delivered this week," he said. "But then we're also hearing the ongoing drumbeat -- a third wave is coming, variants are here. That is taking the forefront of the messaging ... and it can result in anxiety in health-care professionals and otherwise."

Collins says the most striking result of the survey was that of the 65 per cent of respondents who reported increased anxiety, only 16 per cent indicated that they had sought help.

"This clearly shows us that we still have some barriers that we need to work on around physician health and wellness," she said.

This report by The Canadian Press was first published March 10, 2020.