Coronavirus disease 2019 (COVID‐19) has evolved into a global pandemic. Having already experienced the first two waves of infections, in Japan the battle against the disease is expected to last even once the third wave ends. During these waves, many healthcare workers (HCWs), who wore personal protective equipment (PPE), treated COVID‐19‐infected patients with a sense of responsibility despite the absence of vaccines and established medical treatment protocols. In clinical settings, HCWs wear PPE, such as a mask, particulate respirator, goggles, face shield, gloves, apron, and gown, as a preventive measure against infection when caring for COVID‐19 patients, based on the Centers for Disease Control guidelines.¹ HCWs have treated COVID‐19 patients in spite of the risk of infecting themselves and their family members and being targeted by harmful rumors associated with treating COVID‐19 patients. Under such circumstances, incentives for HCWs involved in the potentially long‐term battle against COVID‐19 can be a critical factor in their willingness to continue to engage in COVID‐19‐related work. However, it remains unknown how HCWs evaluate the incentives provided for them. Therefore, we investigated frontline HCW’s awareness of these incentives by conducting an anonymous, open web‐based, and author‐developed survey between 27 August 2020 and 14 September 2020. Members of the Japanese Society of Education for Physicians and Trainees in Intensive Care (JSEPTIC), an organization focused on providing education and research on intensive care medicine, were selected to reflect clinical practice across different HCWs in Japan. The 157 participants included 114 physicians (72.8%), 25 nurses (38.5%), 12 medical engineers (18.5%), four physical therapists (6.2%), and two pharmacists (3.1%). Of the respondents, 77.7% had experienced a dangerous situation, such as getting infected themselves, while treating COVID‐19 patients. Our findings showed that a larger number of HCWs (88.5%) considered financial incentives (FIs) as an important motivation even after the decision of the Government's Supplementary Budget for Healthcare Staff Dealing with COVID‐19 in Japan.² A number of participants selected “the number of hours wearing PPE” and “procedures with a risk of aerosol generation” as factors for seeking incentives. The salary reports of Japanese HCWs showed that the basic salaries of most HCWs are determined by the seniority system, regardless of the hospital department, specialty, or professional expertise.³ Therefore, if there were no FIs, such as risk allowances, there would be no difference between the salaries of HCWs working in low‐risk environments and the salaries of HCWs working in environments with a high risk of exposure to COVID‐19. Compensating HCWs at the level of FIs requested may not be easy; however, maintaining their motivation is as critical as vaccine development and therapeutic agent discovery.

Our results also showed that a majority of frontline HCWs chose “undergoing a regular SARS‐CoV‐2 PCR test” and “regular mental health counseling” as other necessary incentives. Compared to nonphysicians, physicians are significantly more likely to undergo regular mental health counseling (P <.05) (Table 1). Previous studies have demonstrated that frontline HCWs caring for COVID‐19 patients are at a higher risk of burnout and psychological symptoms of depression.⁴ In addition, a recent study reported that providing adequate PPE was also a critical factor in preventing nurses from experiencing a magnitude of mental health problems.⁵ We believe that sustainable, not temporary, incentives, such as FI, regular SARS‐CoV‐2 PCR testing, and mental health counseling, for frontline HCWs would need to continue for as long as they are engaged in COVID‐19‐related work.

While there is a possibility of selection bias, the limitations of an anonymous, original author‐developed questionnaire, and the small sample size, to our knowledge, this is the first report to explore PPE‐wearing frontline HCWs’ awareness of incentives put in place for them while they deal patients with COVID‐19 in Japan.

2019年冠状病毒病（COVID-19）已演变为全球大流行病。在日本已经经历了前两波感染，即使在第三波感染结束后，与该疾病的斗争也有望持续。在这些浪潮中，尽管没有疫苗和既定的医疗方案，但许多戴着个人防护设备（PPE）的医护人员（HCW）对COVID-19感染的患者产生了责任心。在临床环境中，根据疾病控制中心的指导原则，医护人员应穿戴PPE，例如口罩，颗粒呼吸器，护目镜，面罩，手套，围裙和工作服，以预防感染COVID-19患者时的感染。 。^1个尽管有感染自身和家人的风险，并且与治疗COVID-19患者有关的有害谣言成为目标，但HCW仍治疗了COVID-19患者。在这种情况下，对可能与COVID-19进行长期斗争的医护人员的激励措施可能是他们继续参与COVID-19相关工作的意愿的关键因素。但是，医护人员如何评估为他们提供的激励措施仍然未知。因此，我们通过在2020年8月27日至2020年9月14日期间进行匿名的，开放的，基于网络的，由作者开发的调查，调查了一线HCW对这些激励措施的认识。 ），该组织致力于提供有关重症监护医学的教育和研究，选择以反映日本不同HCW的临床实践。157名参与者包括114位医生（72.8％），25位护士（38.5％），12位医学工程师（18.5％），4位理疗师（6.2％）和2位药剂师（3.1％）。在受访者中，有77.7％的人在治疗COVID-19患者时遇到了危险状况，例如被自身感染。我们的研究结果表明，即使在日本政府针对日本处理COVID-19的医护人员补充预算决定后，仍有大量的医务工作者（88.5％）认为财务激励是重要的动机。在受访者中，有77.7％的人在治疗COVID-19患者时遇到了危险状况，例如被自身感染。我们的研究结果表明，即使在日本政府针对日本处理COVID-19的医护人员补充预算决定后，仍有大量的医务工作者（88.5％）认为财务激励是重要的动机。在受访者中，有77.7％的人在治疗COVID-19患者时遇到了危险状况，例如被自身感染。我们的研究结果表明，即使在日本政府针对日本处理COVID-19的医护人员补充预算决定后，仍有大量的医务工作者（88.5％）认为财务激励是重要的动机。²许多参与者选择了“佩戴PPE的小时数”和“有产生烟雾的风险的程序”作为寻求奖励的因素。日本医护人员的工资报告显示，大多数医护人员的基本工资是由年长制决定的，而与医院部门，专业或专业知识无关。³因此，如果没有金融机构（例如风险津贴），则在低风险环境中工作的医护人员的工资与在高暴露于COVID-19风险的环境中工作的医护人员的工资之间就不会有差异。在所要求的金融机构水平上补偿医护人员可能并不容易；然而，保持其动力与疫苗开发和发现治疗剂同样重要。

我们的结果还表明，大多数一线医务工作者选择“接受常规的SARS-CoV-2 PCR测试”和“定期的心理健康咨询”作为其他必要的诱因。与非医师相比，医师更可能接受定期的心理健康咨询（P  <.05）（表1）。先前的研究表明，护理COVID-19患者的一线HCW具有更高的倦怠风险和抑郁心理症状。⁴此外，最近的一项研究报告说，提供足够的个人防护装备也是防止护士出现大量精神健康问题的关键因素。⁵ 我们认为，只要一线医护人员从事与COVID-19相关的工作，就需要继续采取可持续的激励措施，例如FI，定期SARS-CoV-2 PCR检测和心理健康咨询。

据我们所知，尽管存在选择偏见的可能性，匿名的，由作者原创的原始调查表的局限性以及样本量小，但这是第一份探讨佩戴PPE的一线医护人员对激励措施意识的报告。在日本为他们治疗COVID-19患者时为他们服务。