Coronavirus. Unprecedented. Pandemic. Wherever you are in the world, over the past nine months, these words have become part of our everyday vernacular. They’ve bred uncertainty, fear and mental turmoil as more than a million people have died, and the world we knew has been irrevocably changed. And no more so is this true than for the medical workers on the frontline of the fight against Covid-19.

These ordinary heroes have experienced the most challenging time of their lives – professionally and, in many cases, emotionally. Research has shown that first responders are at greater risk for mental ill health, and being able to reach out to friends, family and loved ones has been an essential part of dealing with the fear and unprecedented trials set by the coronavirus pandemic (there are those words again), not to mention the necessary isolation they’ve had to endure outside the hospitals and laboratories they work in.

To mark the first anniversary of the MR PORTER Health In Mind Fund, and as our small way of paying tribute to medical workers across the world, we spoke to healthcare professionals from Europe, the US, Asia and Australia to hear their unique stories, and to find out how they have coped.

“I can’t tell you how many days I would just walk through the front door silently to the back yard, sit and just cry hysterically. My girlfriend would hold my head and I wouldn’t have to say anything.” Dr David Gutteridge, 37, works as an emergency doctor at NYU Langone Hospital in Brooklyn. He can recall the last bar he went to, the last party he attended and the last time he was indoors with friends. It was 4 March. Within a week, everything had changed.

“I remember feeling like there’s a typhoon coming and we can see it, yet we don’t know what it’s going to look like or how to prepare for it.” Dr Gutteridge looks down to pick at something, maybe a thumbnail, and half smiles before regaining his composure. “On some level, doctors believe in our own invincibility, so this highlighted how little we can do sometimes. That was scary. Somebody would come with a sore throat and ask, ‘Doc, is this Covid? Am I going to die?’ I was like, ‘I had a cough yesterday, did I not wear my mask correctly? Am I going to die now?’ Seeing my own fears in my patients and seeing them as people, as opposed to a constellation of symptoms, was really meaningful.”

For Dr Gutteridge, the mornings were the toughest time – not getting enough sleep before waking up to deal with the prospect of what lay ahead. “Sometimes, [it was] the predictability of it; sometimes, the unpredictability,” he utters. With NYU Brooklyn one of the worst affected hospitals in the world, let alone the US, the predictability lay in being helpless to prevent people dying on his watch; the unpredictability was over how many lives would be lost that day.

Since the outbreak peaked, Dr Gutteridge has had experiences where he’s talking about something he saw and, all of a sudden, he’s no longer sitting with friends, he’s in that moment having palpitations and chest pain. “The first time it happened I was like, ‘Oh, wow, so this is what PTSD looks like’,” he says. “Intellectualising it can’t prepare you; feeling it is so wildly different.”

His saviours in all this have been his garden and his girlfriend, Holly. When New York City was on the verging of lockdown, Holly took one decision out of his overworked brain and moved in with him. “At first, I was unsure about it because I didn’t know if we were there yet,” Dr Gutteridge explains, “but she was very insistent and I knew I needed her, so I accepted her gift of helping and being there for me.”

Looking back, he has no words to describe how much Holly’s companionship has helped him fight the flashbacks, his demons and the excruciating unknown. That said, collateral damage has still been done. “I’ve realised there is a limitation to my ability to deal with multiple things,” he concedes. “I just had no emotional bandwidth to deal with anything except for my own heartbreak.”

Dr Jonathan Tsun Lai remembers the first time the coronavirus really scared him. As a hospital doctor in Hong Kong since 2014, his clinical duties would include walkarounds, outpatient care and minimally invasive procedures on patients. When Covid-19 hit in January, all that drastically changed.

“There’s a ceremony where you draw badges to see who gets rotated first in high-risk areas such as the isolation wards. If you’re first, you are frontline, helping patients who tested positive for Covid-19,” recalls Dr Tsun Lai calmly. “The fear is getting the virus yourself when you don’t know what it is and how harmful it is. And even if you get through the acute phase, will you get any long-term complications, and will you infect your immediate family members as well?”

On top of this, there was palpable uncertainty about the shortage of protective equipment, with rumours circulating that healthcare professionals wouldn’t be provided with the basics such as surgical masks. “You hear protective equipment is being centralised so you can’t get the equipment you need unless you ask permission for it. Overall, that was a period where everyone was really scared,” the 35-year-old explains.

Fortunately, in his colleagues he had an emotional outlet to help him through. “Having them relate to what is going on in your everyday work environment has been really useful. I’m also lucky I can always talk to my friends and family if I have a bad day.”

Unlike much of the world, Hong Kong had the experience of the Sars outbreak in 2003 to help initiate its coronavirus response. “The public was quick to be vigilant, wearing masks and practicing good hygiene but no one expected Covid-19 to last this long,” says Dr Tsun Lai. “Sars didn’t have such a global impact – shutting down travel, businesses, restaurants and gyms.”

Ultimately, it’s the curtailing of his favourite pastimes – “running outdoors, seeing friends and travelling” – that Dr Tsun Lai has found most difficult. “Exercising is my way to relieve stress, so I’ve found alternative ways to keep active, but it has been difficult to adjust.”

In late February, the largest known coronavirus super-spreading event outside of China happened at a carnival in Heinsberg, Germany. At the nearby University of Bonn, Dr Hendrik Streeck – previously of Harvard Medical School, US Military HIV Research Program and John Hopkins University – had just started a new role as the director of the Institute of Virology. “I remember sitting together with a colleague and saying, ‘This is an incredible chance to understand what the virus is and understand the pandemic.’”

Within a few weeks, Dr Streeck and his team had produced the now globally renowned Heinsberg Study, which was the first to identify the loss of smell and taste as a symptom of the virus. “We just put it out in popular press because we thought it’s so important that people know about one of the most characteristic symptoms.”

When Dr Streeck, 43, moved to Bonn in October, it was written into his contract that he had to live within 10 minutes of the hospital. “I asked why and the response was, ‘If there was a pandemic, you’d need to be close.’ We were all joking about it because we thought, ‘Well, that is not going to happen.’” No sooner had the joke become a living nightmare, Dr Streeck’s life was turned upside down. Suddenly, he was fielding calls from politicians for the latest updates, becoming one of the most recognisable Covid-19 experts in the world. When he speaks, the world now listens. But it wasn’t all as plain sailing.

“In the very beginning,” he says, “I was dealing with a shit storm and there were two ways to deal with it; either back away and not say anything more or keep on saying your qualified statements and contribute in a good way.” To his enormous credit, Dr Streeck chose the latter.

In his partner Mr Paul Zubeil, who works as a policy adviser at the United Nations Population Fund, Dr Streeck had someone to confide in emotionally, as well as being able to discuss the pandemic’s international impact with him. “He was able to tell me numbers, such as how many deaths we might face because of hunger,” says Dr Streeck, “because the hardest part of my job was communicating the risk in perspective, so I always just tried to walk this tight line between saying, ‘We have to take this virus seriously’ and ‘We can’t overdramatise it.’”

“People are still having heart attacks, suffering strokes and crashing cars throughout this pandemic,” says Mr Ed Hill, a 28-year-old paramedic who’s worked at the Bath station of the NHS’s South Western Ambulance Service for six years.

During the height of the outbreak in the UK, Mr Hill and his colleagues would have to balance the risk of admitting a patient to hospital and potentially contracting the virus, against treating them conservatively and keeping them at home. At their busiest times since lockdown was eased at the start of July, Mr Hill’s station and others across the south west of England dealt with almost 20,000 incidents a week, similar to what they would normally expect to deal with between Christmas and New Year, the busiest times of the year. “In a 12-hour shift, that’s about 10 patients, which is quite significant,” he says.

“They were really difficult times, and it’s fair to say I’ve struggled,” he says, sharing his vulnerability. In early July, Mr Hill and his partner, Becky, celebrated the arrival of their baby daughter, Margot, into the pandemic-stricken world. The celebration was given extra gravity because, in continuing as a key worker, Mr Hill had heaped risk onto his unborn child and pregnant partner. It meant forsaking what Mr Hill called “normal physical connection – hugs, kisses” and not being able to accompany his partner to many appointments, which left him feeling guilty. “If they got ill, how would I feel about that knowing the only way they’ve contracted that is through me?”

One thing that helped quash the guilt was removing all physical elements of work from his home life. “Often, in the emergency services, your uniform is your protective armour, where problems can bounce or deflect off,” he says. “Taking it off reminds you that you’re a dad, you’re a husband, so go home and be who you need to be.”

Mr Hill took solace in his 20-minute drive home from work. The inside of his Golf GTE provided him with a space to rationalise things and reframe any problems. His motto became, “Instead of thinking about what you can’t do, you have to think about what you can do”. He also made an effort to take regular walks with his family and to ignore his phone in order to get away from “the next death toll, the next case load”, to reduce the impact on his mental health, which he has suffered with in the past.

“While the pandemic has been really tough, it has been a positive thing because it’s made me realise that my attitude of ‘I’m OK’ had to change,” says Mr Hill. And having a baby, buying a house and planning a wedding amid a global pandemic has enabled him to be honest with himself.

“It’s made me realise it’s a bigger part of me,” he says. “When I started to accept that in my own mind, it made me feel so much more relaxed and comfortable. I am proud of that because it’s not easy to admit you’re struggling. Struggling doesn’t mean you’re failing or you’re going to lose, it just means you’re struggling.”

Ask any of Dr Brandon Verdonk’s friends and they’ll tell you he was a bad texter before the pandemic. “Now I’m a horrible texter,” he laughs. “I read messages and reply to them in my mind, then a week later my friends are like, ‘Why haven’t you been speaking to me?’ But they understand.”

Originally from Canada, Dr Verdonk moved to Sydney, New South Wales, eight years ago to study medicine. In September, he transferred to Sydney’s Westmead hospital, where he works as a junior doctor. “It’s one of the more intense emergency departments so I wanted to get some of that exposure,” says Dr Verdonk, 32, of the decision. In February, he had plans to start GP training, but that never happened.

Though NSW would only witness relatively few cases (4,212 infections and 53 deaths at the time of writing) compared to Melbourne, Victoria (20,100 and 771 respectively), the hours were still exhausting and Dr Verdonk’s work-life balance went out of the window. It was also the first time in his career that he didn’t have the answers available to him. “Normally, you go to someone above you and someone above them then you eventually get answers,” he says, smiling nervously. “But not with this.”

One advantage, he says, was the fact that the pandemic seemed to “happen everywhere else first”. He would read up on all the latest research, listen to podcasts and learn from the doctors in Italy, the US and the UK, who were acting blindly. He was determined to be prepared for when a second wave might hit Sydney hard.

Dr Verdonk admits all the hypothesising about life or death decisions he might have to make has been particularly hard to deal with. “It’s surreal to look around at work and think if we had an outbreak and all catch it, one of us would be intubating the other. And when push comes to shove, deciding who needs that ventilator the most.”

Above everything, he’s most proud of how he and his colleagues have reacted to living with the uncertainty of the crisis. “Maybe we had it lucky here compared to other places in the world, but we still read the headlines and everyone still showed up to work, put in the hours and looked after people.”

He also promises he’s getting better at texting his friends back. This was set to be his big year to go back home to Canada and spend a few months with his family, and though that’s been canned, he remains in good spirits.

“I have four brothers, so gaming has been good to keep in contact,” he says. “We hop in, play Fortnite and yell at each other so it feels like I’m back home, but there’s no substitute for being there in person.”