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employees who have a strong negative impact from the outbreak (e.g., those with close exposure to loss, illness, moral distress, or long-term wear and tear), here are a few additional recommendations:

Be patient.Stress reactions for those most strongly impacted by the COVID-19 outbreak can remain intense for some time.Fluctuations may occur in how well they are able to engage in work.They may function fine at work sometimes, and at other times feel like they can't function well.

employees who have a strong negative impact from the outbreak (e.g., those with close exposure to loss, illness, moral distress, or long-term wear and tear), here are a few additional recommendations:

Be patient. Stress reactions for those most strongly impacted by the COVID-19 outbreak can remain intense for some time. Fluctuations may occur in how well they are able to engage in work. They may function fine at work sometimes, and at other times feel like they can't function well. It may take time for them to "return to normal," and at times feel discouraged. If you share that these reactions are to be expected, they are a valued employee, and that you can work together to move forward, you can reduce a good deal of misunderstanding and conflict.

Believe in the person. People are often very self-critical when dealing with intense stress, especially those who have previously been very successful at work. They will benefit if you continue to believe in them while not putting too much pressure on them. It requires the capacity to listen and give permission to be both a functioning employee and a human being who is experiencing intense stress. It can be a relief for the employee to see that you hold them in the same regard as before but can tailor your expectations as needed.

Be a role model. When an employee is dealing with significant stressors and needs time off or other adaptations, you can play an important role by respecting confidentiality. That means taking a long-term perspective and not engaging in speculation or negative conversations about people when they are not present.

Advise and refer. If an employee indicates they are seriously struggling, it will be helpful to assist them in identifying specific concerns and issues that warrant additional support or require mental health treatment. Common reactions likely to affect mental, emotional, social, and physical functioning can be identified by the most appropriate person (e.g., supervisor, EAP provider, HR, etc.) An inability to sustain regular work duties in the months after the crisis has passed may be a symptom of complicated or prolonged stress-related illness. There are effective, evidence-based treatments that can reduce suffering and