Our study was based on data collected from the nursing staff of the covid-19 care center and from observation of the hospital environment. The average age was 42.3 ± 8.1 years. 85.7% of the respondents were men and 14.3% were women. This population consisted of 31% Physicians/Pharmacists, 47.6% Nurses and 21.4% support staff. These results are higher than those found by NGOYI, et al [12] This could be explained by the difference between the two professional and academic groups. Health workers were the most affected (16.5%) who had easy access to information and testing services for COVID-19. The positivity rate in our study was 30.79% (97 cases/315 samples) comparable to that found by O Sangho et al with 30.90%. [It is higher than those found by Togola et al [14] and Moubarak Lo et al [15] respectively with 14.86% and 10-20% but lower than that of Greffe, S et al [16] with 38%. The detection rate was 2.56 ‰ which is comparable to that found by O Sangho et al [13]. which would explain an under notification of cases due to the delay in the delivery of samples and the availability of results by the INSP (National Institute of Public Health) which was the reference laboratory distant 380 kms from Sikasso. 36% of positive patients (35/97) were treated at the treatment center and 62 as outpatients.

The majority of respondents had a good knowledge of COVID-19. These results are similar to those found by other authors [17, 18], notably in DRC, Uganda, Vietnam and China. This may be related in part to high exposure to information provided by the media, and the awareness raised by the media since the spread of the virus. Media coverage may be considered an effective way to mitigate the spread of the disease [19]. The change in status of the hospital as a center for disease management, has caused "fear, stress, panic" among caregivers. More than half of the respondents had no experience in managing epidemics. And this inexperience supported the fear, anxiety and even panic. In summary, the anticipation of the seriousness of the epidemic in terms of pulmonary prognosis led to two main types of decisions: measures to limit the spread of the virus via barrier measures (wearing masks, hand washing, confinement); a reorientation of care activities towards resuscitation and respiratory assistance practices, which required the mobilization of a considerable number of health care personnel and led, in parallel with the containment measures, to the cessation of a whole series of ambulatory or non-VIDOC related activities [20].

Recently, Brooks et al. summarized these in the Lancet [21]. The review reports about twenty studies, mainly in Asian countries but also in Canada, Sweden and some African countries. In general, a negative psychological impact is described, with an increase in symptoms of acute stress, anxiety, dissociative confusion, anger and post-traumatic syndromes. Some studies have also reported long-term effects. In terms of the intensity of the consequences of confinement, these are more frequent when the quarantine is prolonged. P. SLOVIC has thus demonstrated that there was a very high correlation between the perception of the average incidence of risks and the frequency of their coverage in the press, so that he could conclude that the media have a strong influence on collective beliefs in terms of health risks [22]. J. DELUMEAU has thus highlighted the continuities in the object of fears in the West. His study of epidemics over the centuries reveals the constancy of the episodes of collective panic that they provoke. This historically generalized anxiety may have been further aggravated by the fact that the re-emergence of infectious diseases has undermined Westerners' confidence in the ability of modern medicine to contain such epidemics [23].

Members of the rapid response team at one point felt isolated and ostracized. This feeling of isolation was less among physicians and among health care managers who participated in many meetings with teams from other departments. This result corroborates the finding of NICKELL and colleagues that "having a management or supervisory position reduces the likelihood of feeling isolated within the hospital during an outbreak." [24]. The change in the status of the hospital as a center for the management of the disease caused "fear, stress, panic and even constraint" among the caregivers. Subsequently, with media pressure and staff training, this fear gradually dissipated. Despite these fears and uncertainties expressed by the health care personnel, the hospital was able to carry out its missions and benefited from equipment and materials to fight covid-19. This information is similar to that reported by Jenny et al [17] during a study on Ebola expressed as follows: "In this respect, it has been shown that the appearance of the risk of Ebola has disrupted these social representations. At the same time, the organizational response resulting from the confrontation with the risk also contributed to destabilizing them. However, when it comes to assessing the situation, once the risk has been integrated, it is clear that the normalization of the risk has helped to reinforce pre-existing representations.

"In the end, there is great uncertainty about the characteristics of the disease (number of reservoirs, transmission routes, incubation period, etc.) and the means to be deployed to deal with it (protective equipment, care protocols, etc.). Moreover, the Ebola epidemic was part of a particularly frightening frame of reference: that of the risk of spreading a fatal disease in a context of globalization. Although contemporary health crises no longer cause mass casualties as they did in the past, the frame of reference of a deadly crisis, such as the Black Death or the Spanish flu, in the case of Ebola, strongly structures the definition of a health crisis event. This feeling of unpreparedness, more or less strong depending on the services because of their own habits in taking care of patients suffering from an infectious disease, was exacerbated by an anxiety-provoking media coverage of the epidemic as our interviews showed. It seems, therefore, that the global health crisis has exacerbated dysfunction at the hospital level among caregivers. It has, in this way, highlighted the differences between the health structures of the South and the North, including access to intensive care with adequate equipment and anti-covid-19 vaccination coverage.

The different efforts of preparation, training, communication and support in the care system have, at first, challenged some hospital routines by the implementation of new procedures, by the drafting of protocols and by the installation of new devices. This process of setting up the health response also highlighted the usual problems of hospital organization and was able to support certain classic claims of the various professionals.