Front-line health care workers see you. They see you traveling for big, indoor holiday gatherings. They see you packing into bars. They see your social media posts from house parties. They see you without a mask.
And they know they’ll see some of you again soon, crammed into increasingly crowded hospitals as coronavirus infections skyrocket across the U.S.
For nine months, physicians, nurses and other workers in hospitals, nursing homes and clinics have put their lives and the lives of their family members at risk as they respond to a pandemic that has sickened 18 million Americans and killed more than 320,000. More than 3,000 Americans a day have died of COVID-19 in recent weeks, more than even during the initial surge of infections in the spring.
Tides of infectious patients pouring into hospitals threaten to overwhelm the entire health care system. Gravely ill patients are suffering and dying alone, with health care workers often the sole witnesses of their final moments. Health care facilities are short-staffed but the sick people keep coming. There’s never enough personal protective equipment (also known as PPE) such as masks. Illness and death are part of the job for medical professionals. But not this much, for this long, with the end still at least months away.
Medical professionals are physically and mentally exhausted. Americans aren’t making matters any better for them. All along, health care workers have pleaded with us to be safe, to wear masks when around other people, to socially distance when around others, to not get together in groups indoors. That’s still what they want, and they’re weary of asking.
“Don’t praise me, don’t call me a hero ― none of that. Stay home,” said Raul Garcia, a hospital nurse in El Paso, Texas. “Stay home, take care of yourself, stop going to see other family members. Just stay home,” he said. “At the end of the day, it is a lack of compassion.”
Misinformation And Misbehavior
When these front-line workers head home at the end of their shifts, they see the behavior that’s going to lead to more coronavirus infections. They also endure infuriating comments and unsafe behavior from COVID-19 denialists, including patients and their own friends and family members.
“I’ve had multiple patients say, ‘Nope, this is not COVID. There’s no way this is COVID. I’m going to go to work tomorrow, I’m going to continue with my daily life,’” said Stacey Marlow, an emergency room doctor in Waterloo, Iowa, who is the president of the American College of Emergency Physicians’ chapter in her state.
Some parents have refused to test their kids for COVID-19, even though they’re presenting symptoms, or ranted about wearing a mask in the emergency department “because COVID’s not real,” she said.
“I’ve had multiple young persons, mainly in their 20s, who have been going out going to bars and they come in with classic COVID symptoms, and their response is, ‘There’s no way I have COVID,’” Marlow said. “They are just so whiny, for lack of better word, but they’re very, very upset at their situation and want a magic fix. And it’s really hard sometimes to hold back and not tell them that, you know, the magic fix was you not going out to the bars. You should have lived your life differently.”
Marlow’s two young daughters know what their mother goes through, and that they aren’t allowed to touch her after work until she’s showered and put on clean clothes. They also understand the importance of masks, and they’re not shy about telling strangers, saving their mother the trouble, she said.
“When we go out somewhere and somebody has their mask on their chin, my kids say it to them. They say, ‘Mom, look, that person doesn’t have their mask on right. They’re spreading the virus.’ And I say that ‘yes, they are,’” Marlow said. “I’m considering that a public health intervention and I have not told them to stop saying it.”
All of these things are causing immense emotional and psychological pain for health care workers. It’s also sickened more than 100,000 health care workers and killed an estimated 1,700 of them.
“They use the word haunted,” said Donna Havens, dean of the Villanova University College of Nursing in Philadelphia. “They’re haunted by the COVID-19 experience, and talk about caring for their co-workers who died while they were caring for them. These are just unimaginable things.”
Havens is conducting a study on the psychological effects of the pandemic on health care workers. The early findings from Villanova’s surveys are grim, she said. These workers are suffering severe-to-moderate depression, moderate-to-severe traumatic stress, moderate-to-severe anxiety and moderate-to-severe insomnia. “This is alarming,” she said.
In the first months of the pandemic, front-line health care workers were hailed as heroes. In cities and towns around America, people would step outside nightly to applaud those fighting for us against the coronavirus outbreak. Government leaders curtailed daily activities to stem the spread. That helped, and health care workers noticed. They’ve also noticed how many Americans seem to have stopped trying to prevent the illness from proliferating, as the rising case numbers indicate.
“In the early stages, they were being celebrated,” Havens said. “That’s all stopped and I’m beginning to hear that, you know, first we were heroes, and now, no one knows we’re here. We’re just doing the best to stay alive,” she said.
Barbara Stanerson, a physical therapist in Iowa City, Iowa, who treats COVID-19 hospital patients, isn’t interested in the hero talk anymore.
“Somebody said, ‘Well, we want to do something for the health care workers. Can we bring in pizza?’ I said, ‘You know what? Go out on the street, and every person you meet without a mask, slap them across the face. That might help us,’” Stanerson said.
The trauma of working during the pandemic will linger after it’s over, Havens said, jeopardizing the health care workforce because disillusioned doctors, nurses and others will flee their jobs and find easier work to do within the health care system. “They’re all incredibly wounded,” she said.
Marlow understands that feeling. “Medicine is my calling, but it definitely made me question how long I will be able to practice, how long I’ll be able to practice at full time,” she said.
Alone For The Holidays
For Stanerson, COVID-19 denialism has hit home. Her family members who live nearby in her hometown don’t wear masks and they frequently gather together. Part of the problem, she suspects, is that her relatives are supporters of President Donald Trump, who downplayed the severity of the pandemic from the beginning and even insulted health care workers, lying by claiming they overcount cases for financial reasons.
“It’s caused a lot of stress within the family because they interpret my not being there for like Thanksgiving or birthdays or whatever that I don’t care about them anymore,” Stanerson said. “They just don’t connect it to the COVID virus and I’m like, ‘Guys, I’m with these patients all day, every day. I cannot take a chance on bringing this home to you,’” she said.
“I get angry more than anything, but at times, it does just kind of hurt because nobody wants to be alone over the holidays. I mean, it sucks,” Stanerson said. “It is hurtful ― especially friends or family.”
Stanerson wishes there were a way to make people understand how serious the virus can be. She asked Cathy Glasson, president of the Service Employees International Union Local 199 in Iowa City, for a macabre favor in case she contracts COVID-19.
“‘If I get this virus, and I get really sick, and I’m in the unit, I charge you with coming in there and filming every disgusting thing they do to me,’ I said. ‘And you put that out on the media. You get that out there. I don’t care what you show, but show these people what really is going on because they just don’t get it.’”
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