When it comes to the novel coronavirus, I worry… not about the things I see regularly in the news but instead the thing I don’t. I’ve been contemplating this since before Memorial Day, but I’m starting to think I’m the only one. How do we prevent a situation where critical medical and emergency resources are left asking, “Why should I help?”
While we have heard a lot of concern about inadequate supplies of test kits, PPE, and ICU beds, the most critical resource of all seems to be widely overlooked when talking about the recent surge in cases: Medical and emergency personnel. I can’t get past what they must be thinking at this point.
To set the scene:
Let’s say I am a doctor, a nurse, an EMT…
Let’s say I was working in New York City under what I thought were the worst possible conditions…
Maybe I lived and worked there…Or
Maybe I traveled cross-country to help, feeling blessed that my community was not (yet) in need.
Maybe I had co-workers die of covid-19…Or
Maybe they survived the virus but not the aftermath, taking their own life to escape the horrors, the PTSD, the depression from all the deaths we witnessed while feeling so helpless…Or
Maybe I survived but am suffering still from the experience and now am wondering…
Why did I risk so much, fight so hard, and lose so many trying to put a stop to the pandemic before it spread to consume the entire country…
When so few of those I tried to protect seem to care at all about doing their small part to limit the spread?
As they watch the numbers grow across the country, how can they help but wonder:
Why should I help you? If you care only about yourself, flouting all the precautions, and you or someone you care about end up sick, why should I care? Why should I help you when you weren’t willing to help anyone else when all it required was wearing a mask?
Yes, it’s my job, and maybe even my calling. But please don’t take me for granted. I have suffered much already, and going through it all again so soon may be too much to bear.
We’ve learned some things since March that help improve overall outcomes. But these methods take time, attention, and supplies (from respirators to remdesivir) to be successful, resources that aren’t always available when a facility is overwhelmed and the patients just keep coming. The chances of deadly outcomes increase, and the additional emotional/psychological trauma for medical personnel increases along with them, as they reflect on what they “could have done” if there were only the resources. Already in California’s Riverside County, one facility’s nurses launched a strike to protest understaffing and a shortage of PPE.1
Sure, PPE, remdesivir, and bed shortages are already being reported and now need to be sourced all over the country. It was a disaster just trying to get enough for a single geographic area in crisis. And people came from all over the country to help in New York, but we were still stretched to the limit. When the crisis is occurring all over the country, where does the help come from? I fear there just are not enough of us to go around.
As of June 28, the U.S. set single-day records for new cases for at least five consecutive days, and the total number of nationwide infections had risen past 2.5 million — roughly 25 percent of the world total — with the second peak of confirmed cases in the U.S. surpassing the initial peak in April. And already over 130,000 Americans have lost their lives to this virus.1
Even with the full ramifications of Memorial Day weekend not yet clear, the current surge of cases can only be expected to increase since plenty of people charged forward with Independence Day festivities, like those put on by our fearless leader. Speaking of which… The shout-outs to healthcare workers and first-responders “keeping us all safe” were a nice touch but rang more than a bit hollow in a setting filled with an unmasked crowd that will only make their jobs more difficult down the road. Actions speak louder than words.
How can you be so selfish and disrespectful? How much more can I take? And how much can you expect me to?
With Houston and San Antonio raising the flag about ICU limitations and VP Pence promising Arizona 500 medical workers, shortages are already becoming an issue. “Help is on the way,” Pence said, adding the federal government would “spare no expense to provide the kind of reinforcements you will need across this state should this coronavirus pandemic continue to expand in Arizona.”2
Where will these workers come from? How will they be prioritized for deployment with crises not just in Arizona but throughout the country?
Will they be willing to respond when healthcare companies opted to protect their budgets with layoffs and pay cuts before the first COVID-19 wave was even fully tamed? Will they be willing to respond to the government’s call when the government’s disregard or dismissal of the pandemic from day one created this “preventable catastrophe?”3
And this doesn’t even take into consideration the other critical cogs in the system – medical assistants, janitors, cooks, and others thrown into these situations without even earning livable wages or hazard pay. They have no choice but to continue just to stay afloat, the health and safety of themselves and their families be damned.
So I worry about our front-line workers and how they will respond.
- Will they be willing to go another round after just surviving the first one?
- Will they be able to, or are they too traumatized?
- How far does the Hippocratic oath or other compassionate care commitment go? At what point do they say “you’ve done this to yourself by being reckless so now deal with it”?
- How much exposure is too much for older staff, who may have already survived COVID-19, when we don’t yet know the details of any potential immunity?
- What if the students who were allowed to help before completing their medical training have a change of heart about their intended profession?
- What happens if those affected by layoffs and/or pay cuts (i.e., “jilted” as soon as the first crisis subsided) harbor enough ill will that they refuse to return for the current (or future) surges?
- Why should they pay the price for the careless disregard being shown by so many around the country?
These are the things that concern me at this point. I am not ignoring the impacts to the economy. I lost my job in the gaming industry, and women my age are expected to have a particularly rough go. Am I worried? Of course I am. But I can’t imagine anything worse than being responsible for the death of another or being unable to find care for myself or a loved one because others were irresponsible.
This country has pulled together so many times in my time on this planet. It breaks my heart to see the divide that grows every day at this point. How can this be a great country if we care so little for each other? How could anyone let this happen in the good ol’ U.S. of A.? What will it truly take to make America great again? And what will we do if, in the meantime, our most critical resources decide to ask, “Why should I help?”
UPDATE: One day after I posted this, two very relevant articles appeared in The Atlantic. Ed Yong wrote about the impact on public-health advisers/experts in “The Pandemic Experts Are Not Okay,” and Jacob Stern wrote about the mental health effects of the coronavirus on various groups in “This Is Not a Normal Mental-Health Disaster.” A couple of days later, the Las Vegas Sun published Brian Greenspun’s WHERE I STAND column: ‘It’s a hell show’: The truth from a doctor in the COVID-19 trenches.
On July 16, The Washington Post published “Sun Belt hospitals are feeling the strain from virus’ surge — and bracing for worse” by Griff Witte & Rachel Weiner.
On July 20, The Washington Post published an Opinion piece by emergency physician Esther Choo, “Covid-19 is pushing doctors to the brink. Medicine needs to recognize they’re human and need help.“
On July 25, The Washington Post published “Houston, Miami, other cities face mounting health care worker shortages as infections climb” by Frances Stead Sellers & Abigail Hauslohner, which confirms the reality of personnel shortages.
Finally, with the return of the scripted series in November, Hollywood strongly delivered the message (and conveyed the stressors of medical and other front-line workers). From pre-episode messages to plot points, hats off to The Good Doctor, NCIS: New Orleans, and Grey’s Anatomy for bringing it home at a visceral level.
Also in November, Ed Yong followed up with more in The Atlantic:
And from there the pace of coverage on this topic finally picked up on a broader scale:
- South Dakota nurse says many patients deny the coronavirus exists — right up until death by Paulina Villegas, The Washington Post, November 16, 2020
- Health-care workers are desperate for Americans to listen: ‘We didn’t go to nursing school to be martyrs’ by Soo Youn, The Lily, November 18, 2020
- ‘People are going to die’: Hospitals in half the states are facing a massive staffing shortage as Covid-19 surges by Olivia Goldhill, Stat, November 19, 2020
- The pandemic was already testing me. Then a man covered in Nazi tattoos showed up in my ER. by Taylor Nichols, The Washington Post, December 5, 2020
- Their Patients Have COVID-19 and Still Think It’s a Hoax Nurses treating coronavirus skeptics are being spit on and harassed. Many want to quit. by Angelina Chapin, The Cut, November 25, 2020
- On the COVID frontlines, we’re tired of hearing lame excuses for risky behavior By Mark Morocco, LA Times, November 23, 2020
- VIDEO: Nurse describes ‘horrific’ conditions in El Paso hospital treating Covid-19 patients, YouTube, November 20, 2020
- Headlines Don’t Capture the Horror We Saw by Kasey Grewe (anesthesiologist and critical-care-medicine fellow), The Atlantic, December 6, 2020
- What seven ICU nurses want you to know about the battle against covid-19, The Washington Post, Dec. 7, 2020
- What the Chaos in Hospitals Is Doing to Doctors by Jordan Kisner, The Atlantic, January/February 2021 issue
Last updated December 15, 2020
1 “The Failed U.S. Reopening Has Served Up a Feast for the Coronavirus,” Chas Danner, Intelligencer by New York, June 29, 2020 https://nymag.com/intelligencer/2020/06/failed-us-reopening-serves-up-a-feast-for-the-coronavirus.html
2“Pence vows to provide Arizona with 500 additional medical workers as cases surge,” Michael Brice-Saddler, Washington Post, July 1, 2020 (2:31 p.m.) https://www.washingtonpost.com/nation/2020/07/01/coronavirus-live-updates-us/
3 “The 3 Weeks That Changed Everything,” James Fallows, The Atlantic, June 29, 2020 https://www.theatlantic.com/politics/archive/2020/06/how-white-house-coronavirus-response-went-wrong/613591/