It was summer in central Pennsylvania. Rays of sun shone down onto golden cornstalks. Children played in community pools. Neighbors gathered for picnics and barbecues. People started dining indoors in restaurants again. Families enjoyed vacations that had been put on hold in 2020. Our local hospital had fewer than five hospitalized COVID-19 inpatients for the first time in more than a year.
It seemed like life might almost be back to normal. And yet, for those working in health care, it was like an eerie calm before the storm. We were keenly aware of the delta variant and the havoc it was wreaking on the other side of the earth, while steadily moving westward. And in a strange twist of events, as people removed their masks and stopped social distancing, we saw a huge outbreak of non-COVID-19 respiratory illnesses in babies and children, who quickly began filling up pediatric units across the country. We trembled at what it might look like if these patients kept coming as the next potential COVID-19 surge hit. We were dismayed by the fact that, at that point, Lancaster County’s total population had not yet reached the 50% mark for COVID-19 vaccination. We sighed as we realized that many school reopening plans did not include masks.
And then, in late summer, it happened. In just a matter of weeks, we went from fewer than five COVID-19 inpatients to more than 60. And that number continued to climb. Staff members in the emergency room were once again working harder than ever. The intensive care unit again filled with COVID-19 patients on ventilators. In some cases, whole families were sickened.
But this time was different. This surge was not like the surges we’d had before. And one of the biggest reasons for this is that the majority of death and destruction we’re seeing with this surge could have been prevented.
The toll it’s taken
In the beginning of the pandemic, so many of us pulled together as a community, indeed even as a country, to care for one another. Now pandemic-related issues have become politicized and we are seeing so much more of an “everyone out for themselves” attitude. In the early days of the pandemic, those in health care were heard. We were trusted. We were counted on to care for the sick and dying.
Now? It seems everyone has become an expert in public health, infectious disease, microbiology and statistics. At times, the misinformation spreads faster than the virus. Our pleas to take precautions seriously and to get vaccinated have been met with skepticism, mockery, threats and even violence. Our efforts to stabilize and treat patients and to save lives have been questioned as unnecessary, dishonest and even greedy. In many cases we, instead of the disease itself, have become the target of people’s anger. And yet, we are still counted on to care for the sick and the dying, as they continue to show up. And of course, we will continue to do so as long as we are able.
But it has taken a toll. We are exhausted. We often feel defeated. We are frustrated. We are heartbroken. We are traumatized. Sometimes we are even afraid.
We don’t talk about these things much outside of work, for many reasons — we don’t want to burden our friends and loved ones; we know they probably won’t be able to relate to our experiences; and we don’t want to “contaminate” our time off with what is happening at work. So we talk to therapists, clergy and others in health care. But at what cost? It is as if we are living dual lives, further isolated from those who cannot, who will not, see what we are seeing.
It has been intense. We are all so tired. We watch in disbelief as people fight over mask mandates and mitigation strategies and claim their personal right to spread aerosolized virus. Day after day, we put ourselves and our loved ones at risk, exposing ourselves to COVID-19, working long shifts to care for sick patients, sweating beneath layers of protective equipment, then stripping off our clothes and showering when we get home to avoid spreading any germs to our families.
We live in fear of bringing COVID-19 home to our unvaccinated children and our elderly parents.
Pharmacies are overwhelmed by people wanting COVID-19 tests. Home tests are harder and harder to find. Family physicians, weary of hearing the same disinformation and anti-science rhetoric, have given up trying to have meaningful conversations about vaccination with some of their patients, and are sad that people won’t do their part to protect the vulnerable. Once again, hospitals across the nation are canceling elective surgeries and bringing already exhausted people in to work overtime. In some states they are even rationing care, as COVID-19 hospitalizations pull resources that they don’t have to spare.
Do you know what really makes us cry in the stairwells though? It’s not just that across our country children are losing parents, parents are losing children, and families are being changed forever. It’s the fact that almost all of the deaths and the majority of hospitalizations we are seeing this time around were completely preventable.
COVID-19 mitigation measures and vaccines work, and the numbers prove this. And yet here we are, in another “Groundhog Day,” wondering if things will ever end differently.
It’s not hard for people to look away from what is happening when they don’t have to watch patients and families suffering day in and day out. But those who work in health care don’t have the luxury of looking away. And as a result, our country is seeing an increased incidence of burnout, suicide and post-traumatic stress among those in health care. There are increasing staff shortages as those who have weathered this past year and a half have left the field due to the overwhelming stress, and their replacements often come on board without much experience.
So many times, we’ve wished that someone who expresses disbelief about COVID-19 and vaccines could make rounds with us, join us for office hours, work a shift in the ICU, or even the morgue. Walk through the hospital. See what we are seeing. Because we cannot and will not share specific stories. HIPAA (the medical information law) and our deep respect for our patients’ privacy keeps us from disclosing these details.
One recent morning, I read an article titled “COVID’s Assault on the Moral Fiber of Medicine” in one of my online medical journals. It was such a spot-on description of what is happening now.
Health care workers in every domain — nurses, physicians, respiratory therapists, aides and care assistants, housekeepers, technicians, pharmacists, contact tracers, paramedics, EMTs, administrators, and everyone else who holds our health care system together in the trenches — are experiencing true moral injury. We have been villainized by conspiracy theorists for wanting to do the right thing. For giving the best, most up-to-date and evidence-based care to our patients. For staying late and working extra shifts when we long to be home with our families.
And yet, we are resilient. We show up hour after hour, day after day, week after week. And we will continue to do what we have been called to do, until we no longer have the resources to do it.
But we’d love your help. Please. Realize that while we’ve come so far, the pandemic is not over, and each person needs to continue to do their part to care for each other. Wear your mask when you are in an indoor public place outside your home, or in a larger group of people anywhere. Avoid crowds. Practice social distancing if you have to be indoors with people outside your immediate family, including at work. Get tested and stay home if you have symptoms or a significant exposure. Learn what constitutes symptoms and “significant exposure” by looking at the Centers for Disease Control and Prevention website (cdc.gov) or by talking to your physician. If your kids have symptoms, get them tested and don’t send them to school while you are waiting for the results. Get vaccinated and get your children vaccinated as soon as they are eligible.
We ask that you take these actions not out of fear, but out of love. Show your children what it really means to care for our fellow humans. And, if you are so inclined, check in from time to time on those you know who are working in health care, and ask them how they are doing. I’m sure they will appreciate it.
Dr. Alexandra Solosko is a pediatric hospitalist employed by Children’s Hospital of Philadelphia who practices at Lancaster General Hospital. LGH is part of Penn Medicine Lancaster General Health.