COVID-related Emotions Near an Edge During Holidays

I previously wrote about the fear factor among health care professionals early in the COVID-19 epidemic, analogous to the fear I observed early in the HIV epidemic. Now, at the edge of 2021, as we are experiencing our second surge of COVID-19 cases, it seems that most healthcare workers I know have a quiet resignation about the situation. We go about our jobs, wearing masks, in an environment where we know the COVID-19 status of all the patients, and where everyone else wears masks as well. That hospital environment is not 100% safe, of course, and transmission of SARS-CoV-2 likely still occurs, but the majority of us feels reasonably comfortable with the “new normal.”

Outside of the hospital, the situation seems very different.

The State of Georgia, where I practice, is now at more than 15% test positivity rate since the 1st of December, higher than it was 5 months earlier. In other words, community spread of the virus continues at a dangerous level. And it couldn’t come at a worse time, as people, ever more anxious to be with family, pushed travel to the highest levels seen during the pandemic.

Like many of you, I am sure, I am approached by family, friends, and colleagues who have questions about how to navigate our altered reality. As a researcher and clinician, I have no difficulty answering the queries about the virus, and now about the mutation, or about treatment, vaccines, or the wealth of public health guidance from federal agencies.

But there also are questions on emotion-laden issues on which it is much harder to provide counsel. These strike at the psychic toll of COVID-19 pandemic conditions.

I recently got a call from a colleague, not in the medical profession, whose wife and father-in-law tested positive for SARS-CoV-2.The father-in-law was fine, but his wife had to be hospitalized for 3 days with an O2 saturation that was in the upper 80s.Both his wife and father-in-law had taken a pleasure trip to another state that was experiencing a huge surge in cases, and where restaurants and bars were still open. Mask usage was inconsistent, at best, in that environment. He asked my professional advice, not about how to best treat COVID-19, but how to deal with the anger that his two college-aged children were directing at his wife concerning her decision to travel for pleasure.

And he wanted to know how best to tell his wife that he didn’t want to be in the same house with her, at the same time that she was terrified to be alone.

Just yesterday, I was called by a student who had developed symptoms consistent with COVID-19 several days after he went home for the holidays. He had eaten with his family on multiple occasions, without anyone wearing masks. His nasopharyngeal swab PCR test came back positive. He wanted advice from me about how to tell his dad the results.

He apparently told the news first to his younger sister (over the phone), who burst into tears upon hearing it.

The “non-medical” advice questions I get often are the hardest to answer. Nevertheless, these questions typically are the most important ones to the persons asking them. There is no substitute for experience, but I do address these and similar issues during my small-group sessions with first- and second-year medical students. Issues of empathy, compassion, understanding, sincerity, and patience are discussed, even role-played or simulated, as part of our students’ training. We start this part of their education in their first year.

I feel very privileged and honored that so many individuals, students, faculty, friends, colleagues, and patients, trust my opinion on matters concerning a virus that isn’t going away anytime soon. I have no doubt that the majority of health care professionals in similar situations feel the same way.

We are all in this mess together, and together we will prevail.

Rodger D. MacArthur, MD
Professor of Medicine, Division of Infectious Diseases and Office of Academic Affairs
Medical College of Georgia at Augusta University, Augusta, Georgia