Opinion: Supporting those on pandemic’s frontlines

Are we just vital statistics, waiting to be calculated? COVID-19 has infected and killed more than 50,000 Americans. We must remember that every single one of these deaths is a loved one — a son or daughter, a father or mother, a husband or wife, a friend, a colleague. And in the background of each one of those deaths is a healthcare worker. A doctor holding the phone allowing loved ones to say goodbye, a caring nurse holding the hand as the family cannot, a respiratory therapist ensuring they are breathing comfortably.

“How are ya holding up?” – a friend texts me.

I’m an infectious disease doctor caring for patients with COVID-19 in Atlanta hospitals. My work has provided a strong sense of purpose. Even while tending those dying, we are enrolling patients in clinical trials, constantly testing medications, and developing new protocols to improve care — filling me with scientific vigor.

“I am doing alright, I think,” I respond. All things considered, I get to work face-to-face with literal heroes everyday, while others are often alone in isolation.

“Yea, but didn’t you sign up for this?,” another friend teased.

To be clear, 99% of health care workers did not sign up for disaster medicine. When entering the profession, most did not envision their days were going to be filled with fear, questioning their own mortality. Most did not envision days with bruises on their face from prolonged mask use. Two from my own team contracted the illness recently, leaving me with the anxious question, “Am I next?” To be fair to my friend, I am part of a very tiny minority that did sign up for this line of duty. I studied communicable disease control and contagion prior to the outbreak, I have practiced in areas with turmoil before, and infectious disease has been my lifelong calling. But you should not and cannot assume this is true for others.

Medicine changes you; death changes you. Grief comes in waves. When I think about what I am seeing – the horrors of so many intubated patients suffering from multi-organ failure, the amount of deaths, some of whom are young veterans — I cry. I can count on one hand the amount of times I have cried in my adult life. One, when my parents died when I was younger. Two, when my brother died unexpectedly five years ago. Three, at the end of “A Star is Born,” and four, when my other brother had his perfect daughter. Yet, I can’t help but get emotional at the COVID-19 images seared into my mind.

The daily appreciation and acknowledgement I receive keeps me anchored. Some make my smile, while others, unintentionally, exponentiate stress.

I write today to provide personal suggestions on how to support your friend or family member in the health workforce battling COVID-19.

1. Reach out, but with an expectation of short and simple conversation and often without a reply.

Your goal is to let the other person know you are thinking about them and opening the opportunity to chat if they want to. Remember, many workers are feeling overwhelmed and may not respond immediately. If you don’t get a response, try not to take it personally. Sometimes, I won’t respond until I’m off and have more energy, which can be days later.

The messages I enjoy the most are ones that say something like “Thinking of you, no need to respond but am proud of you.” Instead of expecting a reply, enjoy the thought that your message probably delivered a slice of happiness and perhaps made a difference in someone’s day.

2. Use informal modes of communication

With the demanding schedule of pandemic work, phone calls can feel intrusive and possibly laborious, while emails seem impersonal and cumbersome. Instead, try reaching out via text message or Facebook. I know this affords me time to respond whenever I can and eliminates the feeling that you may have reached out at a bad or inconvenient time.

3. Avoid creating more work

After reaching out, try to shy away from asking pointed hypothetical coronavirus questions or posing clinical dilemmas. Questions like “When will this go back to normal?”, “When can my grandparents visit my baby?” are tough to answer in general and may cause stress.

Also, if you wish to send equipment donations, perhaps go directly to the hospital or through an organization, as coordination may require work. Items such as meals are appreciated as they save time cooking, but know it requires off-time to accept.

4. Don’t assume we saw the news from 5 minutes ago

A new health policy, test, or treatment is approved every day. The environment is incredibly dynamic. Questions like “What are your thoughts of this?” may seem benign at first but require the healthcare worker to investigate further.

In addition, we are not frontline news reporters. I am often asked “What is it like in the hospital or ICU?” “What’s it like in your city?” Being repeatedly asked questions to relive my experience may risk further trauma. I know these questions have good intention, but ask yourself why are you seeking these answers? Is the question to help the healthcare worker process their experience, or is it to address your own fear?

Instead, you could share an article and simply state “I saw this was going on and it made me think of you, I hope you are okay. I’m here for you if you ever need to talk or get things off your chest.”

5. Know we appreciate you

Medical professionals are likely to experience fear, anxiety, and a sense of powerlessness. We know how hard it can be to follow distancing protocols. It can feel like Netflix and chilling are insignificant in the pandemic world, but these protocols are one of the few methods we have to curb cases while we learn more about the disease. Your commitment is saving lives.

Life in medicine is a storm – one moment we are basking in the success of extubating and discharging a patient, then shattered onto the rocks the next as a patient succumbs to COVID-19. We as medical professionals are going through trialing times, but simple, thoughtful acts can really help support us.

Jesse O’Shea, M.D., is an infectious disease fellow and internal medicine physician at Emory University.