The New York Times recently reminded us that frontline health care workers — more than anyone else — have been the one constant in the face of today’s pandemic. Says the Times’ Katherine J. Wu, they stand as “medical soldiers forming row after row in the ground war against the raging spread of the coronavirus.” This week, we saw the 79th anniversary of the attack on Pearl Harbor. A correlation between this moment in history and today’s health care workers standing tall in the face of an overwhelming attack rings true.
The ongoing struggle of these caregivers was also silently present in a scaled-back annual National Pearl Harbor Remembrance Day ceremony. Of the more than a dozen living veterans who survived the attack and normally attend the annual commemoration in Honolulu, none was present. According to Stars and Stripes, military members who were present wore face masks and socially distanced as they addressed the cameras and a virtual audience. Initial plans for the memorial were changed with coronavirus infections on the rise in Hawaii. The state of Hawaii’s Department of Health reports 91 new COVID-19 cases per day. The master of ceremonies for the Pearl Harbor Visitor Center event, Navy Lt. Cmdr. Mike Genta, ended his comments with the pledge to “continue striving for a better and safer world.”
By the end of that fateful and historic day in 1941, more than 2,400 Americans were killed and 1,100 were injured. In the fight against COVID-19, USA Today reported that the University of Washington’s Institute for Health Metrics and Evaluation projects the pandemic will have caused more than 345,000 deaths in America by Jan. 1, 2021. “We are in a bad position,” Ali Mokdad, chief strategy officer for population health at the University of Washington and professor at the Health Metrics Institute tells USA Today. According to the report, “COVID-19 hospitalizations (are) near 100,000 in the US. And experts fear facilities soon (will) be ‘overrun’ by patients and a lack of staff.”
As pointed out last week, the current onslaught is happening as many frontline health care workers have reached the limit of the capacity of their bodies to carry on. Adds Wu, “especially without sufficient tools to defend themselves against a disease that has killed more than 1,000 of them.”
“I am an emergency medicine doctor and Iraq war veteran in New York City on the frontlines of the coronavirus pandemic,” writes Dr. Cleavon Gilman in an online journal through which he is chronicling his COVID-19-related experiences. “Each day, I enter a war zone, risking my life to provide the best patient care and save as many lives as possible,” he writes. Working as chief resident of emergency medicine at New York Presbyterian Hospital, he described to Insider as it feeling like a boundaryless war. “It’s not unusual to walk into a shift and there’s a corpse or something like that from an hour prior that has tags on the sheets. That’s just a constant reminder that I’m in a war zone. He says it’s “a lot harder” than being in Iraq.
As reported by Kaiser Health Network, “Researchers are concerned that nurses working in a rapidly changing crisis like the pandemic can develop a psychological response called ‘moral injury.'” It occurs “when nurses feel stymied by their inability to provide the level of care they believe patients require.” It can lead to burnout or worse.
The American Nurses Association, the American Association of Critical-Care Nurses and several other nursing groups have compiled online resources with links to mental health programs as well as tips for getting through each pandemic workday.
According to The New York Times, doctors may be reluctant to seek out such mental health services. “Many state medical boards still ask intrusive questions about physicians’ history of mental health diagnoses or treatments in applications to renew a license — a disincentive to many doctors who might otherwise seek professional help.”
It is said that with the Spanish flu of more than a century ago, resistance to public health measures (like those imposed today) was neither as vocal nor as widespread as at present. According to Howard Markel, professor of the history of medicine at the University of Michigan and co-editor-in chief of The American Influenza Epidemic of 1918-1919: “A lot of these rules and regulations were wrapped up in the patriotism of World War I, and most people followed them. But we don’t have that unifying situation right now.”
There also seems to be a building consequence that the failure today is not in the message but in the messaging. As noted by The New York Times, The Centers for Disease Control and Prevention urges people to wear masks in videos that feature scientists and doctors talking about wanting to send kids safely to school or protecting freedom. “I think that’s one of the challenges,” Jennifer Balkus, an infectious disease epidemiologist at the University of Washington School of Public Health, tells USA Today. “The tools we have had since April are the tools we have now. That consistency is good, but it can feel frustrating.” Seemingly lost in the conversation is the fact that if even a small fraction of people do not comply with the safety measures, it can still lead to thousands of cases. Even deaths.
While Dec. 7, 1941, marked the beginning of a war, the year 2020 also marked the 75th anniversary of the war’s end, when Japanese officials signed the surrender agreement aboard the USS Missouri. As we reflect on those times, let’s also take a moment to remember the sacrifices both large and small that Americans made during those war years. They were sacrifices made in support of a common effort. “It was a remarkable, extraordinary time. Never before or since has America been so unified,” Craig Shirley of Fox News recalled in a story that ran in March.