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The Pandemic At One Year: A Personal Reflection





The woman was far too young. I’ll call her Sharon, although that’s not really her name.

Sharon was tiny and slim, almost childlike in appearance. Her long, dark hair was entangled with electrocardiographic wires and nasogastric tubes. Surrounded on all sides by banks of insistently beeping IV pumps and the myriad multicolored monitoring devices we all rely on when someone is critically ill, she was still supine, having not yet reached the stage in COVID-19 respiratory failure when she would be turned face down just to help her lungs work. That usually came later.


Most importantly, although she was intubated, she was awake.


I approached her ICU bed in full PPE—head covering, goggles, N95 mask, gowned and gloved. I knew that all she could really see of me were my eyes, so I tried consciously to smile. Patients can tell by your eyes when you are smiling. Sometimes, the smile in someone’s eyes is the only shred of humanity they know, and they cling to it.


I grasped her hand in mine, turning it over. Some of her fingernails still had chipped blue-spangled nail polish on them, a remnant from a more carefree time.


Her wide, dark eyes were filled with fear.


“Hey,” I said. “How are you feeling? Are you having any pain?”


She shook her head but squeezed my hand even more tightly.


I hate the way my voice sounds when I’m in full gear. My words end up muffled and distant, and all nuance of verbal emotion is lost.


She’s the same age as my children, I thought. The idea lodged heavy in my chest, like a sharp-edged stone.


Sharon had children of her own. Pictures of them festooned the walls, their freshly-scrubbed faces grinning in static school portrait fashion. One was a tiny cherub not more than six months old. On a piece of tan construction paper, one of her kids had drawn a stick figure in crayon of a long-haired woman with her arms outstretched, as she were going to embrace someone.


“Get well soon, Mama!!” the inscription across the top of the picture s in a child’s crude block letters.


But her children could not see her. Her husband could not visit, either. Those were the COVID House rules, and they could not be broken.


Sharon let go of my hand and made a scribbling motion.


“You want to write a note?” I asked.


She nodded.


I handed her a pen and some paper clipped to a clipboard. Her penmanship was crooked and shaky, but I could read it plainly enough.


“AM I GOING TO DIE?” she asked.


I leaned down toward her so that she could see my eyes.


“No,” I said, taking her hand in mine once again.


I could have been lying. I didn’t really know, and I didn’t really care. The cruelty of any other answer would have been too much of a burden for her.


A year ago this week, Savannah had its first case of COVID-19. Back then, we did not know very much at all about the illness itself or about SARS CoV-2, its causative agent. Now we have three vaccines authorized to use against it. We’ve become more proficient at managing the disease after it attacks. The medical community’s approach to COVID 19 has been a work in progress, to be sure, but we can almost see the light at the end of the tunnel at this point.


Almost.


The mountains of data can be mind-numbing at times, but reviewing it is worthwhile: As of this writing, there have been about 22,000 documented cases of COVID-19 in Chatham County. Over 380 people in our county, and nearly 700 in the Coastal Georgia health district, have died from the disease (https://covid19.gachd.org/cumulative-cases-deaths-by-age/ ). It’s hit home for me in a very personal way, as I’ve lost several friends, a few medical colleagues and a number of long-term patients to COVID.


The official U.S. casualty figures are about 29 million cases and 523,000 deaths. The death toll alone is staggering, a number exceeding the total number of American soldiers' lives lost in warfare during the entire 20th Century, a period of time that includes two World Wars, the Korean conflict and Vietnam (https://en.wikipedia.org/wiki/United_States_military_casualties_of_war ). However, using those dry recitations of morbidity and mortality data to measure the impact of COVID-19 grossly underestimates the pandemic's impact on humanity. Deaths which have been directly attributed to COVID-19 only account for two-thirds of the excess deaths seen during the pandemic year, implying either some deaths caused by COVID-19 were unrecognized or that there were excess deaths in 2020 caused by other factors, such as substance abuse, suicide or non-COVID illnesses which were neglected or not effectively managed due to the pandemic (https://www.bmj.com/content/371/bmj.m3948 ). All of these variables likely played a role in the excess mortality figures. Here's one startling figure: Life expectancy in this country dropped by 1.13 years during the course of 2020 alone (https://www.livescience.com/us-life-expectancy-drop-covid-19.html ).


Even those horrific figures fail to illustrate the overall impact the COVID-19 pandemic has had on our nation and our world. It has been estimated one out of every three Americans has lost someone they are close to to COVID-19 (https://www.nytimes.com/interactive/2021/03/05/us/covid-deaths.html ). I've seen many families whose lives were torn completely apart by COVID-19, and that's a statistic you'll never see in any chart. The morbidity and mortality data don't measure the long-term debility incurred by many COVID-19 survivors, nor do they gauge the impact of depression, alcohol and drug abuse, domestic violence and other impacts of the pandemic-related lockdowns and job losses.


Among health care workers such as myself, the pandemic has engendered a pervasive element of fear. It has been estimated that nearly 3000 U.S. health care workers died of COVID 19 during 2020 (https://www.statista.com/chart/23882/healthcare-worker-deaths-by-state/ ). My fellow health care providers and I have lived with the sheer terror of becoming infected with COVID 19 and possibly transmitting the illness to our loved ones for over a year now. In that respect, the capricious randomness of the disease is perhaps its most frightening characteristic . While the old and sick generally do worse, some older patients have no symptoms at all. Conversely, COVID will sometimes savage unsuspecting young folks like Sharon, in the prime of life. The tragedy can be heartbreaking. We see it every single day. And most of us have had nightmares about bringing that sort of tragedy into our own homes.


I have a collection of overstuffed paper bags in my office. The bags are filled with all of the N95 masks I’ve used during the past year. I’ve been afraid to throw them away because I wasn’t certain I would be able to get any more—and if I don’t wear an N95, I can’t work safely. I mask up each morning at 6:30 and don’t take my mask off until I go home at night, typically around 7:30 PM.


I’m living for the day that I can throw those damned bags away for good.

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