The Hidden “Blessings” of COVID-19

Contributor: Z. Colette Edwards, WG’84, MD’85
To learn more about Colette, click here.

 

COVID-19 is a devastating virus. It affects every corner of the globe. At the time of this writing there are more than 27 million confirmed cases, and deaths are well on the way to reaching 1 million. The U.S. has led the world for many months, accounting for approximately 25% of each of the numbers. The future is uncertain, and it is unlikely things will ever go back to “normal” again. And therein lie the hidden “blessings” of COVID-19.

The novel coronavirus is transformational, forcing us to change whether we want to do so or not. It’s moving at lightning speed, not caring one whit if we are ready.

In the U.S., the virus is surging well past its prior peaks, and ICUs are filling to 100% capacity again. And the second wave forecasted for the fall hasn’t even hit yet.

To add to an already complicated picture, there is now news of an emerging flu virus, G4, discovered in pigs in China. G4 is similar to H1N1, can spread from pigs to people, and current seasonal flu vaccines are reported to not be protective. This virus has the potential to become a pandemic.

“As the current crisis ultimately abates, we need to remember the lesson that the system can be reset.”  ~ Pamela Hartzband, MD

For several years it has been difficult for me to imagine how the world and the human race would be able to dig out of the hole we created. I believed it would take an unprecedented and global event to save us from ourselves. Mother nature seems to have given us a second chance and the opportunity to create a “new normal.” Let’s not blow it, people!

Personal Blessing #1: Comfort Amidst the Grief
My father died in December 2019, two days before his 93rd birthday, after a long and difficult journey through cerebrovascular dementia.

He was a brilliant, compassionate, dedicated, and beloved physician and was a man frequently ahead of the times. He was a devoted, gentle, and loving father of two children, who believed his daughters should never be limited in their dreams and aspirations because of their female gender or race.

I miss him every day. Most of the time his death still does not seem quite real because I feel his spirit so strongly.

So how was his death a blessing? He passed from the earth pre-COVID.

He was hospitalized 8 times the year of his death and would have been at high risk for severe complications and death from the novel coronavirus. Just imaging the anguish if he had died in the hospital all alone and, due to his dementia, likely thinking he had been abandoned when he took his last breath is haunting.

And then not being able to have the opportunity to celebrate his life in person with family and friends would have made things even more heartbreaking.

Timing is sometimes everything, and I feel immense gratitude for his having been spared a COVID death. And, in that way, the coronavirus has helped bring comfort on days when grief is strongly making its presence known.

Personal Blessing #2: Even More Special Family Time
Except for two and a half weeks thus far, I have spent the year with my mother. She had knee replacement surgery, thankfully at the hands of a skilled sur-geon and without complications. Her recovery was uneventful and proceeded more quickly than anticipated.

And then COVID-19 arrived on the shores of the U.S. So we’ve been sheltering in place together since February, taking as many precautions as possible to reduce the risk of exposure and infection. The blessing? I treasure this oppor-tunity to spend so much concentrated time with her, especially so soon after my father’s death.

Climate Change
“We are the first generation to feel the impact of climate change and the last generation that can do something about it.”  ~ Jay Inslee

By 2019 we seemed to have reached the point where even taking all the actions recommended by the scientific community would still have been way too little way too late. However, it’s mind-blowing to see how quickly (less than a month!) the air became crystal clear in places like Los Angeles, China, and India with cars off the road due to a global quarantine.

The Blessing: Vanishing pollution and air quality that is better than it has been in decades has shown in a very visible way that IFwe become conscious and consistently committed stewards of the environment NOW, we have the power to reverse course and save a future in which the earth is not only habitable but life-sustaining.

A second pandemic, the ongoing emotional fallout from COVID-19, followed the novel coronavirus pandemic.

And with the now widely acknowledged and long-standing epidemic of racial injustice, police brutality, and the frequent killings of African Americans at the hands of law enforcement, a “trifecta of suffering” has emerged.

8 minutes 46 seconds….the time it took for the life of George Floyd, an unarmed African American man in Minneapolis, to drain from his body under the knee of a white police officer on his neck, in full and brazen view for the entire world to see and clearly without fear of retribution.

Research by social scientists has found that when one person makes a sustainability-oriented decision, other people do too. You have the power to inspire others to take action.

A “Trifecta of Suffering”

“The only thing necessary for the triumph of evil is for good men to do nothing.” ~ Andrew Marshall

The world is feeling turmoil and a wide range of emotions – fear, horror, disbelief, grief, heartbreak, anger, resentment, rage, an ignited sense of purpose and a reactivated commitment to action. For some, overwhelming physical and emotional exhaustion has set in. After all, we have seen some version of this movie for 400 years.

But much of the world had its eyes opened wide in less than 10 minutes to the deep-seated racism which stalks its victims each and every day. Sometimes in ways that are “small,” but spirit-crushing (like the daily microaggressions so common in the workplace, which contribute to the emotional tax paid by Black people and negatively impact physical health and well-being), and sometimes ending in a horrific demise. And when an opportunity seems to present itself, it not infrequently may turn out to be a “glass cliff” Trojan horse.

One way to begin to understand and walk in another’s shoes is to get a glimpse of someone else’s life…..in this case by way of Proctor and Gamble:


The Talk

 

The Look

 

The tragedy of George Floyd’s senseless death (and the many deaths that preceded it, including Elijah McClain, Ahmaud Arbery, Breonna Taylor as well as the death of Rayshard Brooks which followed 3 weeks later) has triggered global protests numbering in the millions.

For the first time in decades, there is renewed hope for substantive and concrete change powered by righteous rage, clear-cut demands, strategic actions, and a multicultural demand for the elimination of the myriad disparities created by design in the many internecine systems which have rigged the outcomes long before its victims are even born.

If you are not Black, Proctor and Gamble inspires action and a choice of civic engagement. They point out racial inequality “didn’t begin with us, but it can end with us. If we choose to act.”

The Choice tells the story through the lens of the white community and focuses on its role in making equality a reality rather than a dream.

The Blessing: A “woke” global populace who hopefully will no longer ignore and cannot “unsee” the reality of racial injustice; those who have the passion and make the time to join the many generations who have been at the fight from the time the first slaves were ripped from their motherland, put on plan-tations, separated from their families, and physically violated …….but had the courage to consciously decide to live against all odds and build the resilience that has sustained the generations who have followed long after they died.

It feels like a multi-decade movement has evolved and been turbocharged to achieve material and sustainable change. One can only hope mightily that we don’t fall back into incremental symbolism and an amnestic fog once the cameras have moved on to another story.

Justice for All
Unemployment in the U.S. as a result of the coronavirus is front and center for millions of Americans and has laid bare the income inequality which has long existed.

Miles-long lines of cars for food pantry distributions, low-income workers deemed essential whose lives are endangered because they do not have the luxury of working at home, and the anticipated rental evictions and mortgage defaults forecasted to result in previously unseen levels of homelessness……. These are all signs of the fragility of the current economy and even tougher times ahead.

  • 1%…..the amount paid to women as a whole compared to their white male colleagues who also work full-time, year-round. (The story is even worse for Native American and Alaska Native women, African American women, and Hispanic women. They earn only 75% of a white male counterpart.)
  • 1 in 6 ……. the number of Americans who live below the poverty line
  • 60 million ……. the number of Americans who do not make a living wage
  • $32,731 ………. the average student loan debt in the U.S. in 2019
  • 50-55 million……. the number of unemployed (if you also count those who are unemployed but don’t qualify for an unemployment check, e.g., certain solopreneurs and small business owners, and those whose unemployment benefits have run out and have yet to still find jobs).
  • 40% …… the percent of Americans who would not be able to afford a $400 unexpected expense
  • 367 ……. the number of people in the United States exonerated by DNA testing (includes 21 who served time on death row)

14 …… the average number of years they served in prison before exoneration and release

These individuals have paid a dear price for a debt they never even owed.

Financial insecurity, fading American dreams, and the first several generations expected to be worse off than their parents all reflect a system that has increasingly favored those who have and has favored them to a greater extent than ever before.

The Blessing: A much more diverse portion of the populace is experiencing the breadth and depth of financial instability. It extends well beyond those often caught in a generational legacy of poverty due to a lack of access to opportunity.

With more people living paycheck to paycheck and soon to have no paycheck on its way at all, Americans of all stripes have been pushed like no other time, including the Great Depression.

Now that more people are in the same boat (where others have been at sea for far too long), a greater opportunity exists to step into the collective power that has always been present but often underestimated both by citizens and the system.

The power which won’t take no for an answer and demands – with confidence, unerring determination, informed boycotts, and voting – changes like gender pay equity, a real living wage without the need for 3 jobs just to make ends meet, access to both affordable college education and housing, and race-blind criminal justice.

“Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.” ~ Margaret Mead

Gen Y, Millennials, and Gen Xers are actively engaged and have higher expectations which assume a more truly inclusive and just world than many of those in the generations preceding them.

With the multicultural, multi-generational movement sparked by George Floyd’s death, there is opportunity to address many inequities simultaneously, particularly given that in many cases they are inextricably intertwined.

Healthcare

  • 3 – 4 times higher …… the maternal death rate of black women in the U.S. when compared to their white counterparts (regardless of socioeconomic status and educational level)
  • 70% higher than the rest of the U.S. …. the mortality rate from opioid overdose for those age 25-44 living in Appalachia
  • 12% …… the percentage of the U.S. population that is black
    30 – 90% …… depending on the locale, the percentage of the total deaths due to COVID-19 that are the fate of African Americans in the U.S.
  • 1 in 4 …. the number of rural hospitals at risk of closure in 2020
  • 1 in 5 …. the number of Americans impacted by a mental health condition
  • 5% … the percentage of personal bankruptcies related to medical issues and the repercussions thereof, including income loss and job loss, reduced hours, and a preexisting debt load tipped over by medical bills into insolvency

“In times of crisis, things that people wouldn’t normally think about or things they would think about sort of on a slow-burn basis start to get some traction. Crises have a way of making things happen.”  ~ Dr. Bruce Leff

The landscape for those in healthcare is changing dramatically. It is also unlikely to return to “business as usual.”

Telehealth services are skyrocketing. As initial forays are made to provide services which were deferred in order to reduce the risk of exposure, infection, and spread of COVID-19, providers and health systems must develop processes and make adjustments to their workflows and physical plant in order to offer the physical and psychological safety needed for patients to return for in-person services.   Even those with symptoms of heart attack and stroke have avoided going to the hospital due to fear of catching COVID-19 in that setting, often either arriving too late for optimal intervention or dying a potentially avoidable death at home. Unfortunately, the current surge will only exacerbate that reality.

Survival in the future will necessitate:

  • innovation and an openness to new ways of thinking
  • continuous identification and implementation of best practices
  • data-driven agility in decision-making and execution
  • collaboration that knows no borders
  • human-centered design
  • physician leadership
  • a holistic view of health and well-being and a whole-person view of patients
  • the eradication of health inequities
  • strategic thinking with a view which incorporates a longer time horizon and a greater focus on proactive preparedness
  • clinically, looking at the puzzle pieces of symptoms and signs and considering (1) both a zebra and as well as a horse and (2) the possibility that something counterintuitive may be required to treat and potentially save a life
  • changes to medical education, training, and healthcare systems to support the emotional health and well-being of cliniciansand to reduce the upward trends in burnout, PTSD, and suicide

The Blessing: The novel coronavirus has pushed all stakeholders in the healthcare system to change and change quickly. There is neither the time nor the option not to focus on the patient and not to accommodate and embrace both different modes of care delivery as well as amended reimbursement methodologies.

With all hands on deck, team-based care is now a survival technique for saving lives and sustaining clinicians as they are immersed in the overwhelm and emotional toll of supporting patients infected with a virus about which we still have much to learn. In the process, many have found a renewed sense of pur-pose and a return to the reason they chose to enter the field of medicine in the first place.

Providers and payers have been reminded of their inextricable interdepen-dencies. Scientists and big Pharma across the globe have collaborated and are running parallel or serial stage pathways of development in the race to find an effective and safe vaccine.

Innovative and disciplined start-up technology and service companies have had the luxury of laser focus, with both well-defined needs and a market ready for their offerings.

And the often underestimated benefit and positive impact of simplicity, common sense, logic, reason, and pragmatism have been rediscovered and have resumed their rightful place on stage.

I will say it again. Mother nature, by way of COVID-19, seems to have given us a second chance and the opportunity to create a “new normal.” And that new normal has the mega-potential for designing a humane and caring world guided by the lessons the coronavirus has taught us – I value your life and protect you, and you value my life and protect me in order for each of us to survive.  Let’s not blow it, people!

 

Contact Colette at: colette@accessinsightmd.com