We will soon be making personal decisions about how we move about in public as stay-at-home orders and business restrictions are lifted. We have to appreciate the threat we face to make good decisions. At the same time, the statement that COVID-19 is no worse than the seasonal flu or a common cold is back in circulation again.
The COVID-19 pandemic of 2020 is starkly different from the common cold or the seasonal flu we have faced for decades. The contrast is clear when comparing the clinical course of the different diseases, what we know and don’t know, and the many statistics. But the human experience of patients, families and providers at all levels deserves to be front and center.
At the human, gut-level, the experiences of U.S. patients, families and providers in the midst of the COVID-19 pandemic stand alone. There simply is no comparison with anyone’s experience with the worst seasonal flu outbreaks. The common cold isn’t even on the table.
Elderly, frail family members have been isolated in nursing homes and their assisted-living apartments without family visits. Family members have died alone in nursing homes or hospitals, separated from their loved ones who often can’t even talk with them on the phone. Families have delivered their loved one to an ER, been told they can’t come in with the patient, and have never seen the person alive again.
If the condition of their loved one rapidly deteriorates, they may have to discuss profound issues of end-of-life care with providers they have never laid eyes on. Family members may be trying desperately to communicate some last words to a dying loved one second hand, with the help of staff who relay the messages. The patient often can’t speak at all because they are on a ventilator with a breathing tube.
On that same human scale, health care providers at every level have never faced the relentless, crushing force of a medical crisis like the COVID-19 pandemic unless they were directly engaged in frontline, battlefield situations. This is the case from top to bottom. It has broken the sleep and seared the hearts and minds of countless safety planners, first responders, nursing and medical providers in emergency rooms, ICUs and critical care units, ventilator and X-ray technicians, hospital maintenance and house-keeping staff, food service staff, switchboard operators, nursing home caregivers at every level, not to mention the planning and leadership individuals struggling to prepare in the midst of one uncertainty after another.
Providers have regularly had to put their health at risk to care for infected patients while wearing inadequate protective equipment. The mere use of this inadequate equipment under normal conditions would have gotten providers fired or sued. They have had to park an RV in their driveway, or live in a garage because they can’t find a motel room and can’t go in their own homes for fear of infecting their families. Nothing remotely close to these circumstances has arisen during seasonal flu outbreaks.
These daily experiences are heartbreaking, beyond exhausting and grind down the soul. ICU providers in the worst of influenza outbreaks have never had to put so many patients on ventilators in just one shift. Each time, they were looking directly down the throat of the patient to position the breathing tube and exposing themselves to the riskiest moments for getting infected directly from the patient’s lungs.
ER providers have never had to manage increasing numbers of patients in the ER because an ICU bed is not available, navigating hallways filled with patients on gurneys, knowing any one of those patients could crash into respiratory failure in less than 15 minutes because of a new disease no one had even treated less than five months ago. Behind them is a waiting room filled with even more COVID-19 patients.
Patients with many other chronic, life-threatening conditions unrelated to COVID-19 have had to delay necessary treatments because of staff redeployment, restrictions on procedures or fears that they would become infected if they went to a hospital. These delays increase the risks for these patients, some needing regular cancer treatments, dialysis or heart disease interventions.
These events have been caused by the COVID-19 pandemic and are unprecedented. They encompass the suffering wrought by seasonal flu outbreaks, and then go beyond it into uncharted territory. We cannot forget this. The patients, families and providers who have experienced these horrible circumstances deserve our strongest recollection of these events so we can work to prevent them. Let’s keep their faces in mind and not the words of those who say the pandemic is nothing more than a bad flu.
(Dr. David R. Coursin of Northwood represents Rockingham District 1 in the N.H. House of Representatives.)
