This pandemic has completely changed our perception of the world we live in. At this point, almost all of us have been affected by it in one way of another. A lot of unfortunate souls have been lost to it and the struggle is still ongoing.
A lot of patients when they come into a hospital, may have episodes of confusion often termed as hospital delirium. Many things play a role in causing hospital delirium, like being ill, in unfamiliar surroundings, lack of quality sleep, lack of social stimulation and certain medications. Things like social interactions, family visits, and familiar objects from home being placed in their room (specially in demented patients) seem to help such episode. However, COVID-19 has made things 10 times worse for these patients. A good number of such patients is the elderly who often have vision and hearing issues. Imagine now, everyone interacting with such patients is wearing a mask, obstructing the face and lips, making lip reading impossible, as well as not letting the patient get familiar with faces, not to mention muffling the voice of the providers. All this makes the patient’s time in the hospital much harder, leading up to delirium. The sick patients cannot breathe but the not-so-sick patients are having a hard time thinking straight, confused, isolated in a room.
This is not limited to the patients but extends to their families. Visitors are not allowed for COVID-19 patients. Families are limited to talking to them on the phone and maybe video chat. However, if the patient is confused and delirious, the family has no option but to wait for an update from the overworked doctor or nurse. Not only is this adding to the anxiety of families but also to the frustration of the healthcare workers, who are struggling to keep up with providing care but have to be interrupted by calls from the families.
COVID-19 victims who don’t get admitted to the hospital are no better. Being isolated in a room, not seeing your family who may be in the same house with you and not being able to get out comes with its own set of challenges. One of my coworker’s biggest complaint was that every time he had a fever, he could not help but think about what if things get worse for him, what if his 4 years old son gets sick, what if the son has to grow up without a father. When I was in isolation because of COVID-19, as much as I was moved by some friends checking on me and leaving comfort food at my door, I did strike some friends off my favorite list because they did not text/call. Sounds funny, specially since I do not think of myself as a dramatic person, however, the pandemic did put things into perspective for all of us and reminded us of what matters the most of us.
The pandemic has also led to exacerbation of mental health issues. The social distancing may have a lot to do with that, as a lot of people lost their emotional support. A phone call cannot replace a hug. One of my friends is about to break up with her boyfriend, because of his anxiety being so high right now, he refuses to go out even for a walk. To ease his anxiety, he has resorted to playing video games for distraction, after spending all of his morning and afternoon on his PC for work. Her life has reduced to lonely walks at random times of the day, calling her friends to vent. I feel bad for the boyfriend though, just when the pandemic is over, another calamity is going to hit him as my friend has lately said, more than once, “I just don’t want to make any decisions until the pandemic is over”.
It is interesting how the dynamics in any hospital has changed. Generally, you will see surgeons walking heads up, with an aura of arrogance around them (apologies to any surgeon reading this), anything they don’t feel like doing, they will say “page the hospitalist”. The hospitalists (internal medicine doctors that do only inpatient medicine) are the ones pretty much doing all the things that the specialists or surgeons don’t want to deal with: talking to families, social workers and making sure everyone is on the same page. A lot of hospitalists will move on to fellowships to specialize in one system because they feel they are sort of the lowest in the chain. However, with COVID-19, most surgeons have very little to do, while hospitalists are the ones running the show. It may have made the hospitalists’ lives harder, but the job satisfaction and sense of self-worth is much higher, feeling proud about playing a vital role in all this. Similarly, infection disease specialists are generally one of the lowest paid specialties in medicine, but they have become a hot commodity. Everyone turns to them for answers, and I kid you not, they have always been extremely helpful and knowledgeable, just that they are in the spotlight now because of the viral pandemic.
Today, I received a call about a cousin who passed away because of COVID-19, one of many people who we had to say goodbye to this year. The loss is permanent and the void will never be filled for many. But their is hope for the future generations, we have to make sure they don’t have to know the pain of losing so much that most of us did.