For a while now, Maya has quietly struggled with the mental effects of fighting the novel coronavirus. “You come home from work and it’s not like you can forget about everything that happened,” she said. “Sometimes, I think about COVID during sex.”By early April, Max, an ER doctor at Elmhurst public hospital in Queens, was only able to sleep two to three hours a night because of his anxious thoughts about the virus, which had ravaged the patients in his hospital, at one point killing 13 people in one 24-hour span. When he did sleep, the coronavirus seeped into his dreams too, with patients replaced by family members and co-workers. “In one shift, I would put a dozen people on ventilators,” he recalled. “And half of them ended up dying.”
"I’m either having a panic attack or I have coronavirus."
Already, signs are emerging that the coronavirus pandemic could exacerbate the problem around the world. In one early study on the coronavirus’ effects on health care workers in 34 hospitals throughout China, 34 percent reported insomnia, 45 percent reported feelings of anxiety, 50 percent of participants reported symptoms of depression, and more than 70 percent reported general distress.Anecdotal evidence indicates the impact will be similar in the U.S. The death by suicide of Lorna Breen, an ER doctor who had been treating COVID patients at New York-Presbyterian Allen hospital in New York City, brought attention to the mental toll the virus is taking on health care workers. VICE spoke with eight medical workers on the frontlines of the COVID fight in New York—six doctors, one nurse, and one EMT—about how the pandemic is affecting their mental health. They described experiencing new levels of chaos, tragedy, and stress in a workplace where mental health challenges are stigmatized and seen as a sign of weakness.
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Allison, an ER doctor at a hospital in New York, explained, “In residency, you learn not to complain about being sleep-deprived, or about your patient load, or feeling overwhelmed. So when you get to the point where you’re depressed, you fall into the same thing of just not talking about it.”In a lot of ways, the specifics involved in treating coronavirus are a perfect recipe for PTSD. The virus is potentially fatal, highly transmissible, and, critically for health care workers, largely unknown and next to impossible to treat right now. Health care workers aren’t learning about this virus from a medical textbook. They’re figuring out how it kills in real time—every time one of their patients dies from it, or they do. Already, two dozen health care workers have died from the coronavirus in the U.S.“You’re paranoid and worried all the time,” said Avir Mitra, an emergency medicine specialist at Mount Sinai in New York. “Even something as simple as eating a five-minute snack, there’s this whole process like how do I take my gown off so I can safely put it back on?”The reality of how difficult treating a novel virus would be didn’t hit Maya all at once, but rather in drips.
Every hospital employee said that their hospital was offering mental health support. But not one had taken the hospital up on the offer. Some worried that negative comments they made about their employer would find their way back to the administration.
“It’s horrible,” she added, “to think of our patients as a threat.”Other doctors and nurses have struggled to grapple with the distance they need to keep from their patients. Rather than standing by their bedside, some doctors and nurses are only able to talk to their patients on the phone from elsewhere in the hospital to minimize in-person contact.Not being able to touch patients’ flesh or have the patient see her face is one of the hardest things for Vanessa, a critical care physician at a hospital in New York. “Call me old fashioned, but I didn't always wear gloves like I should [before COVID],” Vanessa said. “I want to make sure patients can feel me there—that they have another human being beside them. Now, I don't get to do that as much and that's tough for me.”
"You’re paranoid and worried all the time. Even something as simple as eating a five-minute snack, there’s this whole process like how do I take my gown off so I can safely put it back on?"
“[The box] is where all my COVID-covered clothes stay for a few days until we do the laundry,” Maya said. “Then I immediately run into the shower and use surgical grade scrub on all the skin that was exposed.”The SARS pandemic gives us a small window into the mental health challenges health care workers are likely to develop before the end of the pandemic. A study published in 2009 in the Canadian Journal of Psychiatry surveyed hospital employees who worked at a Beijing hospital during the outbreak. It found that 10 percent of respondents experienced high levels of post-traumatic stress (PTS). Those who “had been quarantined or worked in high-risk locations such as SARS wards, or had family or friends who contracted SARS were two to three times more likely to have PTS symptoms than those without these exposures.” A different study, published in General Hospital Psychiatry, found that 41 percent of health care workers and SARS survivors have PTSD.
“I’m a threat to my family and friends.”
At least in New York, it appears that COVID hospitalizations are declining. On May 2, Governor Andrew Cuomo announced that COVID-19 hospitalizations had hit the lowest number since March 29, when 9,517 people were hospitalized. At its peak on April 12, the number of new COVID-19 hospitalizations in New York was 18,825.“When this started, it felt like the virus was always two steps ahead of us,” Mitra said. “Now, it finally feels like we’re winning.” But as the deaths fall, some health care workers are left with the lingering trauma of what they went through.“Right now, most of those health care workers are in survival mode,” Reiss said. “When you’re in survival mode, you’re not really ready to process it.”Reiss said there is no substitute for professional help. But for now, emergency medicine providers are coping the best way they know how—with more gallows humor. “My friend at work made a meme in which the punchline was ‘funeral expenses for health care workers,’ and we cracked up over that,” Maya said.“When I posted it on Instagram, all my health care worker friends laughed at it,” she added, “and all my non-health care worker friends sent the sad emoji.”
“When you’re in survival mode, you’re not really ready to process it.”