Miguel Lerma, the Aldaco family and the H1N1 pandemic heaviest burden: coping with COVID-19
“It’s a strange feeling,” Semhar Fisseha says of the end of the pandemic declaration. “Now there’s kind of like a stop button happening, like, ‘OK, we’re done with this public health emergency,’ but there are thousands of people that are still left dealing with the impact of it, including myself.”
In March 2021, Miguel Lerma had just lost two granduncles to COVID. It followed the death of his grandfather, Jose Aldaco, also of COVID. For the Aldaco family of Phoenix, Ariz., these three deaths – within six months of each other – shattered a generation of men.
He says that after the Pandemic took away their father from them, they left that parent. “We really weren’t prepared for that as we were still dealing with losing my dad.” Virginia had recovered from a severe case of COVID for which she’d been hospitalized, and Lerma’s family wonders if the strokes may have been a post-COVID complication.
While his health insurance benefits are not yet available, Lerma is still trying to process his grief without the assistance of a therapist. He’s ready to get on with his life after the H1N1 epidemic. “I’m triple vaccinated,” he says, “I don’t wear a mask but I make sure I wash my hands. I feel like I’m taking care of my side of the street.” But it feels unfair to Lerma that some people are moving forward with much heavier burdens than others.
Lerma moved from Phoenix to Los Angeles last June. He took a job as a city bus driver, which is easier, he says. “Now, I don’t take work and the stress of it home with me,” he says, “I’m able to handle my mental health a little bit better, and cope with what I need to cope with post-pandemic.”
In November 2021, Semhar Fisseha shared how her COVID-19 infection morphed into long COVID and upended her life. Once an active parent, she became debilitated and needed a wheelchair for a time.
She says she’s now in a better place with her health and no longer needs a wheelchair, but she’s still getting a handle on what triggers an episode for her. If I go from cold temperature to heat, I know that my body is not able to function, even though I learn new ones all the time. “My body stops shutting down and I start slurring my words, I move really slowly.” If I don’t remedy the problem, I will be in a coma, because I do not have a snack. I’m aware of everything that’s going on, but I lose my mobility. I don’t have the power to control my arms and legs.
Malachi Stewart, the first public health worker in the U.S. during the pandemic: Vaccines for adults and children were unreasonably distributed
In the early days of the Pandemic, contact tracing exploded as a way to alert the community to the spread of the new Viruses without vaccine or knowledge of how it spreads. Malachi Stewart of the D.C. Department of Health changed over from contact tracing sexually transmitted infections to the COVID-19 team. He explained his job to NPR in April 2020.
One thing he celebrates about the pandemic is that it helped more members of the public understand what the health department is and what it does. “We know how to make people feel like they’re not just a number – one patient said ‘a petri dish of infection’ – but you’re a person,” Stewart says of those early interactions he had when people were first getting infected.
There are many stories of public health workers leaving their jobs because of threats. Stewart doesn’t take fear personally, but he says there are many positive connections that are less likely to make the news and that sometimes fear makes people lash out. “People are afraid, people are processing,” when you tell them on the phone that they are positive, whether for COVID-19 or any other infection. That’s not something that’s personal when you are in that space with people. The people who answer the phone the next day are the ones you care about. S.S.d. is an acronym for Standard Search and Dictionary.
When COVID vaccines first became available, the shots were in short supply, the distribution was chaotic, and every health department was doing its own thing. Her job was to look after a bunch of cats. After toiling behind the scenes on children’s vaccinations for decades, immunization managers around the country were called to roll out life-saving vaccines that could end the pandemic. “Suddenly the limelight was on us,” Hannan recalls.
Vaccines for adults were disorganized and diffuse. “You could have adult providers, pharmacists, family physicians, gynecologists, OB-GYNs giving out vaccines, all in the private sector,” Hannan explains, “There was no interaction with public health agencies.”
The government had requirements for data reporting about the vaccine plan, they wanted to know how many were going into arms, how much was wasted and who was getting them. “We started sharing data in real time, capturing the doses administered and sharing with CDC, something that had never been previously accomplished, enroll hundreds of thousands of private providers.”
Amid the many losses brought by the pandemic – the loss of many lives, the loss of trust in science and vaccines due to politicization – Hannan holds room for optimism. She wants to make use of the adult vaccination system to fight diseases like shingles. “We can do better against certain diseases and make strides in the prevention of them.” –P.H.
Source: https://www.npr.org/sections/health-shots/2023/05/11/1175463986/public-health-emergency-ends-people-most-affected-reflect
Ms. Cheung: A canary in the coalmine after a pandemic, and she’s out for a second generation
In one conversation with NPR from her basement, where she was in isolation from the disease, she defined normal as partying in the parking lot at her daughter’s lacrosse games. She’s been back at it: “I have just had the most fun tailgating at my daughter’s lacrosse games this past year. Being able to have those events with people you don’t ordinarily see – I missed that so much during the pandemic,” she says.
Dr. Vivian Cheung takes immune-suppressing steroids to manage a rare genetic disease and she relied on her connections as a pediatrician and research scientist to get Evusheld. Her behavior did not change even though she got the shot; she said she didn’t go out at all but that it gave her some peace of mind.
She has been able to venture out despite still being vulnerable. She’ll go to the grocery store at 6 in the morning, when no one is around. She’s gone to a few conferences and dined indoors once. Still, she draws the line at crowds and long flights.
Masks were in her life before COVID and they remain part of her daily routine. She worries that people’s understanding is fading after the pandemic raised people’s awareness of disabilities. When I see another person wearing a mask, I think it’s good not to be the only one. But the other day, as she stood on the street in a mask waiting for an Uber, someone walked up and chastised her, saying, “Don’t you know that COVID is over?”
As the PHE ends, Cheung worries that gaps in data reporting will leave vulnerable people at greater risk. She’d like not to be a canary in the coalmine – or in COVID terms, a patient sick in the hospital – that alerts others to an impending wave. She hopes that she can get all the protections available and help start new ones. She keeps her eyes on a second generation Evusheld and asks her doctors if she can enroll in the trials. P.H.
Educators also stood on a fault line of the pandemic, as COVID safety protocols interfered with school attendance. Superintendent Alena Zachery-Ross told NPR about how the “test-to-stay” policy was playing out in her Michigan school district in December 2021, after the CDC recommended letting students exposed to the virus stay in school if they tested negative.
There are lasting changes from the pandemic in Ypsilanti schools, Zachery-Ross says. She says the way the place is designed doesn’t correspond to the ventilation systems or the fact that people are more aware of staying home when sick. The district was able to give laptops to students that needed them. Plus, parents and schools got more used to coordinating and communicating with each other, she says. “I think we can do some of those takeaways that can continue now – so that gives us hope.” — S.S.D.
Source: https://www.npr.org/sections/health-shots/2023/05/11/1175463986/public-health-emergency-ends-people-most-affected-reflect
Don’t Clock Out: a non-profit organization to support mental health workers and healthcare workers during the post-pandemic era
Michael was a nurse in critical care and died by suicide. His death became a rallying cry for health care workers’ mental health. It pushed a group of nurses, including Odell’s closest friends in the profession to start a non-profit organization called Don’t Clock Out to support nurses experiencing mental health crises.
“It’s been a huge learning experience going from this pandemic and starting the organization,” says Joshua Paredes, Odell’s close friend and former roommate. I knew there would be a need and I was surprised at how much support my colleagues are really needing.
Peer support for health care workers who are experiencing mental health issues is provided by the organization.
“We had to add an extra meeting because we realized that it’s not just nurses that need support, it’s actually the entire health care team,” says Paredes.
According to Paredes and his associates at Don’t Clock Out, health care workers continue to suffer stress due to their work. Moral injury is the sense that healthcare professionals have had to work in situations that violate their ethical code and have been let down by their employers with ongoing staffing shortages.
The co- founders of Don’t Clock Out are worried that the lifting of the declaration will cause a loss of access to mental health care.
“There will be an inevitable discontinuation of mental health services for people,” says LeBlanc, who recently lost access to his therapist. “They decided to focus on their in-person practice instead of their online clients.”
The fact that healthcare workers are starting to fight for better work environments and support one another for their mental health is giving Paredes hope.
“We’re kind of uniting in new ways, we’re unionizing, we’re communicating across disciplines,” he says, “all under the motivation that we’re building something new to replace what hasn’t worked in the past.”
“My sense of hope is definitely rooted in these volunteer-led organizations and health care worker-led organizations, that have a passion that’s rooted in their experiences during the pandemic,” says LeBlanc. “These organizations serve solely to support nurses, residents, other health care workers through the damage that the pandemic has done or the damage that was done prior to the pandemic that we weren’t able to talk about openly.”
Source: https://www.npr.org/sections/health-shots/2023/05/11/1175463986/public-health-emergency-ends-people-most-affected-reflect
How should we live in a world without epidemics? From NPR’s FAQ to the new phase of the COVID-19 pandemic
He says that talking openly about mental health is huge and not just in the healthcare field. I’m able to talk to my family about mental health that I never have done before.
All of this led LeBlanc to want to work as a mental health practitioner. He is going to be attending a Masters program to become a Psychiatrist.
The FAQ series was a cornerstone of NPR’s coverage and touched on a lot of topics from transmission via pets to whether a glass of wine after a vaccine is advisable. As the world enters a new phase of the pandemic, we talked to public health gurus about how to move forward since the disease appears to be here to stay even as the emergency is lifted. If you have questions about the new phase of the Pandemic, contact us at [email protected]. Please include your name and location. A follow-up FAQ will be answering a few of the questions.
Thomas Bollyky, senior fellow for global health, economics and development at the Council on Foreign Relations, says that a public health emergency is “really designed to spur international cooperation around a public health event that is serious, sudden, unexpected and requires immediate attention.”
The agencies could have explained to the public how low the case and death count would need to be to lift mask mandates or school closings, since they decided to conclude the outbreak in May 2023. “If the public can’t see progress, it will be harder to convince them next time that these emergency measures are necessary,” says Bollyky.
The announcement that the emergency is over doesn’t mean the virus been vanquished, says Dr. Wafa El-Sadr, director of the Global Health Initiative at the Mailman School of Public Health at Columbia University. Each week, it’s infecting thousands and killing thousands.
“HIV, tetanus, and others do not have a public health emergency declaration, and yet people keep up to date with vaccinations and treatments,” says Dr. Amesh, senior scholar at the center.
The reassuring message came from the CDC and WHO, that you’re less likely to catch COVID-19, because case counts have dropped due to vigilance and treatments.
We will be living with COVID-19 for a while. Wen, who gave birth to her second child during the pandemic, says “it has become clear that this coronavirus will be with us for the foreseeable future and is an infectious disease that must be prevented, treated, and managed, like other serious conditions. The focus should be on helping those at the highest risk from severe outcomes due to COVID-19 and protecting the most vulnerable, instead of population-wide measures.
Even if you’re not high-risk, it’s still possible to feel awful if you catch the virus because of the health risks. You might have to miss work. You run a risk of being trapped for long. There’s a chance you could transmit the virus to someone who is at risk of dying from it.
If you don’t have underlying conditions that put you at risk, have a discussion with your doctor or health-care provider in regards to how to proceed. Ask how to gauge your personal risk.
For example, there’s the COVID antiviral drug paxlovid — which has been proven to help. A review of federal data in JAMA Internal Medicine found that the risk of long-term health problems, hospitalization and death after a COVID-19 infection diminishes among those who take the medication within five days after testing positive. That’s according to an analysis of federal health data by researchers at Washington University School of Medicine in St. Louis and the Veterans Affairs St. Louis Health Care system.
It is worth noting that even though masks were often deemed ineffective in the U.S. in the early days of the pandemic, global evidence shows that N-95s and KN-95s worn properly do reduce your risk of contracting COVID (not to mention the flu and other respiratory ailments). And the U.S. did eventually embrace masks.
He maintains that he has a Purell in his car and carries a small bottle when he travels. I don’t have to expose my eyes in my own seat, so I only wear a mask when the plane takes off and when I get to my hotel room. I still travel with a pair of tests at home.
Many people love to doff masks and get back into the crowds at transportation hubs, concert arenas and sports arenas, but others are understandably nervous.
Malani does believe that too much worry is not good for you: Fear of COVID or severe anxiety out of proportion to risk can lead to depression and other mental health concerns, says Malani.
Why should we unmask and smile or adjust our worries? Explaining the importance of remembering to always look after yourself, rather than worry about what you are wearing
You may still need to mask up in certain places, like health-care faciliites – although rules are changing, with many hospitals and doctors offices ending the requirement for staff and patients. But that doesn’t mean you have to take yours off. And if you’re concerned you can ask maskless staff that interact with you to put one on. You can say a mask should go above the nose if you see a carelessly worn mask.
The rapid development of effective COVID vaccines around the world has been a medical marvel. New boosters will be available occasionally. NPR reporter gets a message that his vaccine reminders will stop when he tries to use his cellphone.
So with the emergency state over, you may have to pay attention to your own vaccine schedule rather than hearing calls from the government to go get your booster.
And public health specialists note that you shouldn’t just focus on COVID when it comes to vaccines. “Learn about and stay up to date on all vaccines,” says Dr. William Schaffner, medical director of the National Foundation for Infectious Diseases. The first-ever vaccine for adults to prevent respiratory syncytial virus (RSV) is expected to be available by September in the U.S.. Then there are easonal flu shots and likely a new COVID booster. “Adults will want to talk to their doctors this fall about all the vaccines they need,” he says.
Source: https://www.npr.org/sections/goatsandsoda/2023/05/12/1173993754/coronavirus-faq-emergency-over-do-we-unmask-and-grin-or-adjust-our-worries
How do I feel when I’m alone? Dr. Malani, MD, PHI, and MIGRA conducted a 2023 Survey on the Effects of Social Cognition on Mental Health
It feels more likeLoneliness than you can imagine. Yeah, well maybe that’s not a big surprise — but the pandemic reinforced the toll that a lack of social contacts can take on mental health.
Dr. Malani is the lead researcher on a January 2023 survey of more than 2,500 people ages 50 to 80 conducted by the University of Michigan Institute for Healthcare Policy and Innovation and supported by AARP and Michigan Medicine. The survey found that one in three people between the ages of 50 and 80 say they sometimes or often experience loneliness.
Even though people at risk of a severe disease from COVID-19 should take precautions to avoid isolation and meet outside where the risk of transmission is lower, she says there are still precautions that must be taken to get a clear sense of their risk of severe disease.
Some people who were treated for cancer years ago are still worried about their risk. It is possible for you to have a talk with your doctor about your risk and precautions. She said that she masks when caring for patients but not in meetings or even while on the road. “I don’t want to expose anyone if I have any symptoms at all, even if mild,” she says.
If you have been exposed to someone who has the virus or are at risk, you should be tested, according to the doctors that we talked to. Put those masks on. You’ll want one if someone in your home tests positive so you can protect yourself — and protect others if you test positive.
We offer our sincere thanks to the medical professionals who answered questions for the FAQ series, even as many of them put themselves at risk for infections while caring for patients.