Dispatch

April 6: A growing sense of dread

This time feels different. Just like in previous waves, we are told the road ahead will be difficult and unpredictable, but as I see younger people coming for care in higher numbers, I feel a growing sense of dread. 

A year ago, I was checking into a hotel in preparation for going on COVID service. It was the longest stretch of time I would spend away from my toddler since he was born. We didn’t know much about COVID then and I tried my best to stay up to date on the literature. The mental and administrative stress was high but the “Italy” or “New York” worst-case scenarios didn’t happen.

Compare that to this week. I am fully vaccinated and grateful to have been. It’s a source of peace of mind. I’ve now treated many COVID patients. I know how to care for them – at least initially. But I can’t shake this feeling of dread. The COVID patients coming from the ICU are young and previously healthy. They have been infected at work or from a family member. Often, their children have tested positive. They are off oxygen when they go home but not feeling like their old selves and struggling with their feelings: stigmatized for having caught the disease; guilt for having exposed others; frustration because this is a vaccine-preventable illness yet they are still ineligible.

I started this rotation on Thursday last week. I’ve seen several people with COVID, too many of them young. I have no great way to predict or understand whose symptoms will be serious and whose will be mild. The variants seem like a different disease that makes people much sicker.

But the most striking from the Easter long weekend was walking past several closed vaccine clinics. It’s almost like they operate in a different world than the hospital ward where the COVID patients lie. Why are they closed? Why are they not open 24/7? My non-COVID patients who are eligible to get the vaccine can’t navigate the booking process or get through on the phone. Or they have a structural barrier in accessing the vaccine. I try to help them book an appointment but I can’t get them one. I try to get them vaccinated on the ward but it’s not possible to do so most of the time. It’s frustrating to know you have the means to protect people but can’t get it to them. Sometimes, I feel like the vaccine-hesitant suck all the air out of the room while the people desperate for the vaccine get no airtime.

I can see the numbers increasing in real time. I can see the age dropping and severity of illness increasing. I can see how delayed the symptoms can be and how hard it is to trace back. I can see it move quickly through classrooms, workspaces and households. I can’t shake this growing feeling of dread. Let’s see how tomorrow goes.

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2 Comments
  • Elaine MacNeil says:

    I am so thankful that caring professionals like you have selflessly set aside your personal lives to care for all of us and am saddened by how adminstrative nightmares, the vast majority outside your control, have created such anxiety. Your skills and working hours as a doctor, so critical to the care of very sick individuals, should not be used for administrative tasks such as booking appointments. Each hospital must have a cohort of knowlegeable, organized and compassionate staff members or volunteers – an organizational tactical team – brought together because their skills are well-honed and can be focused on what they do best. Vaccine delivery is a challenge over which few of us have control but one hopes it may be possible to improve vaccine distribution.

  • Maureen says:

    Hang on Seema- we are with you.

Author

Seema Marwaha

Editor-in-chief

Seema Marwaha is a general internal medicine physician, educator, researcher and journalist.