SGIM Forum

Perspective

SGIM Forum Editors Reflect on Nearly Two Years of the COVID-19 Pandemic

Dr. Block (lblock2@northwell.edu) is associate professor of medicine and science education at Zucker School of Medicine at Hofstra/Northwell. Dr. Burger (alfred.burger@mountsinai.org) is a professor of medicine and medical education in the Department of Medicine at Icahn School of Medicine at Mount Sinai. Dr. O’Glasser (oglassea@ohsu.edu) is an associate professor of medicine in the Departments of Medicine and Anesthesiology & Perioperative Medicine at Oregon Health & Science University. Dr. Ali (yousaf_ali@urmc.rochester.edu) is a professor of medicine in the Department of Medicine, University of Rochester School of Medicine and Dentistry. Dr. Mookherjee (smookh@uw.edu) is an associate professor of medicine in the Department of Medicine, University of Washington School of Medicine.

COVID-19 has been a difficult, stressful, and potentially isolating time. SGIM’s members continue to be called upon to keep the medical system going while under tremendous personal and professional pressure. SGIM members have also had to evolve to better balance our personal and professional lives. This article shares our experiences of doubt and the challenges we face navigating our worlds outside of the hospital, knowing that these challenges are universal. We hope our reflections will help others reflect on their own experiences and not feel as isolated. Each SGIM Forum associate editor responds to this question: Give an example of uncertainty as it pertains to protecting yourself and your family from COVID-19, possibly one that raises conflict with others, and how do you deal with it?

Block: The pandemic has changed how I approach life cycle events, and other people. This summer, I received an invitation to a family wedding, rescheduled from a year earlier. Normally, I’d be elated to celebrate with family from near and far. This time, as the COVID-19 Delta variant spread, the date loomed with something like dread. My mom, who was flying in for the event, expected me to go. There were about 250 guests and all were “required” to be vaccinated. Being lucky enough to be fully vaccinated, I breathed a little easier. Looking across the dinner table at my three elementary school kids, too young to be vaccinated, I became concerned again: How could I forgive myself if I got them sick?

I certainly trusted the organizers to make a reasonable effort to make sure everyone was vaccinated, but would they exclude a key cousin or bridesmaid if they weren’t? Would people feeling mildly ill stay home after making the effort to come? My husband bowed out, saying he’d stay home to watch the kids. I put on my best double-masked party face, and went. It was great having the chance to get dressed up, dance, and sing with the family and the couple who had waited so long to tie the knot. But as I looked around the huge room, I saw I was one of a handful who wore my mask throughout the event. I tried my best and mostly succeeded in prioritizing fun over fear. I tried not to judge others, even those who had recently lost loved ones to COVID-19, for their decisions. I drove home hoping that everyone would stay healthy, and nobody would judge me for having worn my mask the entire event. As I got home and on with the last few days of summer, I shed my mask and these extra layers of baggage we all carry around, trying to carry on through the pandemic.

Ali: The effects of the pandemic in the United States have made visiting our loved ones very difficult. But visiting family abroad across the other side of the world was extremely challenging. I thought it would just be limited to wearing a mask while aboard the airplane and at the airport. It turned out to be much more brutal than that. My brother back home called to tell me that mom was not doing well in Islamabad, Pakistan.

My wife and I decided to visit her, since at age 85 anything could happen. We arranged for a flight and got our mandatory 72 hours pre-flight COVID-19 test done. Thank God it was negative after taking care of COVID-19 patients the week before. Our connecting flight to the JFK International Airport in New York was rolling down the runway when the captain announced that we would need to go back to the gate due to technical issues with the plane. Both of us are thinking the same thing: we are going to lose our international flight. After two hours at the gate, they announced that the flight was cancelled.

We returned home, disheartened, and started looking for other flight routes. We found a flight from Boston with the same carrier after a lot of phone time. Then, we realized that our pre-flight COVID-19 test would expire for the new flight, so we went to urgent care, got our new test, waited 24 hours for the test result, and then drove six hours straight to Boston. Finally, we were able to catch that flight and, after 24 hours of masking, arrived in Islamabad. We also had one more COVID-19 test before meeting Mom. We had a great time with her for about eight days and were so happy that my mother came back to her baseline before we left Pakistan about a week later. Looking back now, I feel that this was one of the most important decisions that I ever made in my life because that was the last time that I saw my mother alive.

O’Glasser: The summer camp daily check-in questions were the same as they had been for eight weeks: “Have you travelled by commercial train/plane/bus/boat? Has anyone in your household? Have you been exposed to anyone with COVID-19?” Once again, the answers were “no, no, and no.” For some reason that morning, I quipped to the camp counselor, “we’re boring,” and then I immediately retracted it.

For nearly two years, we have led a very cautious existence with our two elementary school-aged children (at the time of this writing, still too young to receive the COVID-19 vaccine). My husband and I aimed to do everything we could to keep them safe. Lockdown in the beginning. Minimal contact outside the household—and always with masks and outdoors. No family trips. As a generally risk-averse family, any broadening of our activity levels was done cautiously and carefully—returning to in-person school, my husband starting a new job for which he could no longer telecommute, eating outdoors at restaurants, and going into stores.

But it struck me that morning that life wasn’t boring. We weren’t boring. As a family, we had discovered so many ways to keep ourselves—and our communities—safe by exploring new hobbies and where we lived. Weekly hikes. Frequent bike rides. Cooking new recipes. A bigger summer vegetable garden. More board games. Saturday night family movie nights. Our kids have learned the value of family bonds, social awareness, and collective good. Cautious, yes. Conscientious, yes. Boring? No.

Burger: For my family, how to engage in social activities in a post-vaccine (optional) world has become a huge challenge. Prior to the arrival of COVID-19 vaccines, it seemed simpler: stay home and isolate. Go out always with masks on. Keep socialization to a minimum and always outdoors in a mask or not at all. But “FOMO” (fear of missing out) is real. The posted pictures of people in shared bubbles or pods captured our attention. As front-line providers, it was hard to assure others of limited risk while we cared for those with COVID-19 in the hospital or coming to the office to be diagnosed. Now, with the vaccine roll-out, we try to re-enter our lives cautiously, but still moving forward. This leads to more tough discussions with others. Have you been vaccinated? If you are outdoors with your child under 12 (our youngest is 8), do the kids mask when playing? Do you approach friends outside if they aren’t masked? How do you handle family or long-time friends with a different view? There are no simple answers.

Personally, my family’s approach has been to be open and honest about our level of risk tolerance. Most conversations have not been confrontational, but they can be triggering to some and the effects on our relationships of any lasting resentment remain unknown. Then there are areas in our lives where we can’t ask those questions, such as how we behave in public spaces. As people return to work, there is less open space on public transportation. People sit closer to one another than they did at the height of the pandemic and there isn’t always room to socially distance. I don’t think there is an answer yet about how to navigate these public spaces. COVID-19 will continue to impact our social relationships, whether with the people we know, or the stranger next to us on the train. As more people are vaccinated, all these questions linger in my mind. I have no good answers and like everyone else I find it hard to know what to do.  


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