We’re All Afraid. Just of Different Things.
A large refrigerator truck from a regional poultry company recently pulled up to the high school in Walhalla, South Carolina, and its owners began another morning selling large boxes of chicken breasts, thighs, and drumsticks. The family-owned farm’s sales are down, because the restaurants it supplies are either closed or doing minimal carry-out orders. There was inventory to move. The cars began to line up early. I was right there too. People are afraid that the already-strained supply chain will break. Fifty dollars for 40 pounds of chicken is a pretty good deal. Stick it in the freezer, and you have a temporary buffer against future shortages. Freezers, though, are now in short supply.
As my state has started to open back up, one thing seems to unite us: fear. Physicians are afraid; hairdressers are afraid; teachers and students are afraid. But not everyone is afraid of the same thing.
Sarah Farris is an academic emergency physician at Prisma Health in Greenville. She has seen COVID-19 patients and knows just how quickly their conditions can deteriorate. She was so concerned about the number of patients potentially overwhelming health centers in the area that she and her husband, Ryan, a software engineer, developed a 3-D-printed device called the “VESper” to make it easier for patients to share ventilators.
Farris is competent and prepared, working in a cutting-edge medical system. She fears what may happen in the fall if COVID-19 comes back in full force. “I remember the second wave of H1N1 [swine flu] in 2009,” she told me. “I was a shiny new attending physician at Duke, and I had a newborn. Children were just suddenly dying in the emergency department. Because of associated myocarditis, a number of children had to have heart transplants.”
I’m also an emergency physician, in a rural area of the state, and I’ve heard from doctors all over South Carolina who are worried either about the devastation they’ve already seen returning or about what they haven’t seen in rural areas suddenly emerging.
It’s hard enough to pronounce someone dead, then give the patient’s family the news. It’s worse when it happens every hour—and for weeks. The stress of those caring for these patients is real and palpable in what they write and say.
Doctors are also worried about the patients who don’t have the coronavirus. As people cancel doctor’s appointments and avoid the hospital out of fear of catching the coronavirus, they are ignoring new symptoms, and that can mean missed heart attacks or delayed stroke care. Kenneth Perry, a member of the board of directors of the South Carolina College of Emergency Physicians, wrote me, “I’ve had multiple patients stay home with STEMI [a heart attack] and sepsis because they were afraid of getting COVID-19.” Hospital administrators, worried about increasing exposure to infected patients, are also canceling outpatient procedures. Laura B., a nurse who works in ambulatory surgery, is concerned that patients aren’t getting what they need.
Other health-care professionals are fearful for another reason: They are losing work. A physician wrote me, “It feels like COVID has run all the other diseases out of town.” Many doctors, specialists included, have had hours cut or contracts terminated. As enormous as the problem of the coronavirus is in some places, in many others, the “bread and butter” of medicine, the regular appointments people have with their primary care physician, endocrinologist, oncologist, allergist, and so on, have dropped off precipitously.
A radiology technician, who asked not to be named, is suddenly out of work and exploring unemployment benefits. “It’s supposed to be a time of enjoyment,” his wife wrote to me, referencing their empty nest. “Instead it’s a time of worry and stress.” She wonders whether they will have to sell their house. A respiratory therapist I know is less worried of contracting the virus than she is of having zero income. A nurse practitioner wrote to me that she is concerned because she is paid only on a per-patient basis. “Still blessed, despite,” she said. Most of these people were afraid to use their names. Health-care workers can be fired if their comments are perceived to reflect poorly on their hospitals.
Lisa, who also asked not to be fully named, is not in health care. She is a bookkeeper for a local grocery store. Her husband, Keith, an engineer, pays close attention to the statistics on COVID-19. He thought she should stay home, because he was worried that she might catch the virus, but she felt that she needed to work. “I was afraid people would be violent if they couldn’t get what they needed,” she wrote me. She knows that people are concerned they won’t have food, but her husband is scared of not having her. Nevertheless, mask over her smile, she goes to work every day.
Teachers are worried that they can’t help their students from afar. Some kids lack internet connectivity or have parents who struggle to help them learn as they need. Social workers fear that they can’t really monitor the well-being of the children in the system. One of them, who withheld her name to protect the privacy of the kids whose cases she oversees, told me, “FaceTime is okay, but you can’t tell like you can in person. Are their parents in the room? Are they being honest?”
University students are struggling too. The transition to online classes was clumsy for my own college-aged kids. Now the fall semester may not even happen. Educational and career plans are on hold. Smaller colleges, with less endowment money, may not survive.
And so many people in my state, and around the country, simply need money. Alanna Trotter, a massage therapist at a spa in Pickens, wrote to me that she and her husband rely on her income. She understands the dangers of her work right now. But without it, there’s little money. Those with bigger bank accounts sometimes forget that most people can’t just stay home until a vaccine comes around—if it comes around. By then, they’ll be destitute.
Fear and safety mean different things to different people during the pandemic. But in the midst of the divisions over restrictions, between snide dismissiveness and ridiculous armed protests, we should recognize that people have individual reasons for fear during this time. Fear of infection is understandable. Fear of financial devastation is reasonable. Fear of retribution from or layoffs by employers is legitimate. Fear of hunger, abuse, loneliness, governmental overreach, or governmental failure are all rational.
We could take a step toward healing if we would consider these fears with compassion, knowing that we are all, in the end, worried.