We can help people feel cared for during this crisis — even from a distance
I’m a physician. My colleagues are on the front lines, already in the thick of the cornavirus pandemic, feeling its effects personally. We know it is going to get worse.
We are doing what we can and planning for more. We postponed all elective appointments and procedures; we ramped up our telehealth capabilities; and we sent home everyone we could. We created new screening protocols. and conserving our personal protective equipment (PPE). We know who is prioritized for viral testing with our limited supplies of reagents and nasal-pharyngeal swabs. Already, some of our own have been taken by COVID.
It is hard to predict how long the contagion — and our new way of life — will last. Yet, it certainly looks like we will be relatively shut down for months. The social consequences of this have begun to hit, and hit hard: school closures, furloughs, layoffs, food insecurity, isolation, family conflicts, child abuse, risk of relapse.
The effects of social distancing are numerous and deep. They also affect public health. Healthcare providers will eventually care for the outcomes of unemployment, stress and loneliness.
But our community can act now to prevent these outcomes. Our community can practice physical distancing while engaging in social connectedness.
The media have recognized front-line providers — and the people supporting them — as heroes for the risk they are taking on behalf of others. Working in these circumstances is noble, necessary and nearly all consuming. That is why we need more heroes, community heroes who plan, organize, give, create, influence and care so that members of our community are supported, and not socially isolated.
Lots of people are already taking action — dentists and veterinarians have donated masks and gloves, houses of worship have online services, those who provide elder care are adjusting their services, childcare services are offered to the children of first responders and healthcare workers. What more can the rest of us do to take care of each other, to keep our communities connected, safe, healthy and stronger when we come out of this?
Those of us in healthcare are worried about what is happening not just in the hospital, but also in our communities. There are gaps and needs that others can fill, both individually and as leaders of major efforts. This will require time, effort, new ways of organizing and some sacrifice. Heroes in our community can help narrow social distance. Below is a partial list of ways non-healthcare workers can do more to support social connectedness — and public health.
Create masks: Communities around the country have organized sewing circles, enlisting others who can measure, cut, sew, provide fabric and sewing machines, and manage the social media to engage volunteers and donations. Surgical masks can be used by local hospitals, which in addition to doctors, nurses and respiratory therapists, also have to keep maintenance staff, cleaning crews and culinary workers healthy.
Shelter and support the most vulnerable. Our families care for children, seniors, people with physical and mental disabilities who are dependent on us for shelter, food, medications and emotional support. When the primary caregiver of a family gets hospitalized with COVID, what happens to the others at home? Some may be positive for coronavirus, or await test results. Local and state agencies may have plans for these children and adults. What if the need is greater than the plans? Some of these dependents have never required services before. Do we know who is at risk? Do they know how to access care for their loved ones, if needed? How can we help?
Sheltering at home can be stressful. Those who were lonely before may be even more isolated. Even healthy, engaged people living alone may become lonely. Individuals living with families in a crowded space may find themselves wishing they lived alone! Depression, anxiety, frustration, resentment, helplessness and loneliness shouldn’t be dealt with in isolation. Do we know about the demands on crisis intervention phone lines and their staff? Psychologists in our community have moved to provide tele-counseling services. Is this enough? Access for those without significant resources or excellent health insurance is difficult in normal times. How do people in under-resourced neighborhoods find support now? Do we need an organized virtual network of social workers, psychologists and others to provide intervention and counseling? Can someone in our community assess the need, with attention to high-risk people and neighborhoods?
Academic supports: Miami-Dade County Public Schools, the YMCA and area hospitals have teamed up to provide childcare for school-aged children (4-12 years old) of first responders and healthcare workers. That is a huge boost for parents who need to know their children are safe, fed and cared for when they are at work. Yet, these same parents are perplexed as to how their children will be able to participate in virtual classes during school hours. They worry that other children have a parent to direct them to pay attention to the instruction and do their homework, while their children do not. Can we augment the childcare, and find ways to provide for academic centers with teaching staff for these families? Further, a lot of college students and other accomplished people are now home, some with far less work, or unfortunately, no work at all. Can our community create a network of tutors to provide assistance as needed (via conference calls, shared screens and over the telephone) to children struggling to learn and achieve?
Infrastructure for those in quarantine: A colleague is in quarantine with her COVID-positive husband. Fortunately, both are doing well. Neither should leave their home, not for groceries, medications or to take out the garbage. They live in an area where delivery services still operate and they can use credit cards for payment. I am hoping a nice neighbor with gloves will take out their trash if it is left outside the door. They have a social network that will check on them. Many of the people we are requiring to be in quarantine, and others who are high risk, do not have access to credit cards and, without Internet, may not be able to order online. These people need the social connection and care that will get them what they need and support them emotionally by asking how they are doing. Some people will not want to do this for their neighbors. They will be afraid and prefer to be in their own homes. Others will recognize that they can make a phone call or knock on a door and, standing six feet away, look into someone’s eyes, sincerely ask how they are and bring by fresh fruit and toilet paper. We can do this in our own neighborhoods, and we should. In addition, I imagine a hero creating an inventory of who needs help and matching that with a network of volunteers, each willing to assume a check-in on two or three neighbors within their area. They could be provided masks and gloves. The hero organizing this infrastructure will have to work with grocers, food banks and the government to be sure low-income people at high-risk or in quarantine are able to access food and supplies. Some circumscribed relaxation of privacy laws may be needed to allow those who determine quarantine recommendations or provide coronavirus test results to give location information to those who need it. Such a service not only helps the person on quarantine, but the rest of us as well, as a person who feels well but has a positive result, if not provided for, will no doubt go to the grocery store, which no one should do.
Our community does not have to be socially distant, only physically separated. Not being at work doesn’t mean not working. We can all find ways to engage. Some of us in small ways, some in large, transformational ways.
Healthcare workers will face the virus. All of us can care for our community through this challenge.
Stay six feet away physically. Keep your hands clean, but please, reach out — by phone, video or across a fence.
Judy Schaechter, M.D. is the George E. Batchelor Endowed Chair in Child Health; professor in the Department of Pediatrics and Public Health Sciences and chair of the Department of Pediatrics at the University of Miami Miller School of Medicine, She also is chief of service at Holtz Children’s Hospital, Jackson Health System.
Go ahead, sew up some surgical masks. Find links to free patterns included with this oped at miamiherald.com/opinion.