As the Delta variant spreads, so does PTSD among health care workers: 'I'm living in a parallel reality'
It’s been said that between the vaccinated and the unvaccinated in the U.S., there is a tale of two pandemics.
But there also seems to be a distinct third, according to those living it: that of health care workers, who, 17 months in, are exhausted from caring for patients, traumatized in the face of such suffering, and feeling alienated by the parts of society that cannot begin to understand what they’re going through.
“It’s like I’m living in a parallel universe to my nonclinical friends,” Dr. Andrée LeRoy, a physician and single Los Angeles mom, tells Yahoo Life. “I’m living in a parallel reality.”
That reality has included working in a hospital through the frenetic early days of the pandemic, contracting COVID-19 there and being out of work and incapacitated for five months, and subsequently passing on the coronavirus to her 6-year-old daughter, who wound up in the ICU with complications.
“I’m still recovering from the trauma,” says LeRoy, who is struggling to come to terms with what she’s been through and to relate to those who don’t get it.
“You can live in your bubble of reality, especially in L.A., and never really have to come in contact with the reality of COVID. ... But for me, as an African American physician? I lost six family members to COVID. I lost my best friend to COVID,” she says, not to mention the numerous patients she’s treated with major complications from the virus. “It’s hard for me to relate to people who say, ‘Oh, masks don’t help and they don’t work’ when we know that they actually do. It’s hard for me to relate to people who want to be careless and do whatever they want — which is a privilege, to be honest with you.”
It’s all taken a psychological toll on LeRoy, who has come to rely on therapists and coaches to help pull her through.
And she is far from alone: While data about the toll on health care workers is still largely from the earlier days of the pandemic, those worrisome findings — that 76 percent reported burnout, 82 percent felt emotional exhaustion and 63 percent experienced work-related dread — seem to only have worsened, at least for those where the Delta variant, and low vaccination rates, have made the pandemic unrelenting.
Recent findings show that between 20 and 30 percent of frontline U.S. health care workers are considering a change of profession, and an April 2021 survey found that 43 percent of nurses — and 48 percent of ICU nurses — are considering a change of profession.
“Over one-third of health care workers are experiencing anxiety or depression, and as many as one in four are experiencing symptoms of post-traumatic stress disorder. ... This is the state of the workforce asked to return to the COVID-19 frontlines for a second, third and now fourth wave,” stressed New Orleans ICU physician Dr. David Janz, testifying before the U.S. Senate Committee on Health, Education, Labor and Pensions last week.
1/🧵🎥 Leading #COVID19 ICU Doctor @DavidJanz5 in New Orleans, the epicenter of U.S. #DeltaVariant surge, testified before US Senate Committee on Health, Education & Labor. Here is what he said: “Studies of #FrontLine workers caring for COVID-19 patients have shown…👇 pic.twitter.com/dNT0pZx1KH
— WesElyMD (@WesElyMD) August 6, 2021
Though they were widely hailed as “heroes” in the first part of the pandemic, doctors and nurses around the country, still in the throes of the crisis and desperate to be heard, now largely feel forgotten. Many have taken to social media to share heart-wrenching stories of illness and loss, as well as frustration over those who resist the vaccine and other precautions to the detriment of the health care workers who are eventually tasked with saving their lives.
“As a nurse, to know that if you can’t get these two people home that their kids will be orphans ... I cannot even explain how that feels as a nurse and as a mom,” said a tearful Shreveport, La., nurse in a widely shared viral video recently.
There have been many other similar pleas:
Nurses in Florida are upset, frustrated & exhausted. We have been waiting for things to get better, a month ago, we truly thought we might have a real lull. Now we are dealing with the worst wave since the start of the pandemic & we have no staff to keep up.
This is hell.
— Sarah, RN (@shesinscrubs) August 5, 2021
— Taylor Nichols, MD (@tnicholsmd) July 29, 2021
We still aren't talking enough about the long-term effects this pandemic is already having on healthcare workers as society betrays them yet calls them heroes and expects them to smile about how the populace couldn't do the bare minimum.
— Chase Anderson, MD, MS (K.C. Ardem) 🦸🏽♂️🏳️🌈 (@ChaseTMAnderson) August 1, 2021
I could specialize in mental health for healthcare workers and never have an open appointment.
— Kelly D, RN, BSN (she/her) 🏳️🌈 (@KellyBSNRN) August 1, 2021
Of her colleagues, says LeRoy, who plans to now focus on wellness coaching for health care practitioners and clients, “I’m hearing some say, ‘I’m ready, I’m done, I’m out,’” she says. “As for me, I’m not quite ready to throw in the towel. But I can understand why so many are.” It’s because the entire system is broken, she believes — and it took a pandemic to shine a light on that truth.
“It is nowhere near the same job a lot of us set out to do,” LeRoy says, speaking of healthcare becoming corporatized. “It has watered away the art of medicine. Physicians have empathy, they have compassion, but when you couple that with a system not meant to support compassion and empathy, and instead only look at the bottom line — and then layer that with a pandemic — it just doesn't work.”
Showing symptoms of PTSD
Dr. Nicole Christian-Brathwaite, medical director of a telepsychiatry company and a Boston-based psychiatrist with a national telehealth practice, recently shared her experience — of her growing caseload of physicians being pushed to the mental brink — with Slate, noting, “Right now, I am concerned about the sustainability of health care workers and their ability to withstand another surge.” She has frequently taken to social media to share anecdotes about what she’s witnessing — including a physician client who “just cried for over 20 minutes” — in an attempt to foster greater understanding.
“This was a physician who had been through the first wave and had stepped away from critical care medicine, but was now realizing they may be called back in — and simply the threat of being on the frontline again was so daunting it rendered them speechless,” Christian-Brathwaite, a mother of two, explains to Yahoo Life. “Health care workers are seeing this sickness and death, but also experiencing it — many have had COVID, or lost family and friends.”
That goes for therapists as well, she says, noting that it’s not only the physicians caring for COVID patients who experience trauma, but also the therapists caring for those physicians, who then experience secondary trauma.
“I’ve lost family ... so when I listen to this doctor cry, I’m also remembering speaking to my cousin — [being the] last person he spoke to before he was intubated, and sounding like he was drowning,” she shares. “That’s a voice I cannot get out of my head. ... I tried not to cry with [the patient] but immediately after, I fell apart. So that was triggering for me as well.” These moments, she adds, make this moment feel like “a vortex, and everyone is being sucked in.”
Christian-Brathwaite first began noticing a shift in her client base as physicians sent her their children, who were anxious about losing their parents in the pandemic. Then, she says, those parents decided they needed to start paying for their own sessions and going on psychotropic medications as well. Many of them, she says, have shown symptoms of PTSD.
“When people think about PTSD, they think about veterans, or survivors of physical or sexual abuse — not realizing it can come from any event where you feel like your life or safety is at risk, or the safety or life of one of your loved ones is at risk, or are experiencing significantly toxic stress,” the psychiatrist explains. “They have this profound sense of helplessness,” with many never having seen “this level of mortality.”
PTSD symptoms she’s seen have included insomnia or excessive sleeping, irritability, unhealthy coping skills such as an uptick in nicotine or alcohol use, visceral reactions to sounds or smells that are hospital reminders, nightmares and physical reactions such as nausea or headaches right before the start of a shift.
“It’s very consistent with what we see in veterans or other survivors, because of the helplessness,” she says. “We go into medicine because we believe we can help and support people, but watching people die, despite your best efforts? I can’t imagine how devastating that is.”
Dr. Tameka Blake, head of a hospital emergency room in Atlanta, where just over 40 percent are fully vaccinated and cases have been rising, knows firsthand, and says she struggles to keep herself together so that she can effectively manage and support her overwhelmed team members.
“You can see it on everyone’s face: ‘How can I help when I feel helpless?’” Blake tells Yahoo Life.
“I’ve had patients, of different age groups, look at me and tell me, ‘I’m scared,’ and I’m scared for them, and when it’s someone younger than me and they’re not vaccinated ... I know exactly what they want to hear — that they’ll be OK,” she shares. “And the physician in me says, ‘Yes, we will do everything we can.’ But we just don’t know. That is what’s so frustrating, because the virus doesn’t discriminate based on age. I don’t know who’s going to be the one who does well or not.”
Why it’s ‘different this time’
This time around, says Blake, there is a lot more frustration than in 2020. “I was actually looking up the term ‘compassion fatigue,’ because it’s different this time,” she says. “When we first started, we were all just hoping to get through it. We were thinking that, hopefully, we’ll have a vaccine one day. Everyone was staying home. Now there’s this divide, where you have the world of vaccinated vs. unvaccinated.” That reality, she says, is leading to resentments that concern her.
“A doctor potentially saying, ‘I don’t care...’? I don’t ever want to get to that place in health care,” she explains. But it’s possible, she fears, “when you’ve been beaten up so much.”
An ER doctor in a different Atlanta-area hospital, Dr. Erika Chowa, agrees. “It’s overwhelming to know that people are not going to get vaccinated, and now here we are again,” she tells Yahoo Life. “We’re struggling. It’s terrible to go to work and see people who have other conditions who are waiting to be seen — but cannot be seen, because the hospitals are full.”
Chowa, who is from the small African country of Eswatini (formerly known as Swaziland), says she first wanted to go into medicine at the age of 9, when she saw “the inequities that existed” in health care there, by witnessing her grandmother receiving subpar care following a stroke.
“From that age, I always wanted to go into medicine to help people — humanity as a whole. ... A lot of times that’s what got me through school, as it wasn’t always easy,” Chowa shares. And while she stays in her profession for the same reasons now, she says, she is disheartened.
“With the pandemic, it’s been really rough to go through it and to know that we are having to deal with this constantly, when we thought there was an end in sight,” she says, adding that she is also parenting a 3-year-old and trying to stay on top of her own self-care.
“I can’t really allow myself to get to a point where I’m traumatized, because I have to be mom and be complete for [my daughter],” Chowa says, adding that, to that end, she exercises, gets massages and sees a therapist — though she knows that the therapist is overwhelmed too. “I’ve never seen her calendar fill up months in advance,” she says. “I’m scheduling for October now.”
But the burnout, she says, is real. “If we are not OK,” she stresses, “it’s going to affect everybody in the long run.”
Lead video courtesy of NBCUniversal and MSNBC. For more, check out MSNBC.com