'There's no vaccine for grief:' Academics address how coronavirus changed dying and grief

Jun. 11—As a community activist, Julian Mack was used to being there for others in their grief, especially related to alleged police violence or addiction. But when his own losses came wave after wave throughout the pandemic, he wasn't sure how to cope himself.

"There's been so much death I've been in proximity to over the last two months its been incredibly difficult to properly grieve..." he wrote in a May 14 Facebook post honoring the third friend he'd lost since April.

Over the past year, five of his friends have died of overdoses, their addictions fed by the isolation of the pandemic and the loss of the support systems that kept them sober. Mr. Mack himself fell victim to it, surviving an overdose in February after two years of sobriety.

Three more friends died of coronavirus. Another died from sepsis.

Then add on some of the record homicides Toledo has faced in the last year, the funerals missed, the social isolation, and new grief compounding on top of every still-raw wound and the pandemic created a perfect storm for a mental-health disaster.

"It seems like there's no way all of this can be real, that there can be this much trauma around me," Mr. Mack told The Blade on Wednesday. "Not only was there COVID, not only was there an uptick in violence, but there was an election like no other, there was one of the most socially active summers, there was an unprecedented amount of people out of work, we had an insurrection. When you add up everything that happened ... we've been through a traumatic year."

Coronavirus changed how we died — alone, with families and friends unable to say good-bye, hold funerals, or support each other in the loss — but it changed how we grieve, too, health experts say. And for many, that grief lingers on.

In a recently published paper promoted on the World Health Organization's website, a research team of academics headed by Timothy Jordan, a professor of public health at the University of Toledo, sounded a warning for what is coming if something isn't done to stop people from drowning in grief following the barrage of death and trauma over the last year.

"We believe that a surge of complicated grief will take place in the U.S.," the team wrote.

Complicated grief, or Prolonged Grief Disorder, applies when a person is unable to return to the activities of daily living following a loss. They may suffer complications including a sense of disbelief regarding the death, anger, bitterness, recurrent painful emotions that feature intense yearning and longing for the deceased, and preoccupation with the deceased.

Coronavirus has killed nearly 600,000 Americans in the last year. If researchers are correct in estimating that each death leaves behind at least nine grieving loved ones, that's 5.4 million people who are now left to cope amid a host of other exacerbating stressors that came with the pandemic, including job loss, financial strains, virtual learning, work-from-home, informal caregiving, and social isolation.

In Lucas County, 850 residents died so far from the virus. Another 197 Wood County residents have.

"That's a lot of grief," Mr. Jordan said. "That's a lot of hurt."

And there aren't enough support systems in place to help people channel it, argue Mr. Jordan and his partners, former UT graduate students Amy Wotring, now an assistant professor at Indiana State University, and Colette McAfee, an associate professor at Westminster College.

Other contributors included Derek Cegelka, Victoria Wagner-Greene, Mounika Polavarapu, and Zena Hamdan.

On the prevention side, they recommend teaching about death and healthy coping strategies in schools as well as at the collegiate level, especially for students majoring in education and health professions most likely to encounter students and patients who need support.

But they also are advocating for more robust mental health services.

According to a study published on the CDC's website, 40 percent of adults reported struggling with mental health or substance use because of coronavirus back in June, 2020. Younger adults, racial and ethnic minorities, essential workers, and unpaid adult caregivers reported having experienced disproportionately worse mental-health outcomes, increased substance use, and elevated suicidal ideation, the study said.

Those struggles haven't dissipated just because health mandates were lifted, experts said.

"With grief I think there's a common assumption or stereotype that people get over a loss, and that doesn't happen. People learn to live with their grief for the rest of their lives," Ms. McAfee said. "Yes, population wide we might return to a sense of normalcy, but on this individual level or among these people who've experienced [loss during the pandemic], this is going to be a very long thing that we're going to have to be handling and helping them with."

Because it wasn't just the loss of life itself that has left people mourning in perpetuity, they said.

With chronic illnesses, families have time to prepare for the loss. Coronavirus was more sudden. The last time some spoke with a sick loved one was dropping them off at a hospital, from which they expected to pick them back up after recovery.

In normal times, families can gather at the bedside to say good-bye. Coronavirus made that important ritual impossible.

Afterward, there was no formal funeral to lay the loved one to rest. Families weren't able to gather together in grief and healing.

It all can compound to create a sense of ambiguous loss — "Did this really happen?" — that can further prevent healing and moving on.

The United States may be taking steps to get back to normal by lifting health orders, restoring rituals like funerals, and encouraging vaccinated individuals to hug and gather and restore their family bonds, but that doesn't mean individuals are getting back to normal at the same rate.

"It's still out there and our grief doesn't magically disappear," Ms. Wotring said.

"There's no vaccine for grief," Mr. Jordan agreed.

A lack of death education for all ages has been a problem for decades, the team said. The sudden onslaught of loss during the pandemic just brought it to the fore.

They're now calling for improved training among mental health counselors and increased access to mental health care, especially among communities of color, which were disproportionately impacted by the virus and thus are carrying a disproportionate burden of grief.

People need to be open and willing, though, to ask for support when it's available, Mr. Mack said.

After his overdose, he checked himself into rehab for help with addiction. He sees two therapists for help with his losses and his overall mental health. He's participating in support groups again, and leaning more on trusted friends.

Working through grief isn't always linear, he admitted, but it also doesn't have to be forever.

"There's no shame in admitting you need help," Mr. Mack said. "We just went through one of the most difficult things in human history, it's OK to need help."

First Published June 11, 2021, 3:18pm