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Monkeypox and the prolonged COVID pandemic could seal the fate of the health care system

Tomi Mitchell, MD
Physician
August 8, 2022
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I understand it’s been over two years since the World Health Organization announced the coronavirus pandemic, and we are tired.

I speak for the thousands of health care workers and frontline workers: We are exhausted, we feel taken for granted, and for many of us, we are leaving the industry. In some cases, we went from health care heroes being villanized as if we somehow benefited from the pandemic. So many health care workers have paid the ultimate price with their lives. Amidst the COVID-19 pandemic, health care workers have been on the front lines, caring for sick people and working to prevent the spread of the disease. Unfortunately, many of them have paid the ultimate price. According to one estimate, over 1,700 health care workers in the United States have died from COVID-19. This is a devastating loss, not only for their families and friends but also for the communities they served. Health care workers are essential to our society, and we must do everything we can to protect them.

After the tragedy of deaths from COVID, the media has long since shifted to thousands of other news topics. If I could summarize the general attitude to COVID, it would be “Meh.” I will not pretend and say that I don’t feel like this at times. I get it, it’s tiring, but COVID isn’t done with us yet, even if we are done with it.

Families have been destroyed due to the prolonged intensive pressures from the stress of COVID and unrealistic work-life balance. Skilled workers, who took decades to train, are leaving health care in droves. Studies suggest that a staggering 1 in 5 health care workers have left medicine since the pandemic’s start.

Burnout is part to blame.

It’s no secret that the health care industry has been under immense strain since the pandemic’s start. Hospitals have been overwhelmed with patients, and staff has been working around the clock to keep up. Unfortunately, this stress has taken a toll on health care workers, leading to a high burnout rate.

However, in the current situation, I believe the term moral injury more accurately expresses how many health care workers are feeling. Moral injury is a term used more frequently in the medical field to describe the feelings of betrayal and disillusionment that many health care workers feel. Burnout does not fully capture the emotion and mental distress that often accompanies moral injury. For example, in a study of over 3,000 physicians, nearly 60 percent said they were experiencing at least one symptom of burnout, and almost 30 percent said they were considering leaving medicine altogether. While many factors contribute to this high stress and dissatisfaction, I believe that moral injury is a significant contributing factor.

Health care workers dedicate their lives to helping others, and when they see the system betraying their patients or putting them in danger, it can be devastating. When moral injury goes unrecognized and unaddressed, it can lead to compassion fatigue, anxiety, depression, and even suicidal thoughts. Therefore, it’s vital that we begin to acknowledge and address moral injury in the health care community to support the well-being of our frontline workers.

Health care systems across the country are being crushed. Health care workers are forced to work in an unsafe environment, where dangerous provider and patient ratios are the new normal. In Canada, we see the closure of hospitals and reduced hours for emergency departments. There are headlines where non-nurses (i.e., medical students and residents) are asked to fill ER nursing positions. We are seeing patients waiting for life-saving treatments and deaths occurring that should have been prevented. Hospitals in at least 25 U.S. states are critically short of health care providers, and patients will suffer.

I am personally pleading with those key decision makers. The messaging needs to be changed; quite frankly, it should have changed over two years ago. We would have been reaping the rewards of emphasizing a healthier lifestyle and creating community programs to promote healthy choices. We know the most significant risk factors for COVID, obesity, and other chronic diseases are one–many of which are treatable with proper diet and exercise. So let’s start there. Let’s create messaging that tells people to eat better and move more and provides resources on how to do so affordably and conveniently. Community programs providing safe spaces for physical activity, affordable healthy food options, and educational resources on chronic disease prevention can significantly impact. We have the power to change the trajectory of this pandemic, but it starts with making healthier lifestyle choices the easy choice.

Summer will come and go, and those who live in colder climates will venture indoors into crowded, poorly ventilated buildings. As a physician, I am always concerned about the spread of illness, especially during the winter months. When people are confined to indoor spaces, respiratory viruses have a more significant opportunity to spread. Poor ventilation can exacerbate the problem, as virus-laden droplets can circulate through the air and infect others. Additionally, crowded conditions make it difficult for people to avoid contact with sick people.

As a physician, who took a break from clinical practice to deal with my burnout (moral injury), I am gravely concerned. I learned in my adult life to express my concerns so they do not bottle up inside me. I also took the time to learn other skills and have interests outside clinical practice.

Will it take a second pandemic to force our leader’s hands and make them fall to their knees? What will it take for them to value clinicians who have stepped up to the plate and are willing to share their expertise to help avert a pending crisis?

It is evident that COVID-19 has not only been a physical health pandemic but a mental health one as well. The effects of this pandemic will continue to be felt for years to come. We need our leaders to step up and do their part to help prevent another health care crisis.

Amid this pandemic, another disease outbreak is also making headlines- monkeypox. These two outbreaks highlight a more significant problem: our general lack of health and preparedness. For too long, we have neglected our health and allowed ourselves to become susceptible to diseases. Unfortunately, we have not invested in adequate medical resources or infrastructure. We have not made healthy lifestyle choices. As a result, we are now paying the price. The COVID-19 pandemic and the monkeypox outbreak are just two examples of what can happen when we neglect our health. We must take our health seriously and make the necessary changes to protect ourselves from future disease outbreaks.

The emergence of the second pandemic might be the straw that broke the camel’s back and delivers a deadly blow to the health care system as we know it.

Tomi Mitchell is a family physician and founder, Dr. Tomi Mitchell Holistic Wellness Strategies. She can be reached on Twitter @DrTomiMitchell, Facebook, Pinterest, and Clubhouse.

Image credit: Shutterstock.com

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Monkeypox and the prolonged COVID pandemic could seal the fate of the health care system
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