Will social distancing turn into doctor distancing?

Across our country, Americans are under a stay at home order.  People are toiling over the hardships of juggling so many things — childcare, homeschooling, working, or not working — all at once.  The day that society can rejoin the public sits like a mirage of water in the desert of their isolated lives. Health care workers yearn for that day as well.  In the hospital, that day means that we have reached the downtrend of “the curve.” Disaster scenarios in the hospital can be scaled back, and our standbys of broken bones, appendicitis, and chest pain will return to our orbit, and all will feel normal with the universe.  But that mirage of social re-integration sits in the minds of those in health care too.  A time when our skin may not be indented by the impressions of masks and goggles.  A time when rebreathing our own CO2 in our masks is replaced by fresh air. A time that we may talk to our neighbors about something, anything other than COVID-19.  A time when hugging our family is never taken for granted again.

But, when it’s OK for everyone else to return to the world, will it be OK for those in health care?  It’s not like the coronavirus will have disappeared.  We are not going to come to a time of eradication anytime soon.  The cases will substantially lessen, but they will still be in our hospitals for weeks and months, maybe much longer until a vaccine can be developed.  Are health care workers now tainted?  Will our presence make friends scared of us?  Do we have a responsibility to stay isolated because of our exposure risk? What is the protocol here?

Health care workers across the world will ultimately be faced with this reality.  Although our world will not return to the old normal, most will go back to some semblance of their pre-COVID lives.   Health care workers, however, will be stuck in the COVID world indefinitely.  We can’t let our guard down because when we do, we may be exposed.  If we are exposed, we can expose others, and the cycle repeats.  We will watch from the inside out as everyone else eventually returns to their social circles and family gatherings. What will we do?  There is some optimism about antibody testing, and I pray that it can provide a path to move everyone safely towards normalcy, but it’s still too early. And what if we don’t even have those antibodies and we continue to face exposure?  We worked so hard to obtain and wear our protection diligently, to not expose ourselves to this virus.  But what if we were lucky enough to not have had the virus within us in order to make antibodies?  Will we remain hostage to its demands anyway?

My husband and I pulled our son out of school before schools were officially closed as we were afraid that he could be exposed through us, both emergency medicine physicians.  The last thing we wanted was for him to unknowingly transmit the virus to someone else.  How long should we continue to keep him isolated? What if he doesn’t have the antibodies, or isn’t allowed testing yet?  Our son didn’t sign up for a life of seclusion and confinement.  He is 4.  He wants to run and play, go to swimming and soccer practice, hug his grandparents.  We never thought that our decision to become physicians would affect our son in such a way.  We are not risk-takers.  We have always been responsible, measured, and planned.  But now our son’s health could be at risk because of us?  Does he have to make sacrifices because of our choice to be physicians?  I’m not sure I can be OK with that.  But I think I may have to be.

Maybe we will get the green light.  But society may be a hard sell.  I fear that friends who know we work in the hospital will want to keep their distance.  I fear that neighbors will continue to cross to the other side of the street when we are on a walk knowing where we have been.  I fear that family will keep us out of gatherings until they know they are safe around us.  As a physician, I always viewed myself as someone there to help my community and family to protect those I love.  Now, I fear my presence may not be welcomed.  With antibodies, we may be deemed safe to rejoin society.  But will society allow us our passage?  Or will the people we love continue to be a mirage that we reach for but continue to be just out of our grasp? Or rather, 6 feet?

Tina Choudhri is an emergency physician and can be reached on Twitter @tcemed.

Image credit: Shutterstock.com

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