COVID-19 is a war on two fronts

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“I can’t fight you anymore.
It’s you I’m fighting for.”
-Ordinary Love by U2

I’m exhausted.  As the pandemic rages on, the mental toll of dealing with COVID-19 has started to wear on me.  As a practicing hospitalist in the Midwest impacted by one of the many hotspots caused by the meatpacking industry, I have spent a fair bit of time with this virus on the frontline.  Some aspects of practicing medicine in a pandemic have actually improved, such as the increase in possible treatments and data to support those treatments.  But one of the most stressful aspects of practicing medicine right now is the unexpected second front—the propagation of information from an increasingly vocal group of people who think the dangers of COVID-19 are imagined or manufactured.

Recently I saw my first ICU patient with COVID-19 extubated.  A month ago, this seemed almost impossible.  We had no disease-specific treatments at that point and constantly changing guidelines.  While the final “standard of care” will have to be determined after all of the studies are complete, having options to treat people, including the use of convalescent plasma, is a significant step forward.

At the beginning of this pandemic, I wrote an article titled, “In times of crisis, physicians will always come together to take care of you.” As I expected, many of my colleagues are at the frontlines.  And others who aren’t have spent these early days preparing to be called should the need arise.  There is no question my colleagues and I have sacrificed for this pandemic. We’ve worked long hours in a sea of constant change, fighting an unknown enemy that seems to be constantly changing, with tools that are less-tested than we’re used to. We’ve separated ourselves from our families to protect them. I’m thankful I haven’t had some of the struggles found in other places, such as having to fight to get adequate PPE or to continue working despite pay cuts.  Some of us have fallen ill due to our close and constant proximity to COVID-19.  Most of this we do without complaint.  I knew there was a risk I would get COVID-19.  I told my family to expect I would get sick.  While ultimately, I was right, and I did get COVID-19, I also recovered.   Some of my colleagues were not as lucky and paid the ultimate price.

I just finished a stretch in the ICU.  With few exceptions, this meant days filled with COVID-19.  Each day was mentally taxing.  The death rate for COVID-19 patients who are intubated is still quite high, and many days, someone died.  This is hard enough to deal with, but at least it’s a relatively expected stress.  The practice of bedside medicine is the frontline of this pandemic.  What I didn’t anticipate was what happened when I came home.  Posts about physicians falsifying death certificates, to get more reimbursement from the government, saying people died from COVID-19 littered my social media feed (spoiler alert, filling out a death certificate is complicated, and no matter what a physician writes, their pay remains the same).  Some posts claimed that physicians were deliberately killing patients or that the virus was manufactured to set up a payday for an already existing vaccine.  Yet other posts indicate that because many of the deceased are older or had other health problems, there is no reason for themselves as younger, healthy people to change their behaviors.  Pictures abound on my feed and in real life of large social gatherings with no respect for social distancing or universal masking.  My social media feed had become an unexpected second front.

Every time I see posts about how the dangers of COVID-19 are imagined, created on purpose, or worsened by health care workers scamming the system, it feels like salt in the wounds.  How can anyone believe these stories when they’ve seen what I’ve seen?  Of course, the short answer is: Because they haven’t seen it.  I understand the desire to make sense of what’s happening. It’s easy to deny the danger you haven’t seen first-hand.  It feels safer to believe that there is a secret vaccine out there that will end this pandemic tomorrow.

Life at the frontlines of medicine is hard right now.  I come home exhausted, dehydrated, and with indentations on my skin from the PPE (though I am grateful to have it).  I spent weeks separated from my husband and young kids while I had COVID-19.  There are hardships, but the physicians, nurses, and other frontline workers endure them because taking care of others during some of the worst moments of their lives is a core value for us.  However, we can’t fight a war on two fronts.  It is disheartening to spend our days fighting COVID-19 and then come home to find people sharing stories, videos, and posts about how none of our efforts matter (or worse, maybe we’re part of the grand conspiracy).  U2 said it best in their song Ordinary Love: “I can’t fight you anymore. It’s you I’m fighting for.” As the pandemic continues, health care workers will continue to show up every day to do their best for you.  I doubt internet conspiracy theories will disappear, but please think twice before you share them.  I don’t have the mental energy to refute them point by point, but if you want to know what’s really happening out there, please just ask.  I, and thousands like me, will be happy to tell you.

Clarissa Barnes is an internal medicine physician.

Image credit: Shutterstock.com

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