Big thanks, not threats, are owed to all who work for our better health

baltsunjerryjackson-300x222In the spring of 2020, health workers were serenaded, cheered, and greeted as courageous heroes for their 24/7 commitment to battling the frightening, new coronavirus pandemic.

People — especially New Yorkers with their nightly eruptions — could not contain their admiration and gratitude for medicine’s marvels, with spontaneous and sustained demonstrations breaking out, as one news story reported, “from the Chinese epicenter of Wuhan to the medieval villages of Lombardy, from Milan to Madrid, onto Paris, and now London. There have been standing ovations, too, in Istanbul, Atlanta, Buenos Aires, and Tamil Nadu, India.”

Much has changed in the months since, of course, with the public’s health having become politicized and polarized, including with wild falsehoods and disinformation campaigns.

Maybe as Americans sit down with family, friends, and colleagues to pause, feast, and give thanks for the good things in their lives, could it also be time to turn the tables on a grievous and growing wrong committed against those the country toasted so recently — essential workers, first responders, health workers, medical scientists, and many others who have fought, and continue to do so, one of the deadliest disease outbreaks in a century?

The counterfactual, anti-science extremists may insist that they are expressing constitutionally protected views and that they are entitled to their individual rights. As the pandemic has ground on, however, their evidence-light raging about matters including science, medicine, and health care has inflicted a measurable toll. This has proven true, especially as a safe and effective vaccines became available, the Delta variant surged, and health workers and systems were overwhelmed.

Public health officials, of course, have been targeted by extremists almost from the pandemic’s outset. But now, first responders and health workers have been subjected to protests and screaming abuse, including from the very patients they are seeking to treat.

If the coronavirus and the intensive care it requires from the already had not sapped their energies, health workers are crying out that they are exhausted, demoralized, and have had enough, maybe even for the careers to which they devoted years or decades. As an article in U.S. News and World Report found:

“Before the pandemic, physicians were at twice the risk for burnout compared to the general population, and about 40% of those surveyed reported depression and suicidal ideation, said Dr. Victor Dzau, president of the National Academy of Medicine  … Increases in patient volume, the demands of making health care more businesslike, the pressure of meeting more regulations and requirements and other factors have left providers feeling overwhelmed and with less time to spend one-on-one with patients, panelists noted.

“The situation has deteriorated further since the start of the pandemic with some 60% to 75% of clinicians reporting symptoms of exhaustion, depression, sleep disorders, and PTSD, Dzau said, while nurses are equally if not more stressed. About 20% of health care workers have quit during this period, he said, and 4 out of 5 of those who remain say that staff shortages have affected their ability to work safely and to satisfy patient needs. Research estimates that burnout cost the health care system about $4.6 billion a year before the spread of Covid-19, Dzau said, and that number has surely risen since then.”

News organizations, including Vox and the Wall Street Journal, have reported that the U.S. health care system is struggling with significant staffing challenges, especially with vital, highly trained, seasoned, front-line nurses. They bear the brunt of direct patient care. And they grapple with the emotions of having a tidal wave of sickness and death washing over them with coronavirus cases, including recently with furious and anxious patients espousing extremist views about health care.

But nurses have found they have options, too. They, and other health workers are demanding better working conditions, hours, and staffing, as well as higher pay (see the labor agreement that Kaiser Permanente struck with its personnel). Nurses have jumped into “traveler” programs, in which they just may cross the street but with huge boosts in pay. Hospital administrators have been groaning about the bills that will need to be paid — patients will foot these, of course — as health workers threaten to quit unless they see their working conditions improve.

Nurses have told news reporters that they are tired and that institutional expressions of thanks have been insufficient. They are not settling for pizza parties and nice speeches, they say.

That makes sense. Health economists have warned hospitals for a while now that they eventually would see the consequences for choosing to stint on direct patient care staff, while building up the personnel for billing, marketing, administration, and other areas.

It’s time not only for an institutional re-balancing, but also for all of us outside health care to cool the fervency with which we discuss complex, uncertain, life-and-death challenges in medicine, especially as it involves public responses to the pandemic. We can give a lot less attention to actors who balk at vaccines for kids, or unvaccinated pro athletes who put teammates’ accomplishments and health at risk. We’ve seen how much harm can occur when we let radiologists and TV psychologists and drug addiction experts opine about dealing with a lethal infection that spread like wildfire.

It would be great, yes, if more health workers (as well as first-responders and members of the military) heeded their own expert and knowledgeable colleagues and wise leaders and increased the vaccination rate in their industry, so that 30% of those entrusted with our care, at last, got their shots.

But, as President Biden likes to say, C’mon, man. The people in the medical establishment, with all the many faults that yours truly won’t hesitate to point out, has by and large done remarkable, valiant work, combatting the pandemic for what is becoming too long a time.

They — and the essential workers, first responders, and personnel in the armed forces — deserve our thanks and support, especially as so many of them will be hard at work, night and day, through the holidays.

Photo credit: Health workers in Baltimore, earlier in pandemic, cheered on for their work by police, fire fighters. Jerry Jackson / Baltimore Sun
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