Fear

I don’t recall feeling much fear since the beginning of the COVID-19 pandemic. One definite exception occurred near the beginning of March. It was then that I first began reading about how bad things were in northern Italy. I read of horrific scenes in overwhelmed hospitals with shortages of ventilators and scores of people rapidly perishing. The fear I felt was not for myself. While I did expect to eventually see a case, the first confirmed COVID-19 in El Paso was not reported until March 13th. At that time, in early March, my fear was for my parents. They live in Washington state which was an early epicenter of COVID-19 in the U.S. and they’re old enough that they’d be at high risk for severe illness. I remember telling them to isolate themselves on their five acres and to try to have minimal contact with others. It was not easy for me to make this recommendation. My parents are both social people — visiting with friends and going to church are important activities for them. I felt bad asking them to do something that would impair their quality of life but the fear I felt about the risk of COVID-19 weighed more heavily in my mind than any detriment from a period of isolation. In hindsight I think I made the right recommendation to my parents.

The latter half of March I began caring for COVID-19 patients. I carefully donned and doffed personal protective equipment and I trusted that if I did this as I had been trained the risk to myself would be minimal. It was at the very end of March that I next felt something akin to fear. It was at that time that I learned I’d had very close contact, without protective gear, with someone who ended up testing positive for COVID-19. While I knew my risk for having severe illness was low, I couldn’t help but think of the otherwise healthy patient in his 30s I’d seen who’d had a fairly severe disease course. I knew from direct experience that this is a very easily transmitted virus and it was hard for me to imagine that I had not been very much exposed. I imagined how terrified I’d be if I knew I was about to be intubated. Looking back on almost nine years since graduating from medical school I can honestly say that this was the first time I really worried about possibly having acquired an infection in my line of work. I take care of patients with a wide range of infections on a daily basis, I’ve cared for people with very contagious infections like tuberculosis (in Ghana without any protective equipment) and measles (although being vaccinated I knew I was safe) but COVID-19 was the first one that really gave me a sense of unease. Ultimately I never developed any symptoms and tested negative for COVID-19 by PCR. I would like to be tested for antibodies eventually to find out if I may have had an asymptomatic case.

In April I accepted an invitation to dinner at a friend’s house. This friend, who is a co-worker, and her husband are both old enough that they would be at risk for severe COVID-19. They are also both excellent cooks and conversationalists. So when I accepted the invitation, in the midst of caring for multiple COVID-19 patients, my only thoughts were anticipation of an excellent meal and enjoyable conversation. It was not until the day of the dinner that the thought first entered my mind that I probably should have declined the invitation. Although I had always been extremely cautious when caring for (known) COVID-19 patients, the reality was that I had recently spent time with multiple people with a very contagious and potentially dangerous disease. And I knew that the fact I was asymptomatic gave no assurance of not being infected or contagious. So I thought of very rudely declining the invitation on the day of the dinner. I called the host, relayed my concerns, stating the risks in as dire a fashion as I could and left it up to her whether I should still come over. I could tell that she thought it was ridiculous that I would even consider not coming to dinner. So I did go — wearing a mask at all times (other than while I was eating), keeping a distance of at least 6 ft (even at the dinner table), washing my own dishes and then wiping down every place in the house I’d come close to with bleach wipes. Thankfully, both my co-worker and her husband are still well two weeks later. I would be lying though if I said I felt no fear about the possibility I could have exposed someone to the virus. I can also say that, in hindsight, given what I know now, I should have declined the invitation.

One fear I haven’t had to deal with is the one I’ve heard expressed more frequently than any other from the doctors, nurses and other healthcare providers with whom I work. That is the fear of bringing COVID-19 home to a loved one. Through a series of unfortunate events described in the first post on this blog I am now temporarily living “the bachelor life.” Of everything I’ve had to deal with in the past few months there is nothing I hate more than the fact I am separated from my partner. But I will admit that the one redeeming factor is that I don’t have to worry about giving him COVID-19. Even though he is young and healthy I know I would still worry about it. I can’t even imagine coming home to someone who is elderly or who has comorbid conditions putting them at high risk for severe COVID-19. If that were the case I think I would have taken extreme measures to stay as distanced as possible from them while still living in the same house.

I struggle with how to view a concept like fear in our current context. Part of the struggle is that “fear” has such a wide range of meanings — anything from an intense, visceral, emotional response to a more rational respect for the seriousness of the situation we’re in. When thinking about something like fear it is important to keep in mind the emotional and psychological struggles people are dealing with in this time and to seek to alleviate or at least not further burden those who struggle with an unhealthy kind or degree of fear. When I think about what I see on social media it also seems that people often go to extremes with a concept like fear, either believing that any kind of “fear” is wrong or uncalled for or being so risk-averse that there appears to be no way out of lockdowns and strict social distancing. One thing I do know is that I don’t have answers to larger societal questions about the best response to the pandemic. I do think a degree of something like fear can be helpful if it means wearing a mask or practicing the right amount of social distancing. There is a rational kind of “fear” which simply means taking seriously the best and most up-to-date science and attempting to mitigate risk to oneself and others with sustainable practices that are good for both individuals and society as a whole. In a setting where containment of the virus is no longer possible, such as in the U.S. currently, I think we’re still learning what that looks like. As we figure that out together I hope we can find more unity than acrimony, I hope we can find the humility to admit we all still have a lot to learn and I hope that when we do disagree we can do it in a respectful way and not assume the worst about the other side.