Caring for Those Who Care for Us

Exactly three years ago today, I was wrapping a belt around a plastic mannequin to move it from a bed to a wheelchair. This was one of the many skills, ranging from recording blood pleasure to denture cleaning, I had to demonstrate during my exam to become a licensed certified nursing assistant, or CNA. A couple of hours later, the instructors told me and my fellow CNA training students we had passed. Over pizza, we celebrated our futures in hospitals, nursing homes, hospices, and schools. The opportunities seemed endless.

Now, as our country confronts the COVID-19 pandemic, I embrace the responsibility of mostly staying at my home in California and maintaining physical distance from others when I venture out for exercise, fresh air, or necessary supplies. While my life has been upended, I feel very fortunate to be able to focus on my schoolwork without worrying about losing income to pay bills.

I salute the heroes of this pandemic. They are our doctors and nurses — women and men — who are risking their health to help others. They are also our allied health care professionals, the women and men such as radiology technicians, paramedics, CNAs and other caregivers currently at risk as this disease spreads in our communities. So many are women.

Of the 20 of us who passed the CNA certification with me, all were women. In fact, all the CNAs involved in my training were women. My peers, the CNAs at the rehabilitation center where I did my clinical training, my test evaluator — everyone. This is not surprising when you consider that of the 600,000 nursing assistants in the nation, 90% are women. Women also compose 85% of nurses and perform 76% of all health care jobs in the country. Apart from occupying health professions, women also tend to be the principal providers of informal care for family members due to social and cultural demands.

I often think about my CNA friends working long hours in understaffed rehab centers. I think about the predominantly female nursing staff in the Yale New Haven Hospital ER where I volunteer when living on campus. I also think about mothers caring for sick kids and grandparents. I think about the particularly acute stress experienced by pregnant women.

What attracted me to the CNA role was the opportunity to provide direct patient care. I wanted to make patients feel comfortable and secure, hold their hands and listen to their stories. However, it is this same proximity to the patient that makes the work of health care workers so dangerous today. More than 3,300 health workers in China have contracted COVID-19, and 20% of responding health care workers in Italy have been infected. We are similarly beginning to see the number of infected health care workers grow in the United States. In light of the dominant numbers of female workers in the health care profession and their roles as caregivers in society, women may face a unique risk of COVID-19 infection.

This conceivable risk underscores the need for more publicly available gendered data on this outbreak, a need I discussed in an op-ed for The Hartford Courant. I explored how COVID-19 seems to be more dangerous for men than women, possibly due to factors ranging from higher smoking rates among men to the varying effects of sex hormones on immune responses. Just like this gender difference in health outcomes has implications on the COVID-19 response, identifying the gender differences in disease risk can inform this response as well.

Unfortunately, shortages of personal protective equipment and inadequate training are leaving many health care workers unprepared for this danger. Aside from the risk of physical illness, they face the burden of losing patients and coworkers to the disease, caring for children who are not in school, and exhaustion from working long shifts. A friend recently told me how her mother, a nurse, has chosen to live apart from her family to protect them from infection. I was moved by an article about Chinese nurses shaving their hair and having to deal with menstruation wearing full-body suits. The incredible psychological toll of their work explains why large numbers of health care workers in China, especially women, have reported symptoms of depression, anxiety, insomnia, and other mental health challenges.

Given the stakes, I am confident that our country can provide these essential workers the training, protective equipment, and psychological assistance they need to continue their indispensable work.

While those of us under lockdown may occasionally feel helpless, there are still actions we can take to protect this vulnerable population. Here is a link to a FEMA web page with opportunities for you to help. For people in the New Haven area, here are some recommendations for donating PPE to Yale New Haven Hospital.

Even if you are unable to make a donation, by voicing our support for frontline workers in this pandemic, we can ensure that their protection remains a vital focus of our attention. We are all in this together.