(Apologies. This is a long one. Turned out I had quite a lot to say!)
This post has been languishing in my list of drafts for ages. After a difficult week, though, it felt like the right time to actually take it out of the ‘to do’ pile and finally finish it. The main driver for this is seeing how excited people are for June. The plans being made. The jubilance seen on social media. Weirdly combined with seeing yet more protests about the inhumanity of what has been done to society by lockdowns and mask-wearing requirement. All the time getting updates from India, Peru, Brazil about the realities of a virus that is out of control and still killing people globally.
I have previously posted about the dangers of looking at the situation and some of these responses from my position of privilege (Science Communication: Reflections from an Ivory Tower | girlymicro (girlymicrobiologist.com). I do, therefore, acknowledge that this is a complex topic and that people will write PhD thesis on the confluence of science, human behaviour and policy. I’m not that smart and so this post is just my personal tale of being an Infection Prevention and Control scientist surviving in the midst of a global pandemic, and why some healthcare workers may not be keen to re-engage with life as normal.
On the 31st January 2020 I posted on my personal Facebook about the fact that I thought the spread of SARS CoV2 was going to cause real issues along with some commentary and guidance. Some of what happened over the last 14 months I could have predicted. So much of the non-science and emotional/relationship impacts I could never have seen coming.
What Is This Work Life Balance You Speak Of?
I work in IPC because I enjoy the responsiveness of it. I love a challenge as I discussed in a previous post. The difference with this vs normal infection control is that it hasn’t been high adrenaline and intense for three days, or three weeks. This has been life for over a year. No matter how much you love your job, no matter how much you know the difference it makes, that brings with it a weight and a burden that no amount of resilience or wellness seminars are going to dissipate.
I’ve been thinking about a metaphor for it for a while and this is what I’ve landed on. I love a blanket. I always have one to snuggle under when on the sofa. On cold days, or when I’m feeling particularly challenged, I may even layer up with two, for that extra level of comfort. There are some parallels with the parts of my job I find comfortable, such as how I feel about responding to the crisis management part of IPC. It’s what keeps the job interesting and never dull. Right now, though, I feel like I’m lying on my sofa and the blankets just keep on being added. At first I moved from comfortable and snuggled to overly warm and uncomfortable. Now, with the constant piling of new ones, I feel like I’ve moved to suffocating and trapped. At some point you wonder how many can be added before you’ll never be able to escape from under the pile.
I think one of the reasons for this is not just the work but that, suddenly, life outside of work is now also work. Every conversation you have is about SARS CoV2. Conversations with friends, Facebook posts, taxi rides. When you have a bad day at work normally, at some point, you can walk away from it. There’s been no walking away from this: it’s everywhere and so there’s no space in which to recover.
The Clear and Present Danger
One of the other layers to this is the fear. It’s not something I dwell upon. It’s something I try to actively not think about, but there’s no denying it’s been an ever present feature of the last year. I posted about the fact that my sister passed away some years ago, so my parents and family have already been faced with losing someone. This is something that families don’t get over. What I haven’t posted about is that viruses and I have a rather turbulent past. I’ve been ventilated when I was younger due to acute respiratory distress brought on by viral infections. Viral infections also exacerbate my angio oedema, which makes my face and hands swell and impacts on my ability to eat and sleep. There has been understandable concern from friends and family about me needing to travel on public transport and attend work, whereas they would have loved for me to be able to stay home and build walls of protection around myself. Seeing that anxiety has not been easy. It has also not been easy ignoring that nagging fear at the back of my own mind. The ‘what happens if’. I’ve had to put faith in my ability to be super-compliant and in the guidelines I was issuing to keep both myself and others safe. This is always the case, but there’s no doubt that this has been a high consequences event if I got it wrong. Normally, when you are managing an outbreak, you are not also part of the outbreak.
This has been brought home by the deaths of colleagues and family. My family, like many others, have lost people as has my Trust. So you don’t have to hypothesise about how others are feeling. I’m feeling it too. The grief, the loss, the fear. There’s no walking away. The only thing you can do is acknowledge it, then straighten your shoulders and, as they say, ‘Keep Calm and Carry On’.
Everyone’s an Expert
One of the things I’ve found personally frustrating, no matter how understandable, is that everyone is now an expert. They appear to all have an in depth understanding of diagnostics, of virology, of infection control and of public health policy. I completely understand the drivers for this: it helps people feel in control, but even so it’s still super frustrating. The worst ones for me are the people who are definitely on the Top of Mount Stupid in terms of levels of knowledge. There was a lot of social media commentary on every action taken. Especially by people who others look to as being informed due to them having good levels of general knowledge. People who others will then take advice from without fact-checking or understanding that this is a complex situation with a lot of moving parts. As much as these people are often certain they are correct, it is also a certainty that they definitely don’t have access to all the facts, as even working within the system I couldn’t claim to have access to everything. At the start, I spent a lot of time trying to counter this misinformation but, as time goes on, I must admit I’ve struggled to have the energy. I think this has not helped in getting scientific messages out there and good communication, as many people involved are also maxed out on other actions. This guilt adds another blanket to my pile.
Real Science vs Movie Science
Although people normally smile and ask polite questions about what it is I do, I’ve never felt it has been in any way mainstream. It has been fascinating to me seeing decisions and things I’m doing in real time playing out in the media a day or two later. Early on, guidance and diagnostics were changing every few days or weeks. The speed at which everyone needed to flex and respond to changing demands and new information is something I have never experienced before. For me, on the ground, this was an amazing feat. But the criticism of speed and response does make me think of scenes from Star Trek, where you can get more just by saying how urgent it is: the implication being that we just aren’t working hard enough. The same can be said of individual sample requests. Sometimes when you get a call and someone explains how urgent a result is and the only response you can give is that the process is limited in speed by the underlying chemistry, it therefore cannot go faster no matter how much I want it to. There are certainly speed savings in workflow but these require workflows not to be changing every other day for you to truly understand where speed can be gained without impacting quality.
Reality Strikes and It’s Not Pretty
This all brings me to the thing that I have found most difficult. Seeing the response to the science. Not only in terms of protests in the streets from people who believe that the virus that has killed their family and colleagues doesn’t exist, but seeing the non-compliance with measures to save lives. The living reality of seeing how ‘the needs of the many outweighs the needs of the few’ plays out in the behaviour of both strangers and friends. The reality is that the scientific conspiracy theories have been present everywhere. What would, in other scenarios, have been chats that caused me to roll my eyes about data manipulation, vaccine hesitancy, and refusal to take personal actions lead to a different level of impact when it is all you are living and breathing. It’s not discussing hypotheticals when you are exhausted and dealing with sick people every day and experiencing personal loss.
I’ve found this super hard when these conversations and behaviours are displayed by not just strangers on the internet but by friends and family who you would otherwise have thought of as being part of your ‘tribe’. Part of the discomfort in this is that you are constantly faced with the failure to get sound information out there, and of your personal lack of energy to engage. I’ve also, on occasion, been attacked for being the bearer of bad news when trying to expectation manage on my personal social media. It means that, as of right now, I feel I will come out of this with some permanently altered relationships as it’s just not that easy to forget and move on. This will be a personal legacy of the COVID-19 pandemic that I will be dealing with for some time.
So Why Am I Telling You This?
A good friend, when I was talking some of these thoughts through, suggested I share some of this. Not just to talk it through, although that has been useful, but also to explain why I’m not excited about the so called ‘return to normal’.
Everyone’s journey and experiences over the last year have been different. Mine, like many people, has been one of exhaustion and stress, but not for the same reasons. A lot of stress discussed with me by others has come from feeling isolated and scared about personal well-being. Due to that some people, now they are vaccinated, are feeling less at risk. They are also understandably energised by the thought of seeing friends and family.
I on the other hand am in a much worse physical place than I was pre-pandemic as the stress has exacerbated everything somewhat. I’m also really tired and feel like I’ve been running non-stop for over a year. All I want now is to hide away and recover, see no one, and sleep until I am more like me again.
So please understand, if you invite me to things post-lockdown end, or if you phone and I don’t answer, it’s not because I don’t value our connection. It’s because I value it enough to want to engage again when I can be fully present. Until then forgive me for retreating back to my sofa and trying to get back to having one blanket that brings me comfort, rather than 150 which make it hard to breath. See you in 2022.
All opinions on this blog are my own