Health Care Workers Hit Hard by the Coronavirus Pandemic

The Four Percent


Dr. Sheetal Khedkar Rao, 42, an internist in suburban Chicago, can’t pinpoint the exact moment when she decided to hang up her stethoscope for the last time. There were the chaos and confusion of the spring, when a nationwide shortage of N95 masks forced her to examine patients with a surgical mask, the fears she might take the coronavirus home to her family and the exasperating public disregard for mask-wearing and social distancing that was amplified by the White House.

Among the final blows, though, were a 30 percent pay cut to compensate for a drop in patients seeking primary care, and the realization that she needed to spend more time at home after her children, 10 and 11, switched to remote learning.

“Everyone says doctors are heroes and they put us on a pedestal, but we also have kids and aging parents to worry about,” said Dr. Rao, who left her practice in October. “After awhile, the emotional burden and moral injury become too much to bear.”

Doctors, paramedics and nurses’ aides have been hailed as America’s frontline Covid warriors, but gone are the days when people applauded workers outside hospitals and on city streets.

“We have a great obligation to people who put their lives on the line for the nation,” said Dr. Victor J. Dzau, president of the National Academy of Medicine.

Celia Nieto, 44, an intensive care nurse in Las Vegas, said many Americans had scant appreciation for the tribulations that she and her colleagues face day after day. There is the physical exhaustion of lifting and turning patients on their bellies so they might breathe easier, the never-ending scramble to adjust ventilators and pain medication, and the mental anguish of telling relatives she doesn’t have the time to help them FaceTime with their loved ones.

“It feels like we’re failing, when in actuality we’re working with what we’ve got and we don’t have enough,” she said. “We feel quite helpless, and it’s a real injury to our psyches.”

Dr. Donald Pathman, a researcher at the University of North Carolina at Chapel Hill, said he was struck by the early results of a study he has been conducting on the pandemic’s effect on clinicians who serve in poor communities. Many of the 2,000 medical, dental and mental health professionals who have participated in the survey so far say they are disillusioned.

“There is a lot of personal trauma,” Dr. Pathman said. “Many people have been scarred by their experiences during the pandemic, and they will look to leave their practices.”

In interviews, doctors who have recently left the field or are considering early retirement said the pandemic had exacerbated frustrations spurred by shifts in the business of medical care that often required them to work longer hours without increased compensation.

“The number of health care worker deaths in this country are staggering, but as shocking and horrifying as they are, we can’t be surprised because some very basic tools to address the crisis were left on the shelf,” said Dr. Friese, who directs the school’s Center for Improving Patient and Population Health.

Jasmine Reed, a spokeswoman for the C.D.C., acknowledged the limitations of its coronavirus case data, noting that the agency relies on reporting from state health departments and that can vary according to the state. At least a dozen states do not even participate in the C.D.C.’s reporting process, she said.

Many medical workers who have survived Covid-19 face more immediate challenges. Dr. Bial, the pain specialist from Boston, is still plagued by fatigue and impaired lung function.

“The day before I got sick, I could comfortably run eight to 10 miles,” said Dr. Bial, 45, who started a Facebook group memorializing doctors lost to Covid. “Now I go out for a brisk walk and my heart is pounding. I’m starting to wonder whether these effects could be permanent.”

Dr. Andrew T. Chan, a professor at Harvard Medical School and a gastroenterologist at Massachusetts General Hospital who has been studying the pandemic’s disproportionate toll on health care workers, said his preliminary research suggested that long haulers in the medical field suffer greater health challenges than the overall population. That is in part because they are often exposed to increased levels of virus, which can lead to more severe illness.

Another factor, he said, is that the worsening staffing shortages in much of the country lead many Covid survivors to return to work before they have fully recovered.

Health care workers “are likely to experience a greater risk of long-term complications,” Dr. Chan said. “Covid could impact our health care system for years to come by not only depleting our work force but by impairing the ability of survivors to do their jobs.”



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