Pandemic Fatigue

stress

In the United States, many of the recent news reports are focusing on trying to find a new normal.  Merely using the word normal implies that things can go back to the way it used to be before COVID-19.  Unfortunately, we know that is not going to happen.   

One definition of fatigue is a person lacks the energy to perform tasks.  It is also known as exhaustion, feeling run down, lethargy, listless, malaise, or weakness.   Fatigue may be due to mental stress.  It may be due to physical demands.  Sometimes it is a combination of both psychological and physical.  Pandemic fatigue is feeling these symptoms as a result of adjusting our daily routine due to the COVID-19 pandemic.  We in the United States are suffering lives lost, unemployment, business disruption, and financial burden.  How the pandemic affects individual Americans varies considerably –  the contrasts can be as different as night and day.

Lives lost due to COVID 19 – over 90,000 Americans.  Australia – lives lost 98.  Iowa State has more COVID related deaths than the country of Australia.   Lucas county of Ohio has more COVID related deaths than the country of Greece.  The city of Chicago has more COVID associated deaths than the country of Poland.  In the United States, we have a stark difference between places that have lost a significant number of lives vs places that have significantly less.  Albany in Georgia, Baton Rouge, Bridgeport in Connecticut, Boston, Buffalo, Cedar Rapids in Iowa, Chicago, Detroit, Farmington in New Mexico, Flagstaff in Arizona, Greely in Colorado, Greensburg in Indiana, New York City, New Orleans, Philadelphia, Salem in Ohio, Sumter in South Carolina, Trenton in New Jersey, and Washington DC are among the hardest-hit cities with higher total death rates per capita.  Some metropolitan areas with low infection rates per capita include Portland, Sacramento, San Antonio, and Tampa Bay.   Another contrast is the percentage of African Americans who died in comparison to other races.  Theories as to why the African American population has suffered more include higher rates of pre-existing conditions, less access to health care, housing disparities, and a higher percentage of essential workers cited as probable causes.  Globally, the United States has one of the higher death rates per capita.  Countries with higher infection rates per capita should logically have higher numbers of COVID related deaths.   However, Singapore has a high number of infections per capita but is not among the top 15 countries in COVID related deaths.  It could be explained by how they define COVID related deaths.   Other undetermined factors could be reasons why they are not seeing as many deaths per capita.

Staggering unemployment is the new normal.   According to the Bureau of Labor Statistics, the unemployment rate for April 2020 spiked to 14.7% as 20.5 million workers lost their jobs.  Those facts do not include May unemployment figures.

Unemployment Rates for the World’s Largest Economies 

The unemployment rates for the world’s largest economies were generally low at the end of 2019.

  • Japan: 2.4%
  • India: 3.5%
  • Germany: 3.6%
  • United Kingdom: 3.9%
  • United States: 4.1%
  • China: 4.8%
  • Canada: 5.9%
  • France: 8.6%
  • Italy: 10.4%
  • Brazil: 11.6%4 

Source: https://www.investopedia.com/articles/personal-finance/062315/unemployment-rates-country.asp

In contrast the unemployment of the same countries in April 2020:

  • Japan: 3.0%
  • India: no data
  • Germany: 3.9%
  • United Kingdom: 4.8%
  • United States: 14.7%
  • China: 4.3%
  • Canada: 7.5%
  • France: 10.4%
  • Italy: 12.7%
  • Brazil: 14.7% 

Source: https://www.imf.org/external/datamapper/LUR@WEO/OEMDC/ADVEC/WEOWORLD/JPN

The United States Unemployment rate is now equal to Brazil.  Other countries who have faced COVID lockdowns such as Germany and the UK have not had as much of a change as the US.  China is the only country to decrease the unemployment rate.  People who still have employment are either essential workers or jobs that accommodated them to work from home.  1 in 5 Americans who had employment, lost it due to coronavirus. Some positions terminated while some companies forced to put their employees on hold, and when the weeks turned into a month, the anger was palpable.  People protested, wanting to return to their jobs or owners fighting for the survival of their business.   We as Americans have invested years of blood, sweat, and tears into our livelihoods, and we realized that we had to return to work.   The problem remains, how to make that happen without allowing the virus to spread out of control.

Finances – While the United States has been the most exceptional economy for more than a decade, we could lose that status. Increased national debt and the loss of employment will have an impact on the GDP.  The actual financial burden with the pandemic and its effect on the US has only begun.  At the beginning of the year, our economy was strong.  Business experts are talking about a recession that could rival the great depression.  One billionaire believes the United States will suffer an economic depression if the lockdowns last for a year.  The United States was already trying to balance saving lives and saving the economy back at the end of March.

Meanwhile, two professors at Northwestern University predicted the costs of not closing down non-essential businesses and allowing the virus to spread unchecked would have been more expensive than closing non-essential businesses. They were not alone in their predictions.  In the US and abroad, experts weighed in on what the best course of action would be. Investors are now predicting a 3.9% fall in U.S. GDP in 2020.

All this stress creates mental fatigue from the pandemic.  The kind that disrupts sleep and changes your appetite.  Psychological stress affects your ability to concentrate and contributes to other symptoms like headaches, muscle aches, and abdominal pains.  It is new stress, and our country unprepared.  Our food banks are in high demand, the unemployment offices that process payments unable to keep up, and the federal government was providing a stimulus intended to offset the financial strains are giving away money to corporations and institutions that do not need it.  While some large chain restaurants and sports franchises have already said they will return the money, one educational institution has already declared they will keep the money and use it for students.  If you don’t acknowledge the mental strain, you are in denial.  Denial itself is a psychological mechanism to try and protect oneself from facts.  When facts are too painful to admit, denial is a coping mechanism to allow you to continue to function, to move on.

Front line health care professionals are working extra hours – the physical demands of caring for more patients in hot zones day after day contributes to fatigue.  The post-traumatic disorder is already presenting in some of them from witnessing more deaths than usual.  It also gives a risk of suicide as we learned of one emergency room physician who got COVID, recovered, returned to work, and ultimately took her own life.  Nonessential workers are also affected.   They are at home, getting restless and weary as they watch the news, interact on social media, and worry about the safety of their loved ones.   In some hot zones, they are returning to work.  They now have to worry about how they can do their job safely and must plan a new work environment to reduce the chances of spreading infection.

What follows are some of the lives lost or changed due to COVID-19.  The loss of these heroes affects their loved ones, their neighbors, the communities they served, and our world:

Police officers – https://www.lawenforcementtoday.com/senior-detention-officer-officer-of-23-years-man-of-faith-dead/

Paramedics – https://www.ems1.com/coronavirus-covid-19/articles/covid-19-ems-deaths-jk5zWFziwYVYUaM4/

Store workers – https://www.eater.com/2020/4/7/21212135/grocery-workers-are-dying-from-coronavirus-trader-joes-walmart

https://www.kcra.com/article/he-was-a-healthy-man-family-mourns-safeway-worker-who-died-of-covid-19/32179508#

Meatpackers – https://www.usnews.com/news/healthiest-communities/articles/2020-05-01/cdc-nearly-5-000-meat-plant-workers-infected-by-coronavirus

Doctors – https://www.nbcnewyork.com/news/local/new-jersey-er-doctor-dies-one-week-after-exhibiting-covid-19-symptoms/2354084/

Nurses – https://www.usatoday.com/story/news/nation/2020/04/21/us-nurses-who-died-coronavirus-honored-white-house-protest/2996839001/

Physician Assistants – https://www.military.com/daily-news/2020/03/31/guardsman-who-died-covid-19-remembered-1st-responder-passion-serve.html

Nurse Practitioners – fortunately, no deaths reported https://www.11alive.com/article/news/health/coronavirus/georgia-nurse-survives-covid19-battle/85-37c7b703-fe2f-41d3-b62f-f4a6ee2a838d

Nurse Anesthetists – thankfully, no deaths reported – https://www.nola.com/news/coronavirus/article_25b835c0-7b65-11ea-ab5c-67ceca2dba77.html

Respiratory Therapists – https://www.local10.com/news/local/2020/04/24/partner-of-fallen-healthcare-worker-says-they-need-more-protection-from-coronavirus/

https://www.poynter.org/business-work/2020/the-journalists-and-colleagues-weve-lost-to-the-coronavirus/

Politicians – https://www.forbes.com/sites/jackbrewster/2020/04/07/these-34-us-lawmakers-have-tested-positive-for-covid-19/#378ee12d46d9

https://www.newscenter1.tv/south-dakota-state-representative-bob-glanzer-dies-at-74/

TSA employees – https://www.khou.com/article/news/health/coronavirus/fifth-tsa-employee-dies-of-coronavirus-as-more-than-500-have-tested-positive/285-8910f312-fd8e-418a-acc6-6ca303474a05

Overall Medical workers:  https://www.businessinsider.com/healthcare-workers-who-died-with-the-coronavirus-2020-4?op=1#douglas-linn-hickok-57-a-physician-assistant-and-new-jersey-national-guardsman-became-the-first-us-military-service-member-to-die-from-the-coronavirus-7

Overall memorials: https://www.cnn.com/interactive/2020/health/coronavirus-victims-memories/

When does the pandemic improve?  It could dramatically improve with successful treatments.   Finding effective antiviral medicines would allow for less severe outcomes.  A successful vaccine would prevent illness.   Herd immunity.  Even the possibility of finding a post-exposure prophylactic medication that is mostly safe and lessen the severity of disease would dramatically change things.  Until then, defense remains our best strategy.  Good luck in avoiding exposure to coronavirus in America.  Recent data shows you have had it with the shelter in place recommendations.  The latest guidelines implemented by the CDC to safely return us to work suppressed by the White House task force.  Some Americans are unwilling to wear masks when out in public but eager to protest and visibly display assault weapons to make their voices heard.  The concept of comprehensive testing before Americans returned to work seems to have lost traction.   America is suffering, and it will continue to do so in the unforeseen future as we will are unwilling to help stop the spread.  What we do here in the US has implications for others all around the globe. Our actions as a country will not only affect our economy but will have a ripple effect on other countries that rely upon the US for their country to function.  Many innovators and scientists are finding solutions to these complex problems.  Keep them in your prayers, for they are the ones who will save lives and decrease the suffering.  Our government had the opportunity to prevent the devastation of this pandemic, but that window of opportunity closed a long time ago.  At this time, our politicians can only react as prevention was not enough of a priority.

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Published 5/17/2020 at 8:30 am EST

All State Department of Health or equivalent websites in the United States.

Health Departments from around the country:

Alabama. Alabama map with confirmed cases.

Alaska.

Arizona. State map of confirmed cases.

Arkansas. Arkansas map with confirmed cases.

California. California Department of Health.

Colorado.

Connecticut. Connecticut map of confirmed cases.

Delaware. Delaware map of confirmed cases.

Florida.

Georgia.

Hawaii. Hawaii department of health.

Idaho. COVID-19 in Idaho.

Illinois. Illinois map of confirmed cases.

Indiana. Indiana map of confirmed cases.

Iowa. Iowa map of confirmed cases.

Kansas. Site contains a link with a map of confirmed cases.

Kentucky. Kentucky’s COVID-19 website.

Louisianna. State department of health with map of confirmed cases.

Maine. Maine department of health.

Massachusetts.

Maryland. Contains a map of confirmed cases.

Michigan. Michigan map of confirmed cases by county.

Minnesota.

Mississippi. Includes a map of confirmed cases in the state.

Missouri.

Montana.

Nebraska.

Nevada.

New Hampshire.

New Jersey.

New Mexico.

New York.

North Carolina.

North Dakota.

Ohio.

Oklahoma.

Oregon.

Pennsylvania. Site includes a map of confirmed cases.

Puerto Rico.

Rhode Island.

Samoa.

South Carolina.

South Dakota.

Tennessee. Includes a map of confirmed counties.

Texas.

Utah.

Vermont.

Virgin Islands.

Virginia. Includes a map of confirmed cases by county in the state.

Washington. Includes a map of confirmed cases by county.

West Virginia.

Wisconsin.

Wyoming.

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Updated 4/15/2020 at 6:35 am EST

Updated Local Reports as of 4-3-20 impact of COVID 19 in the United States

Reports from around the country

Alabama Auburn University Graduate helped to develop test widely used in Alabama.

Alaska 80% of the residents of Whittier who live in a single high-rise apartment building are viewing the pandemic from a different perspective when compared to other residents of the state.

Arizona Leader of Arizona’s response to COVID-19 quits.

Arkansas. Jonesboro Church to hold services this weekend despite pandemic.

California Native of Santa Rosa, California cheered by his crew as after he was relieved of duty for sounding alarm on COVID-19. More on Captain Brett Crozier.

Colorado Pediatric hospital is accepting donors for antibodies to use as treatment for COVID patients.

Connecticut. Connecticut Children’s Medical Center is furloughing 400.

Delaware Troopers in the state are allowed to stop vehciles with out of state license plates.

Florida Approximately one dozen critically ill patients transported from crusise ship to two local hospitals on Thursday 4/2/20.

Georgia Governor states learning the virus can spread before showing symptoms is a “game changer”.

Hawaii Hawaii molecular epidemiologist to study if some racial groups are more prone to COVID-19 infection and complications.

Idaho Health group tries a new approach to screen, test, and treat COVID 19 patients.

Illinois Hospitals preapare for surge in COVID-19 patients.

Indiana 5 cases of COVID found in two prisons.

Iowa Over half of the counties in the state have confirmed cases.

Kansas Governor of Kansas expresses her frustration with the federal response to her emergency requests.

Kentucky Judges order ankle monitoring for COVID patients who defy quarantine order.

Louisianna Over 500 patients who are hospitalized with COVID-19 in Louisanna are on ventilators.

Maine Maine newspaper/editoral board gives their opinion on why it is smart to release some prisoners early.

Massachusetts At least 12 of 18 patients who have died at Massachusetts veterans hospital had COVID-19.

Maryland Maryland calls on the National Guard for assistance.

Michigan Michigan government issues hiring freeze in response to COVID-19.

Minnesota Minnesota hospitals are losing revenue because of the COVID-19 pandemic.

Mississippi Over 1,000 confirmed cases in the state.

Missouri Missouri man allegedly coughs on customers.

Montana Musician/Artist John Mayer donates money to Montana hosptial so it can purchase ventilators.

Nebraska. Reports 6th death from COVID-19 in the state.

Nevada Large quantities of Personal Protective Equipment on the way to Nevada.

New Hampshire Opinion/Editoral recommending less federal spending on nuclear weapons, more federal spending for COVID-19 pandemic.

New Jersey One quarter of nursing homes in New Jersey have COVID-19 infections.

New Mexico More than 70 businesses violate governor’s order.

New York. Experimental antiviral treatment site begins in New York.

North Carolina Health Care Systems expect furloughs as revenue decreases.

North Dakota Governor is frustrated that residents are not taking the pandemeic seriously.

Ohio In one Ohio family, 3 members die from COVID-19.

Oklahoma Oklahoma reports second largest spike of COVID 19 infections on 4/2/2020.

Oregon Personal Protective Equipment shortages straining hospitals and increasing risk/stress for health care professionals.

Pennsylvania 102 year old recovers from and defeats COVID-19.

Rhode Island Insurers provide 5 million in funding to help with the pyschological need during the pandemic.

South Carolina After Donald Trump claimed at a South Carolina rally that the virus was a hoax, an AI company notes a spike of hashtags in social media and campaigns to spread disinformation attempting to discredit politicians, the media, medical experts, and scientists who were trying to protect the public.

South Dakota Hospitals prepare for a surge in two weeks.

Tennessee On Thursday, Governor Lee spoke to Tennesseans. “We need you to understand that home isn’t an option,” he said. “It’s a requirement for the swift defeat of COVID-19.”

Texas Report from Houston on the struggles of one care facility preventing the spread of COVID 19.

Utah The state partners with private company to allow for more testing.

Vermont State orders large store retailers to stop selling nonessential items in their stores.

Virginia Updates of cases around the state.

Washington Governor extends stay at home order through May 4.

West Virginia One company has 4 of its employees test positive for COVID-19.

Wisconsin Dairy farmers are being asked to dump milk until April 6th.

Wyoming Survey of over 400 Wyoming residents demonstrate the impact of the pandemic.

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Updated 4/3/2020 at 1:15 pm EST

We are all interconnected and must do our part to prevent COVID 19 spread.

world in his hands

If you didn’t believe before that we are all interconnected, I am confident you believe it now.

One new viral infection has led to a pandemic.  While pandemics are not new, it is new for most of us in the United States.  Few of us were alive in 1918 when the Spanish flu affected the world.  And if you were here at that time, it is highly unlikely that you even remember it.  If you are now age 105, you would have been age 3 or 4 during the Spanish flu.

I’ve heard many people say, “it is like we are living in a sci-fi movie”. If you would have asked me two months ago, that most flights overseas are grounded, that major sporting events canceled, that nonessential businesses would be closed, and physical distancing measures be implemented,  I would have stated that it is impossible.  However, that is the reality.  If you are among the percentage of people who believe the outbreak to be a hoax, try to not deny what is happening.  Denial will trick you into thinking you will not get sick or the virus does not have any direct impact on you.  Denial will allow you to not follow the recommendations of specialists and experts who understand how pandemics work and are advocating to save lives.  Even if you never get exposed to COVID 19 virus, the implications of this virus have already changed societies and will continue to do so.  For some of us in minor ways, for some of us in tragic ways.

Now is not the time to place blame on other countries.  Now is not the time to blame politicians.  It is not the time for political figures to point blame at travelers, nursing home health care administrators, etc. Blaming one another for this crisis is not allowing us to work cooperatively to solve new problems.  If scientists and experts recommend guidelines on how to move forward, they are the experts who we need to be listening to.  We are still learning about how the virus spreads, infects, and how to medically treat it so we can save lives.  Until more effective treatments are discovered, prevention is your best medicine.  Our world has been through pandemics before and we should learn from the past.  Many have used the lesson learned with two cities during the Spanish Flu that took two different approaches to fight the spread.  Our country is doing similar things.  Every state is making local decisions.  While each location has its own unique circumstances, we will look back at what we did right and what we did wrong.  We just have not seen anything on this grand of a scale for quite some time.  It is my opinion that it is not wise to compare it to the H1N1 virus of 2009, SARS, MERS, or Ebola.  Each of those viruses had a unique impact on the world.  The Spanish Flu of 1918 is probably the best pandemic to compare it to, however, even that was influenza and this is a coronavirus.  We should not compare apples and oranges.  Another parable is that of the blind men and elephant.  We need to listen to experts.  Listen to the infectious disease specialists, epidemiologists, historians, and professors.   

There are times to be offensive and there times to be defensive.  If you want to be successful and win the game, a team works together and knows when to be offensive and knows when to be defensive.  These are lessons we are taught early in life.  The consequence of not winning this war on this virus can have a vast toll on us.  We are in this together.  At some point, medical professionals and/or scientists will find successful treatment and in the process save millions of lives.  Yes, millions. If we do not listen to the experts, we will continue to see sad and difficult days ahead.  We have no idea how long that will be.  You have to do your part.  Now is the time to play defense.   Even if you live in a remote part of the world and do not get exposed to the virus, you can show your support by leading by example.  Stay home.  Rural areas have cases.  No one is immune to a new virus.

Please follow the recommendations of the CDC.  The only recommendation I do not agree with by the CDC is the one that healthy people do not need masks.  I understand the importance of first responders and health care providers to have masks.  Yet, people have the right to protect themselves.  Plus, even if you do not have a mask to wear – consider wearing a bandana over your mouth and nose.  In my observation and opinion, South Korea has been more effective at reducing the spread of the COVID virus.  I read that 70% of the population has been wearing masks over their nose and mouth when they are out in public.  We should be doing the same.  When we do go out for groceries or to the pharmacy, wear a protective mask or bandana. If it is being recommended for those health care professionals who are treating the infected, the same guidelines apply to you to protect yourself from the virus.  You still should try to stay six feet away from others in addition to the other guidelines.  Keep in mind, not all people who are sick will be staying home.  To complicate matters, some infected people may not have symptoms and are unintentionally spreading the virus.

Hope.  The FDA has allowed the ability to begin using antibodies of infected individuals who recovered as a way to treat the severely ill in New York.  I heard today that the virus is not mutating easily.  This is good news.

Some people, like Jahova Witness believers, may not agree to this form of treatment.   Yet, for those who want it, it is a way to possibly defeat the virus and save lives.  Other measures are being discussed and will be attempted.  Until we have an effective treatment, continue to play defense.

Updated 3/25/2020 at 12:14 pm EST