From Applause to Anger and Apathy

As we let exhaustion and frustration win, so too do we let COVID-19 in

“Here are the new COVID cases recorded in BC on the first day of each month:

June: 4 cases

July: 10 cases

August: 29 cases

September: 96 cases

October: 138 cases

November: 380 cases

Maybe we only just noticed in past few weeks, but growth has been kinda sorta exponential for ages” (Twitter @ianjamesyoung70, November 18, 2020)

OUR LAST DEFENSE

Numbers of people testing positive for COVID-19 have been surging upwards and breaking records for weeks, raising all of our anxieties.

While us members of the public have many reasons to be scared, there are among us people who face starker fears.

Imagine if, for eight to ten hours a day, you had to phone strangers and tell them they may have been exposed to COVID-19 – then counsel, coach and comfort them through the next steps. Some of them cooperate but most are shocked, defiant, angry and terrified. It’s toxic and exhausting. Day in and day out, your only job is to make these phone calls, and the list keeps growing, and you just. can’t. keep. up. You skip your breaks and work overtime every single day, worried that if you don’t make the next phone call, many more people could get sick and spread the horrific disease.

Not long ago, you were heralded as a frontliner in the fight against COVID but now you feel more like the last line of defense, barely holding back the never-tiring, ever-growing foe. You can’t deny it – you’re beaten down – you’ve lost hope. Help is not coming fast enough.

And while you’re making those dreadful phone calls, decked head to toe in personal protective equipment alongside dozens of other public health nurses who’ve been uprooted from their regular duties to do solely contact tracing indefinitely, people across the province have continued to gather, see multiple friends and families, ignore physical distancing guidelines and forget their masks (or refuse to wear them).

THE CONTACT TRACING CURSE

Every day for the past month in B.C., more than 100 people have fallen ill with COVID-19. You’ve been working as a contact tracer for months, but the job hasn’t gotten easier – rather the opposite.

As soon as you can, you call the next person on your list. You learn that they were in close contact with 24 other people within the last 14 days. You’re furious. You’re distraught. You’re burnt out. What happened to “safe six?” But you do your best to calmly, compassionately and patiently provide over-the-phone care to this person because, most likely, they didn’t contract COVID on purpose.

Perhaps, they were unlucky… wrong place, wrong time… but it’s your job to find out, so you proceed to interview them. It turns out they’ve been to their workplace, to the shopping mall, to several restaurants, to the gym, to their friends’ house and to their grandparents’ care home.

You spend the next several hours painstakingly trying to figure out every detail of every visit. You are, all at once, a disease detective, trauma therapist, referral researcher and administrative agent while they go through the five stages of grief (denial; anger; bargaining; depression; acceptance) on the other end of the line.

At the end of your shift, you realize that you only made four phone calls but there are 40 on your desk – and surely tomorrow there will be 40 more.

It’s impossible.

That’s what’s happening.

I know a contact tracer.

They are completely overwhelmed by the unforgiving volume of phone calls they need to make to the hundreds of people that are being exposed to COVID-19 daily – a direct result of people not following (or stretching, or loosely interpreting) the guidance of public health authorities.

Honestly, they’ve been past the brink for months.

Some calls don’t take long (oh, you’ve been in close contact with four other people recently?) but others take hours (oh, you lost count of how many people you’ve been in close contact with recently?).

It’s not a simple, “I’m sorry to inform you that you are a close contact of someone who has tested positive for COVID-19 and you now need to self-isolate for 14 days.”

It’s asking, “Who were you with? Have you gone to your worksite? To any stores? Anywhere else? How long were you there for? Were you wearing a mask? Were you able to stay six-feet away from others? …?”

It’s hearing, “Why couldn’t you call me sooner?! You don’t know what you’re doing!! The pandemic isn’t real/a big deal!!! COVID is a lie and you are a liar!!!!!!”

It’s having to contend with, “Why does it have to be 14 days? I can’t isolate for that long, I have to go to work or else I won’t be able to feed myself/take care of my family/pay my rent.”

It’s having to console them through, “Why is this happening to me, what about my kids, my partner, my elderly parents, my coworkers, I was so careful, I didn’t think I could be exposed… what if I have it? What if I get really sick? What if I end up on a ventilator? What if I die?”

Most contact tracers are public health nurses.

This is their “new normal.”

CHANGES COME WITH CONSEQUENCES

In British Columbia, public health nurses normally carry out immunizations; are involved in overdose prevention and response; instruct new parents on how to care for their babies; provide contraceptive management and treat sexually transmitted infections; facilitate community resources to clients’ and families’ needs; and so much more.

Public health nurses across the province are being pulled away from their regular duties to do contact tracing, and there are not enough of them to keep up with the relentless growth of COVID-19 cases. As a result, people are suffering.

Some newborns aren’t getting their vaccinations on schedule.

Some young people aren’t getting the education they need to have healthy intimate relationships.

Some drug users are overdosing and dying.

At-risk populations are more at risk than ever before. All this will have implications long-term.

PRESERVING OUR PUBLIC HEALTH POWER

As hardworking, strong-minded, kind-hearted and heroic our public health nurses are, their ability is limited. This isn’t a video game – there is no limit break. There is no rewind or reset button. There is no infinite HP.

There were warning signs in the summer that our contact tracing capacity was in danger. We are way past that now, but the enemy is still advancing, and their numbers are increasing.

Despite what feels like insurmountable odds, contact-tracing public health nurses continue to phone strangers who yell and curse and cry at them. They do this, while feeling that heavy responsibility set upon them by an irresponsible society. They do this, while fighting a deep guilt over the caseloads they cannot possibly keep up with. They do this, amidst their own deteriorating mental health and mounting pressures to work longer, harder, faster.

“Contact tracing is an important tool to help stop the spread of COVID-19, by diagnosing people who may have it sooner and prevent further community exposure.”

(BC Centre for Disease Control website)

“However, Fraser Health CEO Dr. Victoria Lee says about a quarter of the people who have been called don’t answer their phones. She encourages everybody to pick up their phones, even if it’s an unknown number.”

(News1130, Nov. 13, 2020)

The work of Fraser Health contact tracers, who have tracked over half of the province’s more than 4,000 COVID-19 cases as of mid-August:

• More than 2,400 positive COVID-19 cases

• More than 10,000 people potentially exposed

• Each positive and potentially positive individual called at least 14 times [to ensure they isolated until cleared]

• More than 170,000 phone calls made and counting

(CBC News, Aug. 20, 2020)

It’s now past mid-November. As of the 19th, there have been 24,960 positive COVID-19 cases in B.C. Nearly 10,000 people are under active public health monitoring as a result of identified exposure to known cases. Authorities have not provided an update on how many phone calls contact tracers have made – but can you imagine?

We are approaching ten months into the pandemic, with winter on its way. Things will likely get harder as we deal with colder temperatures and darker days. We must prepare for more isolation during a time of year that we are used to spending surrounded by love and light. But it is not forever. Find your strength - your resilience - and hang in there. The short-term sacrifices we are being ordered – and begged – to make will make all the difference for the long-term health of those dear to us, our communities and ourselves.

For a COVID-free future, we must do this now.

Stay Connected While Staying Apart

Prioritize your well-being, especially during these difficult times.

Seek sources of comfort, both old and new. Pick up a favourite novel, follow a yoga routine on youtube, learn a magic trick, immerse yourself in a video game, watch the Animaniacs reboot (!), video-call with your besties, attempt to video-call with your family (get ready for off-centred close-ups!)… eat well, exercise well, sleep well… recount the things you are grateful for (clean running water, wifi, Baby Yoda)…

Most importantly, remember that there is hope on the horizon. Promising vaccines are on the way. “When winter comes, can spring be far behind?” (Percy Bysshe Shelley)

Until then, let us listen to the experts and follow public health guidance so that our healthcare system can have a chance against COVID-19. While we have been hearing about it practically every day for 300+ days straight, it is still a mysterious and evolving novel coronavirus that scientists have only been studying for less than a year. They continue to learn more about it – how it spreads, how to prevent it and how to overcome it. As their knowledge base grows, public health advice is adjusted to provide us – the public – with the best protection for our health.

Let’s protect our public health teams by preventing their contact tracing workloads from getting worse. Let’s continue to:

(1) mask up well with three-layers including a filter fabric, covering our nose, mouth and chin with no gaps

(2) wash our hands with soap and water for at least 20 seconds

(3) disinfect commonly-touched surfaces frequently

(4) practice respiratory hygiene by coughing/sneezing into a tissue or your elbow

(5) keep a minimum two-metres distance from people outside our household/core pandemic bubble

(6) refrain from travel except for essential trips

Six steps to stay safe.

Let’s stay apart for now – so we can be together sooner.

Let’s push the curve back down – so we can keep COVID-19 out.

We’ve done it before – we can do it again.