Coping with COVID-19: Interviews with Center for Health Equity Stakeholders
Like everyone in the world, Johns Hopkins University researchers, Community Advisory Board personnel and clinical staff have had to change how they do their work—and live their lives— in the context of the global pandemic. In early January, we spoke to three individuals who work with the Center for Health Equity to get a sense of what kinds of adjustments they’ve had to make to carry on, and what kinds of impacts those of adjustments have had on their attitudes, work, and hopes for the future.
We spoke with a clinical nurse for the RICH LIFE project, Stacye Cooper, RN; a Community Advisory Board member and patient advocate, George E. Franklin III; and a Johns Hopkins University Assistant Professor and researcher, Carmen Alvarez, PhD, MSN, RN. Each of them offers different but overlapping perspectives on how COVID-19 has changed themselves, their co-workers, and their views on the people around them. Their responses capture the very real human experiences of this global crisis.
WHAT HAS BEEN THE MOST DIFFICULT ADJUSTMENT TO MAKE DURING THE PANDEMIC?
For all our respondents, the practical and psychological aspects of adapting to the pandemic were top of mind.
Stacye Cooper, a clinical nurse from the RICH LIFE Project (a research effort dedicated to testing at-home chronic disease management) who continued to see patients over the last year, commented on coming to terms with the unrelenting awareness of risk while working during the pandemic:
The main thing was just being conscious of the fact that we are in this pandemic. So, you have to move differently. Make sure you’re social distancing. Always keep your mask on. Things of that nature. Although it’s bothersome, I know it’s for the best. I don’t physically see as many patients as I was in the past. I do still see patients but if I can work with them over the phone and not see them, that’s the change. . . in moving throughout the building, you’re constantly conscious that you don’t get too close.
Stacye noted as well that she had to make changes to how she worked with patients, and that anxiety over the virus seemed to reduce the human touch she prefers to bring to her clinical work:
. . .we didn’t really have the freedom to move around like we wanted to. The patients I needed to see, I couldn’t. Then there’s the uncertainty. The fear of the unknown. You don’t know who has it and who doesn’t. You kind of don’t want to be around anyone. Even though most facilities now, they’ll have the thermometers to take temperatures but I find a lot of times those things don’t work or people are asymptomatic. Still, as I continue to assess my patients, I take my patients to my office, leave the door open which I never used to do, and I take their chair as far away from me in the office as I can. That’s not normally how I conduct assessments.
For George E Franklin III, the biggest adjustment has been dealing with the isolation the pandemic caused:
This thing has me on lockdown. I’m 66 years old. I have a kidney transplant, I’m immunosuppressed. . . So the COVID thing has had me on lock down. . .it’s probably been months since someone has been in this house. The isolation, whether it means no one coming to see you or your not being able to go see someone else. The isolation is the worst thing that can happen. . . Humans need physical interaction and I think when you’re isolated by where you live—which I am, I have no family here whatsoever— this isolation can cause a whole new set of problems. I’ve just been trying to keep my mind clear and do things around the house. Catch up on housework. . .but this COVID thing has really just screwed up a lot of different meetings and boards and so forth.
Dr. Alvarez—whose research focuses on the impacts of stress—also acknowledged that the pandemic is having profound impacts on people’s state of mind. She was particularly mindful of how the pandemic was affecting health care workers:
I did not expect healthcare workers to feel as stressed as they did. Of course, if you have critical patients, that has the intensity it has. But for those of us more in the primary care/community setting, I think I was surprised to hear how stressful and challenging it was for some of our nurses and community health workers.
As with Nurse Cooper, Dr. Alvarez and her team had to make significant adjustments to her patient interactions because of how the pandemic forced people who might not be comfortable with technology to use video calls:
the switching to virtual was the most challenging in the sense that we just had to learn that we needed to do things quite differently. Showing up on time, turning on the camera, being on mute, things we took for granted—[we wound up having to help participants with]. So we really stumbled through it the first 3-4 sessions. Then we had to say it’s just not working. We had to reset and talk to our participants about what they thought would make for a good helpful session. . . Definitely the hardest challenge was switching to virtual because it just required different explanations to be able to conduct a session. It never would have occurred to me to talk about ground rules for a virtual session. We just had to learn it. . .
WERE THERE ANY POSITIVES YOU DIDN’T EXPECT AS A RESULT OF THE PANDEMIC?
For Nurse Cooper, the simple joy of helping patients continued to shine through:
I really enjoyed working with the RICH LIFE research Project. It gave me insight of how many people just don’t know what’s going on with their health. They’ve been diagnosed by their doctor and given medication that they don’t really know about. What’s really going on or other medications you can take to alleviate or decrease your numbers. From that I learned to be available, be there to talk with them to be supportive. A lot of times, that’s all these patients want. To know that someone is in their corner. They needed to know that they had the support.
For Dr. Alvarez, one “positive” experience of the pandemic —which has disproportionately impacted minority communities— is that it has helped America get a better understanding of social inequities:
I think unfortunately, it has taken COVID to get a better sense about the disparities that do exist. When you learn that most people who died from COVID are people of color, people who are in nursing homes you know the fact that we’ve lost so many health care workers also. I think it’s finally getting us to understand that we are as strong as our weakest links. We are as strong as our most marginalized and disenfranchised groups. Until we figure out how to deliver our resources more equitably, then we just we aren’t going to progress.
Stacye Cooper echoed this sentiment, noting that the pandemic
. . . has definitely brought out a few things that pretty much we already knew. How it predominantly affects people of my color and we’re the last to get the vaccine. It points out the health inequity we knew already existed.
For Mr. Franklin, however, there were no tangible positives, only a sense of loss and a hope that 2021 will be better:
Last year, I wasn’t able to go white water rafting, camping, ride a bike on the bike trails here, I couldn’t go swimming. Things I truly enjoy, I could not do because of this virus. I am hoping and praying that whatever happens this year I’ll be able to salvage [this summer]. . . Is there going to be a positive outcome to anything because of this virus? I can’t think of what it would be, I really can’t. People have disobeyed the CDC and flown all over the country. They still don’t understand that you could have this thing and not display any symptoms and be spreading it around.
WHAT LESSONS MAY THE PANDEMIC TEACH THE AMERICAN PUBLIC FOR THE LONG RUN?
For all the respondents, the hope is that we learn to unite and work together to overcome challenges like the pandemic better the next time, and to appreciate each other more.
Stacye Cooper responded that
I would hope people would think that together we can get through this. It’s showing in some ways that together if we just abide by the rules, listen to what the people are telling us to do that we are going to be fine and we are going to get through it.
For Mr. Franklin, there is a hope that Americans will learn enough to do a better job managing a similar crisis the next time:
I think had this come at any other time, politically, it would have been acted on differently. I think people would have moved on the virus quicker. They would have mandated masks. Whatever was done, would have been done quicker. I don’t think it would have been as bad as it’s gotten. You can’t put everything on 1600. A lot of people did not move as they should have. Mayors are waiting on governors. Governors are all waiting on the president to move. So I think that may have been a lesson. So I’m hoping that society as a rule has learned the things that the CDC has said have been true. Wear a mask. Socially distance yourself. Stay away from large crowds. So maybe that’s the lesson that hopefully will be learned here. Because there will be a next time.
Dr. Alvarez also noted that she thought the US could have done a better, faster job of responding to the pandemic, and that perhaps we’ve learned some lessons from this crisis:
I’d like to think that we would have been able to deliver messaging and strategies a lot more quickly. So that we could have responded better when the pandemic first started. I think if there’s anything good, it’s highlighted how important and critical addressing disparities are, how important healthcare workforce is, how important it is for us to have diverse healthcare workforce and how important it is for us to have sound public health infrastructure.
But the bigger lesson for Dr. Alvarez concerns the persistent issue of inequality in American society:
I think slowly I’ve started to see how classist we are as a society. Especially now seeing that our front-line workers have been more affected. It’s also the front-line workers who are keeping our economy going. If you can stay home and order groceries, someone is bringing those groceries. . . So, people who perhaps to some degree have not been appreciated and taken for granted, I would like to think that we are now that much more appreciative of everyone. Regardless of the type of work. So much work is essential and should be valued. To appreciate it to a point that they should be getting a living wage.
We thank our interview subjects for their candid and honest responses. Their words have helped us understand the real human impacts of the COVID-19 pandemic.
LEARNING RESOURCES:
Learn more about ongoing progress from the RICH LIFE Project research team
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