100 Days: Sustainability in Quarantine

Today marks 100 days since COVID-19 was declared a pandemic.  100 days of social distancing.  100 days of staying at home.  100 days of transforming healthcare to meet the new demands.  100 days of learning to recognize each other with masks covering our faces.  100 days of an unbelievable economic collapse.  100 days of witnessing the societal impact of extreme stress on a civilization.  100 days of this enormous mental shift and moving through the stages of grief over the world we used to know.  100 days of coming to terms with the new normal and envisioning what the world will look like when we come out on the other side. 

It has become apparent that there is no end to the pandemic in the near future, and the life we used to know no longer exists.  Large group gatherings are not happening.  Celebrations of life and death are modified.  Meetings are now on Zoom.  Happy hours and coffee dates are in the park, with masks on our faces.  Conferences are now webinars.  Races are virtual.  I don't know when I will attend an in-person yoga class again or get a pedicure or take Ady to gymnastics.  But we are resilient and filling our lives with other things instead.

I worked in the COVID unit at the hospital this week.  As someone who is very passionate about acute care physical therapy and a proponent of early mobility in critical care, I was eager to serve the COVID population and be part of the front line efforts.  Since March I have been a part of the ethics-related conversations around our organization's COVID response, I've attended webinars and Zoom conversations with other acute care therapists around the country, and I've made an effort to educate myself on best practices in managing this patient population so that I could be as prepared as possible when it was my turn to work in the unit.  This pandemic has changed a lot about how we provide healthcare and how we respond to a crisis.  Like many diseases, COVID-19 especially impacts those who are already marginalized, underrepresented, and economically disadvantaged in society.  The impact on the Native American populations is devastating, and in cities all over the country black Americans and people of color are the hardest hit.  And when the most vulnerable populations are affected by illness, it hurts the rest of society.  

There was (and still is) a steep learning curve as we all try to navigate these new waters and treat a new virus, and it can be terrifying and distressing to see severe illness and death on such a massive scale, but I have also witnessed firsthand a lot of positive outcomes.  COVID management is very team-based in my organization and we all depend on one another.  Patients who have been with us for a month (or two) are starting to get better and get out of the hospital.  And our organization has an entire committee dedicated to facilitating communication with family members, overcoming language barriers, and increasing awareness of cultural practices to provide the best care possible to patients.  We are learning a lot that will help us provide better care to our other patients as well.

One thing I have come to truly value during these past 100 days is our interconnectedness and reliance on each other, both at work and in my own life.  I am essential, whether I'm in the COVID unit or taking care of my other patients, but everyone around me who makes it possible for me to continue to do my work is also essential.  The employees at the grocery store, the chefs making our food for take-out, the teachers at my daughters' school, the support staff at the hospital, the barista at the coffee shop, the technician who changes the oil in my car, the maintenance person who fixed my hot water heater when it went out last month, the scientists and public health experts working around the clock to learn more about this disease, and so many more individuals who keep society running even during a pandemic.  We all depend on each other.  While there's undoubtedly a lot of selfishness and hoarding going on, and individuals putting their own interests first, there's also a lot of collaboration.  We're discovering that cooperation is essential to survival.

I've been thinking a lot about sustainability.  Of ourselves.  Of our communities.  Of the planet.  How do we conserve our resources?  How do we practice good self-care?  How do we take care of ourselves so that we may take care of others?  How do we plan for future generations?  As a community we are, in general, pretty terrible at this, but I think we are learning from our mistakes.  Many of our early pandemic behaviors were not sustainable.  Home schooling our kids while learning new recipes and organizing every room of our house?  Binge watching shows and reading all the books on our shelf?  Learning how to crochet while doing 1000-piece jigsaw puzzles?  Hoarding toilet paper and hand sanitizer?  Desperately seeking to protect ourselves at the expense of others around us?  That was not sustainable, and as we come to terms with the duration of this pandemic and the long-lasting impacts, I think we are learning to pace ourselves and to be more compassionate.

Before the pandemic hit, I was re-reading Robin Wall Kimmerer's Braiding Sweetgrass, a beautiful collection of stories about plants, botany, the earth, and the wisdom that comes from a combination of scientific understanding and indigenous teachings.  While I think about sustainability, I recall the creation story in the first chapter of the book, with the image of Skywoman falling from the sky onto the earth, bringing with her seeds from the Tree of Life.  According to the story, Skywoman was pregnant, and therefore already planning for future generations that would inherit the earth.  Throughout the book there is a theme of reciprocity.  Kimmerer tells us what defines a "good mother," and how we can practice sustainability, care for of future generations, and take only what we need.  Throughout the book there is a lesson of putting the needs of the community ahead of those of the individual, and recognizing our connections to the past and the future.  I have thought a lot about the teachings of this book during these first 100 days of COVID-19.

Quarantine itself is not sustainable, and we need human connection to survive.  We're now starting to witness "re-opening" to varying degrees and we're seeing the impact of that on health and the economy.  Some effects are disastrous, while some are beneficial.  It's all about balance, and I don't think any state has yet figured out that balance.  Perhaps if our nation's leaders had been proactive earlier on then we wouldn't be faced with such calamitous conditions now, but I hope we may learn from this and be better prepared for the future.  We all have individual decisions to make for ourselves and our families.  We can't stay in quarantine forever, but we know that every social interaction and attempt to return to normal runs a risk of infection, so we all must decide what activities are worth the risk.  What things are meaningful enough to our own quality of life that we are willing to take a risk.  What things can we modify and still enjoy.  It's not dissimilar to all the other choices we make for ourselves and for our kids.  There's always a risk of danger or injury, but we can't live in a bubble forever.

During the early weeks of social distancing, a colleague sent me an article (Why You Should Ignore All That Coronavirus-Inspired Productivity Pressure) that explains that the legacy of this pandemic will live on for a long time and outlines the stages of adaptation.  I love this quote toward the end of the article: 

"On the other side of this journey of acceptance are hope and resilience. We will know that we can do this, even if our struggles continue for years. We will be creative and responsive, and will find light in all the nooks and crannies. We will learn new recipes and make unusual friends. We will have projects we cannot imagine today, and will inspire students we have not yet met. And we will help each other. No matter what happens next, together, we will be blessed and ready to serve."

A lot has happened over the first 100 days of this pandemic, and a lot more will continue to happen over the next 100 days (or 1,000 days...who knows?...), but we are resilient and will continue to celebrate the beauty that exists in times of pain.