BLOG: Reflections on the COVID-19 pandemic
Last night, my husband and I did something we have not done in quite some time: We went out for dinner at our favorite sushi restaurant in Brookline, Massachusetts.
We had not been there since early 2020! It felt great to have a night out (alone — our children were occupied), enjoy our dinner and reclaim a sense of normalcy.
Unfortunately, it was only a sense of normalcy. The first case of COVID-19 in the U.S. was reported on Jan. 21, 2020, and we are now 2 years into the pandemic. (Does it feel longer or shorter?) Our lives have been fundamentally changed.
As of March 6, there have been 6 million deaths around the world and nearly 1 million deaths in the U.S. In the U.S., this represents the death of about 0.3% of the entire population, or one in 340 people. In the U.S., there are just more than 600,000 deaths from cancer each year.
Although COVID-19 cases from the omicron wave are thankfully sharply down in Massachusetts, daily deaths still exceed 1,000 people per day nationally. The loss of lives during this time is incomprehensible.
Still, it does feel as if our world is opening again. But what happens next? How do we return to “normalcy?” What will be our next chapter?
An ‘unsettling time’
Although the loss of life is devastating to comprehend, the pandemic has fundamentally changed us in many ways.
I am a breast oncologist at Mass General Cancer Center. Working as a physician during the COVID-19 pandemic has been the most difficult challenge of my career, and I know many colleagues have similar sentiments, with many of us temporarily being reassigned to treat inpatients with COVID-19.
During this unsettling time, we have had to learn how to care for patients with COVID-19 while also ensuring the safety of patients with cancer at our hospital. Although oncology treatment is challenging enough, it has been even more challenging to help our patients navigate new, unchartered waters.
How much does the risk/benefit ratio of neutropenia change during each phase of a respiratory pandemic? Besides the obvious fears of infection and dangers of infection, we faced other, unforeseen obstacles. When would my patient, newly diagnosed with operable breast cancer, get to have her surgery? How can a cancer operation be considered “elective?” What is an appropriate treatment protocol in the setting of a pandemic? To what lengths should patients go to protect themselves when they have compromised immune systems?
To make our clinics as safe as possible, the care for our patients with cancer was fundamentally changed for many months. Our patients could not have a family member or friend join them at appointments. Many times, I found myself seeing a patient, newly diagnosed with breast cancer, all by herself, with a partner or friend present via FaceTime on a smartphone.
Our patients in the hospital could not have visitors because this could place them, and other patients, at risk for exposure to COVID-19. Our inpatients were alone all day in the hospital, and this was unsettling, especially for those who were very ill.
I recall attending one of weekly Massachusetts General Hospital (MGH) Schwartz Rounds, sponsored by the Schwartz Center for Compassionate Healthcare. I will never forget the words of one of my nursing colleagues who commented that “hospitalized patients are not alone since they have us.”
Staying grounded amid uncertainty
As we continue to navigate the twists and turns of the pandemic, I know each of us will continue to reflect on the experiences of these past 2 years and ponder the next chapter ahead.
In our Women in Oncology group at MGH, we recently invited Nancy Rappaport, MD, child psychiatrist and associate professor of psychiatry at Harvard Medical School, to speak about “What Cancer and a Pandemic Can Teach Us About Navigating Uncertainty.” One of her important messages that resonated with me is the recognition that we have learned to “stay grounded in the present moment while dancing with uncertainty.”
Learning how to “navigate uncertainty” is certainly a challenge that our patients face after receiving a diagnosis of cancer, and I have learned many lessons of strength and resilience from my own patients over the years. I am hopeful that the lessons I have learned from my own patients, and from this difficult time, will help me navigate further challenges ahead.
I recall another comment during that MGH Schwartz Rounds, back in the Spring of 2020, when a nursing colleague commented, “The only thing more formidable than these scary past few weeks is the incessant outpouring of kindness, compassion and teamwork that have been displayed throughout this time of crisis. Love will always conquer fear. Better days are coming, and we will get through this together.”
References:
- CDC. An update on cancer deaths in the United States. https://www.cdc.gov/cancer/dcpc/research/update-on-cancer-deaths/index.htm. Published Feb. 28, 2022. Accessed March 7, 2022.
- Johns Hopkins University & Medicine. Coronavirus Resource Center. https://coronavirus.jhu.edu/. Accessed March 7, 2022.
For more information:
Amy Comander, MD, DipABLM, is director of breast oncology and survivorship at Mass General Cancer Center in Waltham and at Newton-Wellesley, the medical director of the Mass General Cancer Center in Waltham and an instructor in medicine at Harvard Medical School. She also serves as a Healio Women in Oncology Peer Perspective Board Member. She can be reached at acomander@mgh.harvard.edu.
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