Experiencing my father’s death to coronavirus during the pandemic drastically changed his homegoing celebration. My family held an intimate service with only five of us in attendance, and his grandchildren and hundreds of others watched through Facebook.
Like so many other essential workers, too many of us have only stopped intermittently to tend to our wounds.
A few days later, I sat in my apartment alone and watched my father be buried at a family gravesite nearly 450 miles away, through a video recording. I returned to the hospital the next day. Like so many other essential workers, too many of us have stopped only intermittently to tend to our wounds.
After losing my mom three years ago, I find myself thinking about her more often given the pervasive weight of the pandemic and the fact that my father is now numbered among the ancestors and counted among the Covid-19 dead.
The vulnerability of losing both parents has caused me to sense the pain of so many others who must navigate being left behind. For me, it’s fueled my fight to save as many lives as possible through public advocacy; to seize the moment to build a new way forward by demanding and designing a more equitable and just society.
Over the past year, we’ve watched in utter disbelief as the coronavirus public health emergency has spun out of control. While the federal response was wayward and sputtered, front-line and essential workers had to gut it out, working on the front lines of health care or in essential industries like grocery stores, pharmacies and public safety. Many communities expressed their gratitude in the most genuine and practical ways. The cross to bear was heavy, nonetheless.
The nation, absent moral leadership, seemingly never paused to honor our dead or to give voice to the unnatural mass casualty event that we all were witnessing, and that many were experiencing up close. While the former president downplayed and gaslit the public, every American was touched by the coronavirus crisis on some level.
We all have been affected or devastated in a real economic, social, emotional or physical way. Over a half million Americans and counting have died, yet it took a new administration to intentionally reflect on the magnitude of the loss, to even fly flags over the White House, public buildings, military posts and naval stations at half-staff.
The nation, absent moral leadership, seemingly never paused to honor our dead or to give voice to the very unnatural mass casualty event we all were witnessing.
Coping with death and loss is never easy. How we deal with it is deeply personal, yet so common to the human condition. Grief is like a wave — rushing in to shore and back out to sea again. But like the rhythm of an ocean, it’s always with you. Hopefully, on most days, and if time is kind, the wave breaks more gently. And the sun still shines, and new hope and joy dot the horizon. But when grief comes in like a flood, the sting of the water is no less brutal than the first crashing wave.
More than 500,000 lights have been extinguished in a horrid toll of family members, friends, patients, work companions and neighbors gone too soon in a crisis that didn’t need to be as deadly, lonely or inescapable as it has been. That our grief has been interrupted makes our current experience more surreal. Our rituals have been upended to ensure our safety and to prevent the spread of more devastation. But what is the emotional and spiritual cost?
It is through our remembrances that we heal and begin to process our hurt. The intentional love of my family, faith and the strength and depth of my community and social wells have shouldered the burden and resolve with me. Without designated safe spaces to grieve, to rest, to remember, to organize and to take purposeful action, healing would not be possible.
Many of us have experienced loss at work. In response, Kaiser Health News and The Guardian jointly tracked the thousands of health care workers who have died fighting Covid-19. Elevating the stories of these nurses, nurse assistants, doctors, respiratory therapists, home health aides, environmental service workers, food and nutrition staff, and so many others is crucial to our grieving process. It’s crucial to understanding the trauma of the workforces they leave behind.
Some of us grapple with survivor’s guilt, others have suffered untold moral injuries in the monotony of caring and treating our way through an ongoing pandemic. These heroes need more than episodic wellness offerings or tokenism on resilience. They need deeply invested institutions that prioritize their well-being through robust structures that prevent and mitigate burnout, compassion fatigue and second victim experiences.
These heroes need more than episodic wellness offerings or tokenism on resilience.
Health care — and all industries, as well as the American public — need to understand the role and value of mental and emotional health “first aid.” Training in these skills rank alongside knowing how to treat a physical wound or spot a stroke. With psychological first aid, people are taught to recognize the signs and symptoms of trauma and distress and to respond appropriately.
Public health preparedness is not only about mitigating disasters and saving physical lives, it’s also about promoting mental health hygiene, holistic well-being and social cohesion. We’ve learned that while physically distancing may be necessary, social isolation is never healthy. When front-line workers (or any human beings) feel isolated or overwhelmed, they risk drowning on islands of discontent and disconnectedness. It is well known that the Covid-19 pandemic wreaked havoc on every aspect of society, but the economic, social and physical destruction was particularly bad among marginalized groups such as the poor and historically excluded Black, Indigenous, Asian and Latino communities. This can be seen in the disproportionate hospitalization and mortality rates among persons of color, and the unparalleled changes in life expectancy for all Americans, but especially among Blacks and Latinos. Even now, as a coronavirus relief package is debated and voted on in Congress, the economic fallout of the crisis has been unequally experienced. Some of the same essential workers who staffed our grocery stores and large retail chains that remained open during the pandemic are the ones whose financial well-being is being politically trafficked in abstract terms. And women, especially Black and Latino women, have borne the brunt of the economic downturn, in what has been described as the first female recession in the nation’s history — at the height of the crisis, women lost 12.1 million jobs and, despite some recovery, women lost more jobs than they gained back. And all of this has contributed to our grief. Like the collateral damages surfaced by the pandemic, the economic toll has contributed to a never-ending assault on our mental health. Like so many essential sectors, education has been hit with the brutality of this public health crisis. Teachers and children are in a symbiotic relationship both practicing and learning in unfamiliar territory. That our grief has been interrupted makes our current experience more surreal. There is grief at the loss of educational norms and the associated harms of this less-than-ideal virtual world. There is the painful recognition that toxic stress and adverse childhood events have worsened during the pandemic and may have a negative impact for a generation of children. There is a disturbing trend in suicides among our youth, rising in young adults more sharply, and all ages more broadly. Indeed, this heavy load has launched many necessary calls to action. It should be obvious that we’re fighting a war. Not just in one dimension, but on multiple fronts. The only way to survive is to diversify our tools, to acknowledge our grief, to remember and give space to our healing, and to emphasize well-being for the whole and not the privileged few or in fragmented silos. We have to do more than vaccinate our way to a new normal. We have to live, love and care in a more integrated and interconnected fashion — and to commit not to return to the way things were but to take stock of what isn’t worth saving and to build a new and truly great society. That will require living in truth, honoring our past, building a fair economy, reckoning with racial equity and health justice, and destroying the stigma associated with mental and behavioral health. Only then can we thrive in a post-pandemic world. And then our grieving will not be in vain.
Dr. Chris T. Pernell
Dr. Chris T. Pernell, MD, MPH, FACPM, is a public health physician and health equity champion. She is a fellow of the American College of Preventive Medicine, the daughter of a father lost to the coronavirus pandemic and the sister of a Covid-19 long hauler. 
