Dear Maria in March 2020,
Hi. This is Maria in March 2021. I just want to let you know that you will be alive and well a year into the Covid-19 pandemic. Said nicely: You aren’t prepared for the next 12 months. To be fair, no one is prepared. You and your colleagues who serve people living outside, in shelters, and in permanent supportive housing are going to have a rough year.
First of all, remember that relentless fatigue you felt while you were in training, particularly as an intern? The constant realization that there was so much you didn’t know, the chronic anxiety of what harm you might cause because of your inexperience, and the physical exhaustion that came from working long hours and trying to keep yourself together? There will be many days in 2020 when you will feel something like that. The quality, though, will be different for two main reasons: One, because you do have more experience now, you will have more confidence in what you do and do not know. Two, you unfortunately will not be able to escape this fatigue. It will only worsen as the year goes on. There will be no resolution in March 2021. You won’t be able go off service; there will be no “golden weekends”. You will think about the pandemic and consider what you could or should do about it every single day.
People who receive services in the agency you work in will die from Covid-19. The number will be small—not even double digits—which will surprise everyone, especially you. Initially, you will think the low numbers must be due to luck. Once a Covid outbreak happens in the White House, however, you will recognize the value of the policies and procedures you and the team enacted. You will feel bountiful gratitude to staff for their willingness to follow these protocols, as annoying and inconvenient as they will be. It is because of staff efforts that so few people will get sick.
An uplifting event—one of only a few, I’m sorry to say—will happen in early 2021. You and your teams will establish an in-house Covid-19 vaccination clinic! During those vaccination clinics, staff from all over the agency—older people with various medical conditions, young people who just got out of school, people who left other careers to work in social services, people who do not speak English as their primary language—will come to receive vaccinations. They will express the hearty thanks to you and your staff. You will recognize the depths of their thanks because you will have felt the same way when you get your vaccinations from the beloved county hospital. By March 2021, you and your teams will be eager to vaccinate people receiving care from the agency, but the agency won’t have either the supply or permission to do so just yet.
It will be a terrible year. For many weeks, you will worry you will burst into tears at work. Instead, you will weep at home. It’s the kind of crying where you need to breathe, but all the muscles in your torso contract, so nothing moves. Anger and frustration are your constant companions; what will happen if you let them go? Must you be alone with the grief that you and everyone else feels?
Though few people will die from Covid, people will die. Data will show that the number of people who died in 2020 isn’t greater than the number of people who died in years past, but there will be more deaths on site. People will tumble from windows. The Women in Black will state a stunning number of people—young people, all under the age of 30—died from apparent suicides. The medical examiner will report again and again that someone died from an overdose. Older people won’t exit their apartments; their bodies will be found inside when they don’t respond to door knocks and phone calls.
You will feel anger towards a federal administration that will not demonstrate any concern towards the health and well-being of the nation’s residents. You will witness multiple system failures because there will be no federal coordination or planning. In conversations with state and local public health officials, you will preface your comments with an acknowledgment that they cannot provide optimal support to the community when they are not receiving support or information from the federal government.
Despite your grief and anger, you will often feel gratitude. Is this is a coping mechanism or a genuine reaction? It doesn’t matter. You will be grateful for the generous, non-reactive, and dedicated natures of the colleagues on your teams. You will express thanks that staff don’t quit in droves. You will feel gratitude to people under your care who follow guidance and demonstrate astonishing resilience. You will feel ongoing thanks that no one on staff gets sick and dies. You will be grateful that you still have a a job and are able to buy food and pay your bills when so many others cannot.
I am sorry to say that the pandemic is still ongoing in March 2021. Maria in March 2022 may be able to say more about how much you (and I) have learned and changed. (Perhaps it will be Maria in 2023 or 2025 who will comment on this.)
Do what you can to take care of yourself every day. I might even suggest that you write more, though will understand why if you don’t.
Sincerely,
Maria in March 2021
Maria Yang, MD 