Editor’s Note: Janice Blanchard MD PhD is a professor in the Department of Emergency Medicine at George Washington University. The opinions expressed in this commentary are those of the author. View more opinion articles on CNN.
This year, Memorial Day comes as the US quickly approaches 100,000 deaths from Covid-19, surpassing the number of US military members who died in Vietnam. Soon, it may approach the number of American soldiers who died in World War I. President Donald Trump has ordered the flags to be flown at half-staff at federal buildings and monuments through Memorial Day to honor the nation’s victims of the virus.
The President seems to think of the Covid-19 pandemic as a war. In March, he referred to the developing crisis as a “medical war.” In April, he tweeted that the coronavirus was an “Invisible Enemy” that would “soon be in full retreat!” And just this month he referred to the providers who treat coronavirus patients as “health care warriors…running into death just like soldiers run into bullets.”
There is some validity to the President’s comparison. Like war, the coronavirus presents a threat that is often invisible to those outside of the battle environment. Only a fraction of what our troops experience is conveyed to the public and, similarly, no amount of news coverage can adequately reflect the pain of what health care providers see each day as they care for individuals dying from the coronavirus.
But perhaps the most important commonality between Covid-19 and war is the lasting mental anguish that many of its warriors face. If the President wants to take care of those fighting this viral battle, he should start by making sure that resources are available to cope with the stress, anxiety and psychological ramifications of the pandemic.
Sadly, even in more normal times, physicians have elevated suicide rates, about twice the rate of the general population. A 2018 literature review revealed that an estimated 300 to 400 doctors kill themselves each year. The experience of being on the frontline of Covid-19 is only likely to worsen this.
Based on the limited data from other disease outbreaks, there is reason to worry about increased rates of depression and anxiety among health care workers who treat Covid-19 related cases. Moreover, a study conducted in Wuhan, China, showed high rates of post-traumatic stress syndrome among survivors of the disease. Dr. Lorna Breen, a US frontline health care worker, tragically took her own life after recovering from the coronavirus and suffering from exhaustion upon returning to work amid the pandemic. Breen’s father, who confirmed his daughter’s death to CNN, also compared her work as an ER doctor to a battle, saying, “She went down in the trenches and was killed by the enemy on the front line.”
And the scope of the traumatic effects of this pandemic on the general public is daunting and only beginning to be understood. We do not yet know the effect that the pandemic will have on children or others who do not have the virus but bear witness to its effects.
Just as we see in the aftermath of war, the psychological pain and trauma of this pandemic will endure for years to come, long after its initial ravages have been contained.
Why, then, has the President, so intent on likening the pandemic to a war, not used his platform to highlight the mental health devastation that health care workers, patients and families are facing – and will continue to face? Instead, the administration has made an effort to cut the largest payer of mental health services in the US, Medicaid.
In late April, the Department of Defense took a step in the right direction by teaming up with NYC Health + Hospitals, and the Greater New York Hospital Association to provide mental health support to frontline workers. It is time for the Trump administration to build on this effort and provide similar support to those affected by the coronavirus nationwide in a meaningful way that will allow the US to move forward from this pandemic.
Like Gov. Andrew Cuomo, Trump could urge people to seek help and work to destigmatize mental health care. He could devote more of this administration’s resources to aid emergency mental health, crisis support lines and evidence-based therapies that support treatment of PTSD. Or he could make sure that expanded access to mental health care professionals is provided for those in need, including health care professionals and the most vulnerable residents of this country who have disproportionately suffered from Covid-19.
If Trump does not take these steps, we will likely need to prepare for a different kind of ‘second wave’ than the next outbreak of the disease feared later this year – the illness and death that could result from the mental and emotional toll of this virus.