The Unimaginable Milestone

I knew this day was coming, and I dreaded the thought. Over the past two years, I often referred to the numbers. The numbers revealed global COVID-19 cases and COVID deaths. Updated daily, the COVID-19 Dashboard posted by Johns Hopkins University & Medicine dictated how we spent our lives, primarily indoors. Most of my days were spent in my home office on the computer, communicating digitally. I saw no one in person except my husband for months on end. Every day felt like Groundhog Day

The numbers I so often referred to were anything but numbers; they were people. Mothers, fathers, sisters, brothers, aunts, uncles, cousins, grandparents, friends, and colleagues diagnosed with COVID, lived with COVID, and died from COVID. When I perused the COVID-19 dashboard, I could picture an icon with a person for every statistic posted globally. As cases consistently climbed, it became unfathomable to conceptualize the number of deaths here in the U.S. and globally.

During the week of May 12th, when the U.S. announced one million COVID-related deaths were approaching, I was stunned. Not because I did not know it was possible, but because it was unavoidable. That week while driving, I listened intently to The Daily’s podcast, One Million. The segment contained personal reflections on the heart-wrenching stories about lives lost to COVID. The pain and suffering are unimaginable to those unscathed by severe COVID or loss due to COVID. Tears rolled down my cheeks as I drove to my appointment. At what point did this many deaths become acceptable to Americans? How come we did not ban together, unite as a country, and put the lives of others first? I will never understand.

Recently, I read a study conducted by USC. The research estimates that for every person who lost their life to COVID, at least nine family members are left to grieve. The gravity of millions of people simultaneously mourning is astounding. But when you think about it, that grief extends further when you include the number of nurses, doctors, medical aides, respiratory therapists, and ancillary staff.

As the U.S. neared one million COVID-19-related deaths, I spoke with my cousin Karen, a registered nurse in Canada for 38 years. She said something very profound to me. She started her career during the AIDS crisis and will be ending her career during COVID-19. Karen was a student nurse going into graduation in the 1980s during the outbreak of HIV and AIDS. Her career spans two pandemics. As she reflected on her career in the beginning and now, she shared her personal thoughts with me.

Karen McCuaig is a registered nurse and resides in Vancouver Canada.

The outbreak of COVID was scary at first. But I must admit when I look at my career overall, I think that my experience with COVID was a little calmer than when I was treating HIV/AIDS patients. That’s because we knew that we were going to get a vaccine for COVID, and not everybody was dying.

When I first started my career, there was no recovery from AIDS at the time, and little could be done for patients. They didn’t exactly know where it came from or how HIV was transmitted. It was scary coming home from work and wondering if you would pass it on to anyone in your family.

In 1986, I worked at a hospital in downtown Vancouver. It was a little bit of an epicenter not just for patients, but for employees who were contracting AIDS. That’s where I saw the loss of the people I worked with, not only to AIDS but also to suicide. The nurses, doctors, medical staff… they knew that there was no way out of this, and they knew the suffering. They didn’t want to be a part of it, and back then we didn’t have as many treatment options as we do now. You would go in one day, and see somebody, and the next day they were not there.

In 2020, when patients started coming in at the height of the COVID pandemic, everyone at the clinic was really scared, wearing full PPE, and just not able to manage the workday. Then we started to get more relaxed and put our faith in the people. We would say to patients, don’t come in if you have symptoms. Patients would phone in, saying they had a cough. And we would tell them to get tested and to not come into the clinic.

Most of our treatment was to prepare people. We taught families how to do dressing changes. We packed up dressing supplies to last at least a week for those in quarantine. Our homecare nurses would still go in the home for anyone who couldn’t do their dressing change or didn’t have family available. So, it was more difficult for our homecare nurses, trying to clean everything off, taking off their PPE outside by their cars, and bagging everything up. It was a big job. We just prepared, prioritized everybody, and incorporated families whenever we could so if patients got COVID, their care would not be compromised.

My career as a nurse started during the AIDS/HIV crisis and will end during the COVID-19 pandemic. In comparison, the in-between part was relatively smooth. Of course, I experienced and treated patients during outbreaks like SARS and other epidemics, but it never was anything like it was at the beginning and the end.

My conversation with Karen reminded me of the similarities between the AIDS crisis and COVID-19. One of the most disheartening effects is patient suffering, insurmountable loss, and grief family members experienced. I can only imagine the sacrifices healthcare professionals made caring for patients during these incredibly challenging times. In addition to the immense loss, the U.S. lacked uniformity in its response. We experienced confusion in public health messaging, stigma was associated with both viruses, and populations were disproportionately affected. Now entering year three of COVID, these problems continue.

As the country moves forward, life with COVID-19 continues to provide uncertainty about the future. So, I continue to watch the numbers. Although infection rates and hospitalizations in the U.S. are climbing daily, we have been incredibly fortunate to see mortality rates decline significantly. Still, the stark reality of more than one million lives lost in two years is inconceivable. My deepest sympathy goes out to every individual who lost someone due to COVID.