Fighting the Three “F’s” – Fatigue, Frustration, and Fear

The following was sent to my girlfriend Gail Williams by one of her physicians. Gail sent it to me and I want to share it with you. Thank you Gail and Dana Clay Ackerly, M.D.

“I haven’t written in a while as I haven’t seen much in the way of truly actionable information. However, I did want to share my two cents as to what I am observing, and where we may go from here.

“I am sensing severe pandemic fatigue, immense frustration (particularly regarding the vaccine roll-out); and fear (Should I get the vaccine? What about these new variants? Will I ever be able to hug a family member or feel comfortable having a child in full-time school again?).

“As I discuss in more detail below, despite the concerns that surround us (including continued cases and deaths) and questions that keep bubbling up (What are the implications of the variants? How long will this last?), we have a TON for which to be grateful. We have vaccines that WORK (and I am confident that they will work for a while and are on an mRNA platform that is easily adjusted as needed).

“We have adequate PPE supplies. We have the ability to get same-day PCR tests. We have treatments that work if COVID is caught early!! It’s okay to be glass half full these days. It is still January. January is always dreary. But please keep your heads up. Though it may not seem that way, there is more good news than bad news on the horizon.

“With that, I wanted to make a few observations and provide a bit of guidance and advice:

1) Always remember that negative news sells better than positive news. I am personally frustrated by the incessant focus on all of the things we CAN’T do once vaccinated. Last week’s brief piece by David Leonhardt sums up my frustration well. https://www.nytimes.com/2021/01/18/briefing/donald-trump-pardon-phil-spector-coronavirus-deaths.html [Go to the section about underselling the vaccine.] I have been witnessing undue anxiety and stress as a result of these kinds of reports.

“Rather than perseverating on the unknowns (e.g. does the vaccine COMPLETELY stop the risk of transmission by those vaccinated?), I’d like to instead take a moment to truly celebrate the good news: the vaccines work! And, so far, they seem to work against COVID variants as well! While we need to remain vigilant and patient (especially those who are high-risk but are still awaiting vaccination), things are getting better. And all signs point to the fact that, once those two weeks have elapsed after your second shot, you will be able to regain parts of your lives again and interact with loved ones without fearing the worst.

2) Variants are the big news of the day. https://www.washingtonpost.com/health/interactive/2021/01/25/covid-variants/ Dr Lucy McBride and I have tackled this topic on our FacebookLive conversations (https://www.facebook.com/drlucymcbride ). I am excited and relieved that the scientific community is on-top of this and monitoring it closely. All viruses mutate, so, despite the media hype, this was expected. It was hoped that this Coronavirus would mutate less than other viruses – but nature seems to find a way (especially when left unchecked, as it has been in the U.S. and elsewhere, which has provided it endless opportunities to mutate). Scientists are “on it” and are already working to test the effectiveness of available vaccines (so far so good!) as well as designing vaccine boosters in case a variant arises against which existing vaccines seem to be less effective.

“This all warrants close attention, but I remain as optimistic as ever. It is also important to remember that the virus (including its new variants) are still preventable through mask-wearing, social distancing, and hand hygiene. Modest updates in these procedures include the deprioritization of major surface cleaning ( https://www.wsj.com/articles/new-playbook-for-covid-19-protection-emerges-after- year-of-study-missteps-11611680950 ) as well as considerations of upgrading your masking when outside your own pod ( https://www.washingtonpost.com/opinions/2021/01/26/n95-masks-safest-next-best-options/ ) The key point is that this is not a new or different beast. We know how to defeat it!

“So…what should and can we do?

1) Everyone (vaccinated or not):

a. Manage Fatigue: Check your internal gas tank. How are you feeling? How is your family holding up? Find ways to fill it up.

For those that remember my earlier rowing analogies, now might be a good time for a Power Ten. You can do this.

b. Combat Frustration: One place to start is reciting Reinhold Niebuhr’s Serenity Prayer. Trying to let go of the things that are outside of your control is almost always helpful. That said, if you also want to scream out of your windows at how many hours you’ve wasted trying to track down a vaccine, please do (I’ve done it a number of times already).

c. Face Fear: Not to go too philosophic – but there is nothing to fear but fear itself. You all know what to do to stay safe. It’s getting extremely old and exhausting, I know, but you know what to do, and the light is finally there at the end of the tunnel. You’ve got this.

2) Those who have been vaccinated:

a. Wait two weeks after your second shot…and then celebrate!!

b. Hygiene/Precautions: Keep wearing your masks in public and keep washing your hands. It will help prevent you from getting the Flu, RSV, adenovirus, you name it. This should be our new normal. But do those things because they’re generally smart to do, not due to any lingering concern about catching COVID or giving it to others.

c. Travel: Absolutely consider it. Do not live in fear. All signs point to the vaccine being effective against the new strains, as well. Is it for certain? No…but it is looking pretty darn good for the currently prevalent strains. If we can’t embrace the benefits of this vaccine (and continue to focus on all of the “what ifs”), this will be a very long pandemic indeed. Again, as a general rule of thumb, I’d advise you to mask up and wash your hands when you do travel, but don’t do it because you’re petrified. Now is the time to let a lot of that burden go.

d. Seeing Loved Ones: Do it!!! Hugs for everyone!! We all need this moment in our lives. There are of course those crazy theoreticals: if you have been vaccinated, then visit a COVID hospital ward (i.e. a place just teeming with virus) and don’t wear a mask, and then visit a high risk relative – then I might suggest a little distance and mask wearing… but the chance of carrying and transmittingthevirusaftervaccinationisreallyquitelow. See2.b.aboveandstartcombating1.a.withsomelongoverduehugs!

e. Stay strong and carry on. If you have ANY symptoms, get a rapid PCR test and, if positive, please consider monoclonal antibody treatment (either Eli Lilly or Regeneron’s products). While high-risk individuals automatically qualify for treatment, there are clinical trials that can enroll lower-risk patients, as well. This type of treatment saves lives. Speed of diagnosis and treatment matters. If you test positive and are interested in taking this route, please call the office so we can help you navigate that path.

3) For those awaiting vaccination:

“That’s all for today.

“PS After drafting my letter early this morning, the following article came out. https://www.wsj.com/articles/at-a-retirement- home-covid-19-vaccines-mean-an-end-to-isolation-11611756008

“This is the kind of press we need to see.”

Dana Clay Ackerly, M.D. on Jan. 27, 2021

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2 thoughts on “Fighting the Three “F’s” – Fatigue, Frustration, and Fear

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