“The pandemic is over.” President Biden’s words a few weeks ago are dangerously false. They are also short sighted.
Since we first heard the phrase “novel coronavirus,” our focus has been on deaths. Yes, deaths are an important metric with a global pandemic. But if not dying is our only measurement, we have forgotten its opposite, abundant life.
Michelle Carroll
In his book Invasion of the Dead: Preaching Resurrection, Brian Blount lays out four types of existence based on readings from Revelation: alive, dead, dead dead, and living dead. (How many of you are thinking about zombies right now?) In both our churches and our society, we focus almost exclusively on the first two — life and death, a rigid fixed state that cannot overlap.
How wrong we are. Just as we have focused on COVID deaths exclusively, we have missed the rest of our new reality.
My experience with long COVID
In February 2021, I joined the ranks of the living dead. My doctor said, “You have long COVID.” Several months prior, I’d done my at-home quarantining and recovery for my acute infection. I’d started back at work; things were going well. And then one day I couldn’t read. Brain fog was my primary symptom at the time. Understanding what was wrong was difficult for me to comprehend, much less explain to someone else how I felt. Goodbye BWIM Month of Preaching. I couldn’t get through reading the four Lectionary passages, much less write a sermon.
Thirteen doctors, six daily medications, four as-needed medications, extra strong compression stockings all day every day, two liters of water with five grams of salt daily and a year and a half later, I can function fairly well. It’s not life abundant, but it’s a lot higher up the scale of living dead than I was before.
Looking back, I was very much a zombie for about six months. I have no idea how I managed to feed and clothe myself during that time.
‘Dead’ or ‘alive’
Deciding to evaluate the health of our communities using “dead” or “alive” as the only measure leaves out an entire world of existence. For many years, our churches and individual Christians have done the same by measuring faith in “saved” or “not saved.” A single moment that delivers your “fire insurance” and requires nothing else after that.
But when we go to the Scriptures, when we see robust evaluations of thriving communities, it is not just about life or death. It is a peace, a joy, good health in all its forms, a beloved community, shalom, love invading each and every person’s life and the community as a whole.
“President Biden appears to have decided life and death are the only measures we value for COVID.”
President Biden appears to have decided life and death are the only measures we value for COVID when there are so many other factors to consider.
Early estimates and studies about long COVID vary from 13% to 30% of all people ever infected with an original COVID infection. That’s 79.5 million to 183.6 million people worldwide with a new chronic health condition that we know very little about, have absolutely no idea how long it will last or how it will change in the future.
The waiting
I’ve seen nine specialists since I was diagnosed with long COVID, three of which I continue to see every three to six months a year and a half later. Multiply that by 79.5 million people. I’ve had six significant imaging procedures. Multiply that by 183.6 million. Our health care system is not equipped to handle that volume of new patients for potentially decades to come.
As anyone with a disability or chronic health condition can tell you, the waiting is the worst. While a month or two or three doesn’t seem like that long, it all piles up. First you wait a few weeks to see your primary care, then it takes them a couple weeks to get the specialist referral processed. Then the specialist calls you and that appointment’s in three months. After that appointment, you need significant testing or imaging. Two weeks later they call to schedule that test, which is another month away. Then there’s the prior authorizations or step therapies your insurance requires before you can get the medication your doctor wanted to prescribe in the first appointment, but it takes a few more months. All that life you could be living is spent waiting on appointments. Waiting and waiting and waiting.
Waiting.
CONGRATULATIONS! There’s a surprise bill after one of those appointments for hundreds or thousands of dollars.
“We’ve decided not to measure the fulness of life for each individual after their acute COVID infection.”
We’ve decided not to measure the fulness of life for each individual after their acute COVID infection. Federal policy has ignored a second health pandemic that has measurably affected the number of unfilled jobs in America.
Workplace challenges
If I did not work at a church that had seen staff with chronic illnesses before, that leaned into the abundant grace of Christ, that didn’t keep a strict count of days and hours missed, that let me work from home a lot, there is no doubt in my mind I would have exhausted my paid leave and would need FMLA — and potentially more than those three months.
When we talk about the workplace, we could dig into lots of differences between how men and women are treated at work not related to COVID, but suffice it to say, women are treated drastically different than their male counterparts. In decreased wages, harsher punishments for minor infractions, negative attitudes toward family leave and later kids’ needs during the day and having to talk people into every decision you suggest. I could go on and on.
Then we throw this in the mix: Women are significantly more likely to develop long COVID than men. Scientists are still studying the why and increased risk. Immune response differences in men and women are the most likely reason. Whether it be at work, at home, at church, we’re adding and compounding so many issues that already make it harder into a huge mountain you can’t ever seem to climb. It takes everything you have to get to the next ledge to rest.
Medical gaslighting
And then, welcome to the world of medical gaslighting. Women are more likely to be dismissed and ignored by their doctors than men. That becomes exponentially worse for women of color. Finally, after all that waiting and waiting and waiting and the doctor says it’s all in your head.
This issue showed up for me as well. Early on, I spoke to a general practitioner where I discussed 16 or more symptoms that I had to write down over multiple days before the appointment (hello, brain fog). Her diagnosis was anxiety/depression and carpal tunnel syndrome. Generally, if a woman cries at a doctor’s appointment it’s official, you are depressed. Here’s some Zoloft. Let’s be clear though, the general list of symptoms experienced by most people with long COVID are the exact same symptoms as anxiety and depression.
“Instead of being heard, I was dismissed.”
We talked about anxiety, depression and stress in that appointment where I “had” carpal tunnel. I cried. Absolutely, I had anxiety, depression and stress. But instead of being heard, I was dismissed. The doctor could not hear that I was anxious, depressed and stressed because of the symptoms we discussed. Being anxious and depressed about a new health issue should be normal. But instead, I was another woman who succumbed to emotional hysteria instead of an actual medical issue.
This isn’t a new problem; women have come second for millennia. Even when we look at Jesus’ healing miracles in the Bible, we see a culture, a system designed to disbelieve women. Out of 28 healing miracles in the Gospels, only six of those healed are women. Mary Magdalene is the only woman named; however, she’s only given one sentence. The rest are reduced to their relation to men or simply called “woman.”
The women also demonstrate the extended time required for a diagnosis or treatment. The woman bleeding had suffered 12 years, and the woman bent over for 18. While we’ve come a long way in honoring and including the imago Dei of women, we’re not there yet.
Many studies have shown women and people of color often receive poorer care than their white male counterparts. They’re treated less aggressively, not given pain medications and wait longer for a proper diagnosis. Stir that into the long COVID stew of unknowns, and our medical communities already are biased and trained to dismiss more than half the people exhibiting symptoms from long COVID.
“It’s getting easier and easier to decide the pandemic is over, one chip, one unacknowledged bias at a time.”
You see how it’s getting easier and easier to decide the pandemic is over, one chip, one unacknowledged bias at a time.
Insurance nightmares
Ready to talk insurance? (No, I don’t really want to talk about it either, but we must.) We all know health insurance is overly bureaucratic, delays care and leaves us with insane bills we didn’t expect. We’re all in agreement that it’s awful, but instead we scream at the people across the aisle on solutions that might help fix it a little bit. How many doctor’s appointments have you left where the course of treatment was dictated by insurance benefits and exclusions? It affects us all, whether our insurance is “good” or “bad.”
The part we’re not talking about, though, is its impact on patient care. Every doctor in every health care facility in every state of America has to talk to their patients about insurance. Instead of a collaborative meeting where time is given to discuss, evaluate and become informed and active participants in our care, we’re stuck in confusing co-pays and deductibles, difficult-to-navigate approval processes and patient quotas that have doctors running out the door within five minutes.
“Understanding how much your care will cost is more convoluted than discussing Revelation.”
Understanding how much your care will cost is more convoluted than discussing Revelation. Confusing policies and intentionally hidden pricing structures and negotiating processes make it too difficult to navigate for most people.
It’s also not just insurance. Health care conglomerations are another giant in how our health care system works. As these massive companies continue to buy out hospitals, private practices, imaging centers and pharmacies, it’s a little good and a lot of bad.
The technology available to such a large organization is nice. It’s easier for patient records to be shared, for patients to have access to their own records, and that’s nice. But then comes the list of bad.
I’ve had a unique perspective to compare health care for the insured and uninsured over the past few years. There is a free clinic at our church for the uninsured, where I work as the pastor of missions. There are days I am grateful to have health insurance and days where I wish I were a patient at the clinic.
I’m not the only one who prefers the model at our free clinic. Every week practitioners mention how much they appreciate the time they are allowed to spend with patients. Many only need five minutes or less, but the freedom to spend 45 minutes with a patient, if that’s necessary, is a gift doctors don’t have anymore. Knowing that you’re walking out the door with no surprise bills, with all the paperwork handled and the medication your doctor prescribed during today’s appointment, that’s a gift to patients as well.
No easy answers
There isn’t a neat bow I’m going to tie at the end of this article. The issues facing our health care system are vast and entrenched. Things probably will get worse before they get better. Minorities, women, immigrants, people of color, the least will continue to bear the brunt of these issues and many more.
COVID-19 was an unknown. Saying “I don’t know” as a doctor in the early days was the appropriate response. When we linger in “I don’t know” or it’s over simply because we have a vaccine or because we’re tired of dealing with a pandemic, that’s dangerous to our world. And to the abundant life Christ has called us to.
Michelle Carroll serves as associate pastor for missions at First Baptist Church of Frankfort, Ky. She is a graduate of the University of Georgia and Mercer University.