WEBVTT - Fraying Mental Health on the Front Lines 0:00:02.680 --> 0:00:07.480 Welcome to Prognosis. I'm Laura Carlson. It's day fifty four 0:00:07.720 --> 0:00:12.000 since coronavirus was declared a global pandemic. Our main story. 0:00:12.520 --> 0:00:16.279 Healthcare professionals are hailed as heroes for treating patients on 0:00:16.360 --> 0:00:20.680 the front lines of a global crisis, but they're facing 0:00:20.680 --> 0:00:24.439 a crisis of their own. The outbreak is straining their 0:00:24.440 --> 0:00:31.640 mental health with tragic consequences. But first, here's what happened today. 0:00:35.240 --> 0:00:39.200 Federal health regulators said they would tighten oversight of antibody 0:00:39.240 --> 0:00:42.680 tests that can tell whether patients have been infected with 0:00:42.760 --> 0:00:47.279 the new coronavirus. The Food and Drug Administration said today 0:00:47.360 --> 0:00:49.600 that the makers of the test would have to apply 0:00:49.680 --> 0:00:53.680 for authorization within ten days of putting products on the market. 0:00:54.600 --> 0:00:58.000 Since mid March, the FDA had been allowing them to 0:00:58.000 --> 0:01:02.080 sell the tests without any government sign off. The f 0:01:02.200 --> 0:01:05.640 d A had originally relaxed its rules to give drug 0:01:05.680 --> 0:01:09.720 makers flexibility to get the tests to market faster, but 0:01:09.840 --> 0:01:15.120 some manufacturers allegedly made false or inappropriate claims, and the 0:01:15.200 --> 0:01:19.959 accuracy of some tests was questioned. The FDA has given 0:01:20.000 --> 0:01:24.440 emergency authorizations to twelve antibody tests and said that two 0:01:24.560 --> 0:01:29.399 hundred are currently in the review process. Meanwhile, the COVID 0:01:29.480 --> 0:01:33.679 nineteen treatment, remdesvie, is moving quickly through the drug pipeline. 0:01:34.120 --> 0:01:38.600 The anti viral drug was approved for emergency youth last Friday, 0:01:38.720 --> 0:01:41.959 and Gill Lead Sciences, the maker of the drug, says 0:01:42.080 --> 0:01:44.520 it plans to get it to patients as soon as 0:01:44.640 --> 0:01:49.760 this week. Early results from an ongoing study show remdesvie 0:01:50.120 --> 0:01:56.280 reduced the time it took hospitalized COVID nineteen patients to recover. However, 0:01:56.720 --> 0:02:00.240 the journal The Lancet published results of the same week 0:02:00.480 --> 0:02:04.520 from a small Chinese study that showed less promising results. 0:02:05.920 --> 0:02:08.960 Even though the tests and treatments the FDA is fast 0:02:09.000 --> 0:02:13.360 tracking have yet to even begin containing COVID nineteen, many 0:02:13.440 --> 0:02:18.800 places have already begun restarting business. That's true of companies too. 0:02:19.200 --> 0:02:23.880 Carnival Cruise Lines plans to sail ships again on August one. 0:02:24.280 --> 0:02:27.240 It's the first major cruise operator in the Americas to 0:02:27.320 --> 0:02:32.480 talk about reopening coronavirus outbreaks spread widely on several cruise 0:02:32.480 --> 0:02:36.240 ships earlier this year. The first cruises will set sail 0:02:36.280 --> 0:02:41.600 from Galveston, Texas, Miami, and Port Canaveral, Florida. Other cruises 0:02:41.680 --> 0:02:46.040 have been canceled through August thirty one or longer. It's 0:02:46.160 --> 0:02:49.600 unclear who will sail or how safe it would be 0:02:49.680 --> 0:02:52.720 to cruise with the virus still likely to be at large. 0:02:53.200 --> 0:02:56.720 When the industry shutdown had been March, outbreaks at sea 0:02:56.760 --> 0:03:00.919 had reached havoc. The confined spaces are a perfect vehicle 0:03:01.000 --> 0:03:04.480 for the virus to spread, and passengers were trapped aboard, 0:03:05.200 --> 0:03:18.080 some of whom died and now our main story in hospitals, 0:03:18.080 --> 0:03:20.920 healthcare workers are under threat from more than just the 0:03:20.960 --> 0:03:26.880 coronavirus itself. The mental health effects of the work are grave. Recently, 0:03:27.160 --> 0:03:29.639 the head of emergency medicine at a New York area 0:03:29.720 --> 0:03:34.880 hospital died by suicide. Doctors and nurses fighting COVID nineteen 0:03:35.040 --> 0:03:39.000 are watching patients die at rates rarely seen in civilian medicine, 0:03:39.920 --> 0:03:42.760 and they're delivering the news to family members who aren't 0:03:42.800 --> 0:03:46.240 allowed inside the hospital for fear of spreading the disease. 0:03:47.240 --> 0:03:50.200 Hospitals are trying to treat the minds and hearts of 0:03:50.200 --> 0:03:55.680 the healers, offering counseling, crisis hotlines and therapy dogs. I 0:03:55.760 --> 0:03:58.360 talked to Bloomberg's and a court about the scars. The 0:03:58.400 --> 0:04:01.880 pandemic is leaving on hospital workers and what the health 0:04:01.880 --> 0:04:09.000 care system can do about it. These people are going 0:04:09.040 --> 0:04:11.400 to work every day, you know. First of all, they're 0:04:11.400 --> 0:04:13.960 actually leaving to go to work, unlike a lot of 0:04:14.000 --> 0:04:16.600 people who are lucky enough to stay home. UM. And 0:04:16.640 --> 0:04:19.920 then they're really in sort of the center, the epicenter 0:04:20.000 --> 0:04:23.720 of this of this pandemic right there, seeing a tremendous 0:04:23.720 --> 0:04:27.800 amount of human pain and grief. And they're also bearing 0:04:27.839 --> 0:04:30.039 the burden not just of treating a disease that we 0:04:30.120 --> 0:04:33.919 do not really understand, but they're also bearing the burden 0:04:34.279 --> 0:04:37.159 of knowing that they're kind of the soul, you know, 0:04:37.320 --> 0:04:40.680 representative of the patient. In this environment, people can't come 0:04:40.720 --> 0:04:43.320 in and see their family members because of how infectious 0:04:43.320 --> 0:04:48.440 this diseases are. Hospitals or other organizations, or even perhaps 0:04:48.680 --> 0:04:53.800 some healthcare workers themselves, are they spearheading efforts to provide say, 0:04:53.839 --> 0:04:57.400 more formal resources to two doctors or their other health 0:04:57.440 --> 0:05:03.000 care colleagues to say, um, cope with this kind of stress. 0:05:03.040 --> 0:05:06.120 So we spoke with a couple of different institutions that 0:05:06.160 --> 0:05:09.840 we're trying to offer better support to their providers. One 0:05:09.880 --> 0:05:12.680 of them was Mount Sinai here in New York, setting 0:05:12.720 --> 0:05:15.679 up a center to to screen and treat and study 0:05:16.080 --> 0:05:20.360 their healthcare workers, you know, difficult experiences through this UM. 0:05:20.400 --> 0:05:24.280 I spoke with Julie Beavers, who's a trauma and crisis 0:05:24.360 --> 0:05:28.120 chaplain who flew out here to New York from California 0:05:28.240 --> 0:05:31.279 to be a support and a resource and health counsel 0:05:31.400 --> 0:05:33.920 healthcare providers here on the front lines in New York. 0:05:34.000 --> 0:05:38.640 People are traumatized and also the healthcare workers are traumatized. 0:05:38.920 --> 0:05:42.159 This is not normal. This is not their normal. You know, 0:05:42.560 --> 0:05:46.080 put on your scribs and go to work. UM. When 0:05:46.120 --> 0:05:48.840 they go to work, they have more people to care 0:05:48.920 --> 0:05:53.520 for than might be humanly possible, right, and it's in 0:05:53.640 --> 0:05:58.240 situations that will not make sense to the training that 0:05:58.320 --> 0:06:02.120 they've had. Yes, they are experts and caring for people, 0:06:02.200 --> 0:06:04.280 and they know how to run ventilators, and they know 0:06:04.360 --> 0:06:07.680 how to you know, administer medications, and they know how 0:06:07.720 --> 0:06:12.080 to listen to people. These are ends. These nurses aren't 0:06:12.120 --> 0:06:17.880 necessarily trained to deliver death notifications, right. There's an art 0:06:17.920 --> 0:06:22.080 to that, and they're not trained for that, right. They're 0:06:22.080 --> 0:06:27.120 not used to UM dealing with you know, very critical 0:06:27.160 --> 0:06:30.680 patients and hearing the patient's phone ring. You know, these 0:06:30.680 --> 0:06:32.760 patients might have been just on the phone with their 0:06:32.760 --> 0:06:36.640 family members three hours ago and able to talk, and 0:06:36.680 --> 0:06:39.000 now they're on a ventilator and they may lose their 0:06:39.040 --> 0:06:41.360 life by the end of the day. And the nurses 0:06:41.400 --> 0:06:45.560 are answering some of these phone calls and um, you 0:06:45.600 --> 0:06:53.680 know that's not part of their training, right, an important 0:06:53.680 --> 0:06:57.120 thing to think about in an availability of all these resources. 0:06:57.120 --> 0:07:00.680 Healthcare workers have so much going on at work right now. 0:07:00.720 --> 0:07:03.360 They're working incredibly long shifts. They don't have a lot 0:07:03.400 --> 0:07:06.839 of free time, and they're sad and they're scared, and 0:07:06.880 --> 0:07:08.800 they go home and all they have time to do 0:07:08.920 --> 0:07:11.800 is really eat and sleep. Right, And now we're saying 0:07:11.800 --> 0:07:13.680 in your free time you need to you know, talk 0:07:13.720 --> 0:07:15.760 to counselor about this. Now that that's something that I 0:07:15.760 --> 0:07:18.400 think would be challenging for anyone. But I also spoke 0:07:18.480 --> 0:07:21.120 with a lot of experts who said, you know, there's 0:07:21.120 --> 0:07:23.360 an additional kind of culture here in the in the 0:07:23.400 --> 0:07:26.920 medical field, and especially I think among physicians, of you know, 0:07:27.000 --> 0:07:29.440 we are the helpers, right, We don't need to help, 0:07:29.760 --> 0:07:32.120 we help other people. For a lot of them, it 0:07:32.160 --> 0:07:34.600 can be easy to say, you know, I'm fine, I'm 0:07:34.600 --> 0:07:36.600 doing fine. You know, I have my friends, I have 0:07:36.640 --> 0:07:39.360 my family. I talked to other doctors about this. I'm fine, 0:07:39.840 --> 0:07:42.239 but you know, there's a real concern that if healthcare 0:07:42.280 --> 0:07:45.960 providers don't take advantage of these resources or don't seek 0:07:46.000 --> 0:07:48.720 support in some way, that there will be kind of 0:07:48.760 --> 0:07:52.400 long lasting scars. It's almost inevitable. I think if you 0:07:52.440 --> 0:07:54.960 think about this, the scale of this pandemic and the 0:07:55.000 --> 0:07:57.880 scale of human suffering that healthcare providers are seeing on 0:07:57.920 --> 0:08:01.040 the job every day. I was thing we might dig 0:08:01.120 --> 0:08:04.320 into Julie Beaver's story a little bit more um because, 0:08:04.360 --> 0:08:07.320 as you mentioned, she had recently arrived in New York. 0:08:07.480 --> 0:08:10.520 She's working as a chaplain, and I was hoping you might, 0:08:11.000 --> 0:08:13.280 you know, give us a bit of a like a 0:08:13.280 --> 0:08:16.400 pain as a picture essentially of how she has been 0:08:16.840 --> 0:08:19.560 um engaging with healthcare workers and you know, some of 0:08:19.560 --> 0:08:23.040 the things that she's seen in her her daily experience 0:08:23.080 --> 0:08:26.000 working as a chaplain with doctors or other workers either 0:08:26.040 --> 0:08:30.560 experiencing burnout or just this kind of incredible pressures. Julie 0:08:30.560 --> 0:08:34.320 Beaver's normally lives, you know, out in California and Sacramento, 0:08:34.440 --> 0:08:37.720 and she flew um here to New York to volunteer 0:08:37.960 --> 0:08:41.320 kind of to help frontline healthcare workers with exactly some 0:08:41.360 --> 0:08:43.839 of the things we've been talking about here, right, with 0:08:43.880 --> 0:08:46.679 the sort of trauma and the difficulty of this job. 0:08:47.320 --> 0:08:50.400 And you know, something that is really interesting about her 0:08:50.400 --> 0:08:53.040 experience is she's living in one of these hotels that 0:08:53.160 --> 0:08:56.119 there's a lot of healthcare workers living in these hotels 0:08:56.400 --> 0:08:59.040 kind of being busted over to the hospitals that they're 0:08:59.080 --> 0:09:01.760 working at, you know, each day. And so she really 0:09:01.800 --> 0:09:05.760 structures her day around when the health care providers are, 0:09:06.000 --> 0:09:08.319 you know, leaving for the day for the day shift 0:09:08.360 --> 0:09:12.240 and coming back from an evening shift, just sort of saying, hey, 0:09:12.280 --> 0:09:14.800 I'm here for you. I'm here for you. You can 0:09:14.800 --> 0:09:17.760 talk to me. Here's my card. I want to set 0:09:17.760 --> 0:09:20.800 them up for success going forward. Um. You know, it's 0:09:20.920 --> 0:09:23.560 very common for them to have nightmares. It's very common 0:09:23.640 --> 0:09:26.160 for them to you know, go back to their room 0:09:26.360 --> 0:09:32.440 and spend the day rehashing their shift instead of sleeping. Right. Um. 0:09:32.480 --> 0:09:36.920 The thing that makes this so much like war is 0:09:36.960 --> 0:09:40.200 that this isn't a one time trauma for them. You know, 0:09:40.280 --> 0:09:45.520 It's not like somebody that has experienced finding a loved one, 0:09:45.760 --> 0:09:47.920 you know, that has died by suicide in their home 0:09:48.080 --> 0:09:50.320 or something like that where it's a one time, very 0:09:50.360 --> 0:09:57.240 traumatic event. These healthcare workers are experiencing traumatic events throughout 0:09:57.280 --> 0:10:00.680 their twelve hour shift, and and they come back and 0:10:00.720 --> 0:10:03.400 they try to get some sleep, and then they gear 0:10:03.520 --> 0:10:08.400 up and go again and again and again and again. 0:10:20.120 --> 0:10:24.200 That was Bloomberg's and the Court, and that's our show today. 0:10:24.760 --> 0:10:27.480 For coverage of the outbreak from one and twenty bureaus 0:10:27.520 --> 0:10:33.000 around the world, visit bloomberg dot com slash Coronavirus and 0:10:33.120 --> 0:10:35.400 if you like the show, please leave us a review 0:10:35.679 --> 0:10:39.880 and a rating on Apple Podcasts or Spotify. It's the 0:10:39.920 --> 0:10:43.000 best way to help more listeners find our global reporting. 0:10:44.280 --> 0:10:47.680 The Prognosis Daily edition is hosted by Me Laura Carlson. 0:10:48.280 --> 0:10:51.839 The show was produced by Me top foreheads, Jordan Gospore 0:10:52.200 --> 0:10:57.280 and Magnus Hendrickson. Today's main story was reported by Emma Court. 0:10:57.840 --> 0:11:02.080 Original music by Leo Sidran. Our editors are Francesco Leavi 0:11:02.320 --> 0:11:07.120 and Rick Shawine. Francesca Levi is Bloomberg's head of Podcasts. 0:11:07.880 --> 0:11:08.720 Thanks for listening.