2B
Saturday, May 23, 2020
The Observer & Baker City Herald
DEALING WITH GRIEF DURING THE CORONAVIRUS PANDEMIC
‘Everything just feels fake’
By Bettina Boxall
Los Angeles Times
LOS ANGELES — It’s
been seven weeks since Karen
Blanks’ brother-in-law died
from COVID-19, but his death
still doesn’t seem real to her.
She and her husband
couldn’t visit Scott Blanks in
the hospital. They couldn’t
view his body at the mortu-
ary before he was cremated.
They’re not holding a memo-
rial service until large gather-
ings are permitted.
“Everything just feels fake
— like I’m in this big, clouded
fog, and someone is telling me,
‘Your brother-in-law died,’ ”
she said. “It doesn’t feel real
because everything has been
so different.”
The cruel toll of the CO-
VID-19 pandemic reaches
beyond its victims to hun-
dreds of thousands of family
members and friends who
have been robbed of commu-
nal support and time-honored
rituals to help them cope with
the loss of loved ones.
Long after a vaccine has
halted the spread of the
novel coronavirus, many of
the bereaved will struggle
with feelings of guilt and
prolonged grief over all that
they couldn’t do and say in
the fi nal days and hours of a
relative’s life.
Sweeping virus-related
restrictions — on bedside
visits, funerals, church gather-
ings, support-group meetings,
air travel and even consoling
hugs from caregivers — are
affecting not just COVID-19
victims and their survivors
but “the way everyone is
dying right now and how ev-
eryone is grieving,” said Dale
Larson, a professor of counsel-
ing psychology at Santa Clara
University.
“You couldn’t design a more
impactful set of conditions
to disrupt the kind of things
we like to see happening to
support us in times of loss and
grief. It’s just staggering,” he
said. “I think the novel corona-
virus is creating a novel form
of traumatic bereavement for
a large number of survivors.”
Karen Blanks had known
Scott, a 34-year-old dental as-
sistant from Whittier, since he
was a freshman in high school
and she started dating his
older brother Quentin.
“He was my Scottie. I loved
him,” she said. “Not being able
to be by his side — for me, it’s
almost traumatizing. ... Even
after he passed, I wanted to
go to the mortuary to see him,
thinking that would be OK,
and I couldn’t even do that.”
The social distancing,
shelter-in-place rules and lim-
its on hospital visitation that
are hallmarks of the global
pandemic have deprived
people of the most fundamen-
tal deathbed connections.
They can’t hold a loved
one’s hand, sleep next to their
hospital bed, comb their hair
or shave them.
“All of these physical and
mammalian kinds of signals
and bonding that we share
with any other species — all
of that caregiving is stripped
away,” said Robert Neimeyer,
director of the Portland Insti-
tute for Loss and Transition.
Forgiveness can’t be
granted or sought. Years of
estrangement can’t end with
a deathbed vigil. “We are left
holding a bag of a lot of unfi n-
ished conversations,” he said.
Stacey Silva is haunted by
a phone call with her father,
Gary Young, a week before
he died of complications from
COVID-19 in mid-March in
a hospital in Gilroy, Calif.
Although she had been able
Tolga Akmen / AFP-Getty Images-TNS
Bathers swim in the Serpentine Lido in Hyde
Park, London.
Where is it
safe to swim?
By Christopher Reynolds
Los Angeles Times
Jason Armond / Los Angeles Times-TNS
Gary Blunt, a palliative care coordinator at Providence Cedars-Sinai Tarzana Medi-
cal Center, has been “taken aback at times” by the end-of-life scenes wrought by the
coronavirus.
“You couldn’t design a more impactful set of
conditions to disrupt the kind of things we like to see
happening to support us in times of loss and grief. It’s
just staggering.”
— Dale Larson, professor of counseling psychology
to see him through a glass
partition in the intensive care
unit, the hospital had stopped
visits.
“He called me about 4
o’clock in the morning, and
he had an (oxygen mask). It
was already hard to talk to
my dad and have a conversa-
tion because he would start
coughing after a couple of
words,” Silva said. “I believe
he was calling to tell me that
they were intubating him. I
didn’t understand, and he got
frustrated and he hung up.
“That’s the last conversa-
tion I had with my dad, and
I have so much guilt that I
couldn’t understand and that
I couldn’t tell him that I loved
him,” she said through tears.
“I think about that every day.”
Friends and family are
giving her emotional support,
“but nothing helps,” Silva said.
“Unless you’ve lost a loved one
in this particular manner, you
really have no idea how this
feels.”
Limits on the size of public
gatherings and air travel are
restricting or eliminating
ancient rituals of mourning
that help the living. Funer-
als are small or unattended.
Memorial services are being
postponed to unknown dates
in the future. Families are
choosing cremation for rela-
tives rather than burial with
only a few people present.
Virtual ceremonies and
gatherings can help fi ll that
void, Neimeyer said, if the
bereaved are actively involved
and not just passive observers.
They can share memories and
stories on Zoom or arrange a
time when people across the
country ritually light candles.
“Almost anything we do,”
he said, “that returns to us
a sense of agency, where we
can in some measure exercise
choice or take action.”
The coronavirus has
upended the world of pallia-
tive care teams — the nurses,
doctors, social workers and
chaplains whose job it is to
support patients and families
in times of serious illness and
death.
Gary Blunt is a palliative
care coordinator at Provi-
dence Cedars-Sinai Tarzana
Medical Center. As a pallia-
tive care nurse, he has been
present at hundreds of deaths
when he could hold a patient’s
hand and comfort bereft fam-
ily members.
But he has been “taken
aback at times” by the end-
of-life scenes wrought by the
coronavirus.
The hospital converted a
cardiac unit into a COVID-19
ward. Large, zippered sheets
of heavy, opaque plastic seal
the hallways and the open
doors of each patient’s room. A
small window of clear plastic
provides a view of the bed.
No visitors are allowed in
the rooms. To limit exposure,
even the palliative staff avoids
entering, meaning that the
patient’s primary contact is
with a bedside nurse cloaked
in a gown, face shield, mask
and gloves.
When death is near, the
hospital will let one fam-
ily member — wearing full
protective gear — stand in the
hallway and look through the
window for a short period of
time.
Late last month, Blunt’s
team tried to prepare a
woman for what she would
experience if she came for
a fi nal glimpse of her dying
husband.
He was confused and had
been restrained so he couldn’t
dislodge his oxygen mask and
tubes. He would not be able to
recognize her, garbed in gown
and mask, peering through a
small plastic window several
feet from the bed. He would
not be able to hear her against
the hum of the room’s medical
equipment.
In the end, she decided not
to come. Instead, the family
asked Blunt to play Neil Dia-
mond songs on a Bluetooth
speaker in the room and said
goodbye on FaceTime.
A nurse held an iPad over
the man’s face for about 15
minutes while his sobbing
wife and son uttered their
fi nal endearments.
In normal times, medi-
cal staff would give a fam-
ily privacy in such intimate
moments. Witnessing it now
can leave nurses with “this
horrible guilt of being there,
when you know you shouldn’t
be there,” Blunt said. “It’s re-
ally tough.”
He worries about COVID’s
lingering emotional impact on
caregivers. “These will stick
with us uniquely,” Blunt said.
“I think a lot of staff are going
to be scarred by this pro-
cess and have a lot to work
through.”
Rikki Larson is a clinical
social worker at USC Verdugo
Hills Hospital in Glendale,
which allows short individual
visits to patients on the verge
of death.
But she can no longer con-
sole the grieving the way she
always has. “I like to be able
to hug people and comfort
them,” she said. “I’ve left the
hospital more times than I
can tell with someone else’s
tears on my shoulder.”
Now she has to keep her
distance, at most quickly lay-
ing her hand on a shoulder.
“It’s very hard — it’s not the
same,” Larson said.
At hospitals that aren’t on
the front lines of the COV-
ID-19 battle, visitation limits
aren’t as strict. But they can
still be wrenching for families.
Rachel Rusch, a clinical
social worker in palliative
care at Children’s Hospital
Los Angeles, will not soon
forget her conversation with
a teenage patient and her
mother. The end was near for
the girl, who had cardiovascu-
lar disease.
“The piece that has stayed
in my heart,” Rusch said,
“was the eyes of her mother
across the bedside” as Rusch
explained that, because of the
COVID-19 pandemic, only a
few members of their huge
extended family would be al-
lowed in the room during her
daughter’s fi nal hours.
Such experiences have
left Rusch thinking of “all
the ripple effects that are
going to continue in the days
and weeks and months and
years to come because the
end of someone’s story was so
altered from anything anyone
might have prepared them-
selves for,” she said.
Wayne Strom entered the
Kensington assisted living
facility in Redondo Beach in
early December after a series
of falls made it diffi cult for
him to walk.
His wife, Kathy, who was
staying with her mother in
Rancho Palos Verdes, spent
every day with him, helping
with his physical therapy and
eating meals together.
That routine came to an
abrupt halt on March 12,
when the pandemic prompted
the Kensington to suspend
family visits. Strom switched
to calling Wayne several
times a day and realized
something was amiss in late
March when he said he was
too tired to talk.
He was admitted to the
hospital on March 30, tested
positive for the coronavirus
and died three days later.
Strom had not seen her
husband of 38 years for three
weeks.
“I think it’s taken me a
while to realize that he’s gone
because I wasn’t with him at
the end, and we haven’t had a
memorial,” she said.
She still puts her cellphone
by her bed, expecting Wayne
to call to say their nightly
prayer together.
Summer always means water, whether it’s an ocean,
lake, river, swimming pool or hot tub. But now that
we’re worrying more about germs, it’s natural to won-
der: Will this season’s swimming, surfi ng, fl oating and
soaking be as safe as it used to be?
Yes, many experts say.
“There is no data that somebody got infected this
way (with coronavirus),” said professor Karin B. Mi-
chels, chair of UCLA’s Department of Epidemiology, in
a recent interview.
“I can’t say it’s absolutely 100% zero risk, but I can
tell you that it would never cross my mind to get CO-
VID-19 from a swimming pool or the ocean,” said Paula
Cannon, a professor of molecular microbiology and im-
munology at USC’s Keck School of Medicine. “It’s just
extraordinarily unlikely that this would happen.”
On web pages giving pandemic advice, the federal
Centers for Disease Control say, “There is no evidence
that the virus that causes COVID-19 can be spread
to people through the water in pools, hot tubs, spas or
water play areas.”
As both professors noted, the chlorine in most swim-
ming pools is enough to inactivate the virus. The U.S.
Masters Swimming organization makes the same
point in its coronavirus briefi ng for frequent pool swim-
mers.
As for rivers, lakes and the ocean, experts say there
are no known cases of COVID-19 transmission through
those bodies of water. Also, the outdoors is understood
to pose less risk than indoors because of free air fl ow.
Surfrider Foundation staff scientist Katie Day has
written, “Similar coronaviruses (to COVID-19) have
been shown to remain viable and infectious, at least
temporarily, in natural freshwater environments
including lakes and streams.” But researchers say
they aren’t sure if it’s possible for humans to contract
COVID-19 that way.
Even if it was theoretically possible, “I’m not con-
cerned about the ocean and large lakes,” Michels said.
“The dilution effect is so humongous that I don’t think
there is a risk that anybody gets infected this way.”
Said Cannon: “You’d have to probably drink the
entire lake to get an infectious dose of the coronavirus.”
Some viruses do make their home in fecal matter
carried into the sea with other sewage; that’s why
Southern California beaches often are closed im-
mediately after rains. But research so far shows that
COVID-19’s principal means of transmission is respira-
tory, not fecal-oral.
So far, scientists say, there is no data suggesting
that the COVID-19 virus remains viable in saltwater.
They’re also not sure if the virus remains infectious
once it has been through a human digestive system or
a wastewater treatment plant.
“The virus really likes being 37 degrees Centigrade
(98.6 degrees Fahrenheit) in human saliva. It likes
to be warm and wet,” said Cannon. “Obviously, it can
survive outside the body, but the clock is ticking as soon
as it leaves our body.”
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