COMMENTARY

COVID-19: Guiding Vaccinated Patients Through to the 'New Normal'

Eva Ritvo, MD

July 02, 2021

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

As COVID-related restrictions are lifting and the streets, restaurants, and events are filling back up, we must encourage our patients to take inventory. It is time to help them create posttraumatic growth.

Dr Eva Ritvo

As we help them navigate this part of the pandemic, encourage them to ask what they learned over the last year and how they plan to integrate what they've been through to successfully create the "new normal."

The Biden administration had set a goal of getting at least one shot to 70% of American adults by July 4, and that goal will not be reached. That shortfall, combined with the increase of the highly transmissible Delta variant of SARS-CoV-2 means that we and our patients must not let our guards completely down. At the same time, we can encourage our vaccinated patients to get back to their prepandemic lives – to the extent that they feel comfortable doing so.

Ultimately, this is about respecting physical and emotional boundaries. How do we greet vaccinated people now? Is it okay to shake hands, hug, or kiss to greet a friend or family member – or should we continue to elbow bump – or perhaps wave? Should we confront family members who have opted not to get vaccinated for reasons not related to health? Is it safe to visit with older relatives who are vaccinated? What about children under 12 who are not?

We psychiatrists also need to ask our fellow health care workers how they're doing. Those who were on the front lines of the pandemic faced unfathomable pain and suffering – and mental and physical exhaustion. And we know that the nightmare is not over. Several areas of the country with large numbers of unvaccinated people could face "very dense outbreaks," in large part because of the Delta variant.

As we sort through the remaining challenges, I urge us all to reflect. We have been in this together and will emerge together. We know that the closer we were to the trauma, the longer recovery will take.

Ask patients to consider what is most important to resume and what can still wait. Some are eager to jump back into the deep end of the pool; others prefer to continue to wait cautiously. Families need to be on the same page as they assess risks and opportunities going forward, because household spread continues to be at the highest risk. Remind patients that the health of one of us affects the health of all of us.

Urge patients to take time to explore the following questions as they process the pandemic. We can also ask ourselves these same questions and share them with colleagues who are also rebuilding.

  • Did you prioritize your family more? How can you continue to spend quality time them as other opportunities emerge?

  • Did you have to withdraw from friends/coworkers and family members because of the pandemic? If so, how can you reincorporate them in our lives?

  • Did you send more time caring for yourself with exercise and meditation? Can those new habits remain in place as life presents more options? How can you continue to make time for self-care while adding back other responsibilities?

  • Did you eat better or worse in quarantine? Can you maintain the positive habits you developed as you venture back to restaurants, parties, and gatherings?

  • What habits did you break that you are now better off without?

  • What new habits or hobbies did you create that you want to continue?

  • What hobbies should you resume that you missed during the last year?

  • What new coping skills have you gained?

  • Has your alcohol consumption declined or increased during the pandemic?

  • Did you neglect/decide to forgo your medical and dental care? How quickly can you safely resume that care?

  • How did your value system shift this year?

  • Did the people you feel closest to change?

  • How can you use this trauma to appreciate life more?

Life might get very busy this summer, so encourage patients to find time to answer these questions. Journaling can be a great way to think through all that we have experienced. Our brains will need to change again to adapt. Many of us have felt sad or anxious for a quite a while, and we want to move toward more positive feelings of safety, happiness, optimism, and joy. This will take effort. After all, we have lost more than 600,000 people to COVID, and much of the world is still in the middle of the pandemic. But this will get much easier as the threat of COVID-19 continues to recede. We must now work toward creating better times ahead.

Eva Ritvo, MD, has almost 30 years' experience in psychiatry and is currently practicing telemedicine. She is the author of "Bekindr – The Transformative Power of Kindness" (Hellertown, Pa.: Momosa Publishing, 2018). She has no conflicts of interest.

This article originally appeared on MDedge.com, part of the Medscape Professional Network.

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