Rest, Recover, and Regroup
Under a blanket on the sofa yesterday morning, I felt a special irony watching the New York marathoners gallop along the circuitous path to the finish line in Central Park. What endurance! What grace! And how pleased I was to be watching such athleticism in total stillness in my pajamas!
I thought to myself: I doubt that any of the runners would have trained for months and woken up at the crack of dawn to run their hearts out without a known endpoint of 26.2 miles. Similarly, I’m guessing that you (like me) might not crank out your work product every Monday through Friday without the promise of a weekend—and some downtime on the couch.
In other words, most people need finish lines in order to keep pushing. We need rest and recovery to fuel our bodies and minds. That doesn’t make us lazy or selfish; it makes us human.
Well here’s some good news for all of us: the end of the pandemic is in sight.
In the US, vaccination rates are going up, and the rates of hospitalizations and deaths are going down. Kids ages 5-11 are now eligible for the vaccine. Vaccinating them will help further reduce community transmission and allow kids to resume more normalcy. (For some answers to FAQs about kids and the vaccine, I recorded a short video “explainer” for Yahoo News last week.)
The potential nail in the coffin of this public health emergency? The two oral antiviral medicines in the pipeline.
The preliminary data on these medications reveal a high level of effectiveness against COVID-19 when taken early in the course of illness. Molnupiravir (made by Merck and recently approved for use in the UK) and Paxlovid (made by Pfizer) are oral tablets that, if approved by the FDA, could be prescribed to people with mild or moderate COVID-19 to help prevent hospitalization and death.
These medications are potential game-changers. Not only would they reduce the burden of disease to individuals and hospitals, their mere existence could release us from the shackles of fear over the “what ifs”:
What if I get COVID-19 despite being vaccinated?
What if I need hospital care due to COVID-19 even though I’m generally healthy?
What if resuming normal life means more exposure to coronavirus?
Oral medications will never be a substitute for vaccination. The COVID-19 vaccines do an excellent job of preventing disease in the first place. Antiviral pills, on the other hand, are treatments for people who end up getting sick (with or without prior vaccination). The combination of strong vaccine-induced immunity plus oral medications should help bring us closer to envisioning a return to pre-pandemic life.
This is not to suggest that the pandemic is over. Still too few Americans are vaccinated and too many people are sick and dying from COVID-19. Moreover, we’ve been fooled before. In May and June when things were looking up, we had a fleeting moment of jubilation. We thought we were nearing the end—then came Delta.
So no—we’re not done. But we’re in a much better place than we were even in the summer. And there’s real light at the end of the tunnel.
We desperately need it. The tunnel has been long. We need endpoints to keep going.
To be clear: Fauci isn’t ever going to jog out onto a football field at half-time and blow a whistle, declaring “It’s over, people!'' Given the heterogeneity of vaccination rates, population immunity, and political forces within this country—plus our existence in a global community—there won’t be a single day in which we declare permanent victory over COVID-19. Moreover, the coronavirus won’t ever vanish from the planet.
But once we’ve achieved more widespread vaccination and once we have accessible, affordable and effective therapeutics to offer, the virus won’t overwhelm hospitals and cause needless death and suffering.
So what does that mean for us right now?
We can have hope. We can start to reclaim our health.
We can look toward the coming winter with less dread and more confidence about brighter days ahead. We can put kindling on the fire of our imaginations. We can start to picture life without the constant mental gymnastics about mitigating COVID risk. Most importantly, I’d argue, we can start to zoom out on our health and reclaim important parts of our lives that we’ve let drift away.
After all, health is about more than simply not getting COVID. It’s about our everyday experiences and habits, our fears and coping mechanisms, our self-awareness and sense of agency. It’s about our relationships with alcohol, food, work, and each other. It’s about our ability to connect the dots between how we feel and how we are. It’s about putting ourselves in the driver’s seat of our everyday habits and behaviors.
As I said to one of my longstanding patients this morning for her check-up: Health is about more than seeing me once a year; it’s the 364 days a year you’re not in my office.
As you know, I’m a strong advocate for naming our emotions, normalizing uncomfortable feelings, and connecting the dots between our mental and physical health. There is so much we can’t control in life (i.e. loss, uncertainty, viruses, other people) that it’s critical we focus on the things we can control in order to reclaim agency over our everyday health.
This won’t be easy. We’re still in the throes of ongoing trauma. We have lost loved ones, jobs, relationships, and the contours of regular life. Even if COVID was declared “over” today, we cannot expect ourselves to bounce back overnight—or even to want our old “normal” back.
But we can start by reflecting on what we need to be healthy. (It’s more than just a vaccine and a negative COVID test.) For most of us, it starts with restoring an internal locus of control. It requires meeting our basic biological needs: sleep, regular movement, nutritious meals, and social connections. When our brains and bodies are rested, fed, active and connected, we’re better equipped to manage the stress of everyday life. We’re better able to quiet the noisy brain. We increase our reserves against anxiety and negative self-talk. We’re better able to find joy.
Health is also predicated on acceptance. (I wrote a piece for The Atlantic last month about this, titled A COVID Serenity Prayer.) While it’s difficult to accept that COVID is here to stay, we can use this moment to broadly and honestly reckon with how we live, work, love, and parent.
I ran a half-marathon in 2013. It was my first—and last!—experience with long-distance running. I’m glad I did it, but it wasn’t pretty. Half-way through the run my hip started hurting pretty badly, and I thought I’d have to stop. I didn’t; I just landed in physical therapy for a year afterwards. Reflecting back on that race, I distinctly remember what got me through it: 1) the encouragement from random people lining the sidelines, 2) a river of adrenaline coursing through my veins, and 3) visualizing the finish line.
While we have miles to go before the pandemic is over, the end is drawing near. As we head into winter, let’s be patient with ourselves. Let’s give each other latitude as we adjust to new realities. Let’s grieve over what we’ve lost and plan for better days ahead.
COVID has harshly reminded us what it means to be human. It can also help us redefine what it means to be healthy. Now is the time to visualize the other side and to ponder what we need—mentally and physically—to make it through.
I will see you next week. Until then, be well.