SANTIAGO, Chile — I live here in the capital, in the south of the world, with the Pacific Ocean on the west and the Andes due east. Chile is a country that is recognized for its wonderful, diverse nature but also for its intense sociopolitical processes. Since October 2019, the country has been facing a complex political crisis because of social inequities and other factors. Santiago, an active, populous city of more than 5.6 million people, has played a central role in the crisis with many people advocating in street protests for political changes.
March is when people return to work and schools, after summer vacations. This March was expected to be different because social movements were ready to restart their push for political transformations. In April, a referendum was scheduled to decide on changes to the national constitution.
But 2020 has offered a special surprise for Chile — and the rest of the world. The Covid-19 pandemic arrived with its first case in our country on March 3. The national agenda progressively changed. The referendum was rescheduled for October. TV channels have been overwhelmed with news about the dissemination and impact of the coronavirus. Here I am, in the middle of this real story.
I am a family physician and public health specialist. I work in a local university, mainly in the area of primary care and mental health, with a population approach. I also do some clinical practice. In that setting, Covid-19 has had a big impact on my daily life. National authorities decided to carry out an array of preventive measures, including local lockdowns by geographic sectors. The municipality where I live has been one of the areas quarantined. I am at home most of the time now. All my academic work is done from my computer. My clinical activities are scheduled every two weeks, in a shift system, at the outpatient health center.
Being a clinician right now is quite challenging. Even when I have just a few days of clinical work and in a nonhospital setting, I can feel the passion I experienced when I first decided to be a health professional. This is the time to be there, serving the best way I can. At the same time, I know that being in the thick of things implies a higher risk of being infected by the virus and that once you get infected, nobody knows what can happen. So it is a mix of feelings I am dealing with: commitment, anxiety and fear.
Health professionals are both highly supported by the community for being in the front line, ready to serve, but they can also be a target for stigma and discrimination because of our exposure to Covid-19. I feel the tension. There have been some nights where people have organized to clap health providers for their role. That has been immensely powerful and encouraging.
Other days, however, there are unexpected restrictions put on health professionals, generated by some people without enough evidence to place such rules on others’ lives. For example, I have heard about cases of health professionals being restricted from using elevators in apartment buildings, even when taking all preventive measures. That is sad.
Work meetings are done from home. In my public health department, the main topic is Covid-19: analyzing data of the pandemic and discussing ideas for enhancing the government’s response. At the same time, I and others in the profession do our best to keep our relatives and friends close in these challenging times. For instance, we coordinate some telemeetings with significant others, so we can talk and support each other.
I worry about the mental health implications of this reality. Social isolation and economic problems are fostering health issues. That constellation represents a tremendous risk for our individual and collective mental health. Being a health professional during the pandemic implies an added potential risk for substance abuse and/or mental health decline. We need to take care of ourselves.
I am participating as a collaborator in a new multicountry project to assess the effects of Covid-19 on mental health among health professionals. It includes an online survey for health providers in five continents. We hope to better understand the impact of Covid-19 on health workers and to identify the best way to foster national and global responses to support them as much as possible.
Now we are near the middle of May. A couple of weeks ago, some people were talking about a coming “new normal” that may imply months or even years living with the Covid risk around us. There was a big debate about when and how citizens should or should not return to work and other activities. However, in the last few days there have been many new confirmed cases appearing in Chile — currently there are 31,721 (and worldwide, nearly 4.3 million). Most of the cases in Chile are located in the Metropolitan Region, which includes the capital, and they are progressively affecting low-income areas of the city.
Chile is expecting it will overcome the pandemic, but it also needs sociopolitical changes to enhance equality and recover a real sense of community. This is the time to create a better society not only in Chile but also worldwide, a society where love, peace and justice must reside at the center of everything we do. We must jointly work for it!
This essay is part of a series of people who work in international affairs or global health relating their experiences during the pandemic from across the globe: Vienna, Chicago, Singapore, Madrid, Beirut and Geneva.
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Jaime Sapag Muñoz de la Peña is a medical doctor who specializes in public health and is on the faculty of the Pontifical Catholic University of Chile in Santiago. https://medicina.uc.cl/persona/dr-jaime-sapag-munoz-de-la-pena/