What made America’s Covid death toll even worse: the gnawing pain of human separation

·9 min read
<span>Photograph: John Moore/Getty Images</span>
Photograph: John Moore/Getty Images

In the middle of the night on 20 August last year, Gordon Robertson received a phone call from the Florida highway patrol. The officer had pulled over his brother, Bruce, who was disoriented and claimed he was coming to see him.

“I’m thinking, that’s really odd: I had told him he was not allowed to come up here and visit until he got vaccinated,” said Gordon, 71, who lives in Longwood. “I asked him a dozen times, ‘Bruce, you gotta get this. You gotta get this.’ And he wouldn’t do it.”

Related: Covid cases rise in north-eastern US, driven by the BA.2 subvariant

It was the beginning of a story that highlights the impact of the Covid-19 tragedy in the US. From social distancing to vaccine disagreements or an inability to visit people who were sick in the hospital, a common symptom of the pandemic was human separation – sometimes permanent, in the case of the roughly 1 million Americans that Covid has now killed.

Many of those losses have been especially hard precisely because of the separations involved – not only because family and friends couldn’t be with victims before they died but also because many couldn’t go through the usual grieving rituals afterwards. According to experts who study grief, the toll of the virus counts not just the 1 million deaths, but the immeasurable isolation that accompanied them. And for the people who died unvaccinated by choice, the sorrow among those who knew them was tempered by frustration that the deaths could have been prevented.

In Bruce Robertson’s case, his life before Covid was the opposite of isolated. He lived in Lakeland, Florida, and worked for AT&T for years before he retired. He would walk several miles each day and was in good health, his brother recalled. He volunteered in the kitchen at a Seventh-day Adventist church, feeding homeless people.

And he watched The Jim Bakker Show. A streaming program hosted by the infamous televangelist, it falsely touted “silver solution” as a cure for Covid.

Bruce concluded that he didn’t need the vaccine. “He said, ‘I’m going to live to 100,’” Gordon recalled.

So Gordon politely insisted that he not visit until vaccinated – which made the phone call from Florida highway patrol so baffling. The officer drove Bruce home, Gordon said, and the next day a friend went to Bruce’s house to discover a lawnmower in the middle of the yard. Bruce answered the door not fully clothed. Inside, food was spoiling on the kitchen counter.

The friend called 911. At the hospital, Bruce was diagnosed with Covid. A nurse told Gordon that his brother’s delirium was a symptom of the virus, and that it was common among infected older adults. Bruce insisted to Gordon that he had a little cough but otherwise felt fine.

“He said, ‘I hate it here. There’s no sports on TV,’ and that’s the last thing he said to me,” Gordon said.

The next day the nurse told Gordon that his brother was on oxygen. A day later, the nurse said he had a blood clot in one of his lungs. They could intubate him but he would be in intense pain. The family agreed to just make him comfortable.

Covid-19 social distancing guidelines at the Beardsley Zoo in Bridgeport, Connecticut, in March 2021.
Covid-19 social distancing guidelines at the Beardsley Zoo in Bridgeport, Connecticut, in March 2021. Photograph: Andrew H Walker/Rex/Shutterstock

Gordon has mixed feelings about not seeing his brother before he died: his stepson also had health issues, and he felt he needed to protect him.

“I just couldn’t take the chance that [Bruce] might have” the virus, Gordon said. “I felt kind of guilty, that maybe I should have seen him before he got sick. But it was kind of his choice, and I couldn’t do anything about that. You can’t make people do what they don’t want to do.”

Adapting to Covid deaths had been made exponentially harder, experts said, because people couldn’t watch their loved ones die.

Geraldine Smith, whose husband died before vaccines were available, has spent much of the pandemic trying to educate people in St Louis about the virus and vaccines. Her husband, Carl, was a pastor who founded New Beginning Missionary Baptist church in North St Louis county in 1997 while also working as a police detective; he had started a narcotics training program for local teachers and parents.

“My husband was a pastor who met the people where they were,” including in the streets, Smith said.

On 29 March 2020, the pastor was delivering a sermon online when Smith noticed sweat pouring from his brow. She didn’t feel well, either.

“After he completed his sermon, I told him, ‘Something’s wrong,’ ” Smith recalled.

They went to ER and were tested for Covid, but it took two days to get the results. Doctors discharged Geraldine but kept Carl because his heart was racing. On the third day, after his heart rate returned to normal, she returned to take him home. Carl told her, “I’ve lived a good life.”

“I kept wondering why he said that to me,” she said.

A couple of days later, her own condition worsened. She called 911 and an ambulance brought her to Christian hospital in north St Louis county. “I stayed there for 25 days, and I did not know that I was in this world,” she recalled.

Doctors eventually woke her up from an induced coma, and told her that Carl had died.

“It was devastating – but the reason why it was so devastating was that I was not able to be with him,” Smith said.

Smith’s reaction has been a common one during the pandemic, said Mary-Frances O’Connor, a psychologist who researches grief at the University of Arizona.

“Many people have not been able to spend time at the bedside in a hospital or long-term care facility, and that is very unusual for human beings – not to be able to provide that care,” O’Connor said.

“People I have been doing research with just tell me, ‘It feels like it hasn’t sunk in. She was here, and now she’s not here, and I didn’t get to see anything in between.’”

Smith eventually came to terms with it as best she could. She continues to experience fatigue and short-term memory loss but now works at Show Me Hope, a crisis counseling program – and said she now understands why her husband told her he had lived a good life.

“He had done his work, and God had said, ‘It’s time. Come on home and get your rest.’ God makes those decisions, and I accepted God’s decision,” she said.

Kim Bell saw multiple deaths a week. A nurse at Saint Anne’s hospital in Fall River, Massachusetts, she had plenty of experience with death from working in a cancer unit.

“No one is ready in America” to die, said Bell, 58. “But it doesn’t have to be bad. I always say to people, ‘I can make sure your dad is comfortable. I am more worried about you.’ It’s a whole family thing.”

When the pandemic struck, the hospital converted her unit for Covid patients. They started losing about five patients a week, she said.

Bell and many of her colleagues became depressed. Her doctor prescribed her an antidepressant, which she said helped. A Journal of General Internal Medicine study published in December found that among 500 doctors, nurses and first responders surveyed, 74% reported symptoms of depression; 37% reported symptoms of post-traumatic stress disorder; and 15% reported thoughts of suicide or self-harm.

“I don’t know what being a soldier is like, but it really did feel like being a soldier. You were exhausted, scrappy, dirty, sad, overworked. You never knew what you were going to walk into,” said Bell, who also felt like she was “barely a parent” to her two children, one of whom also grew depressed.

Just as Bell tried to help cancer patients’ families, she tried to do the same for Covid patients. One 53-year-old Portuguese woman who ended up in Bell’s unit stood out. “It was like going to see a friend,” Bell recalled.

The woman had not been vaccinated because her son and daughter-in-law didn’t believe in it, she said. When she was eventually put on oxygen, the woman was “sweaty, panting and just looked scared”, Bell said. “More than once I heard her say, ‘My kids lied to me. They lied to me,’” about the vaccine.

She did not survive. Later, when Bell spoke with the woman’s family, she said, “Please, for your mother’s sake – as a tribute to her – get your whole family vaccinated. Because she does regret it.”

These days, Bell does not have many Covid patients. She no longer needs the personal protective equipment used throughout the pandemic. And she no longer is depressed.

“It just feels so much easier. We can breathe again,” Bell said of not needing all the PPE. “I don’t know how I got used to not breathing for those long days.”

For Gordon, things are not much easier. His brother’s death still feels unresolved. “The thing missing from my brother’s death was the absence of closure,” Gordon said. “It seemed, and continues to seem, unreal. No family gathered to say goodbye, no memorialization due to Covid restrictions.”

The terrible strangeness of it was only underlined when another tragedy struck the family. In January of this year, his wife Linda’s son, Stephen, died in his chair while watching television. He was 50 years old. The family suspects a heart attack.

They are planning a memorial service to celebrate Stephen’s life, Gordon said – while in his brother’s case, there was only a small service at his church, which Gordon didn’t find out about until later. He wouldn’t have gone anyway, he said: it was the height of the Delta surge.

Today, he has a third dog: his stepson’s. When his neighbors would remark on the new companion, and he told them the sad story, he learned four of them had also lost their adult children. People dropped off food and cards.

“It makes neighbors become real neighbors again, which kind of was a lost art for a while – probably because of the pandemic,” Gordon said.

As a semi-retired consultant for car dealerships, he continues to hear stories – about salespeople, parts department workers and office staff who have died.

“It’s just been an awful couple years,” he said.

“I don’t think people realize that every one of that ‘million’ number is attached to two, four, 20 people – so you’re talking 50 million people.

“Who knows how many people this affected?”