The worst days of the spread of infection in our country’s COVID-19 pandemic were not in April after all. They were last week.

There was never really any reason to think the pandemic was winding down, no matter how much reopening was being allowed, but does this mean we have to remain in crisis mode for the rest of the year?

Thankfully, it maybe doesn’t.

One way to think about the response to the pandemic is through a notion called threat vigilance. That means never dropping your guard to the things that might hurt you. And it is exhausting.

After the first stay-at-home orders this spring, those out for walks in St. Paul started giving each other wider berths until it was common to see people cross the street rather than pass by on the same sidewalk.

A courtesy? Maybe, but it was likely driven by concern. So much for a relaxing walk — until crossing to the empty sidewalk becomes a new, unthinking habit.

That is a little like what has been happening in business, as a common topic in conversations in the past 10 days with leaders of organizations is they are not spending so much time in emergency video calls. They are still really busy, but with more one-on-one conversations or visits to facilities.

This pandemic changed daily life for everyone, said Theresa M. Glomb, a professor and organizational psychologist at the University of Minnesota’s Carlson School of Management. There remains so much still not known, she said, that if the stress level has slipped it is because we are “more comfortable with the discomfort” of not knowing what’s going to happen.

Workers want a sense of security at work, she said last week, after bringing up the idea of threat vigilance. Of course, people who have been furloughed or laid off have a whole other level of stress.

But working at home isn’t stress-free either, as the boundary between home life and work disappeared.

Small children have accidentally joined meetings and calls have kept going well into the evening, because everyone was home anyway. One of her friends, Glomb said, has taken to preparing a new cocktail at the end of each workday to mark a clear transition between work and home.

In addition to worker burnout, she has been thinking about the difference between what is sometimes called the peacetime CEO vs. a wartime CEO. It is the same job but in completely different environments.

As she described it, in peacetime the boss can work on building the skills of the team and fostering relationships to ensure there are contributions from everyone. The wartime CEO needs to become narrowly focused and sharply decisive.

Hopefully it is the same person, just working differently.

“You would think, in this crisis, that we need the wartime CEO,” she said. “You could also make the other argument, that this is tough for people. And so how do we have someone who can be more supportive, and nurture people, and lead with empathy? This could be the more important work.”

One industry from which you would expect to hear stories of stress is health care. But here again, that stress in Minnesota’s settings may have eased from earlier this year, even as new COVID-19 infections continue to be confirmed every day.

Health care had a problem of worker burnout, the cumulative effect of stress, well before the pandemic. It is one reason why Minneapolis-based M Health Fairview has Dr. Bryan Williams, an intensive care physician, doing an extra job called system director of well-being.

The coronavirus crisis for health care organizations was mutli-faceted, as they hustled to build capacity for COVID-19 patients even as much of the other work of hospitals and clinics went on hold. That led to furloughs, layoffs and pay cuts.

Since the pandemic began, M Health Fairview has not done any formal surveys of staff morale, Williams said, instead relying on its management reporting to learn where the stress has built.

The organization knew this pandemic wasn’t going to be quickly over. It converted Bethesda Hospital in St. Paul to only treat COVID-19 patients. For the people working at Bethesda, the stress over the uncertainty of whether a patient had the virus was gone: since everyone had it, the staff could prepare mentally, emotionally and with equipment.

Obviously there have been tough times this year, Williams said, largely “the good kind of stress that forces us to change the way we do things.”

The organization has been pulling back from the central command style of leadership used this spring. Daily calls have continued, but they were implemented several years ago to help knit together a health system made up of different parts, including the big HealthEast system that merged into Fairview in 2017.

“It was interesting, with COVID, how quickly that paid off,” Williams said. “When we built Bethesda, we needed people from the entire organization to come to it. It’s sort of like the United Nations of health care systems coming together.”

Temporary intensive-care nurses have been used as well as staff from other departments, but as normal procedures have picked up staff members have gone back to their old jobs.

“Which brings up an interesting query, and that’s what happens if [COVID-19 cases] resurge,” Williams said. “We are going to try our best to stay full functioning, which we need to do. That’s something we’re actively thinking through, making plans for. As of now we have the capacity for it.”

The greatest stress of this year, of course, was from fear earlier that our health care capacity wouldn’t be enough, that social distancing measures and changes in behavior came too late or were too sloppily followed to slow the spread of infection. As of now, that system-crushing surge has not happened.

Asked if he remained hopeful, Williams said it depended on the topic, mentioning among things his worry over the financial strain on health care.

“I like going down [to Bethesda] to care for patients,” Williams said. “It is not a place of desperation, it’s a place of hope. We’ve saved hundreds of lives there.”

 

lee.schafer@startribune.com 612-673-4302