It's time to address the unprecedented grief surrounding the COVID-19 pandemic

Three times as many people have died in the United States from COVID19 than died on September 11, 2001, and we are not yet to the peak in most states. According to recent estimates, more Americans are likely to die in the coming weeks than in World War I, the Korean War or the Vietnam War — a scale of death many of us have never seen, and certainly not on American shores.                                                                                                        

Scholars and mental health providers have spent three decades studying death and grief, coming to understand the processes and best ways to care of the bereaved. Unfortunately, little of that research speaks to our circumstances.

Our understandings were designed to address a wide variety of experiences, but the kind of global grief we are experiencing — and our inability to physically gather together in its midst — is truly unprecedented. Unlike during wars, when we can come together to weep and grieve, we must learn now how to care for one another at physical, but not social, distance from each other.

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We can learn from chaplains and spiritual care providers at this moment — the skill professionals with kind souls who support those who are dying and the ones they leave behind. While much of what they usually do is less physically possible now, there are lessons in their actions that might help us all in these difficult days.

First, we must name the death we see around us. Americans in general, and hospitals in specific, tend to be death-phobic. Physicians often see death as a failure. Hospital chaplains name death for patients and families when no one else will, and help to facilitate conversations about people’s end of life wishes.

COVID-19 is proving too fast-moving for end-of-life conversations after diagnosis. This means you should have them now, while you can, even though you are afraid. Materials from the Conversation Project and the American Hospice Foundation can help get started. In naming death, chaplains create spaces and facilitate conversations between those who are dying and their families. This cannot happen now, as family members are rarely allowed inside healthcare organizations. 

Second, we — all of us — must attend to the shock and grief of those whose loved ones have died. Shock and grief are common in normal circumstances and more difficult now as people cannot be with their dying loved ones, accompany their bodies, and bury them in the ways most would hope. 

What can we do? Make phone calls. Listen. Gently accompany. Remind people that they are not alone. Spiritual and religious leaders are creating improvised memorial services by telephone and online services like Zoom that allow people to share stories. Chaplains across the country are listening and can be with us in our shock and grief, and to help us ease these early days of pain.

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And finally, we must begin to create new rituals — ones that can be done at physical but not emotional distance — to support those who have had a loved one die and the healthcare providers who were around them at the time. Chaplains frequently facilitate annual memorial services for everyone who died in the hospital that year, as well as the staff who cared for them. They know, as do those who created quilts for victims of AIDS and memorials for those who died in 9/11, that rituals and memorials matter. I think of a remembrance book at one medical center where everyone who lost a child before, at, or shortly after birth was invited to share their experiences. Families new to the book, in the early stages of grief, could read entries that came before. They could see that they were not alone, and that at least a few other people had lived through this pain. 

The agony and the truth of the present moment is that so many of us have loved ones who have already died, and that number is only going to grow. Unlike in the military where there is a formal process to notify next of kin when someone dies, there is little in the American play book to prepare us for the deaths we are experiencing. While many chaplains describe working around death as part of what drew them to their work, most of us would rather run away from death than toward it. Let us see in the tears around us a reflection of our own grief, and sew in our care for one another a new memorial quilt that can includes pieces of us all.

Wendy Cadge is a professor of sociology at Brandeis University and founder of the Chaplaincy Innovation Lab.