Faith,Hope,and Love in the Time of COVID

The COVID-19 Pandemic

In late 2019 an atypical pneumonia-like illness was discovered in a cluster of individuals in Wuhan, China. Those afflicted with this condition did not respond well to standard treatment, and it was thought to be a resurgence of the 2002-2004 SARS outbreak (Severe Acute Respiratory Syndrome Coronavirus or SARS-CoV-1). However, researchers discovered that it was a novel coronavirus, a new strand, designated SARS-Cov-2. ¹

Coronaviruses, first discovered in humans in the 1960s, are a family of viruses within the order Nidovilas viruses, which replicate using messenger RNA. The coronaviruses are further classified into alpha, beta, gamma, and delta subgroups. They are called “coronavirus” because of their “crown like” appearance under an electron microscope. ² They cause “common cold” symptoms.

The world watched as the virus spread. On March 3, 2020, the CDC reported sixty cases of COVID-19 in the US, and on March 11 the World Health Organization declared it a pandemic. ³ On March 13 the Trump administration proclaimed COVID-19 a national emergency, and individual states began implementing shutdowns on March 15. ⁴ All non-essential workers were urged to stay home and isolate, and my own state of Alabama “closed” for 6 weeks.

Over the past two years the virus has replicated and evolved into multiple strands. Currently the virus produces “sinus-like” symptoms in many individuals; however, for those with multiple pre-existing conditions, it still may be deadly. Unfortunately, it seems that COVID is here to stay.

Faith

The initial COVID outbreak forced me to put my faith into action. In March 2020 I was in between full-time jobs, still working part-time as a physician in an urgent care facility and part-time at a nearby community hospital. I had accepted a job at the Poarch Band of Creek Indians Health Department, but all operations were closed, only functioning through telehealth and in a limited capacity. As I watched COVID casualties increase daily, I felt helpless and totally unproductive. I saw make-shift hospitals emerge and refrigerated containers brought in to store bodies as hospital morgues quickly filled. I had medical training and time—yet nowhere to go.

Several weeks later I received an email asking if I could leave the next day for Atlanta to staff a field hospital at the Georgia World Congress Center through a partnership with Grady Memorial Hospital. Grady serves a vast number of persons in Atlanta who have limited resources and little access to healthcare. I immediately responded that I would go—even though I was high risk due to an underlying, chronic medical condition.

To many around me it seemed foolish. They told me it was inevitable that I would contract the virus and die. Family members feared for my life and safety. I wrote the following in my journal on April 16, 2020: “Faced with an opportunity to go to Atlanta and work with Coronavirus patients at the World Congress Center with a lot of unknowns. Feels like the time I drove to Nashville and waved to my dad in the rear-view mirror. Of course, the easiest decision would be to shelter in place at the beach, enjoy the sun, stay safe and well. The harder decision is whether to go—to put myself in harm’s way taking care of others.”

My faith led me to go, following the call in Isaiah —“Here I am Lord; send me!” (Isa 6:8). As I have reflected on my quick decision to go, I have thought about what faith really means and how it is manifested in action. Faith is confidence or trust in a person or thing or a belief not based on proof. An individual may place his or her faith/trust in many things: social status, education, financial resources, family heritage, employment—and this faith is followed by actions, attitudes, and behavioral patterns. For instance, I can say that I have faith that a chair will hold me; however, my belief is merely an intellectual assent until I put my weight in the seat. As Paul David Tripp argues: “If your faith does not reshape your life, it is not true faith. . . real faith rearranges your life.” ⁵

The book of James describes faith as it manifests in meeting the physical needs of others: “What good is it, my brothers and sisters, if you say you have faith but do not have works? Can faith save you? If a brother or sister is naked and lacks daily food, and one of you says to them, ‘Go in peace; keep warm and eat your fill’, and yet you do not supply their bodily needs, what is the good of that?” James 2:14–16 NRSV. Similarly, in a letter written by Bishop Dionysius of Alexandria (3^rd cent. CE) he describes how Christians ministered to the sick and dying, even though they became sick themselves and soon died. ⁶

Hope

To hope is to expect with confidence. Despair, on the other hand, is to give up or lose hope. Many conflicting thoughts and feelings surfaced in conversations and opinion pieces when COVID-19 emerged. Some though it would remain in China; others hoped it would last only a few weeks. Many placed confidence in the CDC and medical professionals, while others did not. ⁷

Humans often rely on reason to make sense of the world: we follow a logical “if . . . then” formula. For example, “If I wear a mask, isolate, and get vaccinated, then I will be okay.” Or, “If I am young and healthy with no pre-existing factors, then I will not die from COVID.” However, this virus has not followed rational formulas. On any given day symptoms may range from asymptomatic to loss of taste and smell to multiple organ failure requiring mechanical ventilation. Healthy “young” people have died while older individuals who are “high risk” survived. There is often no rhyme or reason. In working with the Poarch Band of Creek Indians I was assigned the task of developing COVID treatment algorithms. For each presentation of symptoms, there were different protocols. Often patients would say, “I still have my sense of taste and smell but have stomach problems, so I’m sure it’s not COVID.” They would then have a positive COVID test. Not following logical, predictable patterns, COVID has confounded those whose hope depends on reason. There is no guarantee that you or I will be okay regardless of our vaccination or overall state of health, or that our symptoms will mimic someone else’s.

Humans tend to trust medical knowledge to guide our choices. In many ways I became a doctor to have answers, to be a problem solver, to attain insight so that I would know how to treat a patient’s condition. However, on the frontline of this novel virus, medical knowledge literally changed from day to day. Treatment recommendations started with Azithromycin, an antibiotic, and moved to hydroxychloroquine, prednisone, remdesivir, monoclonal antibody infusion, Paxlovid, and then to treatment of symptoms only. Meanwhile, vaccines were being developed amidst evolving COVID strands. Constantly changing medical information, treatment plans, and recommendations provided uncertain foundations. Moreover, medical technology has not solved all COVID-related problems.

Lastly, we hope in institutions. Government, financial, educational, religious, and healthcare institutions experienced upheaval during the onset of COVID. Federal, state, and local governments operated with skeleton crews, many working off-site. The Wall Street trading floor closed for two months and did electronic trading only. Schools quickly switched to “virtual learning”—college students left dorms and returned home, while international students scrambled for housing. Churches stopped meeting together for worship services; weddings and funerals were postponed. Healthcare workers faced burnout and exhaustion, many leaving the practice of medicine altogether and some closing private practices due to lost revenue.

Factors such as unpredictability, job insecurity, social upheaval, loss of freedom, conflicting messages, constantly changing information, economic hardship, resource shortages, and increased workloads left many feeling vulnerable, lonely, and hopeless. Meanwhile, across the United States people watched as individuals were brutally murdered—Ahmaud Arbery, George Floyd, and Breonna Taylor (to name a few). Instability was everywhere, and racial injustice openly exposed. To many it seemed like the world was coming to an end.

Depression and anxiety have both increased since the pandemic began. The CDC began monitoring symptoms of depression and anxiety through the “household pulse survey” and began collecting data on April 23, 2020. Depression rates increased from 5.9% to 7.5% from January to December 2019. From April 202 to August 2021, depression increased from 20.2% to 31.%. Anxiety went from 7.4% to 8.6% from January to December 2019, compared with 28.2% to 37.2% from April 2020 to August 2021. ⁸ According to the Boston University School of Public Health, one out of every three Americans is suspected to have depression, with low-income individuals seven times more likely to experience depression. ⁹

Yet the resolve of so many healthcare workers shows us that hope still abounds. Hope becomes “an anchor for the soul, firm and secure” (Heb 6:19). I found hope in working alongside others at the field hospital and later in the Poarch Creek Health Department. At the Georgia World Congress Center, healthcare workers flew in from across the country. They represented multiple disciplines: nurses, emergency medical technicians, physicians, medical assistants, nurse practitioners, physicians’ assistants, and infection control specialists. Being “in the trenches” together, we were all learning, each of us neophytes to this virus and its ramifications. We were only allowed to spend four hours at a time in the “hot zone” (with patients)—so in between we sat in a large area with tables and talked or walked around the area inside for exercise. With so much down time, we were able to hear one another’s stories—and to this day I keep in touch with some colleagues from this experience. There was hope in being part of a team, not being alone.

Love

The COVID pandemic has revealed vast discrepancies in morbidity and mortality between individuals of color and White Americans. Some people have suffered more due to systemic social inequality—those most severely affected are those with disparities in the “social determinants of health” (SDoH). The term social determinants of health is not a new one, but it gained popularity when adopted by the World Health Organization in 2003—referring to the conditions in which people are born, grow, live, work and age. Factors of SDoH include socioeconomic status, education, employment, social support networks and neighborhood characteristics. ¹⁰ Social determinants of health have a greater impact on population health than biology, behavior, and healthcare. Poverty, structural racism, and discrimination are the primary drivers in health inequities.

The New Testament provides a model for how our society, particularly the church, could address this situation. According to the book of Acts, the earliest followers of Jesus cared for all neighbors:

Now the whole group of those who believed were of one heart and soul, and no one claimed private ownership of any possessions, but everything they owned was held in common. With great power the apostles gave their testimony to the resurrection of the Lord Jesus, and great grace was upon them all. There was not a needy person among them, for as many as owned lands or houses sold them and brought the proceeds of what was sold. They laid it at the apostles’ feet, and it was distributed to each as any had need. (Acts 4:32–35).

The early church attempted to follow this model. For example, in 325 CE, the Council of Nicea directed that hospitals be established in every town in which there was a cathedral. ¹¹ These hostels or hospitals (from root word “hospitality”) were places of refuge for weary travelers, the sick, or the poor. Many monasteries provided these facilities, providing housing, shelter, food, and medical care—however, the overall priority was spiritual care.

In the early history of the United States, many Christian denominations built or founded hospitals. Many of these hospitals are no longer affiliated with Christian ministry but have become secular healthcare entities and corporations.

Unfortunately, as Christianity has evolved in the U.S., the church has stepped back from its role of service as a provider of shelter and as caretaker for those in need. The church has left those tasks to other organizations. Churches may donate to these other institutions but leave most of the work of caregiving to them. In many cases, the church outwardly has become more like a country club, a place of comfort, safety, and security, where one may be surrounded by economically, culturally, and politically like-minded individuals. Many churches are protective of their buildings, and few churches will open their doors to travelers, the sick, or the poor, except on a limited basis, and only on their own terms. In some churches, it seems that seeking personal growth and fellowship with like-minded people has become more important than service and sacrifice.

A Case Study

Fortunately, there are examples of church communities rallying to help those in need. One of our church members, a single mom with multiple medical problems who is confined to a wheelchair, passed away from COVID in September 2021. She had moved to Montgomery, Alabama, in 2016 and was homeless with a ten-year-old son. After obtaining a rundown trailer with dilapidated floors, she began calling churches to see if anyone would be able to drive her and her son to church. One of our pastors volunteered to pick them up weekly, and they were welcomed into the church family. In August 2022 she was found unresponsive at home. Her son, who was with her, was also extremely ill. Both were positive for COVID. She was hospitalized and placed on a ventilator. She died at age 48.

This single mother had given specific instructions for one of the families in the church to raise her son if anything happened to her. Our church gathered a group to care for this teenage boy who had already faced so many hardships in his life. One paid for tuition, others took him for weekends, and the pastor invited him into his already bustling home of five kids, his own parents (father with dementia) and mother-in-law. I watched with renewed hope and joy as this orphan literally was adopted by our village and loved.

Conclusion

I have genuinely struggled with finishing this essay because the need is still so vast, and I feel overwhelmed. In many places, like Atlanta and Montgomery, the needs are largely practical. People require medical, dental, and mental healthcare. They need health education, fitness instruction, and access to good nutrition. As a medical professional and person of faith, I urge all readers to consider the needs of our neighbors and reach out in faith, hope, and love to address those needs. I appeal to all readers to work to change systematic racism and the inequality of poverty in their communities. Though the task may seem overwhelming, we can look to the total commitment of the healthcare workers during the COVID pandemic as an example of courage and hope to emulate. The early church in the book of Acts and the example given above of a church’s radical response to a family in need are examples of what this change could look like in our own churches and communities today. The COVID pandemic has made it plain that we need to make a firm commitment to healing, service, and sacrifice, to show love and care for those in our communities who desperately need our help.