When not caring for COVID-19 patients—her latest was a man with bacterial lung and blood infections superimposed on SARS-CoV-2 pneumonia—Krutika Kuppalli has been helping oversee the rollout of pandemic vaccines at the Medical University of South Carolina (MUSC), where she’s an infectious disease physician. She has also been meeting with vaccine-hesitant hospital staff, sitting on a committee that reviews all planned COVID-19 clinical trials at MUSC, applying for funding to study patients with Long COVID, and handling online harassment that has followed her numerous media appearances and two rounds of congressional testimony last summer.
Asked recently during a Zoom interview how she is doing, she paused for nearly 20 seconds, struggling to regain her composure. “We have been busting our butts for 12, 14 months,” she says. “I just feel I’m empty.”
From academic research centers to intensive care units (ICUs) to scientific journals to government agencies, scientists fighting the pandemic say they are hitting a wall, 16 months after the first report of a cluster of cases of pneumonia in Wuhan, China, introduced the virus that would upend their lives. “The pace that led to the incredible generation of knowledge on SARS-CoV-2 and COVID-19 has put enormous demands on the people who are expected to generate that knowledge,” says David O’Connor, a viral sequencing expert at the University of Wisconsin, Madison, who has been tracking the spread of the virus, doing Zoom Q&A sessions with the vaccine hesitant, and helping neighborhood schools set up diagnostic testing. “This is a terrible time and we should all do what we can to help. But is it going to be sustainable?”
Throughout higher education many are feeling a strain from campus closures, remote teaching, disrupted research, work-from-home challenges, and more. For example, a survey of more than 1100 U.S. faculty members found 55% had seriously considered changing careers or retiring early because of the pandemic. The survey, conducted in October 2020 by The Chronicle of Higher Education and Fidelity Investments, also found that 69% of respondents felt stressed, 68% felt fatigued, and 35% felt angry—more than double the 2019 numbers. An international survey by the publishing house De Gruyter found a similarly bleak picture among medical and life scientists, specifically, although the numbers were small: Of 116 respondents, 76% said the pandemic had impacted their well-being; 30% said the impact was “severe.”
Physicians have borne much of the burden, says Mona Masood, a Philadelphia-area psychiatrist and founder of the Physician Support Line, a free call-in service staffed by volunteer psychiatrists. The help line has fielded calls from more than 2000 people since it launched 1 year ago; calls have peaked during pandemic surges, Masood says. Some are from doctors on the front lines—for example, an ICU physician who had just lost his 20th patient and broke down on the phone after a 48-hour shift. Others come from physician-scientists who, despite their work on vaccines or variants, feel guilty that they are not caring for COVID-19 patients alongside their colleagues.
For junior scientists, the crisis has magnified stresses already present in the academic system. “Everyone is working nights, weekends, every spare minute of their lives. There’s no extra pay. There’s no guarantee of any extra recognition,” says Emma Hodcroft, a computational biologist and postdoc at the University of Bern who has been tracking SARS-CoV-2 evolution for the project Nextstrain. “I am precariously employed; I don’t have a long-term job. I feel a lot of pressure that this is my opportunity and I cannot waste that,” says Hodcroft, who has been an author on 18 SARS-CoV-2 papers and preprints since February 2020.
Some academic scientists—especially those with young children—say their institutions have done little to alleviate their stress. “A few ‘atta-boys’ are tossed by the Provost to thank faculty for their flexibility with coping with challenging times, but no real differences implemented,” one senior lecturer wrote in a recent National Academies of Sciences, Engineering, and Medicine report that found a disproportionate, deleterious impact of COVID-19 on the careers of women in academic science, technology, engineering, math, and medicine.
The demands of reviewing or editing an unceasing glut of coronavirus papers have also been backbreaking for some. “They did replace me with two people. That tells you what my workload was,” says one biology manuscript editor who recently left a top-tier journal and asked not to be identified for fear of career repercussions.
Scientific societies have, in some cases, tried to step into the breach. The American Association for Anatomy (AAA) in October 2020 launched a website of self-care resources called THRIVE in response to “cries for help” from members, largely Ph.D. anatomists who teach and conduct research in medical schools, says Shawn Boynes, AAA’s executive director and the prime mover behind THRIVE. The website, which is open to all, has had roughly 3000 monthly visitors, but Boynes says it is at best a Band-Aid. “Why isn’t more of this addressed at the institutional level on a regular ba-sis? The pandemic pulled the curtain back and you can see how unbelievably challenging it really is with people who choose academia as a career.”
The challenges extend beyond academia. At the Centers for Disease Control and Prevention (CDC), for example, the burden of being the front-line agency responding to the pandemic has taken a major toll. “This question of burnout, personal and professional, is the No. 1 thing I talk about with friends” at the agency, says a senior CDC epidemiologist who has worked at a high level in the pandemic response. Some midcareer CDC scientists are talking about early retirement—a choice that was almost unheard of before COVID-19, they add.
Still, other scientists grappling with the pandemic say that despite the pressure, they have never felt more fulfilled. These past 15 months have been “the hardest of my life,” says Sarah Schmedes, lead bioinformatician at Florida’s Bureau of Public Health Laboratories. Schmedes is adjusting to being a single mother to a 1-year-old son after her husband died of a heart attack in December 2019. “It definitely helps that I love my job. Being in this field at this time is incredibly rewarding. I’m very honored.”
Marion Koopmans, chief of the viroscience department at Erasmus Medical Center in Rotterdam, Netherlands, says she has been working at least 8 a.m. to 11 p.m., 6 or 7 days a week since the pandemic began. Recently, she traveled to Wuhan as part of a World Health Organization team investigating the pandemic’s origins, while still managing a 150-person lab in Rotterdam. “I don’t feel like I’m burning out,” she says. “I can actually do things that contribute to getting through the pandemic. At least that’s what it feels like. And that helps.” Still, she says, she is taking measures to protect a modicum of personal time so she can watch Anne with an E on Netflix or share a nightcap with her husband. “I ask the strictest secretary to block my calendar and route my emails through her.”
But O’Connor emphasizes the need for the community to take broader steps. “A year into this, we need to assess: What does the future look like? Does it look like the same workforce being asked to do twice as much as they were doing before? I don’t know what the right answer is, but the number of times [recently] I’ve heard ‘I’m just done with this’ uttered in frustration from friends and colleagues is really concerning.”
Kuppalli for her part does not see an end to her own exhaustion in sight, in part because whenever she is asked to do one more thing to fight the pandemic, “I don’t feel like I can say no. Because it’s larger than me and I feel lucky to be in a position to contribute.
With reporting by Charles Piller.