COVID Diary: Finding Solace in the Little Things

Illustration by Jon Reinfurt

By July 2020, COVID-19 was already entrenched in Massachusetts. It dominated the airwaves and the newspapers. And for most of us, it dominated our lives.

Dawn was breaking when I arrived at Upper Blackstone Clean Water near Worcester, one of the larger wastewater treatment facilities in New England, where I am on the senior staff and manage environmental lab technicians and compliance inspectors. The ground was still moist from a nighttime rain shower. Between my car and the brick-and-concrete ’70s-style administration building, I picked up every earthworm I could find—about 15 by my count—off the wet pavement and flung them onto the damp grass in front of the first-floor windows. Through no fault of their own, they had crawled to the wrong place at the wrong time, and the sun would soon be baking the parking lot and everything on it.

When I reached my desk, I closed my eyes and took a few deep breaths. It was time to put on my game face and greet the chemists, biologists, field techs, and compliance inspectors from my department who would soon be filtering into the office to begin their day.

My daughter, Erin, works as a nuclear medicine technician in the Boston area. Over the past few years, we’ve often talked about how COVID affects her job, and how it affects her. That same July, Erin told me about one of her most recent days on the job. She was tired, overworked, and hungry. But what broke her was a patient I’ll call Rosaline.

Rosaline was in her mid-sixties, with graying black hair tied tightly in the back. She was restrained in the hospital bed so she couldn’t pull the IVs out of her arm, the multiple drainage tubes out from a hole in her abdomen, or the intubation tube out from her esophagus. Rosaline was suffering from multisystem organ failure and drowning in her own body fluids. COVID was claiming her.

As we’ve seen so many times in the news, the COVID-19 virus is shaped like a small ball. Attach 254,000 of these microscopic viruses together end to end, and they will stretch out to a whole inch. Some scientists do not consider viruses to be living organisms. They are packets of genetic material that neither eat nor replicate in the traditional sense of sexual or asexual reproduction. But once inside a living organism, the virus commandeers the host cells’ DNA and reprograms it to make more viruses. Eventually, the host cells die, and all of the newly minted viruses spew out to infect other cells, repeating the process. When it comes to COVID, sometimes the infections are severe enough to overpower the body’s defenses. For patients like Rosaline, the virus was destroying her organs’ cells faster than her body could rid itself of the virus.

Erin entered Rosaline’s room dressed in workday scrubs, over which she wore a yellow isolation gown. Her mouth and nose were covered with a blue surgical mask over an N95, plus a full face shield. She was
double-gloved, in accordance with hospital policy. Before prepping Rosaline for her medical procedure, Erin live-streamed her daughter on a computer tablet so she could translate to her Creole-speaking mother information about the machines that would soon engulf Rosaline’s body. No loved ones were allowed by Rosaline’s quarantined bedside. Fighting against her restraining straps, Rosaline desperately tried to grab Erin, just to hold onto someone. Anyone. The want of human touch, a dying woman’s wish that Erin could not grant.

The 70 employees at Upper Blackstone Clean Water treat, on average, 30 million gallons of wastewater each day, representing the waste of more than a quarter-million people and the industrial/commercial sewage in Worcester and six surrounding communities. We use bacteria found naturally in the soil to break down human waste and organic material and convert nitrogen waste, such as urea, to nitrogen gas (the air we breathe is 78 percent nitrogen). We biologically remove phosphorus to protect local ecosystems, and we reduce or eliminate human pathogens from entering the environment. Given the importance of our work, we are staffed 24 hours a day, 365 days a year.

Between March and June 2020, I managed two alternating teams: one week on and one week off, with no crossover. The goal was to prevent a complete absence of employees should the virus infect one of the teams.

Taped-off areas kept the technicians isolated in their workspaces. Their desks, usually in a shared office, were put in whatever room or cubbyhole we could find to further reduce the potential for infection. Lab updates and meetings were done through email or the Microsoft Teams platform. Each tech was required to wear their lab coat, gloves, safety glasses, a face mask, and a face shield at all times. Breakroom chatter and group lunches ceased, as did almost all social interactions.

When we were talking on the phone another time, Erin told me of the mental strain she endured while working in a hospital overcrowded with COVID patients. Many medical procedures for non-COVID patients had been postponed during waves of different variants. That included cancer treatments, not only because of limited hospital beds but also because a COVID infection in an immunocompromised person may be a death sentence. Some of these patients would die anyway from their cancer due to a lack of treatment.

When Erin is under stress, she cries. This time, though, the crying wasn’t alleviating her anguish. The lump in my own throat was growing as I tried to tell her it was okay. She could tell from my change in tone that it wasn’t. Not yet. I was glad we were on the phone, where she couldn’t see the tears welling up in my own eyes.

By the summer of 2020, I had combined the two teams into one again but continued to keep their desk spaces isolated and require technicians to wear PPE. Each one of them was getting tired and snapping at the others. Not everyone agreed with our safety requirements. I kept reminding several to keep their masks over their noses and mouths and work in their assigned areas so that if one became infected with the virus, we could keep it from spreading. Some staffers began to voice their disbelief of the seriousness of the virus, ignoring COVID’s butcher bill of more than 1,000 deaths each day in the United States alone.

In early December 2020, one staff member tested positive. Within a couple of days, the whole department, except for me, had to quarantine at home. I called in a college student who had previously interned and was home for the holidays. The two of us attempted to do the work of nine people for the remaining days of the year. For the first two months of 2021, we went back to two alternating teams.

Our job during the pandemic became even more essential in the spring of 2021, after the CDC and other governmental organizations began tracking the presence of COVID in wastewater. As it turned out, infected people shed the virus through their bowel movements even if they don’t exhibit symptoms, so what better way to monitor the local infection status than through a wastewater treatment facility? Upper Blackstone Clean Water quickly signed on to be part of the study, which was used by the CDC, state health departments, and policymakers to help set public health guidelines.

Our first sample was taken on June 7. We used a programmable wastewater sampler to sip up a coffee cup’s worth of raw sewage about every half hour, then combined everything we got over 24 hours into one big sample. Three test-tube-size aliquots representing this daily composite were packaged into a special container, wrapped in an ice pack, and sent to a specialized laboratory for genetic analyses to determine the concentration of COVID.

I soon received the report showing that the Worcester area had an infection rate higher than 58 percent of the United States. I wanted to scream out to those who still doubted the virulence of COVID: “Look at the charts and see for yourselves!”

Just a few weeks later, Erin’s work at the hospital was almost back to normal. Based on wastewater analyses, the national infection rate was rapidly decreasing. It finally looked as though we were entering the last stages of the pandemic. Then Delta, which had been lurking in the background, became the dominant variant, and the infection rate quickly peaked in September.

Erin started spending her free time after work not with people but with dogs, strolling around the campus of a defunct suburban hospital that had become an unofficial dog park and watching the canines play. She made sure to pet every dog whose handlers allowed.

By late 2021, my staff was suffering. I didn’t hear laughter anymore. No more joking and ribbing one another. There was a lot more swearing, including from my mouth. I saw their dour faces as they performed their tasks from muscle memory. I was reminded of Samuel Taylor Coleridge’s poem The Rime of the Ancient Mariner, the cursed sailor lamenting: “Water, water, everywhere, Nor any drop to drink,” except replacing water with people who are yearning for social contact.

One day I brought in a case of wine and gave each technician a bottle. Soon after, I found a container on my desk full of homemade baklava. I ate six of them right away, then finished the other six later that night.

It seemed like those tiny acts of kindness helped bring us back together. As the weeks went on, I began to hear happy chatter again, even if it was just people calling out to one another from their isolated workstations.

In January 2022, Erin called to tell me the hospital was once again filling up with COVID patients. This time it was due to the Omicron variant. I told her I had already suspected that. About a week earlier, the COVID genetic analysis reports showed the beginning of an infection spike in Worcester. My colleagues in Boston reported similar results.

Erin’s voice started to break as she questioned whether she could handle another surge. I told her to pet more dogs this time. Do something. Even the little things help.

She told me she loved me.

The sun was shining through my living room windows on a cold day that same month. I had no idea where they’d come from, but there were half a dozen ladybugs crawling on the inside of my windows and a stinkbug on the sill. I thought about collecting them in a paper cup and letting them go outside. But would they survive in the cold? Maybe they would hibernate again. I really didn’t know. If I did nothing, they would certainly die, and I would be vacuuming up their desiccated bodies from the floor in a couple of days.

I did something.

I got a paper cup. Perhaps, like the earthworms, they might have a chance.

In 2022, as the days grew longer and spring turned into summer, Erin was still seeing COVID-19 patients admitted to the hospital—not as many as during the peak of the pandemic, but enough to make her wary of attending crowded events like church services and concerts. For her, dogs were still a cathartic option for her COVID anxiety.

As for me, I had become an expert on capturing and freeing the hornets that had somehow infiltrated my home, yet another insect that had found its way somewhere it wasn’t supposed to be. Somehow this activity tempered the queasy feeling I got from looking at the data coming into my office. Massachusetts still showed COVID waste­water results that were higher than most of the United States.

What will happen later this fall and winter when we move almost all of our activities indoors? What if the next COVID variant is more infectious, more virulent, or doesn’t respond to our existing vaccines? Will I be able to maintain enough staff to continue essential wastewater monitoring and testing?

Perhaps we’ll avoid a repeat of the past. That is what I hope, at least. That is what Erin hopes for. But from the figurative deck the both of us stand on, we still see shark fins in the water. They’re circling, even if the general population believes we are back to “normal.”

Since the beginning of 2020, the United States has lost more than a million people to COVID-19. When that reality feels too hard to bear, I find it helpful to refocus attention to the things we can control. Rescuing insects. Showing appreciation for coworkers. Petting dogs. The little things.

Tim Loftus is a laboratory manager and industrial pretreatment manager at Upper Blackstone Clean Water.