For over a year, I have watched and witnessed the multitude of ways that COVID has ignited crisis after crisis in our country and across the world. At first, the crisis of the unknown and the ill-prepared – we as health care professionals did not know what we were dealing with, nor did we even have the resources to battle it as we watched other areas of the world helpless to help them, but also helplessly awaiting the predicted incendiary events of globalization that would spread COVID-19 throughout the globe.

Then it was the medical crisis that ensued — the lack of knowledge of a novel and lethal virus. The lack of treatments stemmed from that lack of understanding about how the virus inflicted sometimes differing severity of disease or complete multi-organ system failure and death. And, finally, the long-term effects of COVID affecting individuals and producing.

“COVID long-haulers” who will never have their health return to pre-COVID times and also quite possibly never in their own lifetime have the medical community understand why they were permanently affected.

Then it was the mental health crisis — the mental health of children not in school, afflicted by missed opportunities of life like graduations, sporting events, birthday parties, and lack of social interaction that feed developmental milestones. The mental health toll on the sick. The mental health toll on those caring for the sick.

The mental health toll on loved ones of the sick and the dead. The mental health toll on essential workers who could not stay home. The mental health toll from the financial burden of lost employment, furloughs, and pay cuts. The mental and actual load on families, mothers in particular, who have left the workforce in droves to accommodate a total introversion of life with little or no outside support.

And, lest we not forget, the financial and economic crisis of this past year. Thousands, if not millions, of businesses lost, millions of jobs lost, financial insecurity, economic insecurity.

Glaring examples of socioeconomic and racial disparity, all highlighted by an invisible enemy, packaged in a microscopic virion.

With all of this, we don’t seem to be done, unfortunately.

What will begin to emerge publicly and already has privately is the impending familial crisis: The rifts between families that don’t agree about anything and possibly everything related to COVID, how to prevent infection, and protect family and friends. Increased time spent within confined spaces leads to an increase in substance abuse, domestic violence, abuse, and divorce. Distant family and friends who don’t understand each other’s choices and can’t allow for everyone’s choices for themselves to be acceptable.

The COVID pandemic has increased physical time together with immediate family, but in many cases, created distance and isolation and even cracks in the foundations of families and friends that will never be repaired.

In my own family, for example, I have been highly criticized for falling on the conservative side of public health and safety recommendations. I’ve also been building my own resentment for family members that have decided to travel and see each other with what feels like not only reckless abandon but also blatant disrespect for and disregard of the multitude of sacrifices we have made over this very trying year.

But it is not only COVID’s burden to bear for this last aforementioned crisis.

The last crisis of COVID’s catchment seems to be the public health information crisis — the consistently inconsistent, contradictory, and vague recommendations that serve to introduce gray areas left up to interpretation by individual states, counties, and people.

Without clear and comprehensive guidelines, families and loved ones that fall on opposite sides of risk tolerance and interpretation are divided. They have nowhere to turn but against each other, grasping at whatever information that they can find to suit their individual beliefs. There is literally no captain of the ship, and it is a battle to the end of “right” versus “wrong,” “safe” versus “unsafe,” “united” versus “divided.”

The most recent guidelines put out on April 27th, 2021, further this crisis. Vaccinated are now being told that they can almost return to their normal lives, according to the CDC. Unvaccinated people should not.

But, what about the fact that no children under the age of 16 have been fully vaccinated. When you tell an adult who is fully vaccinated, they don’t have to wear a mask, but all children do (by nature of the lack of vaccination availability) — how much more conflict are you creating within households? How much more afflicted are children and parents by these inconsistencies of behavior within families?

What are we as adults showing our children — Do as we say, not as we do? Don’t model the behaviors we want them to follow? What happened to the idea of children learn from what we do more than what we say? Do you say that parents are self-sacrificing for the well-being of their children? That parents need to demonstrate consistency and solidarity for clear direction?

Those of us with young children, how does the CDC recommend managing not only their feelings that “life is unfair” because you don’t have to wear a mask but I do, but also their fears that they are still unvaccinated and could they get sick from their unmasked adults coming home to their unvaccinated selves.

All the studies in the world demonstrating that kids don’t get as sick from COVID as adults or don’t propagate disease do not reconcile these apparent contradictions in a young child’s mind — an ego-driven mind, appropriately consumed with right and wrong, fair and unfair.

For the sake of our families, this is my ask — please provide guidelines that consider families, not individuals. Please consider the burden already felt by families, particularly mothers, who are trying to balance social isolation for themselves and their family members. Some are mourning the loss of loved ones. Some are trying to work from home while trying to help navigate virtual school. Some are taking care of other dependents like elderly parents. Some are taking care of their homes without the outside support that they relied on previously. Some are at their wits end after more than a year of this … all while still trying to parent children as examples of action, not contradictory words.

The U.S. population does not lack prioritization of individual action. Recommendations that don’t account for family units, small or large, feed the fire of our latest crisis identified and will likely have profound effects in the future.

The author is an anonymous physician.

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