Beware of the ‘last mile, first smile’ towards the end of the pandemic

FStress, distracted attention, and a feeling that a seizure will soon be over all contribute to poor judgment, last-minute accidents, and preventable deaths. This “last mile, first smile” phenomenon occurs in the military, law enforcement, and in the final stages of disasters and crisis situations. It can happen to anyone while driving the last mile home.

Medical teams are not exempt. The end of the crisis phase is almost “class rejected” and a return to normal life.

But it’s much more complicated than that.


In a prime-time speech to the nation in March, President Biden said he sees July 4, 2021 as the start of our independence from Covid-19. As the restrictions disappear and businesses and schools reopen with increased capacity, many will begin to experience regular, normal feelings.

If vaccination keeps Covid-19 and its variants at bay, as we hope, and most Americans get vaccinated, as we hope, reports of the pandemic will gradually disappear from the front pages. Hospitals and health care systems will begin to shut down Covid-19 departments and resume elective medical care, in hopes of getting out of the Covid-induced financial hole they find themselves in. to the pandemic and others to burnout.


As frontline healthcare workers emerge from the work that has consumed them since March 2020, they will cover their eyes to adjust to the optimistic sunlight of a post-Covid world.

For many doctors, nurses and other front-line health care workers, this transition can be difficult and put them at profound risk for burnout, anxiety, depression, post-traumatic stress disorder, and even death. suicide.

Fighting Covid-19 day in and day out, being exposed to the danger of infection and worrying about bringing the virus home; psychological trauma and moral damage suffered when treating deceased patients alone with health workers playing the role of family members; having to prioritize care while compensating for a shortage of medical supplies, time and attention – all of this can take an emotional toll.

The transition of medical teams to the post-Covid-19 era must be planned, supported and carried out with the precision of a delicate surgical intervention.

In 2020, I helped start a business called Dugri, which is the Hebrew word for straight talk. It is a support network for frontline health workers that provides what we call psychological PPE. By connecting these workers to others in the trenches, Dugri facilitates meaningful emotional dialogues. Sharing burdens and vulnerabilities creates emotional flexibility that builds resilience.

Here are some of the things we’ve learned that can help hospitals, healthcare systems, and clinicians transition from Covid mode to normal life.

You have to resist the strong tendency to go ahead and assume that everything will be fine. Wellness, recovery and de-stressing practices in the form of debriefings, outdoor retreats, and therapeutic / wellness resources such as cognitive-behavioral training and mindfulness meditation should be deployed in a manner proactive. Clinicians should be encouraged to share and let go of their enormous emotional burdens – and have the time and space to do so.

At the same time, leaders need to show their workers they care, acknowledge their pain and serve as role models to take a break, look back on the hardships caused by Covid-19 and look to the future with hope and strength.

My experience with military special operations forces has taught me that even in the most culturally masculine organizations, this type of modeling creates a climate of non-judgment and acceptance. Sharing burdens and showing vulnerability can help normalize stress during – and after – a pandemic crisis.

Taking care of yourself is important, but taking care of others is crucial. By working closely together during long shifts, healthcare workers get to know each other and get a good idea of ​​how their co-workers are feeling. Last mile syndrome can make it difficult to identify a colleague in distress. For this reason, all team members should keep their eyes open for coworkers who are showing worrying signs.

Distress alert signals include a significant change in a coworker’s mood, both high and low; eating too much or not enough; donate valuable or emotionally significant goods; make impulsive decisions; and an unusual philosophical discourse on the meaning of life and death. Feeling that something is wrong, an invitation to have coffee together, a compassionate look and even a simple “How are you?” can reveal hidden anxiety or depression, and a friendly “I think you should seek advice” can save a life.

When we finally approach the last mile of the Covid-19 pandemic, healthcare workers need to take it carefully, one curve at a time.

Yotam Dagan is a clinical psychologist, former commander of the Israel Navy SEAL, trauma expert, and co-founder and CEO of Dugri Inc., a support network for health workers and first responders.