By Catharin Shepard •
Staff writer •
Life in Hoke County isn’t the same today as it was just a month ago, all because of the coronavirus, Dr. Karen Smith said.
“Our life has changed,” she said.
As a longtime primary care physician and medical director for the Hoke County Health Department, Smith is hearing from her patients and other medical providers how the outbreak is affecting people.
Telling most of the population to stay at home and banning large gatherings are just a few of the things elected officials have tried to slow the spread of the illness. However, asking an entire population to change its behavior is not easy. The changes in people’s daily lives are causing difficulties for some families.

With schools closed and many people either working from home or left unemployed due to layoffs, families who aren’t used to spending large amounts of time together are suddenly at home together around the clock. Combined with the anxiety, it can put a strain even on happy families. Doctors are starting to see “a deterioration” of people’s mental and emotional health, and an increase in domestic violence, Smith said.

Financial stress makes the problem even worse.

“Here it is the second or third of the month and people are worried about how do I pay my mortgage by the seventh, how do I pay my credit cards,” Smith said.

Doctors are also seeing people with underlying issues like depression and anxiety who are suffering more than usual, due to the uncertainty of the situation and the changes in daily life. Taking the time to recognize that everyone might be feeling some anxiety over the situation can help families cope, Smith said.

“Try to understand the person that you’re with, try to understand what’s on their mind and recognize that there is some anxiety, that there is some nervousness,” she said.

The last time the United States dealt with a pandemic of this nature was a century ago, with the 1918 influenza outbreak. Most people alive today weren’t alive then, and aren’t sure how to respond to the many disruptions.

It’s about finding resilience together, Smith said.

“We have to come back together and pull together that resilience,” she said.

Meanwhile, the virus continues spreading. Slowing the spread to keep from overwhelming hospitals with a flood of critically ill patients is the goal of the initiatives and restrictions put in place. Those restrictions only work if people follow them, however. Local health officials have urged Hoke residents to take the recommended precautions.

“One thing about our community, we do appreciate everyone following the directions of the governor. The governor is getting information and he’s utilizing it for the safety of the people who live in our area,” Smith said. “The recommendations, we have the shelter in place for people to please remain at home unless you are in an essential job function. Wash your hands as frequently as you can. When you go out in public, wear some type of face cover.”

People should consider wearing a homemade mask, and leave the medical-grade masks for the healthcare providers who need them. Social distancing, which means staying at least six feet away from other people, can help cut down on the risk of getting COVID-19.

“Bodily secretions typically do not go past the five to six feet area of personal space,” Smith explained. “We’re beyond the elbow bump and the toe tap, and the reason why is that brings you within the personal space of six feet, (so) that’s no longer being advocated.”

There are things that people can do to help make it through the stay-at-home order during the pandemic. It’s okay to go outside as long as you’re maintaining six feet of room between yourself and others, and obey guidelines about avoiding gatherings.

“We’re not saying stay in bed, we’re not saying sit in your house and look at the four walls, but to use your home space, your yard, your garden,” Smith said. “Get that stack of books that you haven’t read, get that music you haven’t listened to.”

“I just took down the Christmas tree,” she added.

There are digital resources available for people experiencing a mental health crisis. Telemedicine through video conferencing on a phone or computer is one option. Counseling over the phone is another. Many providers are changing their payment structure to include telemedicine now, Smith said.

While phone “visits” are fine, using video visits can help doctors gather more information about their patients and better decide how to help them.

“I want to see your smiling face, I want to see your sad face, I want to be able to pick up on (how you’re feeling)…let us help you and walk you through that, the video is so important,” Smith said.

Some things haven’t changed. The medical director, who also serves on the Hope in Hoke opioid addiction team, pointed out that people are still struggling with opioid use even during the pandemic. But now, they might be having more difficulty getting those opioids.

“They’re not able to access them, so some may go into withdrawal at this time,” Smith said.

The Health Department and Hope in Hoke put together a list of resources for people struggling with opioid addiction. To access those resources, contact the Health Department at (910) 875-3717.

There is some good news in Hoke County. As of Monday none of the people in Hoke with COVID-19 have had to stay in the hospital for treatment of their symptoms, the doctor said. The Health Department is monitoring the positive cases of COVID-19 in Hoke and making sure those individuals are quarantined at home.

Most of all, Smith said, it’s a time to try and be patient with each other.

“I ask people to please, please be patient. Be patient. We recognize and appreciate that every individual is of value, but be patient with your doctors, nurses, hospitals, be patient with your family,” she said. “Recognize that the official recommendations they make are because we already see what’s happening in other places in the world, and we’re trying to preserve out community.

“Please don’t push back but accept that life is not what it was in January, and if we are to get through this with as little loss of life as possible, follow the guidance, follow the recommendations. They are to preserve the life of the entire community and also to preserve our life.”