When bad news about COVID-19 hits families, it often comes in waves. This was certainly true for Zibby Owens and Lois Mufuka Martin, as it was for many of those connected to the more than 566,000 people who have died from the virus in the U.S. this past year.

For Zibby, 44, a mother of four in New York City and creator and host of the podcast Moms Don’t Have Time to Read Books, the nightmare started in July of 2020. That’s when her husband’s grandmother Nene, still vital at nearly 90, developed coronavirus after a hospital stay. Nene passed it to Zibby's 63-year-old mother-in-law Susan, who had been caring for the older woman. “Susan was burning up with fever, and she had to put on a hazmat suit stuffed with ice to say goodbye to Nene,” Zibby recalls. “That was our first introduction to grieving during COVID,” she says.

Susan died about a month later, alone and hooked up to machines until her final few days, when Zibby's husband, Kyle, and sister-in-law, Stephanie, were allowed to see their mother. By then, she was barely conscious. “Susan was young, had a new love in her life, and had been in perfect health. It was one of the worst days of my life,” says Zibby.

For Lois, 52, a school consultant in Pittsburgh, the cycle of tragedy started with her husband’s sister, who, at 47, caught COVID-19 from her 14-year-old son, Lois' nephew, in December 2020. The family was extremely close and lived within walking distance. When the boy called to tell his aunt that he couldn’t wake his mother up, “I was there in five minutes,” recalls Lois. "But I could tell right away that she was gone."

Even more horrifying, when Lois' 80-year-old father-in-law got the news that his daughter had died, he was so distraught that he collapsed and died five hours later. “My nephew, who had gone to be with his grandfather since the two were so close, called again, saying, ‘Pap Pap just fell out!’ The EMT folks couldn’t revive him. Those two were the center of each other’s lives.”

An Epidemic of Unresolved Grief

In normal times, when there's been a death in the family, says Lois, a whole extended family-and-friend network would descend. "The house would be full with people making sure we were eating, making a hot toddy to help us sleep, or praying around the clock,” she says.

Yet these were far from normal times. “Instead, my four best girlfriends showed up at the house and parked outside. Then, all of us stood around, masked up and in heavy winter coats, waiting for the funeral-home people to come.”

Like so many others who have lost loved ones during the pandemic, Zibby and Lois were deprived of the most basic ritual of grieving from the very beginning. First, there’s the trauma of not being able to be there in person, to say the all-important goodbyes, or to try to resolve past difficulties. “With the isolation of COVID-19, there’s no opportunity to say all that remains unsaid, to deal with unresolved issues, or to extend or receive forgiveness,” says Robert Neimeyer, Ph.D., director of the Portland Institute for Loss and Transition and a leading world expert on grief.

Then there are the rituals that come after death. Bans on large indoor gatherings include the traditions, common in nearly every culture and faith, of family and friends getting together in the days after the death. “We’ve lost that—the community that’s usually right there with you,” says Lois.

Perhaps even worse, neither could avail themselves of perhaps the most essential grieving ritual of all: exchanging comforting hugs with family and friends when they are needed most. The loss of our usual mourning rituals is only one contributing factor in what experts predict will be a wave of residual grief that may not be easily resolved even after restrictions are lifted—and that could lead to a range of lasting physical and emotional problems for everyone who has lost someone during the pandemic.

These rituals serve an important role in mourners’ recovery. “Across the world and across cultures, they generally fulfill three core purposes—to provide a ‘container’ of sorts for the difficult emotions of grieving; to provide a way of honoring the deceased and supporting mourners by giving them a guardrail through those difficult early days; and third, to affirm our sense of community," notes Neimeyer. "That’s all been disrupted.”

Initial studies conducted by Neimeyer and his colleagues in the bereavement field as part of The Pandemic Grief Project suggest that this disruption is already having a dramatic negative impact on those who survive. One such study of 831 adults who lost someone during the pandemic found that 66 percent showed signs of what he calls “dysfunctional grief”—grief that goes beyond the normal depth and duration and that can impair functioning over the long term. Thank social distancing, meant to keep us safe from coronavirus, but which may end up leaving mourners with a condition known as prolonged grief disorder (PGD).

“Ordinarily, people start to rebound from a loss within a few months,” says Neimeyer. In contrast, people who develop PGD not only suffer longer—at least six to 12 months or even more—but are also at increased risk for cardiac arrest and congestive heart failure; immune system dysfunction; suicidal thoughts; and, substance abuse.” Neimeyer attributes some of these findings to the fact that the pandemic has made it more difficult for mourners to gain closure. This feeling of having unfinished business can make it difficult to process a loss. “Instead of being surrounded by love, it’s just texts and calls and isolation,” says Zibby.

Given that the majority of COVID-19 deaths have occurred among people of color (Black Americans, for instance, are 37 percent more likely to die of coronavirus according to an analysis by The Washington Post), “the implications of what this will mean for Black and brown communities are profound,” says Victor Murray, a social worker and director of community engagement and capacity building for the nonprofit Camden Coalition.

Online communities such as Grieving.com and Grief in Common offer forums and live chats where you can connect with others who have suffered a loss—particularly helpful for those who don’t have easy access to family and friends. And if the grief just doesn’t let up, “Telehealth therapy with a professional counselor can be a good option,” adds Neimeyer.

Finding Other Ways to Heal

It’s important to remember that there is no one right way to mourn and to get through your grief. “We need to find new rituals and traditions to honor what was, whether virtual gatherings centered around reflection and celebration, or engaging in cathartic activities like reading or cooking a loved one’s favorite recipe,” says Minaa B., a therapist and wellness coach. “As long as the ritual doesn’t feel forced, it can be effective in helping you heal.”

Since support looks different for everyone, she also stresses the importance of determining what your needs are, and what resources exist to help you through, whether participating in online therapy or bereavement groups, going through old photo albums, or meditating. “These are all good ways to help you stay present in the midst of grief.”

What’s crucial is to not try to push grief away and pretend the loss never happened. “Anything you do that honors your loved ones can help,” says Neimeyer. “In contrast, anything that marginalizes our loss or encourages us to forget it will only deepen grief and helplessness.” He suggests creating opportunities to “name and claim your losses, to reassert what matters and has meaning in life, and to learn from loss, rather than attempting to get beyond it.”

Grieving may also be more difficult for people living alone—those who have been completely isolated before the loss, and will go on being isolated after. If you’re grieving alone, it makes sense to build a virtual community. “Mutual support—even if it’s online—can be enough,” says Neimeyer. “It can provide the caring necessary to get through a difficult experience, and adapt to the changes that life requires as we navigate the intimate terrain of grief.”

Zibby and her family opted to hold an online memorial service, as soon as possible, and they were surprised by how comforting the virtual service turned out to be.

“My husband, sister-in-law, and I sat in front of the computer, and there was just screen after screen of people there,” she recalls. Besides blessings from clergy members, “we had two of my husband’s best friends perform a Bruce Springsteen song—he was the soundtrack to Susan’s life."

And because Zibby had been posting about her losses on Instagram, condolences poured in from all over, even from strangers. “Susan was a very giving person—during Hurricane Sandy, she drove a tractor trailer all the way from Charleston, South Carolina to New York City with donations. I like that her name and image are out there now—a lot of people feel they know her, which wouldn’t have happened if she’d died during normal times,” Zibby says.

Lois' family chose to have a double in-person funeral for her sister-in-law and father-in-law, with alternate pews roped off in the church. But she noted that, in normal times, "attendance would have been five times more,” she says. “My father-in-law was 80, and his friends were older, too, so most of those people stayed home because of COVID, which I understand.”

Still, Lois was left with the feeling that all of them—the ones who were taken and the ones who remain—had somehow been short-changed. “It breaks my heart that my father-in-law, a veteran, had to have a private internment, and didn’t get his full due, nor did my sister-in-law.” The family, she says, is considering an in-person gathering when it’s time for the headstones to go into the ground.

“In the Jewish faith, there is the tradition of yahrzeit, lighting a candle on the anniversary of the death every year. People might want to take a cue from that, having a memorial on the anniversary, so people can come together,” says Neimeyer.

Alone in a Crowd

While grief is universal, each death and every person's journey through grief is distinct and individual. Suffering a loss amid so many other losses, however, can be traumatic in its own way. “There’s a numbing effect, like, ‘If I’m just one of half a million who have lost someone, why am I special?’” says Neimeyer.

Zibby sees that added trauma with her husband and sister-in-law. “They can’t get away from COVID-19,” she says. “It’s in the news, it’s all over the place, so they are always being re-exposed to their grief.” Her family has been able to ease some of their pain by creating a COVID-19 vaccine research program at Mount Sinai Hospital in New York City, named for her late mother-in-law. Profits from Zibby's new book, Moms Don’t Have Time To: A Quarantine Anthology, will go to developing new vaccines. “Using a traumatic loss as a way to create meaning can lead to post-traumatic growth,” affirms Neimeyer.

Adds Zibby: “Just being able to do something positive helps.”

Finding ways to uphold those roles and rituals may go a long way to promote healing, even if they are delayed, reflects Neimeyer. “Depending on what you do, how you choose to mark the loss,” he says, “pain can be an impetus for creating something good.”

Originally published on Happify Daily