Showing posts with label 2020s. Show all posts
Showing posts with label 2020s. Show all posts

13 September 2020

Wearing Masks During COVID19: How Neuroscience Can Help Us.


Never have lives depended so much on getting a buy in from the public to wear masks. The evidence that masks protect us from COVID-19 is clear and unequivocal. In terms of scientific evidence, that is. Where it all falls apart is when emotional arguments are made against wearing masks.

Many argue that we should avoid the emotional aspect of COVID and simply concentrate on the rational arguments for mask use. 

However, this argument falls apart too, because all decisions involve emotions and we can’t keep people safe without appealing to them. Why? Because that’s how our brain works.



In the 1990s, the neuroscientist and physician Antonio Damasio wrote a groundbreaking book, Descartes’ Error: Emotion Reason and the Human Brain. Through studying people with brain lesions he demonstrated how decision making necessitates emotional input: decisions cannot be made without emotional input. 



Much research has supported these findings and this has been taken into the political arena by authors like Westen and Lakoff. The basic conversation in both these books is how all political decisions involve emotional input. 



Some may feel that decision-making that necessitates emotional input is not a good thing. They will side with Descartes and claim that purely rational decision-making exists. Like everything in the human body, from kidney to heart function, one doesn’t get to chose how organs work. The vast amount of evidence from lesion studies proves this to be the way the brain works.

I understand the concern with the idea that decisions are emotionally based - I grew up with scientists who felt emotions should never enter decisions. Emotions were seen as out of control and in need of control. 



Perhaps it would be reassuring to look at the areas of the brain that are involved in emotions - there is a complex, interconnected system that is utterly beautiful. A glance at some of the players may inspire you: these areas respond directly and indirectly to bodily and sensory inputs and coordinate, like a symphony: orbitofrontal cortex, dorsolateral prefrontal cortex, anterior temporal lobe, ventrolateral prefrontal cortex, dorsomedial prefrontal cortex, anterior mid-cingulate cortex , amygdala, anterior insula, anterior cingulate cortex, dorsomedial/dorsolateral prefrontal cortex, medial temporal lobe, retrosplenial cortex/posterior cingulate cortex and periaqueductal gray.

So, although emotions are often viewed as the basest form of human reaction, they involve complex cascades of brain activity that are crucial for synthesizing social, empathetic and protective aspects of a decision.

This impacts mask wearing because different countries have different emotional narratives to which they generally respond.

All governments are using narratives to explain the spread of COVID-19. In Canada, the narratives of the federal and provincial governments are largely in line with each other and all appeal to a sense of helping others. This narrative has high emotional salience in Canada, where helping others, working together as a country to help each other is the basis of everything from our universal healthcare system to our investment in schooling. It is a core value. Not for everyone, of course, because no country has a homogenous set of values. However, most countries do have some values that are widely shared. 

Even some of the anti-maskers in Canada protest under the banner of “Hugs not masks”. Appealing to a sense of community well-being while spreading the virus may be odd, but it encapsulates the emotional weight of community in Canada. 



South of our border, COVID-19 infections and deaths are mounting, and masks would help limit the spread of this virus. There are many factors involved in this but one factor is the conflicting messaging coming from the federal government and the states. Another factor may well be the emotional weight given to the idea of individual decisions - much of the messaging has actually been against the community well-being by arguing that individuals can’t be forced to do things by others, particularly governments. We have some of that in Canada, but not in such large numbers because the narrative in Canada is that taking care of others is valuable and putting yourself above the health of others is generally frowned upon.

I have thought long and hard about how to encourage people to wear masks south of the border. Many of my colleagues in the United States spend their days and nights caring for COVID patients and then spend their free time on twitter encouraging people to wear masks. 


When I think of appeals that have been made to Americans, this comes to mind:




Or this as a mantra for today:





So many fine and civic minded Americans have called upon Americans to follow their better angels. These appeals are emotional - heck, I’m Canadian and they move me to the core.

Some of my American friends have argued that the population of America has changed and that appealing to better angels will not work because many are driven by anger and fear. The division of people into those who are angry and scared verses those who are rationally following public health measures is a fallacy. We are all scared and we are all angry. These are difficult times and we would be completely detached from reality if our responses to this drastic situation were not intense: remember our emotional systems are nuanced, coordinated and work with reality because they are dependent on input from our senses.

Directing our fear towards its source - this virus - drives many of us to wear masks, wash our hands, keep our distance from people and allows us to stay safe. Anger? That's a great energizer for fear and enables us to fight paralysis by driving us to action. We are seeing governments and others trying to direct anger when infections increase towards those who are infected and, these days, this is often young people who are painted with the narrative that they are selfish and irresponsible. When we direct anger towards our own, it's rarely productive and always divisive. When young people have heard inaccurate information that they are largely unaffected by this virus, we should look to the source of their behaviour and perhaps correct the information they were given, using that anger to drive us, energetically, to educate them and appeal to the values of community and empathy that we have raised them with. 

History has taught us that citizens who have been complicit in terrible things can and have turned things around - think postwar Germany. Surely, we can give our young and our fellow citizens the benefit of the doubt and appeal to their better angels - to their more noble emotions such as empathy. 

One of the bright spots - maybe - is the response Canadians have seen to mask mandates and this might help in America. “An overwhelming 95 per cent of the survey respondents say they now wear a mask on public transit. In mid-July, those numbers were as low as 45 per cent.”  In cities all over Canada, we are seeing similar response to mask mandates. Not certain if this would work with our southern neighbours given the violence that has accompanied masks refusal and the lives that have been lost. But maybe this provides some hope. Along with an emotional appeal to civic duty grounded in empathy. 

I don’t know if this will work. I’m just hoping that we can all turn the rising infections around by standing on the shoulders of scientists, who explained how we make all decisions, including whether to wear masks or not: facts without emotional appeals will simply not work to help people make the right public health decisions. 

19 July 2020

Florida… Oh No, Not Again!


Florida postcard
Florida’s bizarre politicians overshadow our usual weird news. But let’s take a stab at the strange.

Gator Cater

West Palm Beach, Florida.  No, I am NOT the guy who reads and sings to calm alligators not receiving their share of tourists. Everyone knows I can’t sing.

Marathon, Florida.  I also deny knowledge of the iguana that wrestled a guy and his bicycle to the ground. A spokesman for the bicycle said…

Tampa, Florida.  Nor do I have anything to do with neighbors preventing access to a landlocked bird sanctuary. (I have sympathy in this case. Orange County politicians turned over a county road to a private cattle company, preventing property owners access to their land.)

Head Honcho

St. Petersburg, Florida.  A jogger found a human head on a grassy knoll. Police confirm it is not that of Governor DeSantis, who is known for having lost his mind but not his head. Yet.

Softball Questioning

Jacksonville, Florida.  A hard-hitting woman batted eyelashes at her police detective boyfriend, who gave her a pass during a murder investigation. They made it beyond third base but not quite home when they were called out.

The Mother of All Gifts

Clearwater, Florida.  We missed reporting on Mother’s Day that a spitting, angry Pinellas County wife beat her husband for remembering and giving her flowers. Uh wait. I’m guessing she didn’t want flowers.

Clearwater, Florida.  Another woman attacked her man with a candy cane. And a brick. And a pen. Somehow after a brick and a yard-size candy cane, a pen doesn’t seem all that much.

Micanopy, Florida.  So her boyfriend, see, well, she was on her phone, actually, and her boyfriend, just sorta, kinda, tripped on air and fell on a knife, twisted it in maybe, and writhed and stabbed himself umpteen times or not and raccoons attacked… No flowers for her Mother’s Day.

Sanford, Florida.  Lest ye think it only women who’ve gone corona-mad, there’s the crazed man who stabbed a roommate then turned on police, screaming something about Satan and worms and… You see? Some normal Florida things still happen.

Deltona, Florida.  We mustn’t forget another man who attacked a roommate who’d kindly made him breakfast. Oh wait. The breakfast chef woke him at 5am. That’s like the middle of the night. Last time someone woke me at 5am, police found me sharpening my teeth.

coronavirus
Another Reason to Close the Bars

Indialantic, Florida.  She just spread the love or a message or coronavirus. Just because she kissed strangers without a mask, was that any reason to stop a sunny welcome?

Try as I might, I can’t seem to get away from COVID-19 stories.

Taking the Cure


Bradenton, Florida.  The Genesis II Church of Health and Healing continued selling their Miracle COVID Cure after a judge ordered them to stop selling industrial bleach for human consumption. This is the same chemical their leader wrote about to President Trump who subsequently claimed this wonderful detox would knock out the coronavirus in one minute. Side effects include heartburn, death…

Fort Myers, Florida.  That guy in Costco, you know, the dude who felt threatened by a 60-some year old lady who asked him to wear a mask… from Florida, of course. He’s a star insurance salesman; you’d think he’d want everyone to masque up.

Holly Hill, Florida.  The Costco guy wasn’t as nasty as the woman who spit into Walmart’s fruit and vegetable bins ruining $350 or so of foods. Because of the corona hoax, of course.

Homestead, Florida.  A couple wanted soooo bad to visit the Florida Keys, but those stupid Keys officials didn’t want to spread that hoaxy COVID and like all illegally tyrant-like keep non-residents out, which is soooo Naziish. Anyway, this freedom-loving couple took a teenager prisoner and forced her to drive through the checkpoint. They struck such a blow for freedom, not the terrified girl’s, of course, but theirs. Except they’re locked up.

Cadillac atop cars
Hernando, Florida.  Local drivers might not be as bad as Boston’s, but how do you drive backwards and park atop other cars? And we don’t even get snow?

Reedy Creek Control District, Florida.  One guy decided to self-quarantine in Walt Disney World. He shacked up on Discovery Island, Disney’s former zoo of sorts before Animal Kingdom.

Gainesville, Florida.  If you live in Florida and someone removes your testicles, you might be a politician. Or an adopted kitten. Who knew a stuffed dragon might not protect you?

Full Blown Politics

Tallahassee, Florida.  At the same time the White House blames poor coronavirus response on the media for too much coronavirus reporting, Florida’s governor blasts the media for too little reporting. Indeed, Governor DeSantis says the press reported nothing about COVID-19 until April, so he assumed all was okay. Which is weird, because like a kidnap hostage, I can hold up copies of the Orlando Sentinel and Miami Herald dated back in January. Doesn’t he know the Keys have been off limits to visitors since 22 March?

Grim Reaper on Florida beach
© Tampa Bay Times and Shorty Awards
Florida is famous for costumed characters and since February, the Grim Reaper has patrolled Florida’s beaches warning visitors about the virus. In March, that Grim Reaper, revealed as Daniel Uhfelder, Esq, sued the Governor’s office to require face masks. So apparently our Governor doesn’t check the news, he also pays no attention to lawsuits.

Earlier this month when I wrote about Florida landing the sad position of NÂș 1 and setting new pandemic records every day, I hadn’t expected the Sunshine State to continue setting new records. As one observer put it, if Florida was a separate nation, it would rank among the worst countries on the planet for infections.

Governor DeSantis calls that ‘a blip’. Because, you know, the Black Plague was ‘a bump’ and reporters ‘a bleep’. Such ingrates! Florida has done soooo much to keep the numbers down. Like firing our heroine, Rebekah Jones, the state’s database administrator who revealed Florida’s government was grossly under-reporting cases. And sheriff offices complain that as infection hotspots soared, the state cut off critical information to police agencies including addresses of known outbreaks. And the state ordered medical examiners not to release autopsy data. Because no info, no problems.

Milledgeville, Georgia.  Above our border, Georgia’s Brian “Screw ’em” Kemp is posing a challenge to Florida’s Ron ‘Who Me?’ DeSantis for dumbest governor, but I’m afraid Georgia will have to settle for Miss Uncongeniality. Kemp is suing cities that require masks in public. Because no masks, no problems.

Oh God, the clowns! We’re all gonna die! But keep shaking your head and laughing.

19 April 2020

Florida by the Numbers


Florida postcard
Thursday, a hundred rankled Orange County protestors and children converged on Orlando City Hall to demand an end to government stay-home oppression. They cried out against the horrors of forced unlabor. They sought to be loosed from the bonds of dictatorial rule and set free. And Mike Huckabee clamored in Florida courts to be unshackled from the Orwellian tyranny that required him to follow laws like ordinary, common citizens. He needed to be liberated from onerous beach-front activity restraints because… something.

When Michigan activists protested in drive-in Operation Gridlock, police noted that in their cars, citizens were inadvertently practicing safe, social distancing. Not so in Orlando, where unmasked citrus cankers breathed and sneezed and coughed at will. The numbers can’t be real: 2⅓-million cases globally, 33 383 in Canada, ¾-million in the US, 25½-thousand in Florida, 3000+ in Central Florida– apparently fake news, including 78 local deaths.

The last time I agreed with Orlando Mayor Buddy Dyer was, um, pretty much never, but damn, folks. We’re trying to save lives.

Central Floridians took matters a step further into the Twilight Zone. They contend Dr. Anthony Fauci is a lying, malevolent hoaxer who inexplicably holds the President’s ear, deliberately wreaking havoc at the Federal level. Fauci’s motives are, um, deep state, Obamacare-coddling, and a really nasty infection that afflicted Florida’s governor. Whatever, it demanded protesting.

By the Numbers

Politicians may choose to ignore the science, but it’s difficult to ignore the math. Updating as you read this, the count of cases and deaths are spooky.

Say, each coronavirus victim infects two other people, and those two each infect two others, etc. It doubles exponentially. (The reality is closer to 2½×, but 2× is scary enough and much easier to calculate.)

In an ancient tale from Persia (or India), a king agreed to pay the inventor of chess in rice, one grain on the 1st square of the chessboard, double that (two) on the 2nd square, double again (four) on the 3rd square, and so on for all sixty-four squares. Beginning with Square Zero (think Patient Zero) each square would contain:


results in…    
results in…    
results in…
0
1     22
4 194 304     44
17 592 186 044 416
1
2     23
8 388 608     45
35 184 372 088 832
2
4     24
16 777 216     46
70 368 744 177 664
3
8     25
33 554 432     47
140 737 488 355 328
4
16     26
67 108 864     48
281 474 976 710 656
5
32     27
134 217 728     49
562 949 953 421 312
6
64     28
268 435 456     50
1 125 899 906 842 624
7
128     29
536 870 912     51
2 251 799 813 685 248
8
256     30
1 073 741 824     52
4 503 599 627 370 496
9
512     31
2 147 483 648     53
9 007 199 254 740 992
10
1 024     32
4 294 967 296     54
18 014 398 509 481 984
11
2 048     33
8 589 934 592     55
36 028 797 018 963 968
12
4 096     34
17 179 869 184     56
72 057 594 037 927 936
13
8 192     35
34 359 738 368     57
144 115 188 075 855 872
14
16 384     36
68 719 476 736     58
288 230 376 151 711 744
15
32 768     37
137 438 953 472     59
576 460 752 303 423 488
16
65 536     38
274 877 906 944     60
1 152 921 504 606 846 976
17
131 072     39
549 755 813 888     61
2 305 843 009 213 693 952
18
262 144     40
1 099 511 627 776     62
4 611 686 018 427 387 904
19
524 288     41
2 199 023 255 552     63
9 223 372 036 854 775 808
20
1 048 576     42
4 398 046 511 104    

total:
21
2 097 152     43
8 796 093 022 208    
18 446 744 073 709 551 615

The total, my children, if your eyes haven’t glazed over, is 264-1, or 18 446 744 073 709 551 615, eighteen quintillion. Legends disagree whether the king made the maths wiz an economic advisor or executed the smartass.

The numbers, which start out relatively flat, soon zoom out of control. Relating to coronavirus, say the 10th generation victims infect a thousand more and the 12th another four thousand. The 20th level infects one million and the 30th one trillion. This is why it’s critical to disrupt the spread by masks, isolation, thorough cleansing, and sterilizing public places like Washington. But you knew that, right?

Please take care.

The Left Behind

Many are all atwitter about stimulus checks and several states have moved to protect landlords and tenants. In the rush to pass legislation, Congress and legislatures overlooked some citizens, including many college students and working teens. But here an Florida, another group in dire need has been forgotten. Sean Baker even made a movie about them starring Willem Dafoe.

Stay safe and read on…

12 April 2020

Surviving COVID19


COVID19 is a dangerous adversary and everyone is discussing how stressful they are finding living in the age of COVID19.

There have been many excellent recommendations on how to reduce stress. Many of these recommendations have focused on stress reduction strategies like exercise.

Given my area is mental health, I would like to add to the conversations on stress by presenting a different lens.

First, let’s talk about what stress is and is not, because to tackle something one must always know what one is getting into the ring with. 

In 1936, biologist Hans Selye described a common physiological response in rats subjected to harmful factors and he named this the stress response. “The main features of the syndrome were suppression of the immune system, ulceration of the lining of the stomach and small intestine, and activation of the two … stress-response systems.”

Over the last 80 years, there has been extensive documentation of the widespread damage of stress on our body and brain.

So stress doesn’t just feel bad - it is really bad for you. Reducing stress can save your life and a sense of control is the one way cortisol and other factors provoked by stress can be reduced and the health impacts minimized.

What is crucial is that stress is not just bad things happening to you – it is bad things happening with a sense of having no control over these things.


You might be thinking: if control is crucial to managing stress, how on earth can you control a global outbreak of a virus? How can we control not only the illnesses and deaths but also the economic consequences on such a large scale. Control? It seems like a rather ludicrous word in the face of all this.

All true points. Thank you for making them.

My answer is to introduce some people whom I have known that belong to “The Greatest Generation”- those who lived through World War II. They earned their name because of their tenacity and 'can do' attitude. They did not enter the war with these attitudes but, rather, they were forged by the hardships they faced.

My father-in-law, Bill, and his twin brother were pilots in World War II. Bill’s brother died when his plane went down in Europe and he was never able to speak of him again – it was as if the grief of his loss had torn out his heart. Bill went on to get an engineering degree, marry, have children and live a life of laughter and love.

My mother-in-law, Verna, stayed home and helped in many ways the war effort. She told me stories of how they would try to get butter to make her beloved pastries, how they would save things so they could send packages to those who were fighting along with letters. The volume of letters diminished over time because many of the young men she grew up with died.


Neither of them had any ability to stop the war or save those they loved. Both were irreparably broken by the losses they sustained. Both walked into life after the war with a strong stride. They survived the war by small acts and large ones that were all acts of resistance. Bill was a man who embraced competence – taking care of his family and being the one who got things done – and Verna was loving, taking everyone under her wing. Perhaps those characteristics were their tribute to those they lost and a way to ensure that they would keep those around them safe.

Let me introduce you to Lili. She was Jewish and was sent away from her parents as a small child into hiding. She lost her parents and everyone in her family. I learned later that she had anxiety and many difficulties all her life in response to this, but what I remember about her was that she was one of the kindest people I have ever known. If the world robs you of so much through cruelty, kindness is the ultimate act of defiance.

None of them had control over global events that ended up at their door. What they did was to take control during and after in small and large ways. Ultimately, their characters are a testament to how they became known as the greatest generation, because it was not what they endured but how they endured it that defined them.

Back to COVID19. We have no control over when we will have a vaccine and this nightmare will end. However, the reality is that we have never had control over large global events and this is no different. What we do have control over is our small corner of this planet and that is where we fight. 

Much has been discussed about the courage and tenacity of my colleagues during COVID19. When I speak with them, they talk about doing what they have always done; medicine with the patient in front of them. They read voraciously about this virus, they consult others for more information, they organize their homes to have decontamination zones to keep their family safe and do many other things to manage their corner of the planet.

Many of my non-medical friends are reading and watching the news to educate themselves, they are designing new ways to get groceries safely and clean them down. They are reaching out to friends and family to inform them, check up on them and laugh with them.

When we talk about the new normal – it is the ability of each of us to have small and large acts of defiance and resistance to keep those we love safe.

We will not recover without scars. We can only hope to minimize the number we lose and comfort those who have lost people. There will be anguish: times when we wake up in the middle of the night drenched in fear. When we emerge from this - we can do so with a character forged by how we responded to COVID and how we controlled our corner of the world.