Sunday, December 6, 2020

Mental Illness in Covid Times

For me to stop teaching in a physical classroom, because I don't feel safe in there, I need a note from my doctor indicating that I have a mental illness that prevents me from working and then take a sick leave. It can't just be a note that says I can't work in the building, that I have a situational anxiety that prevents me from working in an unsafe space; it has to be a note that says that my illness is so debilitating that I can't work at all. It was made clear to me that that's how anxiety works: Either you don't have it and you can work, or you do have it and you can't. Period.

Except that's not how anxiety works at all.  

Anxiety can get triggered by specific aspects of a situation. Someone might be unable to write a test in a room full of people but be completely fine to write it in a room alone with the teacher. Some people can't present in front of 30 people they don't know, but can really excel in front of a choice of three friends to bring along as their audience at lunch time. Teachers have been accommodating students with anxiety like this for years. Just IMAGINE if we told students with anxiety that if they really have it, then they have to take a leave from school, that it's impossible for them to do any work in any other way. 

But here's a bigger problem: I don't think I have a mental illness at all.

So, right off the bat, that statement is suspect. Some people with a profound mental illness have periods where they're convinced that they're totally fine even though everyone around them can clearly see that they're not understanding reality quite accurately or that they're afraid of things that are completely innocuous, blowing concerns way out of proportion. How can we ever know what's what if we can't tell just by looking at someone?!? 

There are ways of telling whether my concerns are reasonable. [Are there? What are they?]

In The Bear's Embrace, Patricia Van Tighem wrote about being so afraid of bears after a traumatic experience with a grizzly, that even after moving to New Zealand, where there are no bears, she would be suddenly frozen with fear in the middle of the grocery store aisle, sensing an imminent attack. She had a disabling mental illness, specifically PTSD, and, unfortunately, she later succumbed to the condition

When I go on hikes in northern Ontario, I carry bear spray just in case. Some people call that crazy because the risk of having a problem is very low, but I insist, "better safe than sorry." My frequency of hikes and enjoyment of them isn't affected by having bear spray looped on my belt for easy access. Since it's possible to encounter a bear in the woods, and since some people have had fatal confrontations, it's reasonable to take precautions that don't have an adverse effect on the enjoyment of the scenery. People might make fun of me, but it's harmless to carry. And, as a woman alone in the woods, it can ward off other types of attacks as well. I'm not afraid of bears in the grocery store. My concern is reasonable and the precautions easily manageable, therefore, not "crazy" despite what people might say.

In risk assessment, we always have to weigh the effect of the potential risk with the effect of the potential intervention. We go too far when the intervention is more painful or harmful than the risk itself. Absolutely.

With Covid-19, I keep arguing that we should all keep our masks on in the schools, and now some people really think I'm having mental health issues because I'm not coping well with the rules that prevent me from telling kids to keep their masks on and also, apparently, prevent me from persuading kids to learn from home instead of filling the room (parents have been complaining about me!!). People check up on me to see if I'm okay, and it is very, very sweet that people are so concerned with my mental health, but it addresses the wrong issue! It assumes there's something the matter with me, instead of recognizing that there's something really wrong with the system

Is it the case that I'm not coping well with the very reasonable rules (and that it's ridiculous that I'm actually worried about dying of Covid, as some insist, vehemently: "You're not going to die from it, Marie!!" and there's a weird little part of me that sort of hopes to prove them wrong by dying to bring it home that this virus is actually fatal.)? OR is it the case that we shouldn't be following rules that don't make sense? Either I have an anxiety disorder that's causing me to no longer function as well in a workplace that is reasonably safe and I'm seeing danger where this isn't any, like a fear of bears in the grocery store, OR I don't have an anxiety disorder since my workplace IS unreasonably unsafe, and many, many people are just living in denial of the very real dangers they're facing every day they walk in those doors, coping with it all by forcefully convincing themselves they're safe. Is the reason that I sometimes struggle to walk into the building in the morning because I'm crazy or because I understand the unnecessary risks we're facing?

I don't think I have an anxiety disorder. I think I am just stressed-the-fuck-out at being put into a room each day that has a chance of a hungry bear hiding in the cupboard and being told I'm not allowed to carry bear spray. There's no indication of an anxiety disorder if someone physically shakes when walking into a room in which there is a very real possibility a bear will be waiting to get them. That heart-pounding trembling reaction is a perfectly normal response to danger!

In the only school that was randomly tested, Thorncliff PS, they found a 6% rate of asymptomatic Covid cases in the building (26/433). It still wasn't going to be shut down until three teachers walked out and forced the issue. We're stupidly just paying attention to the active cases, focusing on morning temperatures, and missing all the asymptomatic cases because of a lack of testing. Adjusting for differing weekly incident rates per capita in my region, (125 vs 91), if we extrapolate to our classes of 15, that means at least every second classroom likely has one asymptomatic infectious case. So we've got a 50/50 chance of entering a classroom with a bear in it, and me without my pepper spray. We're not allowed to insist that kids keep their masks on the entire time they're in the building. They have a right to take off their masks in their classrooms despite only being there for four hours/day. They need their morning snack time!! It's not unlike being told you're not allowed to wear a seatbelt in my car that I'm totes driving way over the speed limit down the 401. You, too, would be a little shaky getting in the passenger side. It doesn't mean there's something wrong with you. Right?!?


In the U.S., lax regulations are reaping deaths of about 3,000 people a day - as if a 9/11 is happening daily. Compare that to the rate of fatalities from car accidents, which is about 100/day. When people say, "We have to die of something," I ask them if they still wear a seatbelt. Of course we all take reasonable precautions to avoid the risk of harm whenever we can. In Ontario, last year, 335 people died in a car accident. So far, 3,759 have died of Covid in the past 9 months. We are at a FAR greater risk of dying of Covid-19 than dying in a car accident. We wear seatbelts to reduce the risk, but so many STILL question wearing a mask when in a room full of people outside their household. I keep having to ask some teachers to please not demask to eat or drink in front of me, and they're always stunned by the request. Is it reasonable to demask in a room of people outside your household at this stage of the game, or is it a sign of profound denial of the risks so that they know not what they do? I know I'm in the tiny minority view on this one, so it's possible I'm very wrong, but I'm not seeing any evidence that demasking indoors, outside our own homes, is safe - especially not in schools. The most recent CDC weekly survey shows that, for 30 straight weeks, kids 5-17 have the highest rate of positive tests of all age groups.

Some look to the U.S. as the marker of what not to do. We look at those numbers over there and think that they should have done a better job, but of course we're still safe. But New York City stopped all in-person schooling when they hit 3% positivity rate. My region is currently at 4.1% positivity, and there's no plan to shut down schools (by shut down of course I mean work from home - teachers are all working their asses off this year, no matter where they are).

Here's what I know to be true: There is a FAR greater risk of longterm health concerns from getting Covid than from going without food or water for four straight hours each day. It makes zero sense to allow kids to take off their masks for 45 minutes mid-morning for snack time. I've been fighting to get rid of any masks-off time in the building since last summer. People are positively aghast that I'd suggest kids go without their nutrition break since obviously eating healthy food is so important to children's development. But let's get on that fasting bandwagon, and fast for the entire morning! I make it the full extended teacher day of 6 hours without taking my mask of for anything. Nestle has brainwashed up into thinking we need to sip water all day long, but we can make it all the way from breakfast until lunch without eating or drinking. I promise. We did it for generations. Not that long ago, when my own kids attended elementary schools, they only had one lunch break, which meant they could even come home for lunch, and THEY ALL SURVIVED!! We shifted to two nutrition breaks for supervision reasons, not because of any health benefits. Anyone with a medical condition that demands eating and drinking more than every four hours might be better off at home. Of course it will be hard to untrain the younger kids from eating as often, and maybe there are better solutions for them - like MUCH smaller class sizes, but it's worth some new intervention to keep all their mums and dads alive. 

We also shifted pretty quietly from washing hands for 20 full seconds before and after touching our masks or eating anything, to a quick little squirt of hand sanitizer will be fine, to doing nothing at all!! I remind my students to stop touching their masks over and over during class, so I'm guessing they take them off and on without any hand cleaning going on at all when they're unsupervised. But, as a teacher was quick to inform me, as she demasked and started eating next to me without cleaning up in any way, "There is such a thing as washing your hands TOO MUCH, Marie!" So, there's that, I guess.

I keep being told not to worry about Covid because I can leave the room when kids have a break, but that reveals a gross misunderstanding of aerosol transmission. It's like smoke. If you've ever been in a room after someone has put out a cigarette, and had to waft away the smoke that hits you when you walk in, that's what they, the powers that be, should picture as they insist we return to a room that just had 15 people unmasked in it. The virus is in the air already. A survey of 700 epidemiologists recently found that the people most educated on this believe that the #1 danger facing people today, the NUMBER ONE thing we should NEVER do, is to eat with people outside our households. We have our kids doing this daily. It's unconscionable how poorly we're protecting them and how obviously little we care about stopping the spread. Happily pretending that everything is fine in a sing-song voice doesn't make the schools any safer. The lack of outbreaks locally is just luck, and our luck will run out.

I'd just be happy if people could maybe stop gaslighting anyone who is concerned that kids and staff are in imminent danger from being in a room, every day, with 15 people taking off their masks to eat and talk together when our numbers are so high. Maybe stop calling them helicopter moms if they let their kids work from home. Even if the kids don't die themselves, even if the kids don't have any symptoms and live a long life, thousands of children have lost a parent from this virus. I'm not crazy for wanting to avoid that fate befalling my own children, much less all the students I teach. But I'm starting to feel like I'm one of very few sane ones in the place. 

ETA: A recent analysis of an incident showed an infection from 21' away affected by airflow in the room. Some people get bombarded with the virus if the air flow hits them just right. People safest are people facing the fewest people, so the kids at the front of the class. People at the greatest risk, those facing the most people, so, the teachers. Researchers conclude that, indoor dining is extremely high risk, AND, even with masks, talking indoors should be discouraged. 

AND we were just made to complete a survey enforcing the use of face shield which actually do nothing. The board is always so far behind on their understanding of the virus it's laughable. It's like when Ontario adopted whole language just as the U.S. was recognizing what a bad idea it had been and was ditching it to go back to phonics. Now we're finally on board with faceshields about 2 months after they've been declared all but useless. I can't wear a faceshield and use a microphone because it sends an echo back that renders it unlistenable, and with a faceshield and no mic, nobody can hear anything I say!! But okay. I'll start wearing a faceshield in class!  

AND we have to lean towards "mask forgiveness" if kids can't keep their masks on, but there's no such thing  as "absence forgiveness" if teachers can't find the strength to walk into a room where kids have a right to keep taking off their masks! Every time I call in sick, I expect to be called by admin on my "pattern of absences" whatever the fuck that means!!

ETA on Dec. 17: After reading this philosopher destroy the ridiculous arguments by schools for insisting it's safe to eat together in a school but not in a restaurant, I talked to a board appointed mental health professional who said, in her words, "I am gobsmacked by how this board is running the schools," when I explained that all students take off their masks at once for a morning snack, even though they leave at lunchtime. She reiterated that I don't have any mental health problems; I have an unsafe workplace problem. And she asked what the unions are doing about it. Here's what my union leaders said in a recent email about masks when I asked if they could be revisited now that our numbers are so high:

"Public health" in my region means this all falls on the back of the Medical Officer of Health, Dr. Hsiu-Li Wang. She keeps instructing workplaces to reinforce measures that will help limit the spread of Covid-19, but will NOT revoke her approval of 15 kids in each room, indoors, continuing to eat together every day, despite the fact that the age group with the greatest spread right now is 14-17. 

Gobsmacked indeed


The Disaffected Lib said...

Isn't anxiety a form of defensive reaction when it arises out of a genuine threat? I suppose anxiety to an imagined threat is, what, neurosis?

Societies don't handle anxiety very well. In WWI, when soldiers mustered in their trenches to go "over the top" I'm sure they were all anxious about what awaited them. If they overcame that anxiety and got mowed down they were brave men, heroes. If they refused to go they were court martialed for cowardice and often shot.

It sounds as though you're expected to go "over the top" and just take your chances. I guess school kids probably don't indulge in high-risk behaviours but they are little virus shedders. We see that every year in cold season.

It seems that, if Queen Park is adamant on this, it's incumbent on them to have a thorough (i.e. regular) testing and tracing regime for everyone who is a habitué of the school - teachers, staff and students.

Are schools proving to be hotspots for Covid-19?

Marie Snyder said...

I would love to see regular testing on TOP of keeping the masks on the kids! I can't believe this is such a contentious point. Masks save lives... except, somehow, in schools. So curious!

Yes, anxiety overcome and forged through is courage, yet it's vital to recognize the point at which courage shifts to recklessness. Taking unnecessary risks that benefit no-one falls on the side of recklessness. It will be interesting to see, in retrospect years from now, who will be revered if cases continue to rise and fatalities increase? Teachers who continued to teach despite the risky conditions or those who reject and openly condemn the conditions that will needless deaths. Time will tell (and the perspective of the times as well, as we've seen from stories of war).

Owen Gray said...

Your anxiety is not a disorder, Marie. It's a natural reaction to what we're all facing. Those who can't or won't recognize that fact have an obvious personality disorder.

Marie Snyder said...

Thanks, Owen. I feel like it's all going to drive me to develop a disorder. It's crazy-making behaviour to insist people will all be fine, tralala, when things could be easily made so much safer.