Yup. Still Here. Still Need to Clean the Air.

Covid has been implicated in creating more cases of PANDAS - pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections. A 9-year-old girl dramatically changed personality after a viral infection she didn't even know she had! It was only after years of treating her symptoms as a mental health condition that they turned to a 44 day course of antibiotics which had fantastic results. 

"PANDAS presents in patients with sudden extreme anxiety and some can develop ticks or even can't walk. Others have regression in their speech, and it is all caused by the inflammation of their brain due to an infection. . . . Covid can also cause it. Both times the infection Ava had was missed as she was asymptomatic."

Current work on Long Covid from Akiko Iwasaki, PhD who works as a Sterling Professor of Immunobiology at Yale and was named one of top 100 influential people by Time Magazine. She explains that there are four hypotheses on different causes of Long Covid and all have growing evidence. Covid does all the things!

The number one cause of Long Covid appears to be persistence viral infection from replication or remnants of viral antigen or mRNA hidden in tissues and causing inflammation. They're well hidden in deeper tissues, but circulating spike proteins can be detected which might mean a simple blood test could be used in future to test for Long Covid. Second, autoimmunity from T cells and B cells attacking host proteins and antigens, which can happen after different types of stresses including acute infection with SARS-CoV-2. This is very hard to stop once it starts. Third, is reactivation of dormant viruses, like herpes and chicken pox, which also activates immune responses to those viruses, leading to Epstein-Barr and shingles. Fourth is the change in tissue from the acute phase that can, for instance, inflame microglia in the brain, which can't be restored, resulting in neurocognitive dysfunction. 

She suggests the next step, regardless the cause, is to look into targeting viruses with antivirals and antibiotics. She's studying the role of Paxlovid, looking for biomarkers that indicate who is and isn't going to be helped by the course of meds since some studies show it's effective and others show no effect. And then she gets into prevention with vaccinations, suggesting that booster doses are important in preventing risk. With the Omicron variants, one in ten adults are getting Long Covid, and a lot more people are getting infected now. About six million kids are affected by Long Covid in the U.S. right now, with teens and females at higher risk. 

Unfortunately, she doesn't mention cleaning the air or filtering it directly before viruses get in your system, you know, with an N95, so the entire interview feels like an ad for Pfizer! 

By contrast, Dr. S. Blitshteyn, who works at a Dysautonomia Clinic (disorders that affect the autonomic nervous system) wrote this warning a few months ago. She works from the patient end of care instead of the research end:

"As a neurologist specializing in Dysautonomia, I see patients with LongCovid every day. Most of these patients were vaccinated and had either no or minimal health problems prior to Covid. I am going to be honest: even those Long Covid patients that have improved are at risk of getting worse with recurrent Covid infections. Additionally, every healthy person is at risk of getting Long Covid and numerous other post-Covid neurologic, cardiovascular, metabolic and immune complications. Of course we don't want to scare the public, of course things are definitely better now than in 2020, of course treatment of acute Covid is a lot better now, of course hospitalization rates are down now compared to 2020, but... what is NOT better is us dropping all of the mitigation strategies that we had for Covid starting in 2020, what is NOT better is our lack of FDA-approved therapies for Long Covid, what is NOT better is the general health of Americans because of the ongoing Covid pandemic and the ongoing shadow pandemic of LongCovid.

LongCovid and all post-Covid complications are a major threat to public health in the United States and worldwide. We can pretend that things are fine and that we are "back to normal" pre-pandemic state of affairs, but it's not our reality, it's wishful thinking. Our "new normal" should not include at least 7-10% of population falling chronically ill with Long Covid and post-Covid complications. Our "new normal" should not include billions of dollars in economic loss and disability payments to previously employed people who are too sick to work. Our "new normal" should not include children having Covid every year and long-term neurologic and cognitive dysfunction as a result of the repeated Covid. Our "new normal" should not include adults with brains 20 years older than their age because of Covid. Our "new normal" should not include a higher risk of heart disease, diabetes, blood clots and stroke for every person, young and old, who has had Covid once and a higher risk with every repeated Covid infection.

So... it's not a good time to deny and dismiss the gravity of Covid pandemic. What we need:
✔️ Bring indoor masking back during the months with high Covid rates
✔️ Improve ventilation at schools and all crowded buildings
✔️ Require at least 7-days of quarantine for students and employees with Covid before returning to school/work.
✔️ Provide free Covid testing everywhere and to everyone
✔️ Require all healthcare facilities and clinics to have indoor masking for healthcare providers and patients
✔️ Invest in developing better Covid vaccines
✔️ Make Paxlovid free and available to most Americans
✔️ INVEST IN REAL LONG COVID THERAPEUTICS (not exercise or psychotherapy trials)
✔️ INVEST IN REAL LONG COVID CLINICS (not the ones that gather data and have nothing to offer to patients)"

If you're still wearing a seatbelt in a car, consider wearing a mask when you're inside public transport or buildings!

Cell Phones and Cigarettes

I have some concerns with the new rules for schools as reported by the CBC. The biggest concern is that the funding cuts came Friday, but yet another cell phone ban is the big news, and no money is left for cleaning the air. 

As a teacher, both cell phones and cigarettes being accepted without question and without boundaries is a problem. Well, students aren't officially allowed to smoke on the property, but we created a nice space for them, kids as young as 13, to smoke just on the other side of the property line out back to keep them from loitering on public property at the front of the school, which wouldn't look good. The same thing happened as a student in the 80s. It's still perfectly legal for children to smoke -- it's just illegal to give them cigarettes. That law comes from legislators unduly affected by tobacco lobbying.

What is University For - Part 1

In case you've missed it, many students on university campuses have been protesting the ongoing genocide in Gaza. 

The police have been heavy-handed -- or outright violent -- with some of the students. Yet one prof wrote about his primary concerns in the NY Times: that the constant noise disrupts his class and the protests are upsetting for Jewish students.

Imagine If Goliath Won

A group of scientists backed by years of solid science couldn't sway the mighty World Health Organization from their path of destruction, and we've all paid the price.  

I'm just highlighting Julia Doubleday's latest article on the airborne fiasco here. Her piece in The Gauntlet: "The WHO's claim that COVID wasn't airborne cost millions of lives. Now, they're changing the definition of airborne.

"After two years of argument and discussion, [the WHO] has officially rebranded airborne viral transmission as "through the air" transmission. Airborne particles aren't aerosol anymore; they're "Infectious Respiratory Particles," or IRPs. . . . The correspondence [between the WHO and the aerosol expert petitioners in 2020] shows that the WHO either failed to grasp or represented themselves as failing to grasp the points made by the aerosol experts. Multiple times, they repeat false claims about how sure they are that COVID is spread via 'droplets', that respirator-style masks only need to be worn during AGPs (aerosol-generating procedures, an incorrect claim that is still repeated by medical practitioners today). . . . They cite no studies to shore up their claims that COVID must be spread via droplets, but sneeringly point out that the aerosol scientists have not produced 'peer reviewed' studies demonstrating airborne spread. In April 2020, of course, it was impossible for any peer review to have been completed concerning a virus that was then a few months old. 

Another School Came Around - Not Soon Enough

Slides from Yale School of Public Health, one of the oldest school in Public Health and Epidemiology:

On Psychosomatic Illness

I don't know anything about Fibromyalgia, yet I wince when someone says it's psychosomatic. I wonder about almost any conditioned considered psychosomatic now.

I realize I'm using the term in the vernacular to mean "it's all in your head". That's how it is largely understood even though, technically, psychosomatic illness can refer to anything without a medical explanation. People communicating with the public have to understand the common usage of the term as it's being heard.

Jane Brody wrote about the concern with this label almost a decade ago (in full at the very bottom):

"When I was given a diagnosis of breast cancer in February 1999, many friends and readers wondered: 'Why did you get breast cancer? You take such good care of yourself!' . . . It seems that many people believe that if you do everything 'right', bad things won't happen. But bad things can and do happen. And they happen to the 'best' and the 'worst' of us. . . . If you're blessed with good health, you can say, 'I did it.' But if you lose your health, you know that external forces beyond your control can get in your way. Healthy people tend to act as if beneath every sick person is a healthy person trying to come out. . . . 

Canada's Healthcare Crisis

A major backbone of Canada is falling apart, and much of it is from poor policy decisions that has led to a serious doctor shortage. 

Mary Fernando, MD, wrote about it. 

"A personal post in two parts: 1. Someone I love needs a specialist but wait times are dangerously long because of our specialist shortage. 2. As a doctor who resisted large money offers from the US to stay in Canada, I've lost something more important than money: my family's safety. 

Hostility Creating Isolation

A recent study found that older adults are spending less time in public due to hostility against people in masks. 

"The study comes amid what the U.S. Surgeon General recently called an 'epidemic of loneliness' in which older adults - especially those who are immune compromised or have disabilities - are particularly vulnerable. . . . 60% of respondents said they spend more time in their home while 75% said they dine out less. Some 62% said they visit cultural and arts venues less, adn more than half said they attend church or the gym less than before the pandemic. . . . 80% of respondents reported that there are some places they are reluctant to visit in person anymore. 'The thought of going inside a gym with lots of people breathing heavily and sweating is not something I can see myself ever doing again,' said one 72-year-old male. Those who said they still go to public places like grocery stores reported that they ducked in and out quickly and skipped casual chitchat. . . . 

Many respondents reported that they were afraid of getting infected with a virus or infecting young or immune-compromised loved ones, and said they felt 'irresponsible' for being around a lot of people. Some reported getting dirty looks or rude comments when wearing masks or asking others to keep their distance - interpersonal exchanges that reinforced their inclination to stay home. . . . The loss of spontaneous interactions in what sociologists call 'third places' could have serious health consequences. . . . 

Finlay hopes that her work can encourage policymakers to create spaces more amenable to people of all ages who are now more cautious about getting sick - things like outdoor dining spaces, ventilated concert halls or masked or hybrid events. She also hopes that people will give those still wearing masks or keeping distance some grace."

What's Good for the King is Good for the Kids

We KNOW that Covid makes kids sick, which affects attendance, and we KNOW cleaning the air will help (since so many have been convince not to wear masks to class), but we'll still only implement solutions for the wealthiest 1%. 

Back in June 2020, the New York Times reported how Covid short-circuits the immune system: 

"In many patients hospitalized with the coronavirus, the immune system is threatened by a depletion of certain essential cells, suggesting eerie parallels with H.I.V. . . . and hints that a cocktail of drugs may be needed to bring the coronavirus under control. . . . Ordinarily, IP10 levels are only briefly elevated while T cells are dispatched. But in Covid-19 patients--as was the case in patients with SARS and MERS, also caused by coronaviruses--IP10 levels go up and stay up. That may create chaotic signaling int he body: It's like Usain Bolt hearing the starting gun and starting to run. Then someone keeps firing the starting gun over and over. What would he do? He'd stop, confused and disoriented. The result is that the body may be signaling T cells almost at random, confusing the immune response."

But then, unfortunately, "aerosol physicists were essentially ignored in favour of medical dogma when attempting to advise the WHO at the start of the pandemic. Many lives would have been saved had public health institutions focused on mitigating airborne transmission." 

No Ragrets

The frustrating experiences that linger with me the longest are the times I was able to make a difference in my tiny corner of the world or have some kind of effect or even have the potential to have an effect, and then it was derailed, often by a well-meaning person whose perception of their abilities might have been  greater than the reality. 

I have a far easier time coping with my own mistakes and inane decisions than watching someone else decimate my efforts. Maybe it's because I have more faith in myself to correct my own path than I have in others who seem more willing to let things fall to the wayside. 

This is just a personal rant as I try to work on disattachment from it all. I have some regrets, but when someone takes over a project, from a small task to a political portfolio, it's somehow still ours to mourn or celebrate despite not having any agency to affect it. 

Avian Flu and You

Avian flu has jumped to cows and a person, which is a little bit bigger deal than just avoiding soft boiled eggs. 

H5N1 was contracted by someone in Texas who was in contact with dairy cattle. His only symptom is eye inflammation, and he's doing fine on Tamiflu. He was isolated, and it doesn't appear to have spread further. In cows, the virus doesn't kill them, but lowers milk production, and means we should really avoid non-pasteurized milk. BUT it's a concern that cows are getting it; they're not the type of animal typically expected to catch this virus. And now baby goats are getting it and dying from it!! This is the first time goats have contracted the virus, and they seem less equipped to fight it off. 

A big problem is that it's virtually impossible to keep wild birds out of barns or away from animals and feed. 

Four Long Years

A look back to four years ago:  

From Craig Spencer, MD MPH, 

Four years ago today, I walked into the apocalypse.
Crossing the line in the ER felt like entering a whole other world.
Frenetic alarms.
Patients strewn about, struggling to breathe.
Too few staff. Too many deaths.
Covid was everything.
It had completely taken over our ER.
Covid inundated NYC a week prior. 
And many of our staff fell ill.
Especially the nurses.
We had only a fraction of those we needed.
Too few to notice when the oxygen tanks under patients' beds ran out.
So we did something kinda insane.
Actually unbelievable.

One Step Forward...

More good news about antivirals.

From Nate Bear: People are experiencing, 

"almost complete Long Covid recovery with the use of an HIV antiretroviral [ART]. There is obviously viral persistence in a proportion of Long Covid cases and the denial of this fact in the medical establishment is killing people."

So, because some people rushed to insist Covid is nothing like AIDS, and it far more like a cold, this possibility took years to be tested. But Maraviroc/Atorvastatin, a drug used with HIV, is having a very positive effect on Covid cases in individual cases. Clinical trials are just beginning. Imagine if we looked down this road four years ago instead of pretending there's no connection between two viruses that both hibernate in the body and damage immunity in a long term and deadly fashion! 

In other frustrating news, Nukit Far-UV devises are no longer available in Canada because Nicholaus Jeffers, Compliance Officer with Health Canada in the Pesticide Compliance Program, has made a claim that the devises are pesticides being sold without registration despite the fact that they are harmless to insects. Manufacturer Cyber Night Market wrote this response to the charge (and no longer delivers to Canada). 

The maple syrup and "polite Mad Max" analogies are perfect, but the gun comment at the end falls flat. She might have ended it with something about all the microplastics we're allowed to ingest. 

On Suing Social Media Giants

A collection of school boards are suing a collection of social media sites for allegedly deliberately hurting  students. 

That's from the Toronto Star headline, but deliberate harm?? I'm not sure what the lawsuit actually says, and I'm not a lawyer, but I would think that a charge of deliberate harm means they'd have to prove that the companies want to negatively affect students, instead of their motive being to make as much money as possible with harm to kids just a possible side-effect. 

But let's keep reading. 

The lawsuit from Toronto, Peel, and Ottawa school boards is asking for $4.5 billion because Snapchat, TikTok, and Meta platforms are "designed for compulsive use and have rewired the way children think, behave, and learn." 

Cognitive Tests

 I lost an hour of my morning to cognitive tests - just for fun (and a baseline).

AARP has a battery of tests you can take. They're free, but you have to register. They save them and can be retaken monthly to monitor any changes. I've been part of a study on cognition since 2020 that randomly sends me a bunch of tests to do, but it never gives me a score. This one is nice because they tell you right away how well you did. One slip on your mousepad can cost you, though! 

Neither of my parents had signs of Alzheimers or dementia at all until after hitting 90, which bodes well for me, but it makes sense to me for everyone to check their cognitive health the way we keep tabs on our physical health. 

And we know Covid affects our brain health. Today many on social media are posting and re-posting this:

"If I were in a profession where my cognition was key to my continued employment, I'd wear a respirator everywhere. And I am, so I do."

More than a year ago Dr. Jim Jackson, author of Clearing the Fog, said, "It is hard to overestimate the impact of processing speed deficits. Unfortunately, these seem to be the primary difficulties we see in our Covid-19 long-haulers who can't think on their feet, can't respond to questions or request, and cannot 'keep up.'" Daniel Brittain Dugger took him to task today,

"When I get into a traffic accident, morons who do not read will be to blame. . . . This is not the first time we have observed a virus that depletes CD4 cells, it is persistent, there is an aversion to non-pharmaceutical interventions, vaccines are not protective, there is forward transmission, and a slowing in processing speed. It was known on September 28th, 2020 that SARS-CoV-2 depletes the CD4 compartment, as does HIV. The very next day, Kenneth Podell published a journal article you coudl have read instead of writing a book on brain fog. One can draw on the experience with an HIV/AIDS epidemic. . . . It did not take long to discover that the disease could attack the brain directly, which resulted in long-term cognitive impairment. Subsequently, HIV encephalopathy and AIDS dementia complex leading to long-term cognitive impairment were discovered. Based on the emerging literature, it is reasonable to hypothesize a somewhat similar scenario may unfold in relationship to Covid-19."

Also check out this website: You Have to Live Your Life. It's a collection of studies on Covid, but they're organized as a response to prompts like, "I got it and I'm fine," "Covid is mild now," and the ever popular, "What about the economy?"

ETA: more from Ziyad Al-Aly about the brain damaged caused from Covid was recently published in The Conversation and People, so that might be one way to get a larger audience paying attention to this problem. 

AND another study that found Covid affects the synaptic homeostasis - the balance of neurotransmitters that deliver messages through the synaptic gap between neurons. Jeez! Keep your brain alive with an N95!!

On Identity: Erikson, Freud, and Sartre

 I recently listened to a podcast of Dr. Louis Cozolino, a neuroscientist and psychoanalyst, discussing what he would teach if he were training psychotherapists. The first year would be phenomenology: the power of Carl Rogers' perspective to train how to develop an alliance through reflective listening while keeping countertransference out of the session. The second year would be physiology: developmental neuroscience and the evolutionary history of brains and bodies. The third year might be called intersectionality: the interpenetration of the spectrum of options that affect clients - brain, mind, family, culture - and a reaction against therapy as a mere opiate to calm the oppressed and exploited. The final year would be on narratives and stories that we live by and on that half second that it takes our brain to construct our experience of the present and feed it back to us. 

Cozolino insists that it's not enough to just sit and listen to people vent. After developing a non-judgmental alliance with the client, therapists need to be "amygdala whisperers," to be able to down modulate amygdala activation to stop any inhibitory effect on the parietal system that enables problem solving. In other words, they need to soothe anxieties while arousing enough interest for clients to be able to learn new information. Then it's time to challenge the client's old system of thinking, slowly and delicately, a little at a time, to help them expand previous conceptualizations of themselves and the world. There's a necessary plan and a strategy to the sessions. 

By contrast, in my MA psychotherapy program, we're currently learning Piaget and Erikson's stages of development that many of us first encountered in high school classes. There's little to no encouragement to look at these older theories with a critical eye, and we're required to identify stages without a clear idea of how that knowledge might practically help clients. I'm doing well in the class despite the reality that I don't understand how acknowledging that a client is in the "identity vs role confusion" stage can provoke a useful change in the client's perceptions. 

Some Meds that Might Help

A new PrEP for Covid!

Invivyd got FDA approval for Pemgarda, or pemivibart and formerly VYD222, to be used as Pre-exposure Prophylaxis (PrEP) for Covid, specifically for adults and adolescents with moderate-to-severe immune compromise. Of course it made their stock jump dramatically. They expect it to be available imminently (see more here and here).

People can't actively have an infection when taking it, but it should be a game-changer for anyone who has been stuck at home because getting a virus would be the end of them. 

In other good new, some medicine combinations have been found to be effective in treating Long Covid symptoms. Study synopsis from Kashif Pirzada, MD: 

When the Rain Comes

 A good rain metaphor from tern:

Some people just can't wrap their heads around the multiple dangers caused by covid infection. 

Speaking to a colleague yesterday, I tried to describe it like the effects of rain. If your roof is solid, and there's a light rain shower, your house can handle it easily. Absolutely no cause for alarm. But rain isn't always light, and your roof isn't always in good condition. 

Our bodies are set up to be self healing to some extent, but if they lose that ability due to exhaustion, damage, overload, age, etc, then they can lose the capacity to bounce back. And if it rains heavily, once, twice, three, six, ten times in succession... You may start to get problems with more than the roof. 

The Enshittification of Health Care

Last week David Moscrop wrote an excellent piece in The Walrus about Loblaw. 

He wrote, 

"If you live in Canada, you're probably part of the Loblaw ecosystem, whether you like it or not. . . . It accounts for nearly a third of Canada's grocery market. . . . Loblaw's sensational fourth-quarter results--$14.53 billion in revenue and $541 million in profit--suggest the mission is going well. . . . President Galen Weston Jr. was hauled before a parliamentary committee, which grilled him over soaring food prices. . . . Grocers in Canada have recently enjoyed not just higher profits but higher profit margins--a practice one might call profiteering. Retailers keep charging more, in other words, not just because of increased industry costs but because there isn't enough competition to stop them. . . . Another wave of outrage from customers and experts forced health insurer Manulife to walk back a deal to cover certain prescription drugs exclusively at Loblaw-owned pharmacies--an arrangement that would have deepened Loblaw's reach into Canadian lives, a presence already bordering on the imperial. . . . As Shoppers Drug Mart expanded into health services, critics warned it might be pressured into putting profits first and care second by cutting corners, rushing patients, and pushing unnecessary treatments. And right on target, Shoppers was recently accused of unethical billing practices in its MedsCheck consultation program.

Government Provoked Global Suicide

Governments around the world have discussed solutions to climate change, but not enough are seriously acting to reduce this threat.

From environmentalist Stephen Barlow:

I'd far rather not have to spell out uncomfortable truths, and I have no agenda, other than to stop humanity committing global suicide by ignoring the seriousness of the climate and ecological emergency. If our governments had done what they'd promised to do, after these UN Environment Summits I've highlighted, there would be no need for me to spell any of this out. But the thing is, they didn't take any meaningful action to change direction. In essence, our governments have not merely carried on with Business as Usual BaU, as if the climate and ecological emergency did not exist, but they are planning to reinforce this globally suicidal policy for the foreseeable future. Hence, why we have a crisis. It's not that the things I'm saying are extreme, it's our governments, which are pursuing radical extremist policy, putting our civilization on course for global suicide and an unliveable future. It's not even just me saying that, but António Guterres [Secretary-General to the UN].