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].  

You Can't Care about Refugees and Not Care about Covid

 Disability activist Imani Barbarin made an important connection between Covid precautions and genocide. 

In this Tiktok video she explains why "It's wild that people think they can support Palestinians as they're being disabled without disability justice":

@crutches_and_spice De@th does not follow disabled people, nondisabled people carry it with them to us. #greenscreenvideo @mawd ✯ ♬ original sound - Crutches&Spice ♿️ :

Here's the first half if you don't want to click on the 3 minute video. She starts with another vid admonishing people who support Palestine but don't mask indoors:

Hiding in Plain Sight

Anecdotal information - what we see around us - is far, far less accurate when measuring risks than scientific studies; unfortunately, it's far more persuasive. We need to heed the science. 

I don't actually know anyone who died of lung cancer from smoking. In fact, my grandmother smoked like a chimney and lived a very long life. And, back in my extremely social days of yore, I was a smoker surrounded by tons of people who smoked and none got lung cancer - that I know of. Yet I believe the science when studies show a direct connection between the two, so I quit smoking.

So many studies show a direct connection between Covid and profound brain damage, cardiovascular damage, lung damage, immune system damage, and so much more. Long Covid is a brutal condition. Jeff Gilchrist wrote out a very long list of possible damage to a person with even just a mild or asymptomatic initial case. I get that many people don't know anyone who has it, which makes it feel like it can't possibly be that serious or common. That's why its important to look at stats from random samples of the population (and from wastewater measures and from air measures to see how Covid-y it is out there) and to recognize how serious this disease really is. 

Why Resist Clean Air?

Barry Hunt spent a lot of time in hospitals with a knee injury, but managed to never catch Covid because he knows how to avoid it. 

It's possible for all of us to avoid it!! He wrote this thread in December 2021, but it's still very applicable. This is all from his thread:

I keep saying, "Someday I'll write a book" about the struggle to bring an engineering perspective to infection prevention and control in healthcare. For now I'll just write a thread.

Is there anything worse than knowing there are oceans full of icebergs ahead, how easy it is to engineer systems to detect and steer around them, but not being able to get the owners of the lines or anyone in command to listen as you blindly head straight for them? I've been advocating for engineering and standards for air, water and surfaces in healthcare facilities to ⬇️ disease transmission for over 30 years. The irony of being accused by out-of-touch ID/PH/IPAC/Epi of epistemic trespassing before and during the pandemic is gobsmacking. 

A Long Post for Long Covid Awareness Day!

March 15th is LongCovid Awareness Day, recognized in the U.S. and the U.K., and in Canada, and Sweden, but not yet by the United Nations.

A bit about my biggest concern - the brain - from James Throt, MD:

Covid: A Brain Damaging Story
I believe that in the absence of large scale studies and conducting brain imaging on a mass scale, we have to rely upon ourselves to turn to real world examples we may already be witnessing. Some questions about what you may be seeing. Now before we delve deeper into this, I think it would be felicitous to provide a little background first. MRI brain imaging has previously revealed that Covid reduces the thickness of grey matter within the frontal and temporal lobes. This would mimic symptoms of FTD [Frontotemporal Dementia].

Shame-Free Guide to Masks

Chuck created a slideshow guide of coping with mask wearing:

Our Curious Relationship with Covid Studies

Some questionable ethics in recent studies are making the rounds.

The process and ethics of Didier Raoult's work, which led to the use of hydroxychloroquine (HCQ) as a Covid treatment, was scrutinized in the latest Science Magazine. 

Raoult was saying, ‘I understand everything, I have a solution,’ and people want that kind of information in troubled times, . . . If someone has such a presence in the media landscape, politicians have to listen to him—otherwise they will be really distrusted by the population. On 26 March—amid strong resistance from some other members of the scientific council—Véran issued a decree allowing HCQ to be prescribed to Covid-19 inpatients. . . . Elisabeth Bik decided to take a close look at the HCQ paper. A microbiologist by training, Bik already knew of Raoult and his reputation for prolific publication. On her blog she pointed to several problems she saw with the paper: Patients had not been randomly assigned to the treatment and control groups, which could have biased the results. . . . Besançon, too, was curious. He looked into the paper, which had been submitted to the journal on 16 March and accepted the next day, and noticed that one of the authors was also editor-in-chief at the journal. “So you have a very short reviewing time and editorial conflict of interest,” he says. “I just find this potentially a big red flag. But I thought, it’s just one paper.” . . . 

Lewy, Lewy, Me Gotta Go

A study from May 2021 is still thought by some to be the most disturbing Covid paper out there.

The study, (published in April 2022) looked at how SARS-CoV-2 causes brain inflammation and induces Lewy body formation in macaques. Their conclusion:

"We observed Lewy bodies in brains of all rhesus macaques."

That's right up there with, "The call is coming from inside the house."

Lewy bodies are deposits of abnormal protein particles that accumulate in the brains causing Lewy Body Dementia (LBD), which is what Robin Williams had. Read his wife's description of the trauma he suffered from this disease, which ultimately led to his suicide in 2014. Symptoms include (from John Hopkins Medicine):

For the Next Doctor's Visit

Olivia Belknap made some great fact sheets that can be shared with health care providers who question your mask or try to claim you have an anxiety disorder. More at her linktree site here. 

She made one for Long Covid, too:

At the Movies (nope - not about the Oscars)

Cineplex is getting heat for mask and CO2 issues.

From LandBack

It says, "All guests are asked to lower medical masks and hoods while having their tickets scanned."

Why would Cineplex need people to remove masks and hoods when scanning their tickets?? Tickets can be given to other people so it's not a fraud issue. People aren't being asked for ID for proof of age. These aren't restricted movies. Hmmm....

Kathryn pointed out,

"Does Cineplex understand that requiring disabled patrons to unmask would likely constitute a human right violation in Ontario, specifically, that of adverse effect discrimination? Adverse effect discrimination occurs, 'where a requirement, policy, standard, qualification, rule or factor that 'appears neutral excludes or disadvantages a group protected under the Code' (OHRC, 2016). Friends, keep this in your back pocket. It is powerful." 

A Most Dangerous Place

More evidence that schools drive transmission of a virus that has long term effects on multiple organ systems, including the brain.  

This is entirely from Dr. Malgorzata Gasperowicz:

"If someone looking at this graph dares to claim that in-person schools don't substantially contribute to SARS2 spread and 'simply just reflect transmission in community,' she/he they are an intellectual equivalent of flat earthers.

Canadian Covid Society

It's officially a thing!

Dr. Kashif Pirzada explains how it started:

Wanted to share with you something near and dear to my heart. Today my colleagues and I are proud to launch the Canadian Covid Society. Covid-19 is thankfully not the threat it once was, but there are still significant issues with having a new disease roughly four times as bad as Flu (and much more contagious) floating around, which also disables a lot of people as well. In Canada it was the 3rd leading cause of death 2020, 2021 and 2022. We have the Canadian Cancer Society, and Heart and Stroke foundation for the 1st and 2nd causes; it's time we have one for the 3rd leading cause of death. 

Capitalism is Slavery

 Listen to Nathan explain the problem with a capitalist structure that forces the elderly to continue working. 

@nathanreo #revolution #deconstruction #deconstructingcapitalism #capitalism #socialism #decentralization #socialprogress #awakening #humanevolution #shiftinconsciousness #consciousness #spirituality ♬ original sound - Reo

"Capitalism is a gross system of slavery and human rights abuse. . . .  It's economic authoritarianism. If you're on a fixed income and now can't afford to live, economic forces have effectively forced the elderly to go back to work. . . .These people shouldn't be driving or part of the labour force. . . . We act like capitalism is a truth of nature, but no. We've only had this kind of capitalism for the last couple hundred years. We should be waking up to that this is real economic slavery. It removes from people the product of their own labour as it's centralized in the hands in a few billionaires. Our system is psychotic, and both political parties are not interested in deconstructing the whole thing. We need a new civil rights movement. MLK recognized he couldn't push this through a couple progressive politicians. . . . The real part of the movement happened outside of politics." 

Nothing Changed but the Rules

I might never get used to being the only masked person in a store, but I might never stop, either. 

Original art: 'Cassandra' by Evelyn De Moran' (1898, London); Cassandra in front of the burning city of Troy, depicted with disheveled hair denoting the insanity ascribed to her by the trojans. Words, mask, and viruses added by KayElle.

From #9 Dream:

Trying to warn or inform others now of the dangers of C19 feels like screaming "Fire!" in a burning theater and people saying, "Can you keep it down? I want to see the rest of this movie."

Covid didn't go away; it's still a bio-safety level 3 virus, and it's still brain invasive, causing severe brain damage in almost 20% of people with a mild or asymptomatic case and in almost 60% of people with Long Covid. I flippin' love my brain!! I exercise, eat well, and do tons of reading and puzzles and play music, all - at least in part - to stave off Alzheimer's. So of course I'm also going to wear an N95 when I'm inside public buildings, a bike helmet when I'm on my bike, and a seatbelt when I'm in a car. 

How We Look After the Least Fortunate

Back in the day, the left was all about protesting for rights for marginalized people, and the right fought for a more individualistic, pull-yourself-up-by-the-bootstraps ideology.  

Another thread from Kelly, this time on something I've also noticed in my life: this individualistic right-wing ideology in left-leaning friends:

Had a discussion with a friend on CDC isolation guidelines and how we’re fostering a culture of eugenics and forced infection. Their response? “More like we’re just finally going to stop paying people to sit at home.” 

This is someone who had been a kind and logical person. This type of personality shift is one of the aspects of the pandemic that bothers me the most. This person was kind and considerate and never opposed paid time off. Now they’ve become angry, intolerant and spew right wing rhetoric despite claiming to not belong to any “side.” 

Erosion of Public Health

You would think that after dealing with Covid for over FOUR years that Public Health would be amazing at stopping Measles in its tracks, unless maybe they've been directed otherwise.

From Henry Madison:

Why persist with Covid questions? Because our greatest achievement in history was the invention of public health. Nothing else comes close. We went to war on infections, and suddenly people lived twice as long. Living with infections is a betrayal of our own history.

Maybe Concern with Measles will Save us from Covid!!

A thread on how to stay safe from measles and two on why you should keep testing for Covid.

The first, on measles, from Jeff Gilchrist (I didn't block quote it all because it's so long - but it stops at the three asterisks and the vaccination poll.)

Increased Measles in Canada - Are you Protected? 

As Public Health crumbles and too few people are getting vaccinated for measles, our herd immunity levels have dropped too much, and now many people are at risk for a disease we almost eradicated in Canada. There has been a huge surge in measles cases around the world including cases in the UK and USA. The government is strongly advising everyone in Canada to be vaccinated with two doses of measles vaccine, especially before travelling. Popular March break destinations like Florida are having measles outbreaks, and the Florida Surgeon General is no longer requiring children who are unvaccinated to remain home from schools where measles cases are circulating, which means cases will continue to surge there. 

On Feudalism

Have we ever lived outside of a system of pseudo-feudalism with peasantry, slavery, or the working poor labouring for the benefit of Kings, land barons, or factory owners? 

One perspective of the past thousand years or so might go something like this: Peasants lived on the King's land, first for free, then later in exchange for a portion of the food they grew or products they crafted. A tax on land started when the Lords realized they could profit more from keeping sheep than people, and peasants had to commodify their labour for the privilege of continuing to live where they had been born. Then we had some revolutions to usher in a whole new way of living, to be able to have individual property rights and to choose our leaders. The wealthy expanded their land into plantations and dragged over people from the colonies to work them in exchange for some food and shelter. It was different in tone the King/peasant dynamic but not result: lords allowing food and shelter on their land to people who already lived there in exchange for their labour compared to landowners providing food and shelter to people they kidnapped in exchange for their labour. That type of labour was never abolished; it was merely outsourced to poorer countries and American prisons. More acknowledged today, we have the working poor who make just enough to barely pay for rent and food. Leaving a horrible job at Amazon isn't a realistic choice without any possibility of saving money. They're free in title but not in practice. They might very well still live on land belonging to their overlord! 

So, when did we have a democracy in which each person's unmanipulated and unfettered vote counts as much as any other, or human rights in which we are all have the right to food and shelter and certain freedoms. Did I blink and miss it? I wrote about this five years ago as well. 

Avoiding Pathogens Benefits Babies

My mom was right after all: We really should do everything we can to keep babies from getting sick.  

When I was close to the due date of my first child, my mom warned me not to pass around the baby to people or let lots of people into the house no matter how much they beg to see the baby. Everyone's going to want to see the baby, but the baby shouldn't be in contact with anyone who could be sick. And you can't always tell if someone's sick.  

Then suddenly, for just the past four years or so, the general populace seemed (seems?) to think that children should get as many infections as possible when they're young - and many think they also shouldn't get the inert version of infections offered by vaccines. Funny that. 

But now the old ways - the pre-2020 ways - have even further evidence. 

No Going Back

Conflict, climate, and covid are showing us the worst of ourselves, but it might be what we need to find our collective humanity.

Tiberius wrote:

"The old world is no longer dying, it is dead. There is no going back to how things were after this genocide has been live-streamed in high definition and Technicolour for the world to see and our leaders to endorse. The bloodthirsty status quo has been revealed to too many people, and some cats will simply not go back into their bags. 

I know what the inside of skulls look like now. I know how bodies burn and how limbs come off. I know that children never look more devastatingly innocent than when they’ve been killed by a vicious army using the world’s most advanced weaponry. I know this because I’ve seen so many of them now—so many more than the sum of all the living children I will likely ever know. I know how much pain a person can bear and still exist in this world—just ask any Palestinian still alive. There are so many images I will never forget that everything outside of Gaza seems as meaningless as what colour socks I wear. 

Willful Blindness

 Margaret Heffernan explains the term and the CDC provides a great example of it!

Heffernan lectures to MBA classes and runs a few businesses and such, so she's not someone I'd typically follow, but this is a great talk, and only 14 minutes, but the gist of it is in the slightly abridged transcript below:

In Libby, Montana, there's a rather unusual woman named Gayla Benefield [pictured above]. She always felt a little bit of an outsider, although she's been there almost all her life —a woman of Russian extraction. She told me that when she went to school, she was the only girl who ever chose to do mechanical drawing. Later in life, she got a job going house to house reading utility meters, gas meters, electricity meters. And she was doing the work in the middle of the day. And one thing particularly caught her notice, which was, in the middle of the day, she met a lot of men who were at home — middle-aged, late middle-aged — and a lot of them seemed to be on oxygen tanks. Struck her as strange.