The New Impaired Driving Issue

We're having a rash of car accidents near me.

On a few posts, a left turn on a red in front of a school bus and a collision with a building, I referred to that recent Lancet study as possibly pointing to the cause: 

"19.4% of people who've had Covid and recovered (not officially Long Covid) show signs of SEVERE impairment in brain functioning. I expect we'll see more of this. Buckle up for safety, and keep your brain alive with an N95." 

(The study lists them as not having Long Covid, with more than half of Long Covid suffers having severe impairment, but, really, they just don't count as having it for the study because their other symptoms cleared up.)

Yalom's Gift

I recently binge-watched all of Group, a show inspired by a novel by Irvin Yalom, The Schopenhauer Cure. So I revisited Yalom's non-fiction to see how closely the series aligns to his actual practices.

The Gift of Therapy is a fascinating read from 2017 in which Yalom dives openly into his existential psychotherapy practice, explaining the four givens that affect how we think, feel and act that need to be explored at depth: death, isolation, meaning of life, and freedom (xvii). In the introduction, he jumps right into death denial revealed through a belief in personal specialness (xiii). Our current culture of selfies is likely rife with this! An existential perspective is best for clients who despair from "a confrontation with harsh facts of the human condition" (xvi). We didn't see much of this type of discussion in the show. In fact, the therapist didn't talk much at all beyond reminding the group to be honest and forthcoming.

On Group Therapy 

Yalom clarifies the distinction between group therapy and individual therapy in that group is more useful when "patients fall into despair because of their inability to develop and sustain gratifying interpersonal relationships." He offers two instructive points: a just-right structure to alleviate anxiety yet not miss potential revelations if turn-taking is too regulated, and the importance of individual summaries at the end of session recognizing that each person has a different experience of what happened. Yalom also writes and shares his own summaries of each session to group members to maintain continuity from one session to the next.

N95s Reduce the Risk

There are more studies coming out that show that N95s and fresh air help in schools, and we're still not going to act on them! 

A pre-print just came out yesterday that studied university classrooms and the way students interacted, and concluded, 

"Due to high-population density, frequent close contact, possible poor ventilation, university classrooms are vulnerable for transmission of respiratory infectious diseases. . . . When all students are wearing N95 respirators, the infection risk could be reduced by 96%." 

They also found that increased fresh air can decrease exposure by 81% and that cutting occupancy rate in half and spreading seating out can decrease exposure by 62%. 

Yet universities still demand in-person attendance without any useful mitigations in place.  

Climate Memes

I know weather is different from climate, but it feels like April outside today. 

All the snow's melting (at least we got some snow after a very green Christmas), and I started peeling off layers as I walked. 

Leon Simons (the "gentleman" climate scientist, not the Snowfall character) created the meme above. When it was criticized, he wrote:

"Some thought my meme wasn't accurate enough (it's a meme, not a peer reviewed paper). What about this one?"

A recent study he co-authored indicates that we're entering uncharted territory. Here are some graphs similar to ones that many of us have been seeing and maybe trying to ignore. It shows just how strikingly anomalous this past year has been:

More on Covid and the Brain

A new study further confirms cognitive decline after Covid.

The study weeded out depression and other issues in people with Long Covid or Post-Covid Conditions (PCC) from the effects of Covid-induced brain damage to find,

"The present study reported a significant psychomotor slowing in individuals diagnosed with PCC. Importantly, this cannot be attributed to poor global cognition, fatigue, mental health-related symptoms, or speed-accuracy trade-off. Additionally, the data indicate that this impairment does not improve over time."

Eric Topol made a simple chart to show the comparison between people without Covid (age-matched healthy individuals), those who have had Covid but not Long Covid/PCC, and those with Long Covid/PCC.

Peak Advancement

Measles cases are on the rise because of lower vaccination rates. It's one of the most contagious diseases out there, but that's still not going to budge policy.

An article in yesterday's Guardian explains that we're actually less prepared to cope with any viral activity now than we were in 2019. We've lost capacity to work with viruses! The guy in charge of the UK's vaccine taskforce, Dr. Clive Dix, said there's been a "'complete demise' of work to ensure the UK was better equipped with vaccines." He told the government his recommendations and was more than ignored:

"There were activities already going on that were stopped. . . . The UK also drove vaccine manufacturers away by treating them so poorly. . . . What we've seen is a whole list of incompetent decisions."

He also talks about concern with reliance on mRNA vaccines which need to chase after each specific strain, and are always behind the curve. We have better options, but McKinsey's in bed with Pfizer and Moderna here, so we might not ever get a chance to access them.

It's almost as if we refuse to advance any further. Have we peaked as a species?? Did we get so clever that we're witnessing the downward trend in the willingness to implement care for the public? I often think about the chimp wars the way some men apparently think of the Roman Empire. The chiimps seemed to hit a specific population density or just had too many alpha males, and they turned on each other, taking their own numbers down by half within four years. Maybe that's us right now, willing to let people die by more passive means that protects everyone from ever taking responsibility for anything.

We Need Policy Based on Evidence, not Vibes

Survival of the fittest doesn't mean the strongest survive, it means whomever can best adapt to the conditions of life will survive. 

Adapting doesn't mean tolerating what's happening and ignoring it; it means changing when the conditions of life change. So, in a pandemic, it means changing the way we live in order to avoid getting this virus as much as possible. A super easy way to adapt is to wear an N95 whenever leaving the house. With climate, we can adapt by slowing the system, like by cycling or taking the bus instead of driving a car. 

Unfortunately policy creators have other plans. According to Dr. Jennifer Grant of the BC CDC,  

Our Fragile Democracy

The Financial Times posted a video with Margaret Atwood discussing democracy. It's just 6 minutes, and the illustrations (from Jamie Macdonald) really add to it.

She asks if democracy is fragile or resilient, and points out that we might find out as more climate change effects hit closer to home. I like the video - it's short and sweet and might wake people up to the idea that democracy can be lost if we don't work to protect it. But I don't love it. I have some caveats.

Covid's Immune Response Suppression

For many, Covid seems milder now, closer to a regular flu, but yet another new study suggests otherwise.

I like this analogy from Tern to help explain a recent study from Nature Microbiology. 

"Do you know why it can be a bad sign that an acute covid infection seems more mild? 🔥👉Covid evolved TO SUPPRESS YOUR INITIAL RESPONSE TO INFECTION 😮 I'm going to try to explain this really important concept. 

So when Omicron turned up, the initial or 'acute' stage of infection seemed to be 'milder', but that wasn't because your body was handling it better. It was because Omicron was switching off your body's ability to respond. 😮 When you encounter an invasive pathogen like a virus or bacteria, your body responds, but your first response is generic. It's not tailored to the infection. It's the Innate Immune Response. Like you call 999 or 911 and some police turn up whether it's a fire or crime or medical emergency. And you can tell there's been an incident because there's all these sirens and flashing lights and emergency services vehicles.

Grand Theft Immunity

T. Ryan Gregory asks us to consider the possibility that repeated infection is rolling the dice that leads to Long Covid, which causes immune damage:

"If we're insisting on using the rhetoric of fiscal metaphors, "immunity theft" can be small and brief (petty immunity theft) all the way to severe and long-term (grand immunity theft). It all adds to negative effects on public health. Even if Covid infection caused grand immunity theft "only" in patients with Long Covid and only caused petty immunity theft for a short period in others, that is still a LOT more susceptibility to other infections overall. And that's the best case.

A much worse case is that damage of repeated infections is cumulative, or risk of severe effects is higher (or just even equal) with each infection. We don't know, because this is a new virus. But there are very good reasons to take this risk seriously. Let's be clear. "It's only a temporary reduction of immune function, which other viruses do too" and "It's only a serious issue in people with Long Covid" are terrible arguments for doing nothing. 

The Senate Committee Hearing Addressing Long Covid

It's a funny disconnect between Twitter and everywhere else. Yesterday everyone I know online was glued to the Senate hearings. If you weren't one of them, here's the gist:

You can watch the whole thing here. These are just the highlights that stood out to me.

Long Covid patients, parents of patients, and medical professions gave testimony to the Senate, calling for a moonshot action to match the urgency of the problem. That is, we need to use all available resources and technology to find a solution. Right now there is NO medical process to help Long Covid sufferers. About a third of people with Covid end up with Long Covid, and half of them have symptoms similar to ME-CFS. The more Covid infections you get, the greater your chance of getting Long Covid. Until we have treatment, all we have is prevention, which means N95s. The only way to avoid getting Long Covid is to avoid getting Covid.

Elderly Activism

Fiona Atkinson, retired teacher, gave a couple of MPs a lesson that they refused to learn:

This is a video that was on the news in October, but then hit TikTok yesterday, so is just now being spread on social media. Funny how that works.

The interviewers are also MPs, something you don't see much of here (except that weird Ford Nation show), and they asked about grey haired protesters. As someone with a few grey hairs sneaking in the mix, I've noticed for years that most of the protesters at marches and rallies are older. They young make the news, but the old make the numbers. I've been one of the youngest ones in the group my whole life - even still! MP McVey ask if it's about having time or wanting a legacy, but Fiona just stays on course that it's about caring about children. They're hoping for a fluff piece about a little old lady full of piss and vinegar, and Fiona kept it on track to be about the science of climate change. 

At the end, McVey suggests that Fiona's problem is with the timeline she proposes. I don't think McVey understands what's going on in the world right now! 

They're Going Full Orwell: Sickness is Health

Lots of misinformation out there still. 

On Vaccinations

We know that vaccinations help reduce severity of Covid to keep people out of the hospital, and we know their effectiveness wanes after a few months so boosters are needed at least every six months. In Ontario, they've decided the next shot will be for over 65 and immunocompromised only, but the CBC spun it like this:

"Too many people need serious medical care for flu, Covid when we can prevent it, WHO says. The National Advisory Committee on Immunization (NACI) released guidance on offering an additional dose of Covid-19 vaccines in the spring for people at high risk of severe illness from the pandemic virus."

See what they did there? They made it seem like the next booster of XBB coming in six month will be given in addition to the one people are getting right now for certain people, as an extra, as if those in the know haven't been scrambling to get vaccinated every six months already. An alternative media explanation could look like this:

"Don't expect to get another vaccination despite how well they can help keep you out of the hospital! The NACI has decided to restrict the spring booster to only about 20% of the population despite vaccine protection waning within months. It's unclear if the vaccines on offer right now will be the last that are accessible by the general public."

The Answer is Less Virus

It's not nearly as deadly in the near term as the Spanish Flu, which took out 5% of the population, or the Black Death, which wiped out half of Londoners, but there are other changes in our lives that could make Covid more of a risk overall:

We might have relaxed with Covid knowing that it appears to cause fatalities in just one in a thousand people (about 7 million out of over 7 billion, although some places suggest it's at least four times as high). But T. Ryan Gregory explains why that's little comfort:

"Just a reminder that the following are unprecedented in all of human history and pre-history:
* 8 billion hosts.
* Global travel.
* Older population thanks to long lifespans.
* Repeated infections up to several times per year.
* Extremely dense populations, mostly indoors. 

Let 'er Rip Means Let THEM R.I.P.

 A few people have been commenting on the current "death by semantics", or what Orwell called "doublespeak."

I used that image just in October, but it's too on-the-nose not to use it again here.

T. Ryan Gregory wrote,

"Death by semantics. It's spread in the air, but it's not airborne. It's a major global health risk but not an emergency. It's still a pandemic but not the emergency phase of a pandemic. It's a variant of interest but not a variant of concern."

Teaching with Covid in Class

Is there a better way to do school during an ongoing, quite possibly never-ending pandemic AND with climate crisis coming home to roost? 

Christina Virgil, on TikTok discussed the problem with schools making attendance their highest priority, and highlighted the sentiments of Jim the Hermit:

"Thing is, education does matter, but then so does staying healthy and alive. So this is another reason why 'let Covid rip' can't work as a strategy. We're producing a generation that will be either poorly educated because they didn't go to school or disabled because they did."

Except, of course, for those wealthy enough to be able to use private schools that enlist all possible mitigations or keep their children home with a private tutor. That generational line will be just fine.

It seems likely that we'll have ongoing waves of new variants for some time. Demanding that kids go to school sick seems like the rock bottom worst option. Absolutely we have to stop transmission in schools. 100 million percent! I wrote about that a couple months ago: "Give all the kids and staff N95s and clean the air so everyone is safer in the building and then just watch the "absenteeism" plummet!" 

Compare teacher absences to other fields. It's not just kids getting sick!!

But just in case we don't do that - or don't do it well, and kids keep getting sick with a disease that can cause lifelong disability, maybe we need to re-design teaching to openly acknowledge that we're living during a pandemic and climate change. 

Spread the Word, Not the Virus

We've been behind the curve on Covid mitigations. At this point, we should be able to see the error in removing masks, right?!

When the wastewater data and/or hospitalization rates are low but STARTING to rise, that's when we need masks to be mandated. Instead, we wait until hospitals are overflowing to suggest maybe, if it's not too much trouble, we could put them on. And, as soon as cases start to decline, we take them off again, which makes cases rise again, ad infinitum. At the very least you'd think hospitals could keep them on permanently. 

Chesterfield Royal Hospital in England got trounced after making this statement:

"Clinical update: Masks - Recently we re-introduced mask wearing for everyone in clinical areas. We are pleased to say that we have had no outbreaks during this time and sickness and respiratory illness rates have now dropped significantly. This reduction means that we are now ceasing the requirements to wear masks in clinical areas."

It's getting harder and harder to tell reality from parody anymore:

Covid Basics in Just Five Minutes

There's a TikTok making the rounds that says everything I've been writing here in just five minutes!

It took some cajoling to watch it all the way through because the camera movement is a little bothersome, but it's definitely worth a listen. And, of course, here's the transcript in full with some of my addendums and links. 

Mawd (@mudflapbrokentire) said,

"So...the elephant in the room... Covid. Don't dissociate! Don't look away! I know you're about to, but you need to listen to this. I know it's difficult to listen to things about Covid right now. I know it's hard, but this is pressing. 

I know it's difficult to continue to listen about Covid if you have not been taking precautions, if you've not been wearing a mask. It's hard to hear about the ways in which you may have put yourself in danger [or your parents or your kids], but we are in one of the biggest Covid surges of all time, and you need to be taking precautions. 

The Best Prime Minister We Never Had

There are few politicians that I gush over, but Ed Broadbent is one of them. We lost one of the good ones.

I don't like him because he's NDP - there are others in that party who wouldn't get my vote - but because he's principled. I'm even a member of the Broadbent Institute. He would have turned 88 in March. 

When he left politics to care for his wife back in 2006, The Globe and Mail wrote this about his character:

"Farewell, Honest Ed, the best prime minister Canada never had. In an era of contemptuous, mean-spirited public discourse, Mr. Broadbent is an oxymoron--a decent Canadian politician. . . . In his goodbye speech to teh Commons in May, Mr. Broadbent said, 'I have been here for the great debates of my time--on the Constitution; on the national energy program; on the War Measures Act; on the recognition of Japanese Canadians, their place in history and our unpleasant, to put it euphemistically, treatment of them historically. Many debates went to the root of what this country is all about.' He also played his part int he abolition of capital punishment, the great abortion clashes and the recognition of same-sex marriage. . . . He is leaving office without the slightest whiff of scandal. . . . Although 75% of his constituents in Oshawa were for the death penalty, Mr. Broadbent voted for abolition. To sway fellow MPs, he sent each a copy of Albert Camus's passionate 1957 essay, 'Reflections on the Guillotine.' . . . He is convinced that MMPR [mixed member proportional representation] would also civilize a loutish, testosterone-dominated Parliament."

Calling the debates of 2006 "contemptuous, mean-spirited public discourse" seems cute by our standards which have fallen so far so fast. What would have been absolutely shocking back then is now commonplace, greeted with eye-rolls rather than reprimands: rage-farming, supporting the convoy that disturbed or harmed so many lives in Ottawa, intentionally obfuscating facts, and questioning the value of spending money to care for people. Looking back at the things Broadbent did and the way he interacted with people gives us a marker to work towards. 

Catherine McKenna shared this quote of his:

"To be humane, societies must be democratic - and, to be democratic, every person must be afforded the economic and social rights necessary for their individual flourishing. On their own, political and civil freedoms are insufficient in the realization of that goal."

Of course I have to include what may be the most cringe-inducing 60 seconds of your day today. He ran and won in 1968 and then quit in 1988. He was persuaded to run again by Jack Layton in 2004, and here's part of his campaign. He won with this!

I warned you!

Vaccines are Still Part of the Solution

 The XBB booster can help keep you out of the hospital! Why don't we understand that?

From Prof Raywat Deonandan, Epidemiologist & Research Chair at the University of Ottawa:

"There are many cognitive barriers preventing many people from understanding Covid and vaccine science. There are three I want to highlight today.

1) Inability to Appreciate Exponential Growth:  By the time you see it, it's already here. The magic of compound interest can make you rich, bury you in debt, or overwhelm your hospitals. Accept that no one has a "feel" for it and instead trust the objective math. Do you get exponential growth? If I invest a single dollar into investment fund that doubles my money every three days, how long until I'm a millionaire? The answer is 60 days. If this surprises you, you're not alone. It underlines how we all suffer from this cognitive deficiency. [For a great exponential growth explanation, check out David Suzuki comparing bacteria in a test tube to the number of people on the planet.]

2) Separating Individual from Population Risk: A 1% fatality rate sounds minuscule for the individual. But for a population, it can be crippling. If one million people commuting to work today had a 1% chance of dying, that's 10,000 people suddenly dead. It's a big deal.

3) Inability to Accept Uncertainty:  Current Covid booster jab has 60% efficacy against hospitalization. 'But my uncle was jabbed and he got Covid and is in the ICU!' Yeah, 60% is not 100%. It won't keep everyone out of the hospital. But it will keep *most* people out."

I often wonder why I typically understand these three when so many really struggle to understand them. I think it's from being raised by two physics/math profs who would randomly explain this stuff and correct any errors in thinking at the dinner table. 

What's most curious to me is that we all know that no birth control is 100%, but we still use it, trusting the odds, or, if we're really smart, using two kinds at once (condoms and the pill). But many refuse to use the vaccine unless it's 100% effective. A vaccine that prevents hospitalization 60% (or 76% from this study) of the time is a vaccine that works to help reduce severity of symptoms. And getting vaccinated means you have a much better chance of not ending up in the hospital. Who doesn't want to reduce their chance of breathing through a tube shoved down their throat??