Source: DALL-E/Sazima (keynote speech)
This is the first post in a series about the lingering effects of coronavirus.
The age-old metaphor of the transition from the old year to the brand new is the handing over of an old, worn-out hut to a freshly swaddled, freshly powdered baby. (Where that little cutie ends up wearing her custom top hat and sash is a figment of the imagination.)
Whether this year’s models also have contented smiles or tense frowns is more of a question of political affiliation, which is not addressed in these posts. But for many of us, our newborn baby day selves may still carry some traits of our squeaky December selves. It may be at least some, or more, of the associated symptoms you’ve had since contracting COVID-19. But it was five years ago this month that it made its abysmal, world-changing debut.
Looking back over the longer term, my clinical practice has changed significantly. While virtual work is certainly becoming the norm, what I’m really talking about is the rise in “disorganization,” a combination of reduced concentration and reduced attention span. It’s more of an edgy “meh” depressive state than a “boo-boo” one. Fatigue and pain that increase and decrease. And a secondary anxiety about what it all means. Chronic disease? The beginning of a crazy slide into obsolescence? A new, undiagnosed monster?
This next series of posts aims to address these effects on the body, heart, mind, and attention, including the practice of mindfulness. We also consider how we can devise practices to help patients, students, and ourselves adapt to the lingering aftermath of trauma as we navigate yet another unknown situation. I will. First, let’s briefly review history.
It can be painful to reflect on how shocking the beginning of 2020 was. A mutated virus has swept through much of the Earth, shutting down society. Tens of millions of people were getting really sick. Millions of people lost their lives. A broader examination of this topic would include the social trauma of recent times and its subsequent impact on collective civic consciousness, but for now we will stick to the details of the aftereffects of COVID-19. For a really detailed diagram, check out the excellent Substack “Ground Truths” written by medical researcher and national treasure Dr. Eric Topol.
In the case of the two most frightening early strains, alpha or “wild type” and delta, the malicious weirdness of these strains primarily attacks not only the virus but also healthy “self” (primarily lung tissue). Because of our ability to overstimulate our own immune system. ) caused severe inflammatory reactions and often burned down villages to save them. Unfortunately, these early strains appear more likely to cause post-COVID-19 symptoms and syndromes in patients.
Later strains (all variants of the “Omicron” strain) are mostly less lethal, and subsequent mutations differ by some changes in “stickiness”. As a result, it is more contagious, but perhaps less dangerous, especially as treatments have improved. However, infection with these later variants can also cause downstream post-COVID-19 symptoms.
COVID-19 tends to persist for a long time, with some basic symptoms including fatigue, pain, and abnormal neurological symptoms such as loss of taste and smell. Edgy “flat” mood. and especially the cognitive duo of word-finding problems (aphasia/expressive aphasia) and sequential task problems (“executive function”). Probably 8 to 10 percent of people with COVID-19 have long-term COVID-19 infection.
However, what has been underreported is the widespread occurrence of post-COVID-19 symptoms and strong speculation that people with long-term COVID-19 infection are in a serious late stage. For the remaining 30+ percent of us, many of us suffer from something that is quietly smoldering in the form of cognitive or emotional slowing, a deep feeling of fatigue that quickly sets in after a stressful day, or something trivial inflammatory/infectious. even have at least some recurrence of these symptoms. Surprisingly, colds, allergies, injuries, etc. can also lead to strange post-COVID-19 conditions in the days and weeks that follow. What makes this even more disturbing for many of us is that we use the metaphor “I don’t seem to have any problems, but how could I feel (and do) this shitty thing?” It feels like “gaslighting” to use (excessively).
Mindfulness essentials
These harmful additional symptoms are familiar to those of us who already suffer from various types of autoimmune spectrum conditions, such as rheumatoid arthritis, lupus, Sjögren’s disease, and Hashimoto’s disease. In all of this, a person’s own immune system works like Yosemite Sam against pests large and small. A simplistic evolving hypothesis is that the coronavirus is a sufficiently powerful alien that it has induced our immune systems into some kind of acquired autoimmune state.
Another apt metaphor is PTSD. Just as psychological trauma drives over-built defenses in anticipation of future threats, the coronavirus is causing over-active and unpredictable responses to subsequent physical threats. It seems so.
OK, that’s the backstory. There is no “mindfulness training” per se, but perhaps the reality test for a wide range of public health issues is the act of being mindful. We’re not losing our minds, but there’s definitely something going on. In my next post, I’ll explain some of my speculations about the cause in more detail, and then explain how you can adapt.
