As global governments continue "phased" quarantine measures and we face a summer (and fall) of social distancing, travel restrictions, and the cancellation of annual warm-weather festivals, we all feel more anxiety and stress, not less. When lockdown first happened, none of us knew it would continue for as long as it has. Many lost jobs as companies paired down in the wake of what is now not just a health crisis, but what will be the worst economic recession in 100 years, according to Bloomberg. All of this uncertainty landed squarely in what was already a mental health pandemic, seeing a rise in depression, insomnia, suicide ideation and suicide, domestic violence, stalking, and other crime.
In the midst of all the uncertainty, I'd like to offer some hope...and yes, even healing:
SILVER LININGS
The one positive through self-quarantines and social distancing is that we have had the opportunity to go inward. That means we've had the space to actually think deeply about who we are and what we want. In other words, when you reach the other side of this pandemic, what do you want your life to look like? Who do you want as a life partner? Where do you want to live? And, do you want to change your profession?
Instead of focusing on things we can't control, let's zero-in on how to use our time to examine our lives. Relationships are the foundation of a successful life. Partnering is how we create greater financial stability. So that's an area to really look at as we move into warmer weather and can all take advantage of increased sunshine. More light has a positive affect on mental health and can aid in gaining more clarity. Basically, we will start to feel less vulnerable overall, which means, our decisions are legitimate proactive choices, not reactive fear-based responses to outside stimuli.
We also have the time to connect with family and friends in ways we didn't before. I've spoken to friends more frequently, not less. We've been connecting through voice messages on social media, WhatsApp, Skype, Zoom, Facetime...it's been rather wonderful.
If we all make time to connect with people we care about on a regular basis, we will come out of this pandemic stronger than ever before. We're social distancing to help others stay safe. It's not just a purely selfish act. That's incredible. Humanity is truly coming together by staying apart.
LOOKING FORWARD
Recent updates on the National Institute for Health (NIH) website detail how the first phase of human trials for the COVID-19 vaccine began on 16 March 2020. While traditional vaccines introduce weakened or dead pieces of the virus into our systems as a way to provoke an immune response, it can take a decade or more to make the necessary adjustments to a given formula that proves safe.
The majority of current vaccine trials are less conventional, using genetic molecules called mRNA as a base. No vaccine built from genetic material has ever been approved (see COVID BASICS below for more).
*VACCINE UPDATE AS OF AUGUST 2020*
Could not be happier (or prouder) to report that new findings reported in NATURE show tremendous promise for a SAFE, EFFECTIVE vaccine thanks to colleagues at Harvard in collaboration with Johnson & Johnson. No danger of ADE or enhancement with this formula. And, it will only take one shot as opposed to two! Most of the front-runners in the race for the vaccine are having mixed results and require more than one inoculation for temporary immunity. Human trials for the new Johnson & Johnson-owned formula are next. Keep your fingers and toes crossed! This could be ready by spring 2021...sign me up!
COVID BASICS
The timetable for vaccine approval at the outset was 12-18 months. That's fast. And, part of the challenge is avoiding what's called "antibody dependent enhancement" (ADE)--or a phenomenon that makes our bodies more susceptible to severe illness AFTER inoculation. ADE is known to happen with certain coronaviruses, which is why no vaccine currently exists for SARS.
The other challenge is something called "antigenic drift." Small mutations in the genes of a virus lead to minor changes in the surface proteins of that same virus. These surface proteins are known as "antigens." Antigens are recognized by the immune system, triggering an immune response by creating anti-bodies to block infection--at the moment, there's no evidence anti-bodies exist even after patients recover from COVID-19, making it even more difficult to find a way to create a vaccine that can provide even short-term protection. "Drift" produces different viruses that are closely related, which means there can still be "cross-protection" from a vaccine. But when it accumulates over time, each successive viral variation becomes antigenically different--essentially, the body's immune system no longer recognizes the virus anymore, so any vaccination is rendered ineffective.
"Antigenic shift" is different from "drift" and is the likely reason behind SARS-CoV-2. Unlike "drift," "shift" accounts for major change in a virus creating whole new antigens. When that happens, a virus confined to one species can infect another, like with H1N1 ("swine flu").
Anti-body testing is now available. Quest Diagnostics has a direct-to-consumer product and there are test sites popping up in places like Walgreens and some pharmacy and grocery store chains in the States. My best advice is to contact your General Practitioner (GP) and ask about what the best options may be for you. Knowing one has the anti-bodies present for COVID-19 would theoretically allow for things like future travel and a return to on-site employment, but it's a double-edged sword in that you also may be able to carry the disease to others if you're asymptomatic. Current anti-body testing is mainly relying on what's called serological tests--which identifies if you had the virus--however, that is not the same as being protected from getting another infection in future. Masks and hand-washing will still be a requirement to protect others (and will likely be the norm for the foreseeable future). Also, not all anti-body testing is created equal--I can't stress enough how important it is to check with your GP on your options for ANY testing connected to COVID-19.
"COVID toes" are the latest symptom linked to SARs-CoV-2 (novel coronavirus/COVID-19). "Covid toes" can present as red, swollen and/or have the appearance of bruising and/or a rash. Not everyone will have this symptom. Please check with your GP if you have any symptom connected to COVID-19.
The Center for Disease Control (CDC) added new symptoms to the list that now includes fever, cough, shortness of breath, difficulty breathing, chills, shaking with chills, headache, sore throat, muscle pain, and/or the loss of taste/smell.
"Multisystem Inflammatory Syndrome in Children" (MIS-C) has been reported in children around the world; it presents like Kawasaki Disease but is essentially how COVID-19 manifests in children. According to the CDC, symptoms include fever, rash, swollen lymph nodes, redness/irritation of the eyes, swollen hands and feet, as well as inflammation and irritation of the lips, mouth and throat. Your child may have more than one of these symptoms. If your child presents with any symptom listed here, please contact your pediatrician's office on next steps. It's important not to panic, as well as to protect yourself while caring for a sick child. Go to CDC.gov for guidelines on how parents can stay safe.
Gilead's Remdesivir, used in clinical trials all over the world, has emerged as a promising treatment for those already infected with COVID-19. Recent research published 22 May in the New England Journal of Medicine shows a shortened recovery time for patients with advanced COVID-19: 11 days as opposed to 15. That's not to say that some patients did not still die from COVID-19 while on the drug, but their deaths were not connected to Remdesivir. Researchers found Remdesivir most effective for use with oxygen therapy--only possible if a patient doesn't require being on a ventilator. While it's still too early to assign Remdesivir as an overall treatment, it is hopeful for the future. Other antiviral medication used in conjunction with Remdesivir is being considered as well.
In May 2020, Remdesivir was approved by the FDA as a potential treatment for patients with advanced COVID-19.
Hydroxychloroquine (Plaquenil), the drug President Trump has a financial stake in (and also claims he's taken as a preventative for COVID-19), was suspended by the World Health Organization as a treatment because of it's potential to cause early mortality rates in COVID-19 patients. The drug itself is used to treat Malaria and is accepted as generally safe for patients with autoimmune diseases (lupus, rheumatoid arthritis, etc,), but that doesn't mean it's safe to use on patients with advanced COVID-19.
Plaquenil is known to cause heart arrhythmia, among other adverse effects. Two studies published in BMJ (British Medical Journal) on 14 May out of France and China both found that patients with advanced COVID-19 did not see increased improvement with Plaquenil but were more prone to other issues after use, including heart problems.
What makes COVID-19 so formidable?
COVID-19 uses ACE-2 receptors as entry points. That may not sound very scary until you realize that those entry points are located on the cell membranes of vital organs like your heart, lungs, liver, and kidneys.
What are ACE-2 receptors and why are they so important?
ACE-2 receptors are enzymes that lower blood pressure through a process called hydrolysis--a chemical reaction where a molecule is separated into smaller parts. The term "ACE-2" is an acronym for "angiotensin-converting enzyme 2." Angiotensin is a peptide hormone. Peptides are chains composed of amino acids. They're essentially proteins. Angiotensin causes vascular constriction, which increases blood pressure (to help our blood move around our bodies); it also helps with necessary sodium retention in the kidneys. Angiotensin is an integral part of our hormone system that regulates things like blood pressure and the balance between fluids and electrolytes. ACE-2 receptors are also present on our arteries--which helps to explain why concerns surrounding COVID-19 include blood clots.
ASKING FOR HELP
It's more important than ever before to recruit "helpers" so we can stay strong and healthy until a vaccine becomes available. A good month before lockdown, I started a new telepractice so I could help readers from all over the world gain comfort and clarity in their lives. To that end, I've been pursuing postgrad continuing/education in specialized COVID-19 topics (pregnancy/breastfeeding, psychosocial effects, ethics, leadership, mental health, vulnerable populations, vaccine development, stress, immunology, cancer patients/oncology, cardiology, hematology, pediatrics, endocrinology, obesity, etc.) at Harvard Medical School (HMS), as well as courses on positive psychology, grief, depression, and anxiety in the midst of the current crisis from the American Psychological Association (APA), and finally, a special APA accredited course on the Neurobiology of Trauma (NICABM). Feel free to review my recent CE certificates below. All Harvard Medical School coursework is accredited by the American Medical Association.
My telepractice serves the US, Canada, UK, and Ireland M-F 9am-9pm Eastern and is compassion-based, using positive psychology tools, guided self hypnosis and meditation techniques in targeted sessions. My sessions are meant for EVERYONE so are affordable for EVERYONE! I operate on a sliding scale so if someone has lost their job or is part of a hiring freeze, you can still get affordable care now and in the future.
To read more about my areas of specialization, please click the link below:
https://www.psychologytoday.com/us/therapists/rebecca-a-housel-sudbury-ma/749984
Want to sign up for a session?
https://www.rebeccahousel.com/store/c2/built-for-victory
I'm also offering gift cards for individual sessions...nothing beats the Gift of Peace of Mind:
https://www.rebeccahousel.com/store/p21/Give_the_Gift_of_Peace_of_Mind%21.html
To read my free digital column on Psychology Today, "Survive Anything: Learn How to Live Longer and Stronger," please visit:
https://www.psychologytoday.com/hk/blog/survive-anything/202005/face-shields-and-covid-19
Even though things are tough, we are far from lost. You're never alone. We can effect positive change together. I'm here for you. Remember, you are BUILT FOR VICTORY!!!
Stay safe! And, please check back here for all your COVID-19 health and wellness updates--this page will be continuously updated with the latest information throughout the crisis.
You're never alone...I'm here for you.
Doc H