Links and Random Thoughts

It is a little weird, when you have this crisis going on, and it seems everyone around you is overly fascinated by the epidemiology or medical side of things, but I am more fascinated by crisis management and related things (and perhaps existentialism).

Every time I write, I seem to take longer than intended and write more than intended. I think right now, I just want to talk, to get out my emotions, experiences, hopes, fears, questions, concerns, and random existentialist thoughts. Eventually I will move all this stuff to the pages format which I have set up for my travel journals.

My Current Situation:
As far as I can tell, my issues right now are social isolation and burnout. I think my current phase of this started during my PhD and has gotten worse over time. Granted, considering the current level of knowledge of and respect for mental health concerns in society, I have no certainty in this.

Basically, my difficulty in life is that I think slowly, get overwhelmed easily, learn differently, and have different needs than others. Trying to be involved or included in things is a constant struggle for me, as I often can't find opportunities, and opportunities which do exist are not well fit to me, and trying to do things on my own basically destroys me.

My general experience in life is that either you do what others are doing, how they are doing it, or do things on your own. The notion that others will make room for you tends not to happen in practice. I would say this is especially true for invisible disability, but people don't tend to interpret the needs of others very well in any case.

Doing everything on my own is extremely draining for me as well as alienating when I am forced to do it alone, especially when I need help. And the list of things which are difficult or exhausting for me often includes things that people would not think of as potentially problematic.

My Experience at the Hospital:
When I got into Kingston in September 2018, I had started having issues. Basically, if I were to walk for more than ~ 28 km per week, I would break down, start crying, have trouble with balance, and start having a sense of despair. I had been going into the walk-in clinics to try to get treatment, but the couldn't really do anything. By the end of October, I had kind of felt like I had gotten to the point where I could no longer take care of myself, and decided to go into the emergency room.

The first problems occurred before I got to the doctor. Basically, they want to take the EKG, blood sample, and urine sample from everyone who goes in there. I have a lot of difficulty with needles (a common problem), and they basically had no patience for this. Unlike other times for which I had my blood taken, where they try to find a way to make it work, here they basically called me a troublemaker for not cooperating.

When I finally got to see the doctor, he asked me why I was there, and I told him what I knew. He was not happy with my response, and proceeded to ask the same questions in a harsher and harsher tone. This caused me to break down and start crying. I also attempted to call people I knew on the phone, in order to get help talking to this individual, but there was no phone signal and I didn't have Wi-Fi. The doctor also got annoyed at me for refusing to have blood drawn. (Although, I might point out that I never refused this, I only stated that I have trouble with needles, and they were kind of impatient about the process.)

Eventually the doctor referred me to the outpatient mental health program at the hospital. I apologized for the difficulty, then had them call a taxi to take me home.

The whole incident was kind of traumatic for me, and I was afraid to go back there later.

Follow up:
    So, after you go to a hospital in Canada, they will start sending you mail regularly asking for donations. At least it is better than the US, where you get a ridiculously high bill, but still, a hospital is not a charity, it is critical infrastructure, and should be funded by the government. But the government kind of underfunds the hospitals, so the hospitals are left asking for donations to enable them to maintain a reasonable level of functionality.

Basic general observations (or lessons) from this:
    A) The hospitals and health care system were in crisis before there was a pandemic. This is one of those things that everyone wants their tax money to go to, but the politicians typically undervalue when they develop the budgets. It is especially amusing / scary to see implications that medical professionals had been doing pandemic readiness modeling and simulation games before the pandemic, yet not only did they not get the supplies they requested, but they had been forced to reduce their availability before the crisis due to reduced funding.
    B) Our societies don't value mental health or know how to deal with mental health issues. In the UK, I was able to get a GP much easier after I finally got an address, but they still had no public resources for mental health care. It appears often that unless you actually try to commit suicide, it is impossible to get treatment. Basically, if people die, others freak out, but if people don't die, others just assume that there is no issue and the people with issues are just being troublemakers. Basically, if you can't see the issue, there is no issue, even though we know this is wrong.
    C) People instinctively assume ill intent in the case of lack of ability or unmet needs. This is a perpetual problem I have experienced. I think my struggles with disability and other aspects of life have allowed me to experience enough that I know what people expect of others can often be unrealistic or misguided. Sometimes it is a little weird when I get in conversations, and the other person assumes ill intent of others in a certain circumstance, and I freak out, as if my life or freedom is in danger. Because often it is -- if this individual did not know me, they would interpret my actions in this way as well. And I have had many situations when people have done just this -- assumed I was being selfish or a troublemaker because I had certain needs which differed from others or didn't know what to do or just wanted my needs to also be taken into account in a situation.
    And, yes, a surprising amount of problematic behavior is caused by alienation / social isolation issues, or other underlying issues.

A Summary of My Views of the Pandemic:

In terms of the appropriate response to the pandemic: I am against reacting, and for carefully planned responses, cost-benefit analyses, and long term planning. I am less for or against lockdown as I am against the whole reacting emotionally rather than actually calculating what best benefits the quality of life of people.

That being said, sometimes I find just watching how people react to crisis quite amusing, and seem to have been able to just consider people's poor crisis management skills as part of the crisis. If human emotion is thought of as a natural disaster, it is not so frustrating to deal with. And it is just as predictable and unavoidable as any other part of nature.

What we should be doing: In times of war, in the modern world, governments have increased the emphasis on the war economy: repurposing buildings and factories, conscripting people to serve a soldiers. Most of the things I think have been going on, except for the recruiting of new medical workers. The number of people in medicine is not fixed, most of the training is by practicing the craft, we will need more people later, and this would fix both the underwork and overwork problem at the same time. And unlike killing people, medicine is a useful skill to have in the general populace.

Hopes:

 - A slowing down of our society and a recalculation of priorities -- because we are just trying to push economic growth faster and faster, but it is not actually increasing the well-being of our people, and often actually making it worse.

 - More investment into healthcare, especially if we can get the money, attention, and resources out of the security state in the process. This second part is not going to happen, but would be extremely useful. You don't even need to remove the people or money from these industries, either. Just train the police and soldiers as doctors, nurses, social workers, etc. instead of to distrust or kill people.

 - More solidarity, empathy, socialization within the community, mental health support. Because we need each other to survive.

...

Fears:

 - Increased surveillance or authoritarianism -- This happened after 9/11, for instance. It is quite common for those in charge to exploit a crisis in order to solidify their power or pass unpopular legislation. 

 - Increased reliance on the internet -- The internet is a wonderful tool, but we do need to participate in the real world and not just live online.

Philosophy:
Here are a couple more Slavoj Zizek coronavirus articles: 1, 2
I also keep on remembering Dan Carlin talking about the atomic bomb "Logical Insanity"
Here is someone talking about the experience of people used to dealing with disasters.

Social Isolation vs. Quarantine, Sample Articles:
I don't want to give you too many of these, as they are summaries or opinions, I don't have the greatest of sources, and I tend to disagree with certain aspects of their analyses while liking other parts. What is here is intended to give a decent summary of the various issues, written by people who are in the medical profession.

This appears to be a decent summary of the issues with the coronavirus lockdowns. He doesn't talk about the risks of society breaking down from either doing nothing or poorly planned lockdowns, but he describing things from the point of view of a medical professional. He also starts by saying that he agrees with the social distancing measures if that is what his colleagues in other specializations recommend, which is important, since I have read things talking about such issues which seem more to come from a denial state.

Here is another individual talking about the dangers of lockdowns. He has a bit of a denial tone in his writing, but he does talk about the societal breakdown risks from shutting everything down (without being all "but democracy" or "but the economy"). I personally believe that the "do nothing" or "wait and see" approaches also have many of the same issues as the "quarantine everything" mentality, and we do need to act expecting the worst case scenario, even while acknowledging that it may not be the case. What is the expression: "Plan for the worst, hope for the best." Something like that. I tend to like these, because they point out the flaws in our current pandemic management strategy, but they tend to be very bad at talking about alternatives, or even acknowledging that these issues also exist in the "do nothing" type approaches.

This one has more of a neutral tone as well as ending with the warning to watch more than just coronavirus related things, as politicians can sneak in problematic legislation while nobody is watching. I want to point out that I have friends who are activists, and one of them has talked about the issues of trying to get media coverage for his campaign. [With the environmentalists and peace activists, things are kind of more corona-adjacent, like demands to end sanctions, for instance, which do tie into the current crisis, but technically existed before it.]

This is one general summary of issues with loneliness, unrelated to the virus. You can find many more.

Annual Death Rate:
So, I know it is a difficult to know what to do with this information. Basically, if this can take you out of either a denial (reminding young people that they are still vulnerable) or panic (reminding people that death is normal, and we survive despite this many people dying per year) state, then that is good, while if it causes denial (because if death is normal, we don't need to do anything about it, right?) or panic, then that is bad.

I think my mentality behind looking at this is to get people out of just thinking about the crisis in terms of number dead from the disease. The reason health professionals recommended that we take steps to minimize infection was to prevent the hospitals from being overwhelmed, thus multiplying the death rate just from the disease by a factor of 10 (or something like that) and also preventing others who need treatment for other issues from getting it, further increasing the number of deaths or long-term injury. Besides, the "flattening the curve" plots have the same number of people getting infected, just over a longer period of time.

Here is a comparison of Covid-19 death rates to the yearly death rate. This is the risk of death if you get sick with Covid-19 vs a year of living, not the total number of expected deaths or reduction of life expectancy due to the pandemic (although there may be estimates based on primitive models), which could potentially involve non-Covid-19 deaths caused by the conditions of the pandemic, whatever they may be.

This particular chart from the CDC for the US highlights accident, homicide, and suicide. Probably also relevant for Covid-19 would be to highlight the Influenza & Pneumonia cells as well. (Yes, it does make the top 10, even in years without a pandemic.) You can also look up the general Wikipedia page, or CDC page, for instance.

Other:
This was the video of the American hikers who were lured across the Iran / Iraq border and imprisoned in Iran for a while, which triggered a feeling of relation for me when I watched it in 2014. I don't think it is necessarily relevant, but it is interesting.

"Let us eat, drink, and be merry, for tomorrow we may die."

This is my personal story of the current pandemic for March 2020. Despite the sudden shift in attitude around the middle of this month, I include the whole month, as context is important, as the crisis had actually started earlier in the year, and was known even in February. Events never really happen as suddenly or all at once as people think.

My experience in life is with social isolation and loneliness, among other things which should be clear from the context of the narrative. After going to Russia for September and October, where I feel a strong sense of kinship (and could even deal with working or living alone without a dog), and after having gone home to visit my parents for the Christmas break, in the US where I feel a strong sense of alienation, coming into January, I was already in crisis. This is why my crisis management / preparation instincts were to go to PI (Perimeter Institute for Theoretical Physics) starting at the beginning of February, until the end of March. There, I had people with whom I could talk, who didn't drive me crazy when I talked with them.

The first week of March I broke down due to feeling excluded in certain political discussions. The main trigger occurred on the first weekend of that month, but the problematic state didn't lift until the weekend after. During this week, I had been talking to people about my situation, and felt like I needed to take steps to move to Russia. This led me to look at the Covid-19 maps, to know what regions were risk zones, to see if I would have to quarantine myself for 2 weeks after travel. The answer was yes -- most of Europe was already over 1000 cases each country, and Moscow and Toronto had already outbreaked. I wondered at that point why PI had not yet shut down their visitor program and discouraged people from traveling.

The second week, my entire research group at Queen's was traveling. I knew because I had forgotten to pay rent due to the previous week's emotional stress. My supervisor, who was at PI with me, was in Vancouver that week (which, like Toronto, had community transmitted Covid-19 cases already). I had thought this was suspicious, but set it aside. People know what they are doing and how to make decisions for themselves, right?

PI had been slowly implementing policies to encourage proper hygiene, people talked about the pandemic and knew the situation and risks. I say signs appear in my apartment building related to Covid-19. Something about them bothered me, but I felt it was good for people to putting more effort into proper hygiene, as while there was no outbreak in the Waterloo region, there was already a Covid-19 case, so it was only a manner of time.

Social distancing, when I had first heard that term in relation to this crisis, sort of set of certain alarms in my brain. I kind of remembered every bad instance I had with getting sick as a child. You know, all those times when you get sick and people freak out about catching it instead of helping you in your time of need? One specific instance I remembered was near the end of my time as an undergraduate. During this period in my life, I frequently went back home to my parents. I had gotten sick with a cold, and was in communication with my mother. She had told me that she hoped I was still going to classes while I was sick, which I confirmed was the case. Then I went home that weekend. She got mad at me for coming home sick, potentially infecting her. I told her that she had told me to still go to class, to which she responded that she had not realized how sick I was. I think, because of this, when I saw what was going on, I knew at some level what was happening.

That Thursday evening we received the order that people were encouraged to work from home and PI was going into partial shutdown. The students I was talking with seemed to take it as a reversal to the previous "don't panic" order, as if "don't panic" and "it is time to discourage unnecessary social contact" are somehow contradictory. I was confused about the timing, but then I was told that there was another Covid-19 case in Waterloo, so I assumed that the change of policy was due to the increased risk that someone traveling had messed up and Waterloo had Covid-19 being community transferred.

My supervisor came to pick me up and take me back to Kingston on Saturday. Since Waterloo had cases and Kingston didn't, I was going to isolate for a week to see if my portion of the Waterloo community had cases appear. Coming home, we saw people on the street, celebrating St. Patrick's Day. My supervisor was annoyed at this, but to me, I saw people in groups of 3, with the groups having ample distance between each other, so while I knew they were probably not being careful, I was annoyed by his reaction, as he seemed to not understand the need for people to enjoy themselves in times of crisis.

By Monday, I decided to take advantage of the situation to organize my life. I had been struggling since getting to Kingston, and even before, all the way back to the start of my PhD. I started with unpacking, then basic organization, making lists as to what I needed to do, etc. I knew I needed to deal with food, cleaning, walking the dog, and ensuring socialization.

Yes. I have been dealing with depression-like symptoms all my life. I know what people are supposed to do, as I am told this all the time, and I know which of these tricks help me.

For this last part, socialization, I started calling or messaging people I knew, to start developing online contacts. But I knew this would not be enough. People don't function without in-person social engagement with other humans, and since I have had this history of struggling with developing relationships, taking care of myself, or being a part of the community, this is even more important for me. I needed to find my contacts in Kingston, and to find a way to meet in person. This turned out to be impossible.

The first thing I thought of was trying to put back together our Gloomhaven group. The people in this group were all from our research group at work. We had four regulars, and we were probably all regulars as we had few, if any, other friends in town. My thought process was that we would close the group, only allowing in the four regulars, who were unlikely to have much contact with others outside the group, and wait until two weeks after everyone had traveled in order to restart the game. My supervisor instead suggested we move the game online.

So basically, we got into an argument. He told me it would be irresponsible, and a bad example as a leader to participate in a game in person, even with a closed group with three girls who have struggled with depression or social isolation, two living alone, one with him. The language he used invoked memories of my time at computer camp as a CIT. One such memory was when I refused to play dodge ball, the other was when I got sick and couldn't participate in any exercise, only to be yelled at for having avoided exercise afterwards. Then my brain suddenly realized what was going on. These steps and stages were not rational policy in order to combat a crisis, they were emotional reactions with little thought, analysis, or long term planning.

I might also point out that in this, despite this individual refusing to try to meet in person with someone who probably needs it, he also didn't self-isolate after traveling. He went into the office on Monday, saying that there was nobody around, so it was not an issue. He offered to buy me groceries on Thursday, when I was really struggling, not eating, and sleeping all the time.

As far as I can tell, what happened is this: The brother of the crack smoking mayor of Toronto is our current primer (governor). He shut down Ontario in response to Covid-19, specifically as a response to the St. Patrick's Day celebrations of the students. People kind of went "insane" as a response. They switched from a pseudo-denial phase to a pseudo-panic phase seemingly overnight. I think it is difficult for people to both not panic and to be aware of danger and take protective measures at the same time.

But part of it, as far as I can tell, is how people prioritize things. When work is the most important responsibility, people keep traveling, despite the crisis, because work priorities come first, and canceling meetings would be wrong. When everything snapped, Covid became the top priority, and its needs came first. Hence a lack of realization that socialization IS a necessity for people. (Yes, loneliness kills, including by increasing the risk of infection.) Instead of what is supposed to be going on, a cost-benefit analysis of all the factors in a situation to determine the correct course of action, people instead have this internal priority chart, and everything on top trumps that coming beneath it. Basically, people can't multitask.

Hence, instead of preventing deaths or a breakdown of society, people just focus on trying to prevent Covid-19 cases, and therefore prevent Covid-19 deaths and the overflow of hospitals due specifically to Covid-19. However, the virus is merely the trigger, one piece of the crisis, not its entirety. Healthcare was underfunded long before we had a pandemic, even as we knew this was a possibility.

Everything in this world seems to indicate that people do not understand moderation, long term planning, cost benefit analysis with complex systems, or even thinking for oneself. Denial or panic are not the only options in a crisis; we can make rational decisions.

The lack of long-term planning also seems to be endemic in this situation. What is the end game? Do we need everyone to get sick eventually to prevent future coronaviruses from being so disruptive? Are we expecting that we can make this go away? Are we waiting for a vaccine? How long do people really think this will take? Because it will, almost certainly be more than a few weeks. For less than a couple months, like in China, the current situation may work. But if it will be 6 months to years, we need to talk about shifting our economy and daily life rather than shutting it down. Trying to even out the risks and workload across the healthy population while still minimizing the risks to everyone. So people don't go insane. And we really need to be honest about the situation.

But maybe I am just one of the few strange people who actually likes to sit, talk, plan, strategize, map out cause and effect to help catch counter-intuitive system responses and positive feedback loops, rather than just jump into a situation and do things. That has certainly been a major factor contributing to my feelings of social isolation and loneliness in life.

I also think my attitude to death and crises freaks many people out. Perhaps people are so used to acting on emotion or impulse that they don't even realize it is possible to actually think for themselves about a situation without either being emotional or taking orders from the top. I say that I am not afraid of getting sick or dying, and people assume that this means I am not aware of the risks or that I don't think it is appropriate to take protective measures.

The fact of the matter is that I am aware of practices in experimental science as well as many other situations -- mitigate danger, take precautions, but don't avoid everything because it may be dangerous.

However, my generation, and those who are younger, do come from a world where we were told to do exactly this, i.e. don't do things which are potentially dangerous. People have this instinct to protect others from potential harm, and often cause more harm than good as a result. I know this; I experience this. My mother tried her best to avoid doing such things, but the modern world is as it is.

One of these things that I realized within the past few weeks is that this is normal. Crises are normal. War, famine, disease, we keep thinking we have overcome these things, and we have not. They are a part of life. They have always been with us, and will always be with us. This is not the first crisis we have seen, this is not the worst one for many people, (a fact especially obvious when I talk to Russians who remember the 90s, listen to a couple from the separatist region in Ukraine talk about how they have their own government destroying their city from the sky, listen to Palestinians, Syrians, Iranians, etc, read people describing the other coronavirus epidemics, remember all the coverage of various hurricanes or earthquakes, or even remember all the World War II monuments in Russia ... ), and this will not be the last.

I guess we need to also remember that people can be alone when surrounded by people in a crowd, and can still feel connected at a 2 meters distance. And of course, that just because we are in a crisis, and all are attention is on this crisis, doesn't mean all the other facets of society have gone away, good or bad.

There is a part of me that wants to see there being something good which will come from this pandemic. Perhaps it will force the world to slow down. Perhaps it will give me the chance to catch up, to recover and figure out how to live on my own. Although in this last case, it may be less do to being forced to live on my own as it is due to hatred of people. I don't know. I guess only time will tell.